530 LIEUT.-COLONEL F. E. FREMANTLE : THE GROUND-LEVEL LATRINE.

building is a memorial to the late Dr. Julia A. H.Cock, dean of the school from 1903 to 1914,whose name is inseparably associated with theadvance of the position of women in medicine.The second floor is an extension of the anatomicaldepartment, including a dissecting room, prepara-tion rooms, demonstration theatre, and researchlaboratories. The £30,000 required to build andequip this extension have been subscribed in

response to an appeal first issued by the council onDec. 10th, 1914. It is now possible to give a com-plete course of medical instruction at the school,including the clinical course which is pursued atthe Royal Free Hospital and, under a temporaryagreement, at St. Mary’s Hospital, to 450 students,providing for an entry of 90 new students each year.The architects for the extension and alterationsare Messrs. H. V. Ashley and Winton Newman, andthe buildings will be ready for occupation at theopening of the October session.

PENALTIES FOR MALINGERING ANDSELF-MUTILATION.

THE new Defence of the Realm Regulations, justissued, deal with the cases of those who attempt toavoid military service by self-drugging or self-mutilation. The following are the two regula-tions upon these points :-

If any man of His Majesty’s Reserve forces not for thetime being subject to the Naval Discipline Act or to militarylaw, when under orders to report himself for medical exa-mination, malingers or feigns any disease or infirmity, heshall be gUilty of an offence against these regulations.

If any such man produces any disease or infirmity inhimself, or maims or injures himself, or causes himself tobe maimed or injured, or takes or uses any drug or prepara-tion, or does any other act calculated or likely to render him,or to lead to the belief that he is permanently or temporarilyunfit for service, he shall be guilty of an offence againstthese regulations, unless he proves that he did not so actwith the intent of escaping service.It is an offence also to assist an intending malin-gerer by producing in him any mutilation or bysupplying him with drugs.

THE ancient barony of Cobham has been revived,and a writ has been issued to Dr. Gervase DisneyAlexander summoning him to the House of Lordsunder this style. It will be remembered that theclaim to the peerage was established some four

years ago before the Committee of Privileges byDr. R. G. Alexander, Dr. G. D. Alexander’s father,and a well-known Halifax physician.

CHILD-WELFARE SCHEME IN DUNDEE.—Dr. C. ITempleman, city medical officer of health for Dundee, has Isubmitted a scheme for dealing with infant and child welfare,on the lines suggested by the Local Government Board,which has been adopted by the Dundee health committee.The scheme will be carried out by the inspector ofmidwives, under the supervision of the medical officerof health. It provides for all homes, where it is deemedadvisable, being visited by one or other of the fivehealth visitors, who shall keep the child under observa-tion during its first year of life. In this work help isanticipated from voluntary workers of the Social Union.The medical officer of health has further been empowered toengage the services of trained nurses in connexion withepidemics of measles and whooping-cough. They will visitthe homes and guide the mothers as to steps necessary toprevent complications and the spread of the diseases. Fourinfants’ clinics are to be instituted, and for children under5 a special children’s medical clinic will be held twice aweek at the Royal Infirmary, while surgical cases willreceive daily attention at the out-department. The schemewill provide a health record of all children, and will besupplemented as regards infectious diseases by the recordskept by the public health department. This record willthen be sent to the school medical officer when the childpasses under his supervision

THE GROUND-LEVEL LATRINE.

BY F. E. FREMANTLE, F.R.C S. ENG., F.R.C.P. LOND.,D.P.H.,

LIEUTENANT-COLONEL, R.A.M.C. (T.), D.A.D.M.S., 54TH DIVISION.

UNDER the conditions of service on the Gallipoli Peninsulathe shallow-trench latrine was found inappropriate. It

requires the use of acres of ground, and sufficient safe groundcould not be spared. Moreover, the squatting position istorture for men afflicted with diarrhoea and straining for longperiods at stool. Nor was the superficial covering of earthsufficient protection against the fly-pest, for maggots werefound swarming up through the sparse covering in the hotweather. Nor, again, was the soil in the hot weather likelyto be of much bacterial value in breaking up the fseoes.Finally, in practice, these shallow trenches, especially in thedark, constantly pollute the men’s boots. The methods

employed in Gallipoli to counterbalance these evils mayprove useful in other fields of activity.The choice lay between the deep-trench and the pail

system. In some places, as in certain front trencheswith no appropriate ground handy for deep-trench latrines,pails in the form of biscuit-tins or oil-drums were in-

stituted. But they involved much extra labour, exposure,and danger in porterage to and fro, with manifold occa.sions of pollution in the process. Rough mule-cartsbumping over rough tracks, with much man-handlingat either end and only rare facilities for hand washing,made the process both unwholesome and unpleasant. Theintermediate stage of fæcal disposal was therefore aban-doned and the feaces deposited direct by the sitter into themidden or deep trench.The next development was that made by the Australians

at Anzac in their confined Lone Pine trenches and else-where of (1) narrowing the mouth of the deep trenchto 15 or 18 inches, widening it below, splaying it outat the ends, and deepening it to 10, 15, and even

18 feet deep, and (2) closing it completely in. Thismade the utmost possible use of the space avail-able in a sap, even though it had to be hewn outof rock ; and with proper addition of cresol, crude oil,and so-called chloride of lime it was unobjectionable andquite free from flies. But when it came to fly-proofingthe deep-trench latrine in the open, with its pole supportedon trestles or sandbags, the difficulty without skilledcarpenters or tools or timber was almost insuperable. The

only material available consisted of biscuit-boxes and theirtin linings, with other supply cases, all urgently required forthe improvisation of rough furniture or fuel. It becameessential to economise material as well as space and labourin the construction of latrines.The following modification of the deep trench became,

therefore, a necessary and fairly obvious improvement onthe official "long and deep trench " of pre-war days. The

principle should, it is suggested, be adopted universally,officially, and exclusively for the sealed-pattern deeplatrine.The principle is that the latrine-pole is flush with the

ground. The user then sits level with the ground, with hisfeet in an extra" accommodation trench " sunk in front ofthe pole for the purpose. This has three advantages :-

1. He has an extra 18 inches of protection-a most

important matter when latrines are in a sap, or, if in theopen, necessarily in the more exposed positions.

2. There is only one flat plane to cover in, instead of thetop, back, front, and two irregular ends, where the trestleor tin or earth-bag supports for the pole make covering-indifficult.

3. Simplicity of construction and saving of material.The need of covering-in arose partly as a guard against

the propagation of flies, but chiefly from the desire toreduce latrine digging and to economise ground, for whichpurpose it seemed best to dispense with the throwingin of earth to the latrine. The danger of infection isthen met by :-(1) The darkness of a really deep closedlatrine, which flies avoid ; (2) the imprisonment of the

paper which cannot be blown out of a closed latrine; (3)the use of disinfectants; and, finally, by (4) the necessary