LORD LISTER’S FUNERAL. 527 why a considerable proportion of this should not go to the funeral of Queen Mary in 1694, broke in upon the silence medical profession. from the organ. Tnis was followed by Cnopin’s "Marche Maternity bcnefit.-In estimating remuneration on a capita- Funebre," and finally trombones, stationed high up in the tion basis per insured person, some part of the payment triforium, played the Tres Equali of Beethoven. Then from maternity benefit should be excluded, since it will be came, faintly at first, the voices of the choir singing the paid in many cases in respect of persons outside the hymn "Brief life is here our portion," as the coffin was 13,000,000. The Chancellor of the Exchequer estimated borne from the Chapel of St. Faith, where it had rested during that .8500,000 would go to the medical profession from this the previous night, to a high bier at the foot of the altar rails, source, but the grounds for this opinion were not stated. If surrounded by six burning candles. In the front of the fees are raised very much, societies may encourage their procession came the clergy, with the Dean of Westminster, members to obtain the services of midwives rather than Bishop Ryle, at their head. A magnificent wreath of orchids doctors. The profession should, however, secure a sub- and lilies, sent by the German Emperor, and deposited on stantial increase in the fees paid for attendance upon cases the coffin by the German Ambassador while it’ lay in to which they have been summoned under the Midwives Act St. Faith’s Chapel, was carried in front of the coffin. of 1902. Splendid wreaths were also displayed at the altar rails from ______I the Institut Pasteur of Paris, the Congress of German Surgeons, and the Medical Society of Amsterdam. The LORD LISTER’S FUNERAL. coffin was covered with a purple pall, and on it were laid Lord Lister’s three most distinguished orders-the Order ON Friday last, Feb. 16th, the body of the late Lord of Merit, the Prussian Order Pour le M(3fito. and the Lister, the greatest Englishman of his century, the master Grand Cross of the Order of the Danebrog. The pall- surgeon, was buried at Hampstead Cemetery near that of his bearers, in their various official robes, escorted the body. predeceased wife. So much his country, which would fain They were Lord Rayleigh, O.M., representing the Order of have done him the highest honour that lay in its power by Merit; Lord Rosebery, for the University of London ; Lord burial in the national Pantheon, was constrained to yield Iveagh, for the Lister Institute; Sir Archibald Geikie, to his own personal wishes. But it claimed at least the pre- President of the Royal Society ; Sir Donald MacAlister, rogative of first paying final homage by a solemn memorial Principal of Glasgow University ; Sir Watson Cheyne, Bart., service in the historic great Abbey of Westminster. For for King’s College, London; Mr. Rickman J. Godlee, Presi- Lister was a maker of history, not for England only, but dent of the Royal College of Surgeons of England ; and for the human race. No personal skill as a surgeon, however Professor F. M. Caird, for Edinburgh University. Imme- great, could have gained for him the homage and gratitude of diately following were the principal mourners, consisting the entire world. It was the keen observation, the years of of Mrs. Lister, Mr. and Mrs. J. J. Lister, Dr. A. H. patient questioning of Nature’s ways, the illuminating Lister, Mr. and Mrs. W. T. Lister, Miss Lister, Miss insight, the patient demonstration that finally enabled him to E. M. Lister, Miss G. Lister, Dr. and Mrs. A. G. lay a firm foundation for the surgical art-never to be super- Phear, Mrs. R. J. Godlee, Mr. and Mrs. J. Lister Godlee, seded no matter what developments in superstructure it may Mr. and Mrs. A Godlee, Mr. F. Godlee, General Burn, Mr. be called on to sustain-that called forth the splendid tribute T. Godlee, Miss Godlee, Mr. J. Harold Pim, Mrs. Goodbody, of reverence to the remains of Lord Lister from rulers and Miss Pim, Miss C. Pim, Mr. A. Lister Harrison, the Right nations, from the scientists and savants of the earth, and Hon. J. W. Wilson, Mr. and Mrs. Alhright, Mr. and Mrs. from representatives of every rank and class in life among his C T. Barclay, and Mr. Ernest Beck. The Lord Mayor of own countrymen. London (Sir Thomas Crosby, M.D.) and the Lord Provost of Before 1 P.M. the lantern and choir of Westminster Abbey Edinburgh came next, and were followed by the official were filled with official representatives, and a goodly portion delegates from various scientific and learned societies. The of the general public occupied the north transept and aisle French Academy of Science sent its President (Professor and the nave. The King was represented by Sir Frederick Lippmann), and also Professor Chauveau and Professor Dastre; Treves, Queen Alexandra by Sir Francis Laking, and Princess the Institut Pasteur of Paris sent Professor Roux; the French Louise (Duchess of Argyll) by Mr. Oswald Balfour. The Academy of Medicine, Professor Pozzi; the German Congress Prime Minister in person offered the tribute of the nation of Surgeons its President (Professor Garr6) ; the Société de at large. Austria-Hungary, France, Germany, Italy, and Chirurgie de Paris, Sir Victor Horsley ; and the Medical Russia sent their Ambassadors ; Belgium, Denmark, Greece, Society of Amsterdam, Professor Treub. The Royal Society Sweden, Norway, and Portugal their Ministers ; the Chinese of London sent its treasurer, Sir Alfred Kempe ; its secre- Minister was represented by Dr. Wu Lien-Teh ; and Servia taries, Sir Joseph Larmor, M.P., and Sir John Rose Bradford; by its Charge d’Affaires. The Government was represented and its foreign secretary, Sir William Crookes, O.M. ; while the of sent James Dewar. The through the Medical Departments of the Local Government i Royal Society Edinburgh Sir Board and the Board of Education, the Army and Navy Royal College of Physicians of London sent its President, Medical Services, and the West African Medical Staff. Sir Thomas Barlow, Bart.; its Senior Censor, Dr. J. Mitchell representatives of scientific bodies, foreign as well as Bruce ; its Registrar, Dr. J. A. Ormerod ; and Sir Richard British, were present; the Swedish Academy of Science, the Douglas Powell, Bart. The Royal College of Surgeons of Norwegian Society of Science, the Madrid Academy of England sent its Vice-Presidents, Mr. C. W. Mansell Moullin Medicine, the Accademia dei Lincei of Rome, the Imperial and Mr. C. T. Dent ; that of Edinburgh, its President, Mr. Academy of Sciences of St. Petersburg, the British Academy, G. T. Berry; and that of Ireland, its President, Mr. R. H. the Royal Institution, the British Science Guild, the R)yal Woods. The delegates from the University of London were Institute of Public Health, the Hunterian, Royal Micro- Sir Edward Busk (chairman of Convocation), Sir H. Miers scopical, and Zoological Societies, and Kew Gardens, in addi- (Principal), and Sir Philip Magnus, M.P. ; from the University tion to those enumerated below which sent special delegates of Edinburgh, Professor Alexis Thomson; and from the to the procession. The Royal Colleges of Surgeons and of University of Glasgow, the Lord Rector, Mr. Birrell. Other Physicians of the three kingdoms and the Society of delegates were Sir Henry Morris, President of the Royal Apothecaries were represented, as was every University in Society of Medicine ; Mr. Edmund Owen, for the British Great Britain and Ireland, the medical societies, the Edin- Medical Association ; Sir William Ramsay, President of the burgh and Glasgow University Clubs, the Merchant Taylors’ British Association; the Bishop of Exeter, Principal the Company, Epsom College, University College of South Rev. A. C. Headlam, D.D., and Professor J. M. Thomson, Wales, the constituent colleges of the University of London, F.R S., for King’s College, London; Sir David Ferrier and the Norfolk and Norwich Hospital, and the general and Dr. Nestor Tirard for King’s College Hospital. University special hospitals and medical schools of London, Oxford, College sent its Provost, Dr. Gregory Foster ; and University Edinburgh, and Glasgow. College Hospital Medical School its Dean, Mr. Raymond The scene in the Abbey during the interval of waiting was Johnson. truly impressive. A spirit of reverence dwells within those The service was brief but impressive. After the Ninetieth lofty grey walls, and in very truth it hovered over the entire Psalm, .DoMt, Refugitl1n Nost-ritni, had been chanted by the congregation there gathered together. The silence was pro- choir to Purcell’s music, and the lesson from I. Corinthians, found. Notwithstanding a continuous stream of newcomers xv., had been read by the Dean, the choir sang Handel’s ’hardly a sound could be heard, and the demeanour of all was When the ear heard Him," the concluding sentence of grave. Presently Parcell’s exquisite music, composed for the which-" His body is buried in peace, but his name liveth 528 OFFIC(AL MANUAL OF CAUSES OF DEATH. evermore "-was splendidly appropriate. Goss’s anthem, England and Wales complete uniformity will be obtained by 11 I heard a voice," followed, and after the prayers had been the adoption of the standard list at Somerset House and recited by the Precentor, and the hymn, "0 God, our help Whitehall respectively, and the use of the same list will in ages past," had been sung by the congregation, the doubtless be required in the reports of all medical officers of procession was reformed and the body borne on the way to health. This standard list is already published, and will be its final resting place to the solemn roll of the Dead March circulated with the manual itself among medical officers of in I Saul." health generally. Included in the manual will be found To the onlooker, perhaps, the most significant characteristic revised suggestions to medical practitioners in filling up their of the assembled congregation was the spirit of reverence death certificates. We presume that a copy of these sug- that seemed to permeate all present. In a mixed assemblage gestions will be sent to every medical practitioner on the of all religious creeds, containing many, perhaps, owning no Register, and it would certainly be desirable that this should creed, official attendance on an important function is commonly be accompanied by a copy of the manual itself. the of due decorum. In the satisfied with preservation present Classifioation of Causes ot Death. instance, however, there was more than that visible in the In Dr. Stevenson’s the classification of demeanour of everyone. To those of the Church of England the judgment only diseases that is essential in a standard list is that it should ever beautiful service spoke its accustomed words of hope, secure the correct of a cause to one or but in a voice of unusual sweetness. Those of other assignment given faiths, other of the included titles. The order of titles in the list doubtless, translated its significance into terms of their own. he as of less inasmuch as that order But all at least were alike with that view of regards importance, impressed admits of alteration to individual immortality which sees the survival of personality in the according requirements, whereas the user has no means of the of enduring work of one who devotes his life to furthering the modifying grouping death causes under titles. welfare of the human and this was evident race ; particularly Readers of the earlier of the in the case of him who established the relief of human reports Registrar-General will be aware that the order of causes suffering on an everlasting basis. originally adopted by Dr. Farr about the middle of last century was based on anatomical rather than on etiological considerations. On this point, however, it seems reasonable to conjecture OFFICIAL MANUAL OF CAUSES OF that Farr’s preference may have been determined by the DEATH. primitive and unsettled state of etiological knowledge at the time. In any event, the author of the present manual has decided to revert to Farr’s practice, and he does so on IN his Supplement to the Fortieth Annual Report of the the ground of the greater convenience to statistical students Local Government Board, already noticed in these columns,1 that he believes to attach to a regional as compared with a Dr. A. Newsholme foreshadows the removal of some of the causal arrangement. Whether this decision is the wisest defects in our national vital statistics that detract from their in the circumstances experience alone can determine. usefulness for purposes of sanitary administration. Meanwhile it is due to Dr. Stevenson to note his acknow- that " the of causes of death is a Sanitary and Registration Districts. ledgment grouping subject in regard to which there is room for differences of opinion ; to lack of between the areas dealt Owing correspondence and, further, that the individual points which require con- with by the Local Government Board and the National sideration in such a manual as this are so numerous Office the vital preparing Register respectively, comparison among and in some cases so complicated that it will not be sur- statistics of these areas has hitherto been impracticable. prising if critical use of the work reveals a number of defects These defects will shortly disappear, for the Registrar-General in regard to detail, whether the general principles followed has undertaken to substitute districts for sanitary registration prove acceptable or no." or Poor-law districts as the areas for which returns of birth Cr-itwis1n Nerv and death will be published from the year 1911 onwards. of Depa’J’tllre. Moreover, as the cooperation of the Central Statistical In justification of the action of the Registrar-General’s Office may presumably be relied on for the calculation of predecessor, who in the year 1901 revised the official list of local rates of mortality, we doubt not that in such event the death causes, it may be pointed out that in so doing he county as well as the district medical officers everywhere simply followed the example of the Royal College of Phy- will be glad to be relieved of that irksome part of their duty, sicians of London in the decennial revision of the nomencla- so that more time may be available for the discharge of their ture then in course of preparation. On account of the definitely preventive functions. admittedly infective nature of certain diseases, such as The medical officer of the Local Government Board further pneumonia, cerebro-spinal fever, epidemic diarrhoea, &c., the states that the Registrar-General has undertaken to issue to College deliberately transferred them to the class of I I general every medical officer of health a " Manual of Causes of diseases " from their original places among purely local Death " which will contain the new standard tables, and will affections. If the College in its approaching fourth decennial define the contents proper to the various items in the list, revision, pursues the same course respecting several of the showing how each form of death certificate should be so-called " local " diseases, we shall be in nowise surprised. classified. Among adverse criticisms of the new departure may be Nature and Objeot of Man1bul. noted one by Sir John W. Moore, of Dublin, the eminent In fulfilment of this undertaking the present manual has sanitarian and ex-President of the Irish College of Physicians who in a letter to us severely condemns the changes been issued by authority of the Registrar-General. The work ,, has been compiled by Dr. T. H. C. Stevenson, the super- initiated recently in the Registrar- General’s mortality returns. intendent of statistics, Mr. Bernard Mallet’s contribution The gravamen of his charge is that the transference to local affections of such acute infections thereto being limited to a brief minute officially submitting merely unquestioned as the document to his chief. A work on similar cerebro-spinal fever, pneumonia, epidemic diarrhcea, and parliamentary fever from their under the lines but more comprehensive in scope has recently been puerperal rightful position heading published by Dr. Cressy Wilbur, chief statistician to the epidemic diseases places a formidable block in the path of reformers and medical officers of health. The hands United States Census Bureau. It is upon this work, a copy sanitary of the State-medicine clock are back a of of which lies before us, that the English manual is avowedly being put quarter a at least-to as a based, although in preparing the latter many exclusively century pre-notification days. Writing resident in Sir John Moore with concern a American expressions have been omitted, whilst numerous Ireland, regards terms have been added which are in common use here but modification in the list of causes of death which will probably not in the United States. delay the inclusion under the Notification Act of such death- In the work it has been the compiler’s dealing yet preventable maladies as pneumonic fever and projecting present diarrhoea. endeavour to secure the nearest approach to uniformity of epidemic tabulation of facts throughout the United Kingdom. For Continuity with Past National Reoords. reasons given in the introduction the form of the Scottish Dr. Stevenson assures us that the difficulty of arranging and Irish list of causes will not be identical with that of the for the continuity of official records has been almost entirely English list, though the differences will be slight. But in overcome by subdividing some of the titles in the new 1 THE LANCET, Nov. 25th, 1911, p. 1501. 2 THE LANCET, Jan. 21st, 1911, p. 189.