448

’ ct the principles which underlie all sanatorial treatment. 1

By all means let these institutions be multiplied, but let

us not forget that the rational treatment of the tuberculous

subject does not necessarily imply resort to any institutionat all.

And this brings us to the great lesson which modern know-ledge of the nature of tuberculosis teaches, which cannot betoo strenuously urged upon those responsible for the healthof large communities. We have suffered generations to growup under conditions in which tuberculosis is bound to flourish.

The measures which the most active sanitary authority cantake under the most perfect system of notification are doomedto failure so long as these conditions prevail. Is it not

worth while to consider before entering upon a scheme whichwill involve such heavy burdens whether a wiser course

would not be to set steadily to work at the improvement of

dwellings and the establishment on the outskirts of all largetowns of "garden cities " which should gradually come to

replace the courts and alleys which will always remain asht.oeJ.s of disease.? If the adoption of compulsory notifica-lL’1 and all that is therein implied would tend to check, or

rhaps entirely set aside, the more permanent schemes of

prevention we should still decline to believe that it was the

test means to eradicate tuberculosis. Dr. BRAMWELL speaksof voluntary notification (which is now being adopted in

many centres) as a makeshift, but may not the same term

apply to the more extended system if it stand in the way of Ithe thorough and only scheme likely to subdue this scourgeof civilisation ? The debate in the section of State Medicine

during the meeting of the British Medical Association, to

which we have already referred, terminated in the unanimous

adoption of a motion urging the Local Government Boardto grant extended powers for dealing with tuberculosis tolocal authorities. By all means let these powers be granted,for they would be placed in discreet hands. But the public,instructed by the medical profession, must realise that such

proceeding would not minimise their own responsibilitythe matter. A regulation of a Government department

cannot convert an unhealthy city into a healthy one, andthe prevention of tuberculosis must be largely a question ofsanitation in its broadest sense.

Annotations."Ne quid nimis."

THE CORONATION.

ON Saturday, August 9th, King Edward VII. and

Queen Alexandra were crowned at Westminster Abbey,adding to a long list of memorable coronations one the cir-

cumstances of which will never be forgotten by theirsubjects or by future generations. The postponement of theceremony and the cause which led to it are matters too

recent and too well known for us to dwell upon ; it is, how-ever, a matter for profound thankfulness that His Majestywas able to go through such a ceremony without dis-

tressing fatigue, and that his exertions should have inno way checked or retarded his progress towards perfecthealth. The ancient and interesting religious rites and

observances had been condensed and curtailed as far as

possible with a view to their performance on June 26th,the date originally fixed, so that there was little that could

)e omitted or abbreviated. The ceremony was by no meansi short one, and no better proof of his renewed strengthould have been given to His Majesty’s subjects, boththose who were privileged actually to see him crowned andanointed and those who waited his return from the ceremonywearing the insignia of royalty, than the King’s demeanourthroughout the day. Not only did His Majesty pass throughthe midst of his people along an extended route, but heafterwards showed himself upon the balcony of his palace tothose assembled to greet him. The weather which prevailedin London on August 9th was unusually cold for thetime of year, a fortunate circumstance which must havecontributed in no small degree towards enabling the King tc-endure to the end in comfort and without undue exhaustion.Coronation robes are not garments which even a strong manwould lightly undertake to wear and move in. duringwhat are known as the dog-days, but the grey still

weather of last Saturday, while it diminished to som&

extent the magnificence of the spectacle in the streets, wasideal from the point of view of all who were not merelyonlookers ; and if His Majesty is always favoured throughouthis reign with days as suitable to the task which he mayhave in hand he will be fortunate indeed. To the physi-cians, surgeons, and nurses to whom the charge of His

Majesty during the recent weeks of anxiety was entrusted,and particularly to Sir Frederick Treves who performedthe operation, we beg to offer our sincere congratulations.With the eyes not of their countrymen only but of thewhole world upon them they have successfully done the

duty that was allotted to them and the conclusion at

which they aimed they have triumphantly arrived at. Tothe whole world they have given a striking example of theservice which medical science places at the disposal of highand low, rich and poor, saving the life of the mechanic ip-

the hospital without hope of reward or restoring to a peoplethe monarch to whose long reign in health, peace, and .

prosperity we now look forward. To their Majesties weoffer our heartfelt congratulations, joining in the chorusof goodwill which has echoed and re-echoed throughoutthe world. The warmth of the greeting that would be give!:-to them by their people we were safe in predicting last week,and our prognostication was realised in a magnificent out-burst of spontaneous enthusiasm. It was, indeed, a fittingreception for the King and his Royal Consort that the streetsof London saw last Saturday, a reception that must for everassure their Majesties of the place which they occupy in thehearts of their loyal subjects.

THE IMPERIAL VACCINATION LEAGUE.

IN our issue of July 5th we referred to the formal con-stitution of the Imperial Vaccination League and the mos-tsimportant points which the promoters of the league con-sidered should be dealt with. In a letter which wa&

published in the Tiv?,es of August llth, a letter signed byHis Grace the Archbishop of Canterbury, the Bishop of

London, and the Duke of Northumberland, Lord Kelvin,Sir William Broadbent, Sir Victor Horsley, Sir W. S.

Church, and Dr. J. C. McVail, to quote only a few ofthe names, the league points out that : "It will con-

sider if the entire supply of glycerinated calf-lympbshould not be guaranteed and regulated by some publicauthority. In Germany for 55,000,000 people there are

22 state laboratories for the preparation of lymph. In.

Great Britain and Ireland for 40,000,000 people we

have but one. Private practitioners have to trust to

, the vendors of lymph without any guarantee as to its

. age or quality. If a central authority for vaccination werei established under the Local Government Board the provision

of an adequate amount of lymph would be an important partl of its duties." It cannot be doubted that the fact of the