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had attended a lady who had come from Riga, in Russia,where an epidemic of small-pox existed at the time. Dr. S.and his child became ill with a suspected exanthem, whichhe believed to be chicken-pox, although his child, which,of course, had never been vaccinated, died after a few days.The other medical man, Dr. B., had attended a patient forsmall-pox but did not notify the case until the districtmedical officer of health ordered the patient to be con-

veyed to the fever hospital, where she died from cardiacweakness. He had also attended Dr. S. during his illness.At the trial the wife of Dr. S. gave evidence that shebelieved that her husband had contracted small-pox.but that Dr. B. held the opinion that the case was

chicken-pox; she had nevertheless taken all the necessarymeasures for disinfection. The public prosecutor pleadedfor a verdict of manslaughter by neglect, but the court onlyfined the medical men for contravention against the epidemiclaws because they had omitted to notify the cases. It wassaid in the judgment that it had not been proved to the courtthat the death both of the child of Dr. S. and of the patientof Dr. B. were due to manslaughter by neglect. It is remark-able, and speaks for the efficacy of compulsory vaccinationin this country, that no other cases of small-pox haveoccurred in Frankfort.July 8th.

ITALY.(FROM OUR OWN CORRESPONDENT.)

Government Trading in Quinine and Tltynzol.THE State manufacture of quinine is in a most flourishing

condition. For the year 1911-12 the receipts were .6113,000,with a net profit of .636,750, the highest on record. Thiswas mainly due to the large sales to foreign Governments,as the sale of quinine in Italy was sensibly diminished. The

profits were transferred to the fund for the prevention ofmalaria, which on June 30th, 1912, had to its credit a sumof nearly £50,000. This fund furnishes quinine preparationsto consumers where they are specially needed, and subsidiesof money to districts which have to incur special expenses incombating malaria, and to the Croce Rossa Italiana for theantimalarial campaign in the Pontine Marshes, the AgroRomano, and Sicily. Professor Pieraccini proposed lastmonth in the Chamber that the State should also undertakethe manufacture and sale of thymol in view of the import-ance and extent of ankylostomiasis in Italy. The motionwas referred for further consideration.

Secret Maternity.Apropos the recent founding in France of an institution

for secret maternity," the Rivista Ospedaliera points outthat such institutions have existed for centuries in Italy.At Leghorn is the Istituto della Gravida Occulta, wherepregnant women may be admitted as soon as their conditionbecomes evident; and at Rome is the Istituto della Celate,where they may be admitted at the sixth month or evenearlier. Both at Leghorn and at Rome the women are notobliged to give their names, but must give some referenceor place their names and addresses in a sealed envelope,which is only opened in case of death by the civil authority.They are even allowed to keep their faces veiled (hence thename" Celate ") on the entrance of the doctors as a furtherguarantee of secrecy. ,

The National Congress for Occupational Diseases.The Fourth National Congress for Occupational Diseases,

held in Rome June 8th-llth, was a great success both fromthe point of view of the numbers attending the Congressand the importance of the subjects discussed. Ankylo-stomiasis, Diseases of the Blood of Professional Origin,Infantile Mortality in Relation to the Trades and SocialConditions of the Parents, Dermatitis of Professional Origin,and the Professional Pathology of Railway Workers werethe five themes set for discussion. Other interesting com-munications were made on various aspects of lead poisoningand on the study of fatigue. Dr. Ranelletti gave a splendidaddress in the great hall of the University on the worksof Bernardino Ramazzini, the founder of this branch ofmedical science.July 2nd.

VIENNA.

(FROM OUR OWN CORRESPONDENT.)

Medical Inspection of Schools.WITHIN the last few years the problem of medical

influence upon the conditions prevailing in public schoolshas attained a high degree of prominence in Austria, andone result of the interest taken in the subject is that theVienna Aerztekammer (Medical Council) have organised aninvestigation in which medical men and persons occupied inteaching were asked to give their opinions as regards thestatutory regulations necessary for a regular medical inspec-tion of schools and the children attending them. At a

meeting of persons interested in the problem the three

following general questions were submitted : 1. Ought theposition of a medical inspector of schools to be a whole-time or a part-time appointment ? In the latter case privatepractice or some other remunerative work must, of course,be allowed to the holder of the appointment. 2. Ought amedical inspector of schools to be appointed by the boardof health, and ought he to have authority to take action inany matter of school hygiene, or ought his position to bemerely consultative ? 3. Which schools should be underthe supervision of medical inspectors and which schoolscould dispense with such supervision ? The answers tothese questions were given by overwhelming majorities tothe following effect. The appointment ought at present tobe a part-time one, because there are not enough funds forappointment of whole-time inspectors at an adequate rate ofpayment. The medical man should be appointed by theboard of health, but should have a voice with respect to allmatters of hygiene in all classes of schools ; the kinder-garten schools and the elementary schools, as well as thehigh schools and those for apprentices and the commercialschools should come under the scope of the law ; even theuniversities should be included, for ill-health among uni-versity students was not uncommon. A medical inspector ofschools should limit his work strictly to the prophylactic andhygienic supervision of schools and school children, for inthe opinion of the large majority of experts the medicaltreatment of school children ought not to be undertaken bythe school medical officer under any condition whatever, sothat the private practitioner should not suffer in the least fromthe scheme. The following points were finally summarisedas embodying the principal requisites for a medical servicein schools. The hygiene of the schoolrooms, the ventilation,the water-closets, the lighting, the heating, the cleanlinessof the pupils and the schools, and the hours of work shouldbe controlled by the inspector. All newcomers amongstthe pupils should be carefully examined as regards health.Every few months all pupils should be regularly examined.Defects of the eyes, of the ears, of the respiratory tract(adenoids, tonsils), and of the teeth should be looked for,and the parents should be advised as to the importance ofhaving them corrected. Children suffering from any diseaseshould be excluded from schools, and especial care shouldbe given by the inspector to cases of disease carriersand contacts. The following up of cases of infectiousdiseases should also be included in the duties of a

medical inspection, though for this purpose school nursesshould be employed and not medical men. Furthermore,the attention of the medical officer and the teachers shouldbe directed to the prevention of diseases for which schoolwork may be in some degree responsible, such as nervousoverstrain, anæmia, and orthopaedic defects. Open-airgames, open-air classes, and gymnastic exercises should beencouraged and controlled. The treatment of diseases ordefects should be left to the family medical adviser, or in thecase of the poorer classes the children should be sent tothe hospitals ; special school clinics would be a very usefuladdition to the system of medical school inspection.Such clinics were proposed for diseases of the teeth,eyes, ears, nose, throat, and skin. A point raisedin the discussion dealt with the question whetherexamination of a child by the family medical adviser shouldbe a ground of exemption from examination by the schoolmedical officer. This was, however, considered to beinadvisable. Furthermore, the school medical officer shouldkeep general observation on the state of health of theteachers and those occupied otherwise in the schools. and

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should also advise as to the choice of occupation, from thepoint of view of physical fitness, in the case of pupilsleaving school. One other interesting point was raised-namely, whether instruction in sexual matters should beincluded among the duties of the school medical officer. Itwas agreed that this subject did not belong to his line ofwork. These general principles were brought to the noticeof the Board of Education, which will make use of them incalling into existence the Medical School Service in thiscountry.

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Professor von Noorden.

As I have already mentioned in THE LÀNCET, Professorvon Noorden has decided to leave Vienna and return toFrankfort. The main reason for doing so was the desireto be free from the duties of a director of a .clinic andof a clinical teachei, In Frankfort he will be able’ todevote, his time to research and also to private practice.Professor von Noorden’s departure will be a great loss toscientific medicine in Vienna, for in his clinic over 300important contributions to the problems of metabolism havebeen made by his assistants and pupils within the last fewyears. The splendid clinic and the "metabolism kitchen"were a kind-of Mecca for medical men coming from all partsof the world. In the search for a successor overtures arebeing made to Professor His, -of Berlin, whose work onthe pathology of the circulation and of the- heart is so,important. Many of the medical faculty in Vienna, whilefully recognising the great position of Professor His, would,however, prefer the appointment , of a successor having areputation in connexion with the subject of metabolism, inorder to continue the work inaugurated so successfully by,the professor now returning to his old place in Frankfort.

July 7th.

NOTES FROM CHINA.

(FROM OUR OWN CORRESPONDENT.)

North Manchurian Plague Preve-aztioaa Service.FOUR fully equipped hospitals are now in working order at

the following places : Harbin, Sansing, -La-ha-su-su (at thejunction of the rivers Amor and Sungari), and at Aigun(opposite Blagovestchensk). The personnel of the service

comprises two graduates of Cambridge, one -of Edinburgh,and four who received their medical education in Pekingand Tientsin. Besides these are a number of locallytrained hospital attendants and two female Chinese :nurses. In the absence of plague the- hospitals are,

being utilised,l for general cases. The increasing number ;of sick who come to them for treatment proves that theservice is quickly gaining popularity, and augurs wellfor any future epidemic, since no anti-plague measurescan be ’ thoroughly successful - without the assistanceand concurrence of the people. The confidence ofthe masses is being further gained by a wise regulationwhich directs that the medical officer in charge of eachstation shall give every week a. public lecture, illustrated with lantern slides, on the subject of hygiene. On May lstthe staff of the North Manchurian Plague Prevention Servicereceived a valuable addition in Dr. F. E. Reynolds, whocame to take up the post .of bacteriologist. Dr; Reynoldswas recently assistant in the bacteriological laboratory ofEdinburgh University, and since has been working in thelaboratories of Wassermann and of Bordet. ,

,

The Tarabagan and Pneumonic Plague.Bacteriological and other investigations carried out in

Northern Manchuria, Mongolia, and Eastern Siberia duringthe last two and a half years by the Director of the

Plague Prevention Service, Dr. Wu Lien-teh (G. L. Tuck),.have led him to form an opinion at variance with the’

generally accepted theory of the origin of pneumonic plague.Dr. Wu has satisfied himself that the epidemic of 1910 and1911 did not emanate directly from the tarabagan. In,a report shortly to be published Dr. Wu demonstrates thatthough the tarabagan has been proved experimentally to besusceptible to the disease, yet its connexion with the’

epidemic was more fancied than real owing to the fact thatthe endemic areas happened to be’localities where the

animal was abundant. He brings evidence to show that in astate of nature the marmot is rarely affected. Apart fromtheir scientific value these opinions have great commercialimportance, since the trade in tarabagan skins for manu-facture into imitation sable is an extensive and lucrativeone. On account of the plague tarabagan hunting has beenprohibited during the last two years by both the Chinese andRussian Governments.

.

Opi2cm Smoking.In spite of the general political unrest the Government is

oontmuing to enforce most stringent measures to stamp outthe opium habit. Cultivation of the poppy has ceased in tenout of the 21 provinces. Throughout the country opiumshops have’ been closed, with the result that well-to-dosmokers have flocked in large numbers to the foreign settle.ments at some of the treaty ports, hoping that there theywill be, able to indulge their’craving unmolested. Unfor-

tunately, in many instances they have not been disappointed,for to meet the increased demand extra licences have been

granted and new shops have been opened.The International Opium Conference.

The- Chinese Government is sending two representativesto the International Opium Conference, which will open onJuly 1st at The Hague. One is Dr. Wu Lien-teh, who actedin the same capacity at the Conference that took placeduring the end of 1911 and beginning of 1912. His colleagueis Dr. W. W. Yen, Minister to Germany, who is peculiarlyfitted to discuss the subject, since it: was he-who, togetherwith the British Minister in Peking, drafted the Opium Treatyof May, 1911. The chief duties of the Chinese representa-tives will be to call attention to the action of the authoritiesof the foreign settlements in failing to suppress the opiumhouses under their jurisdiction; also to frame some regula-tions to govern the transport, distribution,’ and sale ofmorphia, cocaine, and allied drugs.

’

Peking, June 10th.

AUSTRALIA.

(FROM OUR OWN CORRESPONDENT.)

The Northern Territory.Professor H. B. Allen, of Melbourne, has at the request of

the Federal Government furnished a report on the- health ofthe Panama Canal Zone, with a view of comparing its con-

ditions with the Northern Territory of Australia and learningwhat measures may be needed to deal with tropical diseasein that region. In his report Professor Allen suggests that apractical survey should be made of all the varieties of the mosquito found in Australia. The Northern Territory coverssuch an enormous expanse that any positive dicta about itsclimatic possibilities for a white population may hot applygenerally. The rainfall varies in parts from 10 to 40inches per annum, and it is only on the -coast belt thatreally oppressive conditions exist. No serious endemic diseasehas yet been shown to exist in any part of- it.

[, Brisbane Medical School.. j

A proposal has been brought before the Queensland’ Branchof the British Medical Association by Dr. E. S. Jacksonaffirming the desirability of opening a medical school inconnexion with the Brisbane University. When the mattercame to the stage of preliminary discussion considerableopposition was manifested by several members in differentparts of the State, and the matter was postponed in orderthat their objections might be more fully heard. _’

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Inebriate -Retreats. "

In the report of Mr. E. Jones, Inspector-General of Lunacyfor Victoria, it is stated that the Lara Retreat for Inebriatestreated 127 cases last year, with a daily average of 33. Of these35 were readmissions. The receipts were .61490, and expendi-ture £2465. The cost to the State was less than 98 perhead for 127 cases. Mr. Jones remarks that among thoseaddicted to drugs cocaine seemed more degrading than opiumor alcohol. Dr. H. P. Godfrey, the medical superintendent,points out the urgent need for a second institution more oil