their foreign colleagues and freely said so in private, as the writer can testify. They despised them just as German military and scientific men despised all other military and scientific men. And they used the International to spread the German idea. It was a form of peaceful penetration quite on a par with the commercial and financial manœuvres. And it found readier dupes. In its name the Germans utilised them up to the outbreak of war, as we have seen; it utilised them during the war and is still making pawns of them in the attempt to secure a peace agreeable to Germany. They began working on the neutrals, touring here and there, holding meetings and conversations, writing Pauline epistles, all in favour of Germany, not of the international proletariate.' No sooner had the original German campaign broken down at the Marne than socialist conferences began to be held in neutral countries in favour of peace. There was one of Swiss and Italian socialists at Lugano at the end of September 1914; a second of Dutch and Scandinavians at Copenhagen in January 1915. These meetings presented a family likeness strongly recalling the familiar features of the German International. The war was attributed to capitalism, for which 'bourgeois' society was equally to blame in all the belligerent countries, and the 'proletariate' was called upon to demand peace by negotiations. The Copenhagen conference uttered a protest against the violation of Belgian neutrality, but so feebly as to excite the scorn of Gustave Hervé, who roundly accused both conferences of merely obeying the word of command from Berlin. When the neutral socialists call for peace, he said, they are nothing but the docile echoes of Germany. Then came the London conference of February 1915, to which reference has already been made. French and Belgians were present, and a more energetic protest was made against the invasion of Belgium and France. The victory of German imperialism would be, it was declared, the defeat and ruin of democracy and liberty in Europe; compensation for Belgium was demanded, and the principles of no annexations and the freedom of nations to decide their own destiny laid down. But even here the German influence crept in and obscured the issue by referring the war to general causes and capitalist society.

In September 1915 an attempt was made, at the instance.

of Italian socialists, to hold a more international meeting at Zimmerwald in Switzerland. It was not called by the International Bureau, but was rather an endeavour to replace that body. It was attended by individual socialists from a number of countries, including France and Germany, which were represented respectively by two syndicalists and two or three members of the minority section of German socialists. Only the Italian Socialist Party was officially represented; even the Swiss took no official cognisance of the meeting. Unanimous declarations were adopted demanding the complete restoration of Belgium, and binding the signatories to work for a lasting peace based on national liberty and no annexations, whether open or disguised. So far as any attention at all was paid to this harmless meeting, it was officially repudiated or adversely criticised by socialist parties in belligerent countries. The fiasco emphasised the bankruptcy of international socialism.

The only other attempt to revive it that need be mentioned was the Stockholm project, which suffered still more complete miscarriage, not through the opposition of governments or the refusal of passports, but through the resistance of trade unions and the inability of Allied socialists to come to an agreement. Whether or not this abortive proposal was inspired by pro-German sympathies, it was favoured by the German government, and the German majority socialists openly boasted of the influence they would exercise at the conference on enemy colleagues. They had good reason to believe they could twist them round their fingers, and with some, eager to be twisted, they would have succeeded. With more they would have failed; the cleft is too deep, and the conference would have come to nothing. Humpty-Dumpty has fallen from the wall and lies broken on the ground.

In conclusion, what of the future? Though the New International is as dead as the Old the idea is not, and the war may eventually provide conditions favourable to a third attempt. That will depend on the course of events which cannot yet be foreseen. But if anything is to come of it, both the spirit and the substance must be different. It must be an affair of the 'proletariate,' not of middle-class socialists. That is to say, it must be formed and run by organised labour, not in name but in fact; and there must be some real solidarity about

it. The International was a make-believe. It professed to represent the solidarity of the 'class-conscious proletariate,' but there was precious little proletariate and no solidarity. As a British delegate put it once, they brought up the heaviest artillery loaded with apple-dumplings. It was a debating society of theorists, who could never agree the moment they approached any practical question, and who did not belong to the class they professed to represent. Sir W. Gilbert created no more whimsical piece of topsy-turvydom than the solidarity of class-conscious proletarianism exhibited to the world by a company of lawyers, authors, journalists, professors, civil servants, teachers, capitalists, and employers shouting out rival theories in a babel of tongues. And their solemnity made it all the more ludicrous. Their intentions were excellent, but the performance was a farce.

A. SHADWELL.

THE FUTURE OF THE PUBLIC HEALTH SERVICES

DE

ESPITE the concentration of public thought and energy upon the war, certain problems, passed on from times of peace, continually thrust themselves forward, and demand solution of difficulties often augmented by the conditions which have prevailed during the last three years. One of these problems is presented by the Insurance Act. Two years prewar experience of this measure had already shown that it was seriously defective; the medical service was unsatisfactory, and was bringing a section of the medical profession into disrepute; the administration was costly and cumbersome, and the financial position of many Approved Societies was unsound. These defects have been increased by the withdrawal of a large number of medical practitioners for service with the army, and the growth of claims for sickness benefit is causing grave anxiety to many Societies. The Government has already come to the rescue, and has partly relieved Societies of the cost of soldiers and sailors disabled in battle. But this can only be regarded as a stop-gap measure, and it is generally recognised that a sweeping reform of the entire Act cannot be long delayed.

When, however, we begin to consider what changes should be effected, we find it impossible to confine our attention to the Insurance Act alone. There is scarcely a branch of the public health services which is not connected in some way with the Insurance Act, and any effective scheme of reform which touches one branch must extend to all. The question of a national medical service must be considered, and the establishment of co-ordination among the central authorities engaged in public health administration, and still more among the local authorities, is an essential condition for the success of any scheme. The object of this article is to outline a scheme for the complete reorganisation of the public health services, and to consider what functions should be discharged by a central public health office or Ministry of Health, and what are best left to be administered by local authorities. As a

preliminary step it is necessary to examine the present system, with a view to noting the main obstacles which militate against sound public health legislation and administration.

A critical study of the steps which have been taken to improve public health during the last twenty or thirty years shows that many of them have failed to achieve their object, owing to lack of knowledge, or inadequate investigation of the problem to be dealt with, or of the suitability of the measures it was proposed to apply. The science of hygiene is complex: new discoveries are constantly widening its boundaries; research continually shows us that views which yesterday seemed established for all time must to-day be abandoned for better-founded theories, to be themselves replaced in their turn as knowledge steadily advances. But the average legislator does not realise this; he is always a stage behind the scientists, clinging to views which they have discarded. He measures the health of a people by their death-rate, with happy unconcern for the principles of standardisation,' and he would learn with surprise that France and Ireland, although their crude deathrates are several points above the English rate, are actually healthier countries than England.

The layman regards all reductions in disease as the result of sanitary and medical science: small-pox was killed by vaccination, typhus has disappeared because we have swept away dirt and overcrowding in our large cities (!), tuberculosis is being robbed of its terrors by better housing, schemes of notification, prevention of infection and sanatoria. That these diseases have disappeared or declined in areas and countries where none of these wise steps have been taken is conveniently ignored, and our debt to Nature for a process of immunisation, so ably described by Archdall Reid, Metchnikoff, and others, is never acknowledged. Prevention of infection is regarded as the great weapon in the attack on infectious disease, hence the disinfection of patients and houses, and the demand for notification and isolation of those affected, regardless of the fact that the isolation of patients in fever hospitals has had little appreciable effect in reducing the prevalence of scarlet fever or diphtheria.

Much of our public health legislation is the outcome of fashionable fads. Thus at the present time it is highly popular to ascribe infant mortality to maternal ignorance and neglect,