both direct and indirect. Direct in the form of instruction of the people themselves; indirect, through the producers, the preparers, and the purveyors of food who must be induced and, if need be, compelled to have regard to hygiene in their methods of marketing and supplying the various articles. Already something of a beginning has been made in this latter part of the procedure, in the case of milk and meat, for example. So far as milk is concerned, as a result of action taken under various Acts and Regulations, it is possible even to claim that progress has been made. In the case of meat, action has only just commenced, the special regulations -The Public Health (Meat) Regulations, 1924—having been in operation only a comparatively short time. Apropos of the reference to these regulations, attention may be directed at this point to the fact that there is not included amongst the papers, one dealing specifically with the subject of meat. This omission is intentional, because it was felt by the Committee and more particularly by Mr. Hayhurst, the member best fitted to advise on this subject, that having regard to the existence of the regulations the subject was sufficiently prominently before the public. Moreover, having regard to the newness of the regulations any detailed discussion of the matters with which they deal, might be regarded as a criticism of provisions which were actually only undergoing their trial. So far as that trial is concerned, it may safely be said that it appears to be proceeding in a manner quite fair to all parties. Though they deal with other matters of great importance, the slaughtering of animals, the inspection of carcases, and the marking of meat, for example, in addition to handling and retailing, it is curious that it has been in regard to these latter provisions of the regulations mainly that feelings appear to have been aroused. At the time the regulations appeared, opinions differed very widely as to the interpretation of many of the requirements, though all seemed to be agreed that the intention behind them was an improvement in meat hygiene generally; the first-named provisions aiming at ensuring that the article to be supplied to the people should be free from disease and unsoundness, and the latter that it should be preserved from dirt and contamination until it passed into the hands of the consumer. It was as to the methods to be adopted in this last-named connection that there was contest, particularly as between the administrators and the people responsible for the supply. Appeals to other bodies, notably the Ministry of Health, having failed to provide a solution satisfactory to both parties, it was clear, as it might always have been clear, that it must be left to the courts to decide as to the rights and wrongs in each particular case. So far as matters have gone, the generality of decisions would seem to show that a reasonable view is to be taken, and that undue exposure to risk of contamination will not be tolerated. The results, up to the present, indeed, almost justify the expression of a wish that there were in existence regulations as comprehensive in respect of other food articles. That the traders concerned with meat have accepted the principle of these regulations with so little of question, and without insistence upon proof that the public health is actually endangered by the methods they seek to amend, gives rise to the hope that dealers in other materials may show a like spirit when as it inevitably must, the time comes for regulating their businesses, For, it must be admitted, the production of definite and specific proof of health injury is a matter of the extremest difficulty. This almost without exception, the individual reporters plainly or impliedly admit in their papers: while the Committee as a whole, evidently anticipating that they may be called upon to justify their demand for action, seek to meet it thus : "It is recognised that the objections urged against the methods adopted are less on the public health than the aesthetic side, and that little or no definite evidence of injury to health is offered. The difficulties in the way of producing such evidence are, however, enormous, and in any case, and fortunately, it is only very rarely that anything in the shape of definite disease is traceable to food contaminated as a result of careless handling or exposure. Vague disturbances of health and digestion that may be caused by such contaminations are rarely particularly noted, and practically never investigated. Even if æsthetic grounds are those that alone can be established, the Committee feel strongly that, having regard to the great variety of conditions that may and do affect food and exert an influence in relation to its nutritive qualities, they are sufficiently strong to justify legislative action with a view to securing adequate supervision and the exercise of such care and cleanliness as will ensure the decency that the increasing refinement of the people demands and that the changed conditions, the result of the intensified urbanization of this country, compel." In connection with the instruction of the people in regard to this aspect of focd hygiene it is unlikely that there will be encountered so exacting a demand for definite evidence of injury to health as in the case of those whose interests in the matter are more distinctly commercial. In any case, it is not on disease prevention grounds merely, but on those of hygiene generally, that the appeal to the people as food consumers is to be made. It is to the undesirability, from the hygienic point of view, of carelessness 432 The Public and Food Hygiene. and uncleanness in relation to handling and exposure of food that their attention must be drawn, and this can very well be done without enlarging particularly on the possibilities of disease. When obvious facts as to contamination with filth can be adduced, as they very easily may, there should be little need for voicing the theories of the experts as to what the effect upon the food and afterwards the consumer may be. upon Teach the individual to see that contamination is inevitable, and to note the contamination that is actually occurring; the results of such contamination upon himself he will imagine. Show him that the contamination can be reduced; let him see that if he wills it, it will be reduced, and his invaluable assistance in obtaining the improvements all hygienists must desire is assured. Propaganda, publicity, teaching are essential, and it is to the health authorities and their officers mainly that the task of instructing the people will fall. It is with the object of assisting them in this work that these papers have been prepared, and put together. That they will be helpful also in stimulating the carrying out of propaganda is most sincerely hoped. JOURNAL OF THE ROYAL SANITARY INSTITUTE. Telephone: VICTORIA 3730. Contents. Telegraph: "SANITUTE, CHURTON. LONDON." 448 451 Congress at Edinburgh— CONFERENCE VII.-Health Visitors. Presidential Address by Lady Leslie Mackenzie "The School Nurse," by James Kerr, M.A., M.D., D.P.H. "Health Visiting in a Rural Area," by Miss M. M. Cowan 66 Co-operation between the Midwife and the Health Visitor," by Miss Hester Viney "The Health Visitor in India," by R. J. Blackham, C.B., C.M.G., C.I.E., D.S.O., M.D. CONFERENCE VIII.-Health Workers. "Mental Development-Montessori and other Methods," by Miss Jean K. Borland, M.A. 459 ... 465 468 ... 469 ... Sessional Meetings— "Some Points on Public Health Propaganda," by A. T. Nankivell, M.D., D.P.H. ... ... 470 472 ... Article Contributed— "Unique Soil Pipe," by C. Armstrong Austin, A.M.Inst.M. & Cy.E. The numeral indicates the page on which the Advertisement appears; the dash (—) denotes that Advertisement is not Particulars of the Arrangements for Advertising in the Journal can be obtained from the Offices of the Institute. xiii iii vi SANITARY EQUIPMENT. The Manufacture of specialities and the design of Bath Rooms to the best advantage constitutes an important branch of our business. We shall be pleased to quote for the complete Sanitary Equipment of any type of building. 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