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certificate course and a common-room reserved forthem. It is thought best that recognition should begranted only to institutions that will conduct eachyear approximately ten courses each attended byten midwives, and in such circumstances the staff isto consist of not less than three midwife teachers, themost senior of whom should if possible hold themidwife-teacher’s certificate. If the course is toinclude obstetric analgesia its duration must be atleast five weeks.

Other rules have been made concerning supervisorsor assistant supervisors of midwives and the con-ditions under which they too must receive periodicalinstruction.

TUBERCULOSIS: A KEY PROBLEM OF

INDIA

Sir JOHN MEGAW gave this title to an addressdelivered at a meeting held in London last Tuesdayunder the auspices of the East India Association andthe Overseas League, the Marchioness of Linlithgowpresiding.The Indian situation, he said, could be understood

only in the light of experience gained in othercountries where reliable evidence was available.Information about the prevalence of tuberculosis inIndia was very scanty ; there was no record of thetuberculosis death-rate except in the cities and largetowns-e.g., in Cawnpore, where it was 4600 per million,or in Calcutta (2500). The death-rate from tubercu-losis among girls and young women who live in

purdah was appalling, being several times higher thanthat of males in the same age-group. Medical menin India were almost unanimous in declaring that thedisease was increasing rapidly, and that it was

extending to rural areas that were formerly free frominfection. They also reported that when the diseasespread to new localities it assumed a more virulentform than in places previously affected. Estimatesbased on various data suggested that there were atleast 1 to 2 million cases in India, while all theevidence pointed so strongly to a serious increasein the disease that an accurate survey of the situationwas urgently needed.

Meanwhile, however, antituberculosis measures,both preventive and remedial, must be vigorouslycarried out. It was obviously impracticable to isolateall tuberculous persons, but there was no need to beunduly discouraged by this, for with tuberculosis, aswith all other public health problems, the best planwas to teach people to do things for themselves.

Things done for the people must necessarily be

expensive and of temporary benefit, whereas thingsdone by the people themselves were both economicaland durable. The spread of infection in India couldonly be prevented by education. The people must betaught, by schools, printing press, public lectures,cinemas, and broadcasting, how droplet and ali-mentary infections were conveyed and how theycould be avoided. Preventive measures which aimedat building up bodily resistance against the bacilluswere essential parts of the programme ; these con-stituted a complex problem in themselves. The keyunit in every State was the family, and the onlyprosperous States were those in which each familylived a well-planned life. The heads of every familymust therefore be taught how to plan a satisfactoryexistence for those dependent on them, and here waswhere the responsibility of governments came in.The most difficult part of the task was to bring

about the change in the outlook of the people without

which better conditions of life were unattainable.Inefficient methods of agriculture, wasteful customs,early and improvident marriages were some of thechief handicaps which the people of India had imposedon themselves. There was good reason to believe thatif a quarter of the money now spent on education inIndia were allotted to a scheme of instruction in life

planning, the problem of tuberculosis and most ofthe other great problems could be solved. The firstessential was to have a sound plan, and the prepara-tion of such a plan demanded the cooperation of menwith practical knowledge of agriculture, industry,economics, hygiene, education, and, above all, of menwith a sympathetic understanding of the psychologyof the Indian peasant. Technical advisers were

needed, whose teaching should be coordinated andtranslated into simple language. When once a planhad been prepared, the rest would be easy ; it would

only be necessary to carry out a system of mass

propaganda on the lines that had always provedsuccessful elsewhere.

Lady LINLI[THGOW spoke of the work that was

planned in connexion with the King George V Thanks-giving Fund in India. The income from this fundamounted to E4000 yearly. It had been decided that95 per cent. of the money collected in each provinceshould go back to that province. Of the remaining5 per cent. part would be devoted to paying for theservices of an expert whose services would be availablein helping to plan appropriate schemes. It was alsohoped to establish a model clinic, and to enlarge thescope of existing buildings. The preventive side of thecampaign was to her the whole crux of the situation,and there was also need for after-care schemes.

Other speakers included Lord Goschen, chairmanof the Overseas League, Major-General E. W. C.Bradfield, director-general of the Indian MedicalService, Sir Cuthbert Sprawson, Dame Edith Brown,and Sir Leonard Rogers, F.R.S.

EPSOM COLLEGE

The eighty-fifth annual general meeting of the governors -

was held at 49, Bedford-square, W.C., on June 17th,with Dr. Henry Robinson in the chair. The result of thelast election of pensioners and foundation scholars wasannounced. The chairman then referred to the loss whichthe college had sustained by the death of Sir RaymondCrawfurd, who was for 23 years a member of the council,and its chairman for 13 years. In presenting the report,Dr. Robinson said that over 400 subscribers had signedseven-yearly covenants. The report gave interestingdetails of the progress of the school in work and in play,with some outstanding records attained by Epsom boysand Old Epsomians, and showed that Old Epsomianswere among the recent benefactors of the college. Forinstance, Colonel W. L. Crawford had given i5000 tofound a leaving scholarship and JE250 to found a prize foran essay dealing with the overseas empire ; Mr. E. E.Fisher, F.R.C.S., had sent ;E250 as an expression of

gratitude to the college ; the sons and daughters of thelate Mr. William Murray Wilson had established a prize inhis memory ; and Dr. W. Rushton-Parker had givenil000 to be expended for the benefit of science and 9100for the library. Mrs. H. G. Tetley had given a furtheri500 to augment the Tetley scholarship fund which shefounded a few years ago.The following members of the council -were re-elected

for a further period of three years : Mr. D. C. Bartley,Sir John Broadbent, F.R.C.P., Surgeon Vice-Admiral SirReginald Bond, F.R.C.P., Sir Ernest Goodhart, Mr. R. M.Handfield-Jones, F.R.C.S., Mr. Frederick Morris, Sir CosmoParkinson, Dr. Harold Spitta, and Mr. T. Hollis Walker.Dr. Daniel Twining was elected to fill a vacancy, andDr. C. E. Douglas was elected a vice-president. ColonelNorman C. King, Mr. H. H. Rew, and Mr. H. A. Deeker wereappointed auditors for the ensuing year.