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NURSING CONFERENCE AND

EXHIBITION.

THE Third Annual Nursing and Midwifery Confer-ence and Exhibition was held at the Horticultural Hall,Westminster, from April 27th to 30th.The ceremony of opening the Conference was performed

by H.R.H. Princess Christian, who was received by LadyBalfour of Burleigh, Sir Dyce Duckworth, and Dr. F. H.

Champneys. Princess CHRISTIAN said she had taken a deepinterest in nurses and their work for the past 40 years, andfelt that every effort should be made to ensure nurses beingthe perfect help to the doctor which now they were

expected to be.Dr. CHAMPNEYS occupied the chair for the first day’s

session, which practically covered the midwifery topics.Miss Lucy ROBINSON read a paper on the Living Wage

for Midwives in Rural Districts, showing that if thefees obtained by midwives all through the country wereequally divided among those who are notified as prac-tising the earnings of each midwife would amount to Z16a year.

Dr. A. NIMMO WALKER, speaking on the Prevention ofInfantile Blindness, described the methods adopted in

Liverpool. On the notification of any inflammatory con-dition of the eyes of the newly born, a visitor is sent totake a swab of the discharge. If on examination this isfound to contain bacteria the authorities of the Eye Hospitalurge the immediate removal of the child and its mother tothe hospital, where it can be under constant supervision andtreatment without being deprived of its natural sustenance.An ambulance is sent for the patient, and it is stated that sofar no evil has resulted from the early removal, though 200cases have been treated in this manner in the last two years.The duration of their stay in hospital is from one to sixweeks. In the last year the amount of blindness has beenhalved, though the number of cases admitted was doublethat of the previous year.

Mr. F. E. FREMANTLE, medical officer of health of the

county of Hertfordshire, spoke in favour of the report ofthe Departmental Committee appointed to consider the

working of the Midwives Act, of which he was a member.The findings and recommendations of that committeedid not commend themselves to subsequent speakers,nor, to judge by comments, to the majority of theaudience.

Miss ALICE GREGORY, who sits on the Midwives Committeeof the London County Council, declared that while theinterests of the Central Midwives Board, of the medicalsocieties, the ratepayers, and, incidentally, of the midwives,had been considered, the mother had been left out as oflittle or no account. The Act had made it compulsory onmidwives to recommend the attendance of a medical man, butin the tardy arrangements for the payment of such attend-ance it could only suggest pauperising the patients.It had forbidden unqualified women to attend labour forgain, and had provided no qualified persons to take theirplace in the scattered rural districts. It had hung a roperound the neck of the handy woman, but rather than pay forskilled attendance it left her, trusting to her human kindness,to go on attending for nothing rather than let her neigh-bour die ; and if any harm came of it the authorities wouldprobably treat her leniently. It had also declined toraise the standard of training, content to let England bebehind every other European country in this. In the dis-cussion which followed Dr. MARGARET MERRY SMITH, Dr.A. H. BYGOTT, and others took part.

Mrs. LAWSON, President of the National Association ofMidwives, Manchester, then read a paper urging reformin the constitution of the Central Midwives Board anddirect representation of midwives. Mrs. STEPHENGLANVILLE, speaking on the same subject, urged the

professional rather than the personal element in alltheir movements towards progress ; but while admittingthat a higher standard of education was needed, she claimedthat midwives, and especially those who belonged to asociety such as the Midwives’ Institute, had the interests of

the mother and child as much at heart as the medicalrepresentatives on the Board. Dr. CHAMPNEYS, in closingthe session, agreed with the last speaker in the necessity forputting aside personal and even society interests in theeffort to carry out the main principle of the Act. To meetsome of the difficulties in rural districts he suggested theendowment of a midwife, just as beds are endowed inhospitals.

Sir DycE DUCKWORTH presided over the second day’ssession, when the subjects dealt with included FeverNursing, by Dr. SIDNEY PHILLIPS, and the Duties ofProbationers in Provincial Hospitals, by Dr. E. B. RECKITT.Discussing the danger of infection to attendants on fevercases, and the complications which sometimes ensue, Dr.

Phillips gave it as his opinion that these conditionswere intimately connected with crowding in the wardsand consequent reduction of the quantity of fresh airobtainable.

Poor-law nursing in its various aspects and branchesoccupied Friday’s afternoon session, Miss BRODIE-HALL pre-siding. Papers were contributed by Miss GIBSON, matron ofthe Birmingham Infirmary ; Miss WILSON, whose paper wasread for her ; and Miss DOUGLAS TOWNSEND. The generalfeeling of the meeting at the conclusion appeared to be thatwhile small infirmaries could not supply the variety of casesand experience necessary to train nurses efficiently, the workand equipment of the large institutions under the Poor-lawwere in every way equal to those of large general hospitals.Under these circumstances the tiresome and invidious distinc-tion between hospital and Poor-law nurses ought to die out ;and it was hoped that in any future scheme for the registra-tion of nurses the same certificate would be available forboth.

In the evening Miss E. L. EDEN gave a lantern lectureon the History of Nursing, exhibiting a unique collectionof photographic slides representing nursing in all ages. Theearliest of these, dating from ancient Egyptian times andcopied from the walls of the Pyramids, showed the attend.ance on women in childbirth. An interesting photograph,taken from the Vase of Sosias in the Berlin Museum, repre-sented Achilles bandaging the arm of his friend Patroclus,and using a double-headed bandage. Coming down to theMiddle Ages, the pictures gave a glimpse of the wards of theHotel Dieu de Paris, which was nursed by the Augustiniannuns for 500 years. Here there were beds containing two andeven more patients, while another slide showed the nuns atwork washing the hospital linen in the river. Among anumber of excellent photographs was one of a plagueattendant’s costume of the seventeenth century, with thecurious beak-like projection over the nose through which theair was inspired over a disinfecting material. The last

pictures showed the development of modern nursing in theup-to-date equipment of a ward in St. Bartholomew’sHospital, an operating theatre, and a district nurse belong-ing to the Queen Victoria’s Imperial Institute entering acottage on the west coast of Ireland.

Saturday’s conference dealt with a variety of subjects,including massage, maternity clubs and creches, Territorialnursing, and State registration. In the afternoon Dr.MURRAY LESLIE occupied the chair, and the principalspeakers were Miss ANNIE MANLEY, a founder of the Incorpo-rated Society of Trained Masseuses, Miss KLAASSEN, andMiss BARTON, matron of the Chelsea Infirmary. Among thespeakers in the evening, when Mr. JOHN LANGTON presided,were the Hon. SYDNEY HOLLAND, Sir VICTOR HORSLEY, Dr.and Mrs. BEDFORD FENWICK, and Miss HAUGHTON, matron ofGuy’s Hospital. The subject discussed was the StateRegistration of Nurses, and it was warmly debated. Itwas a rule of the conference that no resolutions were tobe put.The exhibits displayed on the stalls of many of the

leading firms of instrument makers included the latest

developments of scientific surgery for the use of medicalman, nurse, or patient. A mask and face-protector on

Messrs.1 Garrould’s stand attracted considerable attention,and various improved bed-tables and rests were to be seen.A new "home Pasteuriser" was exhibited by Messrs.Townson and Mercer. Every variety of milk food and

prepared milk had its place.Attention was drawn at one of the sessions of the Confer-

ence to a small stall at which might be seen models offemale urinettes recommended for use in women’s free

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lavatories. These models, made at the suggestion of Dr.E. Murray Leslie by Messrs. Adamsez, obviate the danger ofinfection by their shape and the absence of any woodwork.

LONDON AND COUNTIES MEDICAL

PROTECTION SOCIETY.

THE annual general meeting of the London and CountiesMedical Protection Society was held at 31, Craven-street,’Strand, London, on April 27th, Dr. G. A. HERON being in thechair.The annual report of the council adopted by the meeting

gave an interesting account of the strong financial positionof the society, and stated that there had been a steady’increase in the membership during the past year. The

following resolution of the midwives committee of the

society was approved by the council :-That having regard to the proposed payment bv boards of guardiane

- of the doctors called in to assist midwives, the London and CountiesMedical Protection Society recommends the medical men in each unionto meet and confer on the subject, and to agree as to what fee, or fees,’they will accept, and then combine to insist on such fee or fees beingpaid (or guaranteed) by the guardians, and paid on the statement ofthe medical man that he is unable to obtain payment of his fee fromthe patient or her representatives.

The CHAIRMAN in the course of his remarks referred to thisresolution and declared that the matter was one of import--ance not only because it dealt with a branch of work whichwas of the very first consequence to the general practitionerof medicine, but because he thought that a fight properlycarried out by the medical profession with the localauthorities who were to work the Act would be, if it were

prudently conducted, productive of much good to the pro-fession. If they looked at what had taken place about theMidwives Act they would see that it followed exactlythe lines of every other work which was offered to

the medical profession by local authorities. Whenit came to a question of fees, the local authoritysettled the fee. The medical profession was not askedwhether it would work for those fees, but it was practicallyput in this way: "There is your fee, take it or leave it."He could not but think that that should not be permitted togo on. He thought that the medical profession, followingthe recommendation of their council, in every locality in thecountry when its local authority was considering the paymentwhich it would make for midwifery, should meet and agreethat they would receive certain fees and only those fees, andwhen the local authority said "There is our scale of fees,those of you who like it can take it," the answer should be :"We have nothing to do with your scale of fees ; that scalemay suit you but it does not please us. Our position is, weare not going to work for the fees which you dictate, butfor fees which we ourselves settle." The local medicalmen should say that unless the authorities accepted theirterms they would have to look to others for having thework done. That was the only way in which the medicalprofession would ever make itself of the faintest importanceto local authorities where fees were concerned. If they didnot unite and insist upon their rights, as lawyers and othershad done, medical men were undeserving of any considera-tion at all. He thought the day had gone by when that sortof thing should be treated in a sentimental manner, and ifanyone said he was advocating trades union methods he had’no objection to accept that position and to say it was the dutyof a man, which he owed to his wife and children and those

dependent upon him, that he should insist upon beingadequately paid for what he did, while he should be the judgeof what adequate payment was. He was at all eventsentitled to be heard.

UNIVERSITY OF LONDON : KING’S COLLEGE.-A short course of special lectures in physiology, the subjectbeing the Relationship of the Brain to Voice, will be de-livered by Dr. F. W. Mott in the Physiological Laboratory ofKing’s College on Monday afternoon?, May 23rd, 30th, andJune 6th, at 4.30. These lectures are free to all members of

King’s College, all students in medical schools, all internalstudents of the University of London, and to medical menon presentation of their cards.

Public Health.REPORTS OF SCHOOL MEDICAL OFFICERS.

Tile Cotinty of Berkshire. -For the purpose of the medicalinspection of school children the county has been dividedinto two parts : one includes the Bradfield rural district andthe district eastwards of it, the other all the administrativecountry westward of Bradfield rural district. The schoolmedical officer is Dr. Gerard C. Taylor, the county medicalofficer of health, who for inspectorial purposes has theassistance of two medical officers. The school populationhere in question does not, of course, include the boroughs ofWindsor, Maidenhead, and Newbury, but the number ofchildren on the rolls amounts to about 24,480. Dr. Taylorcondemns what appears to be the usual method of drysweeping in the schools, and he urges that damp sawdustshould be scattered over the floors prior to cleansing. Muchof the dust in schoolrooms is, he thinks, caused by the badsurface of the playgrounds, and he would evidently like tosee more asphalting carried out. In 51 of the schools thereis no supply of drinking water on the premises. As regardsexcrement disposal, Dr. Taylor is in favour of pail closets,to the contents of which earth is freely added. Pediculiwere present in the hair of 16-5 5 per cent. of the childrenexamined, a proportion which shows a decrease of nearly6 per cent. upon the figures for last year. 57 per cent. of thechildren had defective teeth, and it is found to be extremelyrare that any attempt at treatment has been made. Enlargedtonsils were found in 27 per cent. and adenoids in 17 percent. It is not stated what means were adopted for ascertain-ing the presence of adenoids. Of the 2856 whose sight wastested, 73 per cent. had normal vision of both eyes. 4 percent. had defective hearing, but this percentage is opento revision. 88 instances of enlarged thyroid were recorded,22 amongst boys and 66 amongst girls, principally at the ageof puberty. The available methods of treatment are thus

grouped : (a) payment of doctors’ or specialists’ fees ; (b)subscription to a provident dispensary or medical club; (e)a relieving offi0er’s order ; and (d) a recommendation for avoluntary hospital. As regards (a), it is pointed out that,although many of the parents are both able and willing topay for medical attention for an acute and short illness, theyare less able to do so for an operation or prolonged treat-ment ; while with respect to (b) Dr. Taylor thinks that therates of subscriptions to provident clubs do not allow of muchtime being devoted to individual patients. Besides, the rulesbut rarely include operative interference, vision-testing, or

dentistry. (c) As to the employment of the district medicalofficer, Dr. Taylor observes that, although the only recognisedqualification for gratuitous treatment is "destitution," it iscustomary in some unions to grant medical relief on loan, thecase being subsequently considered by the guardians wheneither the loan is written off or repayment obtained. Itseems that in Berkshire school medical inspection has incertain districts increased the number of applicants formedical relief, and it is regarded as unfair that the work ofdistrict medical officers should be thus augmented without aproportional increase in pay. The Poor-law Order of 1847enables the guardians with the consent of the central authorityto pay compensation for extra services, and possibly wherethe demand upon the time of the district medicalofficer has been increased some remuneration might beobtained under this provision. But, as Dr. Taylorioresees,this point raises some important general issues as to theextent to which the Poor-law authorities are prepared toextend facilities for treatment, and as to whether publicopinion will permit parents to be compelled to apply forPoor-law medical relief when not otherwise in need of

public assistance. With reference to (d)-i.e., a recom-

mendation for a general hospital-it appears that con-

siderable use is already made of the Royal Berkshire

Hospital at Reading, the Radcliffe Infirmary at Oxford, andthe King Edward VII. Hospital at Windsor, while a few ofthe children are brought up to the special or generalhospitals in London. There are also several cottage andother hospitals in the county which are available for opera-tions. Dr. Taylor thinks that proposals to subsidise voluntaryhospitals out of the education rate are not likelv to meetwith general approval, since these hospitals already compete