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A QUESTION IN EUGENICS.
THE NATIONAL INSURANCE BILL.
328
One can imagine also the pride he will display among his not have been secured under different conditions. If friends and the contempt he will express for the man who epidemics followed by hundreds of cases, as in Leicester, lives by mere work. And yet, after all, his would-be imitators can occur, started by "missed"unvaccinated cases, where is often find that burglary is not the safest and most profitable the advantage of dropping infantile vaccination because of ’’ missed" cases ? of professions. Dr. I am, Sir, yours faithfully, it is that like to know what But, seriously, one would ARTHUR DRURY, M.B, C.M. Edin. Millard really wants now that the country generally has decided to follow the lead of Leicester. Does he propose to Halifax, July 24th, 1911. prohibit vaccination, under a penalty, except where it is recommended by a medical officer of health ? Because if not THE NATIONAL INSURANCE BILL. (and possibly even if so) there will still be many children vaccinated who will grow up and possibly take small-pox in a To the Editor of THE LANCET. mild form and consequently spread it. Dr. Millard makes should be glad if I might, through your courtesy, SIR,-I much of the case of -’the child, Annie L., who caused the be permitted to state that a copy of the letter which was outbreak in the Mile-End Infirmary resulting in 30 cases from me in your last issue is being sent to all the with eight deaths." He seems to hold this child, or those published The following Members of both Houses of Parliament. who caused her to be vaccinated, personally responsible for statement has been added to it by way of introduction, as the outbreak ! Does it not occur to him that if Annie L. could hardly be expected to gauge without further and the waole community among whom she lived had been un- they vaccinated probably 50 others would have taken the disease explanation the extent of the infliction with which we are Even within our own ranks too few seem to from the source, whatever it may have been, from which she menaced. was infected ? Of course, Annie L. would probably have realise the danger threatening the higher interests of the had the disease in a more severe and recognisable form, but profession, or to understand that the great position to which she has earned every claim can only be secured for her by equally probably the whole 50 would not. faithfulness to her own high standards. is not a disease severe even the Small-pox al7vabs among unvaccinated, although it is so much more frequently than THE NATIONAL INSURANCE BILL AND THE PROFESSION OF MEDICINE. The other side of the question, the hearing of which should always among the vaccinated. The antivaccinationists of Leicester legislation, has not been referred to in the Bill and has not yet could have told Dr. Millard this. I have known cases of precede been stated by any of its critics or even of its threatened victims : it not been placed before our legislators. The Bill and all the dissmall-pox mistaken for chicken pox in unvaccinated children, has The real reason why cussions thereon have considered exclusively the development of the even in the presence of an outbreak. medical advantage to be obtained for the insurers and for the State,. mild cases of small pox are often overlooked is because what and the " lowest figure " at which State medical service could be exacted Dr. Millard regards as the ol sulete system of public vaccina- from the profession short of actual spoliation and sweating. But the tion has rendered small-pox so rare that the great majority advantage and the development which ought to be secured for the other contracting party under any even-handed State contract have not of people, including not a tew medical men, have never seen yet been even mentioned. They are in danger of being overlooked in a a case. Thanks, however, to the eniightened lead of Leicester settlement affecting for an indefinite period the vital interests of the and the docile following of the whole country, this lack of profession, and therefore of the nation. The letter in THE LANCET of 22nd (p. 250) sets forth that part of the case for the profession experience is likely before many years to be remedied. The July which has been passed sub silentio. It calls attention to the solid of "fairly trying" acquired claims of the profession to " treatment with honour" far above country will then have the the Leicester system. I sincerely hope the result may not those level terms of " equivalent advantage," which are now also being denied it under the clause of " the lowest figure." The only consistent prove more disastrous than it has been at Leicester. attitude for the profession is Dedi qtt des." I am, Sir, yours faithfully, I am, Sir, yours faithfully, F. W. STANSFIELD, WILLIAM EWART. Public Vaccinator, Reading. July 22nd, 1911. Upper Brook-street, W., July 25th, 1911. --
---
opportunity
"
To the -Editor of THE LANCET. SIR,-In your issue of July 22nd Dr. C. K. Millard, medical officer of health, Leicester, refers to Mr. W. H. Jalland’s excellent article, part of which appeared in THE LANCET on June 17tb, on Vaccination in Regard to Life Assurance. Dr. Millard lays great stress on the "missed " cases of small-pox, and speaks of them as essentially a product of vaccination. His theory appears to be that infantile vaccination could be safely discarded because of these missed cases. He mentions in support of his contention that the case which caused the recent outbreak of small-pox in Mile End directly resulting in 30 cases with eight deaths was a vaccinated case. " Will anyone assert,"he asks, "that it is probable the same unfortunate mistake would have been made if the child had been unvaccinated ? "" Leicester provides a distinct answer to this in the affirmative, and the results in Leicester were much more disastrous than at Mile End. Dr. A. Warner, the resident medical officer of the isolation and small-pox hospitals, and assistant medical officer of health of the borough of Leicester, contributed an article on cases selected from the Leicester epidemics to which Dr. Millard refers, in the Practitioner, October, 1904, concluding as follows:Personal],-, I do not believe that unrecognised cases in those who have previously had small-pox or who have been previously vaccinated play an important part in the spread of the disease to the unvaccinated. For if there be a severe type of the disease prevalent the modification by passage through swingle resistant person is not sufficient to make the disease appear very mild in the un vaccinated person. Therefore it is recognised and m, asures for its control adopted. But when the disease is of a very mild type it may be equally well unrecognised in the unvaccinated, for the mildness is then not so much due to increased resistance as to an attenuated infection. Indeed, the epidemic of 1903 was started simultaneously by two unvaccinated girls having unrecognised attacLs, since when many similarcases have occurred.
Dr. Millard advocates drastic changes on the so-called experience of Leicester ; he himself admits that the type of the epidemics there has been singularly mild and that the good fortune of Leicester under those eircums’ances might
’
A MEMORIAL TO DR. C. W. LONG. To the Editor of THE LANCET. letter SIR,-A just received from the eldest daughter of’ Dr. C. W. Long tells me that the University of Pennsylvania, of which Dr. C. W. Long was a graduate, proposes to place in its medical school a bronze memorial medallion of her father. The unveiling ceremony is to take place on March 30th, 1912. The Provost of the University (Dr. Smith) "believes that for the purpose in mind, that of accentuating our recognition of Dr. Long’s achievement, the anniversary of the first use of ether in surgery (March 30th), will be the most suitable date." The plaster model of the medallion, which is much admired, is the work of a medical graduate of the University, Dr. R. Tait McKenzie, who enjoys more than a local reputation as a sculptor.-I am, Sir, yours faithfully, GEORGE FOY. July 24th, 1911.
A
QUESTION IN EUGENICS.
To the Editor of THE LANCET. SIR,-I desire to raise an interesting point which has recently presented itself to me, and to obtain an expression of opinion from the profession generally. To state the matter shortly, a man, who has an epileptic son 12 years of age, desired to have the lad sterilised to prevent him from having children if he should live to a marriageable age. The methodof sterilisation is not the question-whether by castration, vasectomy, or X rays-but the legal and moral aspect of the Has a father the right to have his son sterilised, case. and is a surgeon legally and morally justified in carrying I am, Sir, yours faithfully, it out ? M. S. July 18th, 1911. We leave these to our questions readers, in accordance * with the writer’s request.- ED. L.
SCOTLAND.
SCOTLAND. (FROM
.
The
OUR OWN
Royal
CORRESPONDENTS.)
Visit to
Edinburgh.
329
the degree of LL.D. from the University of Edinburgh. He holds the post of consulting physician to the Edinburgh Royal Infirmary, to the City Hospital for Infectious Diseases, and to the Royal Maternity Hospital. He has for some time acted as one of the medical members of the board of management of the Royal Infirmary, and his interest in that institution and in the improvement of the equipment and of the work of the nursing staff has been of great value to the infirmary.
DURING the stay of Their Majesties at Holyrood, the King .and Queen paid a private visit to Edinburgh Royal Infirmary on July 19th. New Victoria Dispensary for Consumption. They were received at the entrance by the Lord Provost of Edinburgh, the superintendent, Colonel As the result of the Coronation appeal for £12,000 to erect W. P. Warburton, C.S I., I.M.S. (retired), and the treasurer, Mr. W. S. Caw. As the visit was a private one no guests were a new Victoria Dispensary for Consumption in Edinburgh, the first list of subscriptions, published on July 19th, showed invited, but there was a large gathering of the managers and that a sum of .t3593 had been already subscribed. medical staff. The King and Queen visited Ward7 on the -surgical side, where Lord Pentland presented Professor F. M. Edinburgh Royal Infirmary : presentation to Colonel Caird, the surgeon-in-charge of the ward. The King named Warburton. this ward " The King George Ward." Oa the medical side Ward 30 was visited, this ward and Ward 7 (surgical) being I At a meeting of the managers of E iinburgh Royal the only two unnamed wards in the infirmary. Dr. Byrom Infirmary held on July 24th a silver cup was presented Bramwell and Dr. G. A. Gibson, the physicians-in-charge of to Colonel W. P. Warburton, I M.S, C S I., on the the ward, were presented to Their Majesties, and the Queen occasion of his retiring from the position of superintendent before leaving named the ward "The Queen Mary Ward." of the infirmary. The presentation was made by the Lord Afterwards the King and Queen paid a visit to the Provost on behalf of the subscribers, past and present kitchen and before leaving the institution they signed members of the board of management. their names in the visitors’ book. After leaving the infirmary Their Majesties drove along Teviot-place and halted Occurrence of Phthisis in Glasgow. at the steps of the S tadents’ Union, where an address for last year relating to phthisis in Glasgow The statistics of loyalty was presented by the President of the Union. are now available. Such statistics, however imperfect at At Bruntsfield Hospital on the previous day Her Majesty the Queen had declared open the new wing of the hospital. present, are rendered possible by the fact that phthisis in Glasgow on Jan. 1st, 1910. At both institutions Their Majesties most kindly endeavoured became compulsorily notifiable the year 3205 primary notifications were received, of to notice individually by a smile or bow or kind word every 1308 were from practitioners in private practice and patient in the wards through which they passed, and at which from medical men in public practice. Other 385 cases 1897 Bruntsfield Hospital Queen Mary, after having passed along on information contained in the hospital the side of one ward and out through the verandah expressed were registered admission and dismissal sheets of the Glasgow and Govan a wish to return to the ward, as she had omitted to notice Parish Councils, and from the death registers, making in the patients on the other side. At the door of the hospital total of 3590 cases for the year, which is equal there was stationed a guard of honour of the Scottish all a The deaths to an attack -rate of 4508 per million. Women’s First Aid Corps The Queen, during her passage the same period numbered 1033, during registered through the hospital, shook hands with the lady practitioners representing a death - rate of 1297 per million persons. and other officials who were stationed in the various wards. In connexion with this it is interesting to note the examinaof milk samples collected by the veterinary surgeon of tion Honours to Edinburgh Medical Men. the corporation during the year, for investigation with referBefore the conclusion of the Edinburgh visit His Majesty ence to the presence of tubercle bacilli. Of 675 samples of conferred the honour of knighthood on Dr. Thomas Smith milk examined 466 were from country byres, 163 from town Clouston and Dr. James Ormiston Affieck, honours which, as byres, and 46 from byres whence milk is supplied to the the profession in Edinburgh know, are well deserved. Sir city fever hospitals. Of the samples from country byres, Thomas Clouston, who had a distinguished career as a 6, or 1-29 per cent., were found to be tuberculous, while student, early turned his attention to asylum work, and after from town byres 2, or 1 -23 per cent., were affected. Both holding for ten years the post of medical superintendent of rates are considerably below those of former years, but the the Cumberland and Westmorland Asylum, Carlisle, was authorities state that it would probably be erroneous to appointed superintendent of the Royal Asylum for the Insane, assume that this indicates a sudden and striking reduction in Edinburgh, from which post he retired in 1908. During his the prevalence of tuberculosis among cattle. tenure of office at the Royal Asylum he brought about great Small-pox Accomodation in Glasgow. improvements in the treatment, nursing, and housing of the insane, perhaps the most outstanding achievement being the In the course of an exhaustive memorandum bearing on - completion of Craig House about 21 years ago. During his the requirements of Glasgow in regard to hospital accommoadministration the revenue derived from the better class of dation, the medical officer of health for the city states that private patients increased from £8000 to £35,000 per annum. the most urgent demand is for small-pox accommodation Three weeks ago he received the deg ee of LL. D. from the because of the proved unsuitability of the present small-pox University of Edinburgh. The University of Aberdeen had hospital site. During the past 40 years a permanent provialready conferred on him a similar honour in 1907. He has sion of 150 beds proved sufficient to meet all the requirements held the offices of President of the Medico-Psychological of the limited outbreaks of small-pox which occurred between Association, President of the Edinburgh Medico-Chirurgical the major prevalences of the early I I seventies "and 1901. The Society, and President of the Royal College of Physicians of population of those years, however, was better protected by Edinburgh. Among his writings perhaps the best known are infantile vaccination than is now the case, owing to the opera" Clinical Lectures on Mental Diseases " and "The Hygiene tion of the Vaccination Act of 1907. The proportion of children of the Mind." For a time he acted as editor of the Journal certified as successfully vaccinated in infancy reached on an of Mental Science. He formerly held the post of lecturer average 86 per cent. during the "eighties"decade and on mental diseases at the University of Edinburgh. 84 5 per cent. during the "nineties." As the result of the Sir James 0. Affieck is well known in Edinburgh as a practi- passing of the Vaccination (Scotland) Act of 1907, how,tioner and consultant. He graduated as Djctor of Medicine ever, the proportion of children successfully vaccinated in the University of Edinburgh in 1869. He later became fell to 75 per cent., the numbers exempted through lecturer on practice of medicine at Surgeons’ Hall, and was conscientious objection on the part of the parents being appointed assistant physician to the Royal Infirmary. In 2183 in 1908 and 2653 in 1909. Making allowances 1885 he became full physician and lecturer on clinical for increase of population during the next 20 years a medicine in the infirmary. He was thrice appointed present provision of 200 beds is required, but on a plan examiner in medicine and clinical medicine at the University which will admit of rapid extension to 600 beds when of Edinburgh, and for many years acted as examiner in medi- occasion arises. cine for the Royal College of Physicians. In 1908 he received July 25th.
During
328
One can imagine also the pride he will display among his not have been secured under different conditions. If friends and the contempt he will express for the man who epidemics followed by hundreds of cases, as in Leicester, lives by mere work. And yet, after all, his would-be imitators can occur, started by "missed"unvaccinated cases, where is often find that burglary is not the safest and most profitable the advantage of dropping infantile vaccination because of ’’ missed" cases ? of professions. Dr. I am, Sir, yours faithfully, it is that like to know what But, seriously, one would ARTHUR DRURY, M.B, C.M. Edin. Millard really wants now that the country generally has decided to follow the lead of Leicester. Does he propose to Halifax, July 24th, 1911. prohibit vaccination, under a penalty, except where it is recommended by a medical officer of health ? Because if not THE NATIONAL INSURANCE BILL. (and possibly even if so) there will still be many children vaccinated who will grow up and possibly take small-pox in a To the Editor of THE LANCET. mild form and consequently spread it. Dr. Millard makes should be glad if I might, through your courtesy, SIR,-I much of the case of -’the child, Annie L., who caused the be permitted to state that a copy of the letter which was outbreak in the Mile-End Infirmary resulting in 30 cases from me in your last issue is being sent to all the with eight deaths." He seems to hold this child, or those published The following Members of both Houses of Parliament. who caused her to be vaccinated, personally responsible for statement has been added to it by way of introduction, as the outbreak ! Does it not occur to him that if Annie L. could hardly be expected to gauge without further and the waole community among whom she lived had been un- they vaccinated probably 50 others would have taken the disease explanation the extent of the infliction with which we are Even within our own ranks too few seem to from the source, whatever it may have been, from which she menaced. was infected ? Of course, Annie L. would probably have realise the danger threatening the higher interests of the had the disease in a more severe and recognisable form, but profession, or to understand that the great position to which she has earned every claim can only be secured for her by equally probably the whole 50 would not. faithfulness to her own high standards. is not a disease severe even the Small-pox al7vabs among unvaccinated, although it is so much more frequently than THE NATIONAL INSURANCE BILL AND THE PROFESSION OF MEDICINE. The other side of the question, the hearing of which should always among the vaccinated. The antivaccinationists of Leicester legislation, has not been referred to in the Bill and has not yet could have told Dr. Millard this. I have known cases of precede been stated by any of its critics or even of its threatened victims : it not been placed before our legislators. The Bill and all the dissmall-pox mistaken for chicken pox in unvaccinated children, has The real reason why cussions thereon have considered exclusively the development of the even in the presence of an outbreak. medical advantage to be obtained for the insurers and for the State,. mild cases of small pox are often overlooked is because what and the " lowest figure " at which State medical service could be exacted Dr. Millard regards as the ol sulete system of public vaccina- from the profession short of actual spoliation and sweating. But the tion has rendered small-pox so rare that the great majority advantage and the development which ought to be secured for the other contracting party under any even-handed State contract have not of people, including not a tew medical men, have never seen yet been even mentioned. They are in danger of being overlooked in a a case. Thanks, however, to the eniightened lead of Leicester settlement affecting for an indefinite period the vital interests of the and the docile following of the whole country, this lack of profession, and therefore of the nation. The letter in THE LANCET of 22nd (p. 250) sets forth that part of the case for the profession experience is likely before many years to be remedied. The July which has been passed sub silentio. It calls attention to the solid of "fairly trying" acquired claims of the profession to " treatment with honour" far above country will then have the the Leicester system. I sincerely hope the result may not those level terms of " equivalent advantage," which are now also being denied it under the clause of " the lowest figure." The only consistent prove more disastrous than it has been at Leicester. attitude for the profession is Dedi qtt des." I am, Sir, yours faithfully, I am, Sir, yours faithfully, F. W. STANSFIELD, WILLIAM EWART. Public Vaccinator, Reading. July 22nd, 1911. Upper Brook-street, W., July 25th, 1911. --
---
opportunity
"
To the -Editor of THE LANCET. SIR,-In your issue of July 22nd Dr. C. K. Millard, medical officer of health, Leicester, refers to Mr. W. H. Jalland’s excellent article, part of which appeared in THE LANCET on June 17tb, on Vaccination in Regard to Life Assurance. Dr. Millard lays great stress on the "missed " cases of small-pox, and speaks of them as essentially a product of vaccination. His theory appears to be that infantile vaccination could be safely discarded because of these missed cases. He mentions in support of his contention that the case which caused the recent outbreak of small-pox in Mile End directly resulting in 30 cases with eight deaths was a vaccinated case. " Will anyone assert,"he asks, "that it is probable the same unfortunate mistake would have been made if the child had been unvaccinated ? "" Leicester provides a distinct answer to this in the affirmative, and the results in Leicester were much more disastrous than at Mile End. Dr. A. Warner, the resident medical officer of the isolation and small-pox hospitals, and assistant medical officer of health of the borough of Leicester, contributed an article on cases selected from the Leicester epidemics to which Dr. Millard refers, in the Practitioner, October, 1904, concluding as follows:Personal],-, I do not believe that unrecognised cases in those who have previously had small-pox or who have been previously vaccinated play an important part in the spread of the disease to the unvaccinated. For if there be a severe type of the disease prevalent the modification by passage through swingle resistant person is not sufficient to make the disease appear very mild in the un vaccinated person. Therefore it is recognised and m, asures for its control adopted. But when the disease is of a very mild type it may be equally well unrecognised in the unvaccinated, for the mildness is then not so much due to increased resistance as to an attenuated infection. Indeed, the epidemic of 1903 was started simultaneously by two unvaccinated girls having unrecognised attacLs, since when many similarcases have occurred.
Dr. Millard advocates drastic changes on the so-called experience of Leicester ; he himself admits that the type of the epidemics there has been singularly mild and that the good fortune of Leicester under those eircums’ances might
’
A MEMORIAL TO DR. C. W. LONG. To the Editor of THE LANCET. letter SIR,-A just received from the eldest daughter of’ Dr. C. W. Long tells me that the University of Pennsylvania, of which Dr. C. W. Long was a graduate, proposes to place in its medical school a bronze memorial medallion of her father. The unveiling ceremony is to take place on March 30th, 1912. The Provost of the University (Dr. Smith) "believes that for the purpose in mind, that of accentuating our recognition of Dr. Long’s achievement, the anniversary of the first use of ether in surgery (March 30th), will be the most suitable date." The plaster model of the medallion, which is much admired, is the work of a medical graduate of the University, Dr. R. Tait McKenzie, who enjoys more than a local reputation as a sculptor.-I am, Sir, yours faithfully, GEORGE FOY. July 24th, 1911.
A
QUESTION IN EUGENICS.
To the Editor of THE LANCET. SIR,-I desire to raise an interesting point which has recently presented itself to me, and to obtain an expression of opinion from the profession generally. To state the matter shortly, a man, who has an epileptic son 12 years of age, desired to have the lad sterilised to prevent him from having children if he should live to a marriageable age. The methodof sterilisation is not the question-whether by castration, vasectomy, or X rays-but the legal and moral aspect of the Has a father the right to have his son sterilised, case. and is a surgeon legally and morally justified in carrying I am, Sir, yours faithfully, it out ? M. S. July 18th, 1911. We leave these to our questions readers, in accordance * with the writer’s request.- ED. L.
SCOTLAND.
SCOTLAND. (FROM
.
The
OUR OWN
Royal
CORRESPONDENTS.)
Visit to
Edinburgh.
329
the degree of LL.D. from the University of Edinburgh. He holds the post of consulting physician to the Edinburgh Royal Infirmary, to the City Hospital for Infectious Diseases, and to the Royal Maternity Hospital. He has for some time acted as one of the medical members of the board of management of the Royal Infirmary, and his interest in that institution and in the improvement of the equipment and of the work of the nursing staff has been of great value to the infirmary.
DURING the stay of Their Majesties at Holyrood, the King .and Queen paid a private visit to Edinburgh Royal Infirmary on July 19th. New Victoria Dispensary for Consumption. They were received at the entrance by the Lord Provost of Edinburgh, the superintendent, Colonel As the result of the Coronation appeal for £12,000 to erect W. P. Warburton, C.S I., I.M.S. (retired), and the treasurer, Mr. W. S. Caw. As the visit was a private one no guests were a new Victoria Dispensary for Consumption in Edinburgh, the first list of subscriptions, published on July 19th, showed invited, but there was a large gathering of the managers and that a sum of .t3593 had been already subscribed. medical staff. The King and Queen visited Ward7 on the -surgical side, where Lord Pentland presented Professor F. M. Edinburgh Royal Infirmary : presentation to Colonel Caird, the surgeon-in-charge of the ward. The King named Warburton. this ward " The King George Ward." Oa the medical side Ward 30 was visited, this ward and Ward 7 (surgical) being I At a meeting of the managers of E iinburgh Royal the only two unnamed wards in the infirmary. Dr. Byrom Infirmary held on July 24th a silver cup was presented Bramwell and Dr. G. A. Gibson, the physicians-in-charge of to Colonel W. P. Warburton, I M.S, C S I., on the the ward, were presented to Their Majesties, and the Queen occasion of his retiring from the position of superintendent before leaving named the ward "The Queen Mary Ward." of the infirmary. The presentation was made by the Lord Afterwards the King and Queen paid a visit to the Provost on behalf of the subscribers, past and present kitchen and before leaving the institution they signed members of the board of management. their names in the visitors’ book. After leaving the infirmary Their Majesties drove along Teviot-place and halted Occurrence of Phthisis in Glasgow. at the steps of the S tadents’ Union, where an address for last year relating to phthisis in Glasgow The statistics of loyalty was presented by the President of the Union. are now available. Such statistics, however imperfect at At Bruntsfield Hospital on the previous day Her Majesty the Queen had declared open the new wing of the hospital. present, are rendered possible by the fact that phthisis in Glasgow on Jan. 1st, 1910. At both institutions Their Majesties most kindly endeavoured became compulsorily notifiable the year 3205 primary notifications were received, of to notice individually by a smile or bow or kind word every 1308 were from practitioners in private practice and patient in the wards through which they passed, and at which from medical men in public practice. Other 385 cases 1897 Bruntsfield Hospital Queen Mary, after having passed along on information contained in the hospital the side of one ward and out through the verandah expressed were registered admission and dismissal sheets of the Glasgow and Govan a wish to return to the ward, as she had omitted to notice Parish Councils, and from the death registers, making in the patients on the other side. At the door of the hospital total of 3590 cases for the year, which is equal there was stationed a guard of honour of the Scottish all a The deaths to an attack -rate of 4508 per million. Women’s First Aid Corps The Queen, during her passage the same period numbered 1033, during registered through the hospital, shook hands with the lady practitioners representing a death - rate of 1297 per million persons. and other officials who were stationed in the various wards. In connexion with this it is interesting to note the examinaof milk samples collected by the veterinary surgeon of tion Honours to Edinburgh Medical Men. the corporation during the year, for investigation with referBefore the conclusion of the Edinburgh visit His Majesty ence to the presence of tubercle bacilli. Of 675 samples of conferred the honour of knighthood on Dr. Thomas Smith milk examined 466 were from country byres, 163 from town Clouston and Dr. James Ormiston Affieck, honours which, as byres, and 46 from byres whence milk is supplied to the the profession in Edinburgh know, are well deserved. Sir city fever hospitals. Of the samples from country byres, Thomas Clouston, who had a distinguished career as a 6, or 1-29 per cent., were found to be tuberculous, while student, early turned his attention to asylum work, and after from town byres 2, or 1 -23 per cent., were affected. Both holding for ten years the post of medical superintendent of rates are considerably below those of former years, but the the Cumberland and Westmorland Asylum, Carlisle, was authorities state that it would probably be erroneous to appointed superintendent of the Royal Asylum for the Insane, assume that this indicates a sudden and striking reduction in Edinburgh, from which post he retired in 1908. During his the prevalence of tuberculosis among cattle. tenure of office at the Royal Asylum he brought about great Small-pox Accomodation in Glasgow. improvements in the treatment, nursing, and housing of the insane, perhaps the most outstanding achievement being the In the course of an exhaustive memorandum bearing on - completion of Craig House about 21 years ago. During his the requirements of Glasgow in regard to hospital accommoadministration the revenue derived from the better class of dation, the medical officer of health for the city states that private patients increased from £8000 to £35,000 per annum. the most urgent demand is for small-pox accommodation Three weeks ago he received the deg ee of LL. D. from the because of the proved unsuitability of the present small-pox University of Edinburgh. The University of Aberdeen had hospital site. During the past 40 years a permanent provialready conferred on him a similar honour in 1907. He has sion of 150 beds proved sufficient to meet all the requirements held the offices of President of the Medico-Psychological of the limited outbreaks of small-pox which occurred between Association, President of the Edinburgh Medico-Chirurgical the major prevalences of the early I I seventies "and 1901. The Society, and President of the Royal College of Physicians of population of those years, however, was better protected by Edinburgh. Among his writings perhaps the best known are infantile vaccination than is now the case, owing to the opera" Clinical Lectures on Mental Diseases " and "The Hygiene tion of the Vaccination Act of 1907. The proportion of children of the Mind." For a time he acted as editor of the Journal certified as successfully vaccinated in infancy reached on an of Mental Science. He formerly held the post of lecturer average 86 per cent. during the "eighties"decade and on mental diseases at the University of Edinburgh. 84 5 per cent. during the "nineties." As the result of the Sir James 0. Affieck is well known in Edinburgh as a practi- passing of the Vaccination (Scotland) Act of 1907, how,tioner and consultant. He graduated as Djctor of Medicine ever, the proportion of children successfully vaccinated in the University of Edinburgh in 1869. He later became fell to 75 per cent., the numbers exempted through lecturer on practice of medicine at Surgeons’ Hall, and was conscientious objection on the part of the parents being appointed assistant physician to the Royal Infirmary. In 2183 in 1908 and 2653 in 1909. Making allowances 1885 he became full physician and lecturer on clinical for increase of population during the next 20 years a medicine in the infirmary. He was thrice appointed present provision of 200 beds is required, but on a plan examiner in medicine and clinical medicine at the University which will admit of rapid extension to 600 beds when of Edinburgh, and for many years acted as examiner in medi- occasion arises. cine for the Royal College of Physicians. In 1908 he received July 25th.
During