It may possibly be misunderstood by the reader what form professional jealousy may take and how it is made manifest. Many might not believe that it exists to any appreciable extent. To illustrate one form, and suggest its effects, I might imagine. an instance of any proposed union or organisation, local or general: the moment certain medical men should attempt to assert themselves a number of others would either have nothing to do with the cause, or, place-hunting themselves, would enter in order to cause strife and tension, if not to upset plans entirely. Medical men seem inclined to make for the interests of self rather than discern the greatest value in comprehensive movements in favour of the profession as a whole. Therefore they remain eternally segregate and comparatively powerless.

The overcrowding in the profession is largely due to competition among the licensing bodies, competition resulting from the keen endeavour to increase numbers on the part of those responsible for the management of medical schools. The more students there are, the more money passes into the pockets of the teaching staff. One could easily imagine that this might lead to want of stringency in the entrance examinations.

APPENDIX D

A PROPOSED MINISTRY OF PUBLIC HEALTH

WHY not a ministry of Public Health? Where do agriculture and commerce come in if a nation is going to pieces mentally and physically? What is the good of a War-Office reorganization, and the fullest preparations being made for war abroad and defence at home if our personnel is weak, mentally and physically-particularly the latter?

We have urgent health questions of various kinds pressing for wise legislation, but there is in our parliamentary medical representation an insufficiency, there being a lack of cohesion and co-ordination on the part of the miserably few medical men who represent, and there is in our medical profession itself a lack of concrete decision and united determination in its members that renders it comparatively helpless and inert. In order to gauge what work there is for a ministry of public health to attend to, let us look for a moment at a few items :1. The Medical profession suffers from serious disorganization

-serious as affecting the commonweal as well as its own prosperity. A Ministry of Public Health would spell reorganization.

2. Medical Officers of Health should not engage in practice

amongst the people; they should enjoy a more permanent tenure of office and be properly paid, not being thumbscrewed by councillors, or subject to dismissal at the

whim of the latter, who are often merely self or partyseeking when considering questions of public health.

3. Consumption should be made a notifiable disease, and the necessity for taking due preventive precautions should be impressed upon the public.

4. Physical education should be encouraged by the establishment of gymnasiums; and swimming baths should be provided.

5. The housing of the working classes requires learned and urgent consideration.

6. A higher authority than merely Boards of Guardians should be responsible for the exercise of the vaccination laws.

7. All classes require educating in methods of maintaining health that may be adopted by individuals themselves.

8. Rampant quackery needs repressing.

9. The public should either be warned against the dangerous

abuse of narcotics and poisons, by being instructed as to the nature and ultimate effects of such when taken without the sanction of a medical man; or a more stringent legislation should be devised to prevent the purchase of such drugs by any who are not directed by medical men.

10. There should be adequate provision of Sanatoria for certain diseases, such as consumption and other infectious diseases.

II. A Ministry of Public Health should institute periodical medical examinations of school-children by specialists, not so much for the detection of specific diseases as for the purpose of obtaining both a particular and a general survey of the physical and mental condition of the young.

12. Venereal diseases should be made notifiable; for a very large amount of mental and physical wreckage exists on account of these diseases alone.

13. We require a standard of purity for food: also for drugs and drink. Adulterations, preservatives of food, patent foods, misrepresentation on the part of the retailer-these are questions needing urgent attention.

14. Medical men should be urged and encouraged to pursue the study of diet, to the end that more definite and more scientific conclusions might be arrived at.

15. The question of provision of food to the poorer classes, its preparation, cooking; instruction in food values, and in food purchase, for all classes-such need immediate attention.

16. Infant mortality would bear investigating without delay. 17. Full opportunity and every encouragement for medical research should be provided, so that such diseases as cancer might be fathomed.

18. The question whether marriages should not be subject to some sort of regulation, by means of a new form of licence, needs deeply considering, it being held that the offspring of diseased persons will likely also be diseased.

19. There is a crying necessity for the management of our hospitals to be fully enquired into.

W. Jolly & Sons, Printers, 35 Bridge Street, Aberdeen