673

end artificial pneumothorax and its allied measuresshould be more frequently employed.ACCESS TO THE DISPENSARY.—Some uncertainty

exists as to how patients are received at the tuber-culosis dispensaries. Is it open to the man-in-the-street who thinks he may have got consumptionto walk in without let or hindrance and ask to beexamined, or must he present a doctor’s card onadmission? f There is a good table in Dr. W. D.Carruthers’s annual report to the Staffordshire,Wolverhampton, and Dudley Joint Committee forTuberculosis, which shows exactly how patients aresent to the dispensaries in these areas. Thus outof 2698 patients examined at the various dispensariesfor the first time in 1932, no less than 1751 (or 64-8per cent.) were sent by medical practitioners ; 263 bythe school medical inspectors ; and 183 by the healthvisitors. The remaining 501 (or 18-5 per cent.) areincluded in a column under the heading " Otherwise,"by which it may be inferred that these particularpatients came upon the recommendation of fellow-sufferers, friends, or may even have walked in fromthe street. Seeing that the main object of thedispensary is to prevent tuberculosis among thecommunity, access thereto for the purposes of medical-examination should not be made too difficult, thoughit is preferable that patients should be sent in thefirst place through their own doctor.

INFECTIOUS DISEASEIN ENGLAND AND WALES DURING THE WEEK ENDED

. SEPT. 2ND, 1933

Notifications.-The following cases of infectious,disease were notified during the week : Small-pox, 4(last week 8) ; scarlet fever, 1977 ; diphtheria, 811 ;enteric fever, 53 ; acute pneumonia (primary or

influenzal), 389 ; puerperal fever, 40 ; puerperalpyrexia, 129 ; cerebro-spinal fever, 17 ; acute polio-myelitis, 35 ; acute polio-encephalitis, 2 ; encephalitislethargica, 6 ; dysentery, 13 ; ophthalmia neonatorum,82. No case of cholera, plague, or typhus fever wasnotified during the week.The number of cases in the Infectious Hospitals of the

London County Council on Sept. 5th-6th was as follows :Small-pox, 15 under treatment, 0 under observation (lastweek 20 and 0 respectively) ; scarlet fever, 1640 ; diphtheria,1475 ; enteric fever, 12 ; measles, 455 ; whooping-cough,292; puerperal fever, 22 mothers (plus 12 babies) ;encephalitis lethargica, 254 ; poliomyelitis, 2 ; "otherdiseases," 177. At St. Margaret’s Hospital there were

17 babies (plus 8 mothers) with ophthalmia neonatorum.Deaths.-In 118 great towns, including London,

there was no death from small-pox or enteric fever,11 (4) from measles, 7 (2) from scarlet fever, 14 (3)from whooping-cough, 20 (4) from diphtheria, 105 (19)from diarrhoea and enteritis under two years, and15 (3) from influenza. The figures in parentheses arethose for London itself.

-

Of the deaths from diarrhoea outside London, 22 werereported from Liverpool, 7 from Leeds, 6 from Hull, 5 eachfrom Sunderland and Leicester, 4 from Birmingham, 3 eachfrom Tynemouth and Nottingham. Measles was fatal in4 cases at Liverpool. Two deaths from diphtheriawere reported from Barnsley, Leeds, Manchester, andWest Hartlepool.The number of stillbirths notified during the week was261 (corresponding to a rate of 41 per 1000 totalbirths), including 47 in London.

UNIVERSITY OF BRISTOL.-On Friday, Sept. 29th,Sir Hilton Young, Minister of Health, will inauguratethe department of preventive medicine of this university.The ceremony will take place in the Canynge Hall at12 noon.

THE SERVICES

ROYAL NAVAL MEDICAL SERVICE

Surg. Lt.-Comdrs. M. B. Devane, P. J. A. The O’Rourke,W. Flynn, R. R. Baker, E. V. Barnes, R. L. G. Proctor,W. A. Hopkins, and C. B. Nicholson to President forcourse ; G. S. Rutherford to Victory for’R.N.B., Ports-mouth ; and M. A. Graham-Yooll to Bideford.

Surg. Lts. A. N. Forsyth to Endeavour, on recommg. ;S. K. Foster to Pembroke for R.M. Infirmary, Deal;W. Greaves to Harebell ; E. L. Littler to Pembrokefor R.N.B., Chatham, and to Weston,. H. O’Connorto Ormonde D. D. Steel-Perkins to Vernon and P. N.Walker-Taylor to Dorsetshire (on relief).The courses for promotion to Surgeon-Commander,

R.N., have been resumed.

ROYAL NAVAL VOLUNTEER RESERVE

Surg. Lt.-Comdrs. A. E. Christie to Fermoy, andH. Parry-Price to Sutton.

Surg. Lt.-Comdr. (D). E. D. Collins to Rodney.Surg. Lts. H. A. Lockhart and R. H. Enoch to Victory

for Haslar Hospital; S. B. Levy to Iron Duke D. W.Bawtree to Valiant ; D. M. Craig to a?ceH6M.< / andR. D. Bradshaw to Victory for R.N.B.

Proby. Surg. Lt. (D) A. B. Bateman to Vivid forR.N.B., Devonport.

ARMY MEDICAL SERVICES

The War Office announces that Brevet-Colonel F. D. G.Howell, D.S.O., M.C., Honorary Surgeon to the King,has been appointed (temporarily) Deputy Director-General,Army Medical Services,. with effect from Sept. 16th,in succession to Major-General W. R. Blackwell, C.B.,C.M.G., Honorary Surgeon to the King. Brevet-ColonelJ. W. L. Scott, D.S.O., has been appointed AssistantDirector-General, Army Medical Services, in successionto Brevet-Colonel Howell, and will take up the appoint-ment about the end of September.

TERRITORIAL ARMY RESERVE OF OFFICERS

Lt..Col. G. Mackie, having attained the age limit,retires and retains his rank, with permission to wear theprescribed uniform.

Capt. J. C. Graham, from Active List, to be Capt.

ROYAL ARMY MEDICAL CORPS

Capt. J. A. Chapel retires, receiving a gratuity.TERRITORIAL ARMY

G. E. O’Riordan to be Lt.

ROYAL AIR FORCE

Dental Branch.-Flight-Lt. J. Twohill is transferredfrom Class D(ii) to Class D(i).

INDIAN MEDICAL SERVICE

Majs. to be Lt.-Cols.: G. H. Mahony, G. Covell, W. R.Stewart, H. Chand, V. Mahadevan, A. C. L. O’S.Bilderbeck, J. W. Vanreenan, M. Das, J. M. R. Hennessy,H. H. Brown, C. H. N. Baker, and K. R. Rao.

ROYAL ARMY MEDICAL COLLEGE

Col. N. Low, on promotion, has relinquished his appt.as professor at the College, and Lt.-Col. and Bt.-Col.G. S. Wallace has been appointed a professor.

COLONIAL SERVICES

Dr. G. Robinson has been promoted to Senior Patho-logist to the Medical Research Institute, Gold Coast.

FIRE AT A TUBERCULOSIS CoLONY.-Fire brokeout last week at the East Lancashire TuberculosisColony for ex-Service men at Barrowmore Hall,near Chester. It is said to have originated in the buildingsin which fire-lighters for sale are produced in large numbers,and much damage was done.