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Scholarships.—A scheme was arranged in 1905 for granting scholarships of the value of £25 to
pupil midwives. The course of training is to be of 6 months duration, and to be taken at one of the
lying-in hospitals selected by the Council. A condition is imposed to the effect that when qualified,
the scholar must practise for two years within the County of London. Eight scholarships were granted
during the year, and four scholars completed their course and passed the examination of the Central
Midwives Board. Some difficulty in obtaining sufficient patients after qualification has been
experienced, and in view of this, seven scholars to whom awards were made resigned their scholarships
before beginning the course of training. Of twenty scholarships awarded since the inauguration of
the scheme in 1905, seven scholars qualified and became certified midwives, seven resigned, three were
still training, and three had not begun their course of training.
Classes for Midwives.—The Education Committee has arranged classes in midwifery in connection
with its scheme of technical education and some of the midwives whose training was deficient or who
were trained many years ago have availed themselves of this instruction.
Revised Rides of the Central Midwives Board.
Revised Rules of the Central Midwives Board were approved by the Privy Council in April,
1907. A copy of the new rules was supplied by the Council to every midwife who gave notice of intention
to practice during the year.
The new rules differ from the old in the following particulars :—
Appliances, etc.—(1) A midwife is not now obliged to carry an antiseptic lubricant.
(2) The Local Supervising Authority may use their discretion in the case of untrained midwives,
with regard to insisting on the carrying of a catheter and appliances for giving vaginal
injections.
Disinfection.—After attendance upon a case of puerperal fever or other infectious disease, the
midwife must satisfy the Local Supervising Authority as to disinfection instead of the Local Sanitary
Authority.
Mother.—A new rule provides that the midwife must in all cases of labour examine the placenta
and membranes before they are destroyed and satisfy herself that they are completely removed.
Child.—As soon as the child's head is born, the eyes are to be carefully cleansed as before, but
the use of an antiseptic lotion is not advised under the new rules, as it was under the old.
Laying out the Dead.—Exceptions to the old rule forbidding a midwife to lay out a dead body
may now be made at the discretion of the Local SupervisingAuthority under the following circumstances—
(а) If a midwife prepares for burial the body of a lying-in woman ; a still-born child, or an infant
dying within ten days.
(b) If a midwife lays out a dead body in a case of non-infectious illness provided she is not
attending a midwifery case at the time.
Medical Help.—When medical help is advised, the notice giving the reason why such help is
required, must now be handed to the husband or nearest relative or friend, in order that it may be
immediately forwarded to a medical practitioner. Copies of these notices must be sent to the Local
Supervising Authority within 24 hours instead of within 12 hours as heretofore. A midwife is not now
forbidden to attend a case of breech presentation in a primipara. Two hours instead of one are now
allowed to elapse between the birth of the child and of the placenta before a midwife is bound to
advise that medical help should be obtained. A midwife is now bound to advise that medical help
should be obtained in a case of dangerous feebleness in a child whether arising from prematurity or not.
A form of notification of still-birth, already referred to, is now prescribed in the rules.
Exemptions.—The rule exempting midwives working in hospitals under the supervision of a
duly appointed medical officer from being subject to the rules, now extends only to midwives working
within hospitals approved by the Central Midwives Board and the exemption is limited to certain
rules only. Those working in workhouses and infirmaries under the supervision of a duly appointed
medical officer are exempt from the rules as before.
Designation.—A rule was added to the effect that the proper designation of a midwife was
certified midwife "and that no abbreviation in the form of letters nor any other description of the
qualification was permissible. The Board has since approached the Privy Council and a modification
of this rule has been effected whereby midwives enrolled as the result of examination may add the
words "by examination."
Water Supply.
Dr. Houston, Director of Water Examinations, in his report to the Metropolitan Water Board
for the twelve months ended 31st March, 1908, points out that caution is necessary in interpreting
the highly useful figures which appear in the Annual Report of the Local Government Board in their
relation to the quality of the supply, inasmuch as the results are averages, and he refers to his statement
in a previous report "that monthly, and still more yearly, averages tend to smooth over
individual results which sometimes are the reverse of satisfactory."
Dr. Houston further states with reference to storage that under certain conditions which do
not lend themselves to accurate definition, a water may deteriorate on storage, as judged by its chemical
and physical qualities, owing to the abnormal growth and subsequent decomposition of some species
of diatomaceæ, cyanophyceæ and protozoa. These words, quoted from the report for 1906-7, on the
growth of algae, Dr. Houston remarks, "turned out to be of prophetic significance, for in the late
summer and autumn months of 1907 a remarkable development of oscillaria occurred in Staines reservoir
water. The growth interfered considerably with filtration at the Kempton Park, Grand Junction
and West Middlesex Works. A good deal of experience, however, was gained incidentally in the successful
use of copper sulphate as a remedial agent. At the commencement of the current year the