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more valuable by the eminence of those by whom it has been

held, and always conferred alternately upon a physician anda surgeon. The President was not only an eminent practi-tioner but was usually selected from among men who haddone good work in subordinate offices and whose known

attachment to the society afforded security that theywould be watchful guardians of its honour and of its

interests. In this respect, indeed, they were all alike,but successive presidents have entertained very different

ideas as to the share which they should take in the

proceedings of the ordinary meetings. Some have con-

sidered it a duty to open every debate and to direct atten-tion to what they conceived to be the chief questions raised

by the paper which had been read. Others have contented

themselves with taking the formal vote of thanks usuallyaccorded to the author of the paper ; and some have either

intervened in the debates or kept silence as they might feel

disposed. Dr. COPLAND usually spoke late and usually saidthat everything important either in the paper itself or in

the remarks of the speakers would be found in such andsuch articles in his Dictionary-an assertion which was

completely justified more often than might have been sup-posed. The great event of the presidential year was, of

course, the address upon first taking the chair, which oftenincluded a retrospective glance at the work of the precedingsession, brief obituary notices of deceased Fellows, and somekind of exhortation concerning the future-exhortation whichsometimes conducted an unskilled orator into verbal snares

or pitfalls from which escape was difficult or impossible.A president once expressed his hope that during the

forthcoming session the working bees of the society wouldput their shoulders to the wheel, and his successor

surpassed this effort by the hope that these same bees

would unite with him to cull fruits in the stream of

science. Such speeches were, of course, merely examplesof what may happen when men even of conspicuous abilityattempt work to which they are unaccustomed and from therequirements of which their minds have been diverted byother and more important pursuits. On the other hand,there were always Fellows of the society to whose periodsit was a delight to listen, and the measured cadences

of PAGET or of SAVORY would often be almost as powerfulas their facts and arguments in giving character and

distinction to a debate. As we think of those days theworthies of the past crowd upon the mental vision.

ALDERSON, an exemplar of grace and courtesy; ADDISON,profuse of gesture, original, and didactic ; BRODIE, alreadybecoming in our day an infrequent visitor; GULL, terselydescribed as "a strenuous bird" and looked upon as a

coming man at Guy’s ; ORMEROD, who then reported the pro-ceedings of the society for THE LANCET and whose careerof promise was cut short by cholera before Sebastopol ;and ANDREW CLARK, steadily laying the foundations of

his reputation in the pathological laboratory of the

London Hospital. As there were strong men before

AGAMEMNON, so there will be worthy successors of the

heroes of the past, and the history of the society justifies itin looking forward to another century of usefulness and ofsuccess, if not in its present form then as an importantconstituent of a united Academy of Medicine. The attemptto federate has been vainly made on previous occasions but

the present time seems undoubtedly to be propitious notonly for its renewal but for carrying such a desirable projectinto accomplishment.

The Hygiene of Flat Life.THE ultimate results of social changes can seldom be

exactly predicted. The advocates of any social reform

usually paint in vivid colours the Utopian conditions

which will prevail if their schemes are carried out, but

when the reforms so earnestly recommended have been

introduced the looked-for benefits are often woefully lessvisible than had been prophesied ; and not only so but new,unexpected, collateral results, by-products of the reform aswe may call them, are found to have developed and the laststate is in only too many cases but little improvement onthe first. The conditions under which very many of the

poorer classes live in all large towns are truly deplorable.The overcrowding is often extreme. Many will rememberthe late Mr. MONTAGU WILLIAMS’S anecdote illustrative

of this. When he was the magistrate at the Whitechapelpolice-court a case came before him of a dispute ending in afree fight. After much questioning he found that in one

room five families lived, one family in each corner and onein the centre, their respective domains being delimited bychalk marks. All went well until the family in the

centre of the room decided to take in lodgers and this

attempt at overcrowding was forcibly resented by the more

particular dwellers in the corners. We do not know how

far Mr. MONTAGU WILLIAMS was ready to vouch for the

exact accuracy of his humorous story, but that such a

tale should be considered a fair comment upon existingconditions goes far to show that in many districts of

London the overcrowding is intense. To remedy this evil

the energies of philanthropists and municipal bodies havebeen directed. Overcrowded quarters have been cleared andin place of ill-designed and ill-built houses lofty structureshave been erected according to the latest teachings of

hygiene.The dwellers in these sanitary buildings are seldom the

inhabitants of the old unwholesome tenement houses which

have been swept away. The appreciation of these new

"dwellings" "is sometimes so great that the owners of themhave the power of selecting amongst the applicants thosewhom they consider to be the most suitable, and then it.

comes to pass that the new tenants belong as a rule to arather higher, class than those who have been displaced. Wedo not wish for one moment to minimise or to detract

from the benefits resulting from the erection of workmen’sdwellings. We are sure that many hard-working people areable to obtain rooms with many hygienic appliances and

fittings at a weekly rent lower than they would have

had to pay if these "improvements" " had not been

carried out. So far so good, but there are some by-resultsof this hygienic building which were doubtless unintendedby the well-meaning philanthropists who promoted theirestablishment but which are of sufficient economic import-ance not to be ignored. In order that the expense of the

rooms of these model dwellings should not be excessive therooms are made very small and as low in height as the

average size of the people will admit, so that the cubic air-

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expect from the hygienic protestations of the promoters.Not long ago the QUEEN after inspecting some model

dwellings pointed out the need for cupboards, but one of theinhabitants remarked on hearing of this suggestion, " We’ve

got the cupboards already, what we really want are rooms."When these buildings are erected by money bequeathed forthe purpose, and when their rents are not expected to yield adividend the chief objection to be urged against them is that,according to an interesting economic law, they tend to lower

wages, though it has also to be remembered that they arenot inhabited by the class for whom they were primarilyintended. When, however, these model dwellings are erected

by municipal bodies the case is altered, as for the most partthey do not repay in rent the cost of building, so that thebalance has to fall on the rates. This is one cause, amongstmany others, of the recent rise in rates in London and other

large towns. Now every increase in rates has a very direct

effect in increasing the expense of living, for no personaleconomy on the part of a householder can affect the amountof rates which he has to pay. A natural consequence of

this increase in rates has been the extension of the numbers

of those who live in flats. We do not suggest that the

increase in the rates is the only cause, or even the chief

cause, but it certainly is a cause and not the least powerfulcause, in causing the present migration of Londoners of

all classes into flats. Now in flats we find a massingtogether of large numbers of people in circumstances thatare often much open to criticism, so that one result of the

efforts of municipalities to improve the hygienic conditionsunder which some of the poorer inhabitants live has been

to deteriorate the hygienic conditions of some of those whoare better off. The view that flats are not so hygienic as

ordinary dwelling-houses is very generally accepted, but ata recent discussion at the Royal Sanitary Institute on the

hygiene of flat life opinions were somewhat divided. The lateDr. FARR used to say that the mere density of the populationincreased the mortality but the statistics based on the

returns at present available do not support this view. These

statistics, however, are merely mortality statistics and giveus no indication of the amount of sickness not imme-

diately leading to death. To take an instance, there is a

widespread belief amongst those who are qualified to

judge that for servants flat life is especially unwholesome,but this harmful effect would not show itself in any

mortality statistics. If we may judge from death returnsservants on flats never die. In a flat there is no accommoda-

tion for a sick servant. Therefore, though in a flat a servant

may fall ill or be permanently damaged in health by her

stay there, yet we shall see no sign of it in the returns

of the Registrar-GeneralThe main hygienic defect of the flats is the absence

of provision for through ventilation. The great priceof the land on which flats are built requires that the

buildings shall be high and closely packed. Thus it

follows that many of the rooms look upon inclosed air

"wells," where a column of air remains almost stagnantfrom day to day. The staircases and corridors are also

- equally guiltless of circulating air. Attempts have been

made by the architects in some cases to provide for

,thorough perflation of air by openings at the base of

the air wells, but in several instances it has been

found that these air inlets have been bricked up or glazedbecause someone has complained of the draught. The

difficulty of providing for through ventilation is the supremedifficulty of the hygiene of flats and it requires to be takeninto careful consideration. In many ways the modern flat is

a better constructed and more conveniently planned dwellingthan the house, but the conditions of its erection compel,or well-nigh compel, stuffiness. It is impossible to preventthe increase in the number of flats. In all large cities

flats are a necessity from the appreciation of the groundvalue of the land. In Rome, the most ancient of the

present-day large cities, flats have existed to a large extentfor centuries and if the idea is well founded that Rome had

in the time of the Emperors a population of over 1,000,000the existence of flats in the Eternal City may be consideredas proved for that epoch, and if so they have existed therefor nearly 2000 years. Flats being inevitable, it ’would bewell to insist on the provision of through ventilation, as

the most important factor in the improvement of their

hygiene.

The Session of the General MedicalCouncil.

THE eighty-first session of the General Council of MedicalEducation and Registration began on Tuesday last. In

his opening speech Dr. MACALISTER, the new President,outlined a businesslike programme of modest dimensions, afact which is of good omen. The scope of the duties

of the Council is so large, and so much of its work is

associated with public interests of the widest sort, that

one of the principal difficulties before it is to decide

what are the subjects that require special attention. There

are but two sessions in the year, although on one or twooccasions a special session has been held, and the cost ofeach is so considerable that it is out of the question thatthe Council should meet more frequently. Moreover, evenif money were of no consideration, it must be rememberedthat the members of the Council are for the most part busymen whose time is charged and surcharged with public andprivate duties, so that in many cases they sit at the Councilboard only with considerable sacrifice of valuable time.

Two sessions, however, each usually amounting to less thana week, hardly suffice for dealing with all the vast number ofquestions that may arise. The relations between the medical

profession and the public are regulated entirely by the Council,the maintenance of an accurate Register and the purificationof that Register from wrong persons is also its duty, while,perhaps most important of all, the standardisation of

medical education is also in its hands. When we remember

the vast field that such various functions must offer for

discussion we see that a fortnight (or less) in the year is notan excessive amount of time for the public deliberations ofthe Council, even though much of the real work is done bycommittees, by inspectors and visitors, and by the Presidentin the intervals between the sessions. A short programme

pointing rather to action than to oratory is consequentlywelcomed by the medical profession, who are also beginningto take note that their interests are not best served by themembers who make the most or the longest speeches.