VITAL STATISTICS OF LONDON DURING MARCH, 1894. 969 aged upwards of sixty years ; the deaths both of infants principal] zymotic diseases in London; of these, 373 resulted and of elderly persons showed a decline from those recordedfromJ measles, 236 from whooping-cough, 212 from diph- in recent weeks. Seven inquest cases and 3 deaths fromtheria,1 72 from scarlet fever, 44 from enteric fever, 41 from violence were registered ; and 50, or nearly a third, of thediarrhoea, and 1 from small-pox. These 979 deaths were deaths occurred in public institutions. The causes of 15, equal to an annual rate of 2’9 per 1000, against 3’1, 2’9, or nearly 10 per cent., of the deaths in the city last weekand 2’5 in the preceding three months. No fatal case of any were not certified. of’ these zymotic diseases was recorded last month in - during London City; in the other sanitary districts the lowest VITAL STATISTICS OF LONDON DURING MARCH, 1894. zymotic death-rates were recorded in St. Luke, Stoke In the accompanying table will be found summarised Newington, Woolwich, and Strand; and the highest in complete statistics relating to sickness and mortality during St. George-in-the-East, Poplar, Bethnal Green, Limehouse, March in each of the forty-three sanitary districts of Rotherhithe, Fulham, and Mile End Old Town. Only 1 fatal case of was London. With regard to the notified cases of infectious small-pox registered in London during the month under disease in the metropolis during last month, it appears that notice, the corrected average number in the of the the number of persons reported to be suffering from one or corresponding periods preceding ten years being this case to Plumstead other of the nine diseases in the accompanying table was 16 ; belonged sanitary district. The deaths referred to measles were equal to 8’9 per 1000 of the population, estimated at 373 165 above the corrected the various 4,349,166 persons in the middle of this year. In the pre- average number ; among sanitary ceding four months the rates had declined from 20’5 to 9’1 districts this disease showed the highest proportional St. Lime- per 1000. Among the various sanitary districts the rates fatality in Fulham, Hackney, George-in-the-East, Mile End Old St. last month were considerably below the average in Hammer- house, Town, Poplar, George Southwark, smith, Westminster, StokeNewington, St. Martin-in-the-Fields, Bermondsey, and Rotherhithe. The 72 fatal cases of scarlet City of London, Whitechapel, and St. Saviour Southwark ; fever exceeded by 8 the corrected average number; this. disease was most fatal in Limehouse and Mile while they showed the largest excess in Holborn, Bethnal proportionally Green, Mile End Old Town, Poplar, Rotherhithe, Battersea, End Old Town sanitary districts. The 212 deaths referred Greenwich, and Lee. The prevalence of small-pox in to diphtheria were more than double the corrected average ;P the various districts this disease showed the London showed a decline March, an average of among sanitary slight during in 15 cases weekly being notified, against 20, 12, and 16 in highest proportional fatality Fulham, Westminster, Bethnal and Plumstead. The 236 fatal the preceding three months ; of the 60 cases notified during Green, Greenwich, last month, 13 belonged to Poplar, 5 to Islington, 4 to cases of whooping-cough were 72 below the corrected St. Pancras, and 4 to Mile End Old Town sanitary districts. average ; this disease was proportionally most fatal in The Metropolitan Asylum Hospitals contained 56 small-pox Clerkenwell, Bethnal Green, Whitechapel, Mile End Old patients at the end of March, against 82, 70, and 68 at the Town, Bermondsey, Greenwich, and Plumstead sanitary end of the preceding three months ; the weekly admis- districts. The 44 deaths referred to enteric fever slightly sions averaged 12, against 13 in each of the preceding two exceeded the corrected average ; there was no marked excess months. The prevalence of scarlet fever in London showed of enteric fever mortality in any of the sanitary districts. a slight further decline from that recorded in recent months; The 41 fatal cases of diarrhœa were below the corrected this disease was proportionally most prevalent in St. George average. In conclusion, it may be stated that the mortality Hanover-square, Hackney, Holborn, Limehouse, Mile End in London during March from these principal zymotic diseases Old Town, St. George Southwark, Rotherhithe, Battersea, exceeded the average by nearly 26 per cent. Greenwich, and Lee sanitary districts. The Metropolitan Infant mortality in London during the month under notice, Asylum Hospitals contained 2070 scarlet fever patients at the measured by the proportion of deaths under one year of age end of March, against 2873, 2404, and 2139 at the end of to registered births, was equal to 136 per 1000 ; the lowest. the preceding three months ; the weekly admissions averaged rates were recorded in St. Giles, St. Luke, St. Saviour 213, against 244 and 207 in the preceding two months. Southwark, Rotherhithe, Wandsworth, and Lee ; and the Diphtheria also showed a slightly decreasing prevalence highest rates in Fulham, St. Martin-in-the-Fields, Strand,. St. during the month under notice ; among the various sani- George-in-the-East, St. George Southwark, and Newington. tary districts this disease showed the highest proportional prevalence in Chelsea, Shoreditch, Bethnal Green, St. George-in-the-East, Mile End Old Town, Poplar, New- THE SERVICES. ington, Rotherhithe, and Greenwich. There were 307 cases of diphtheria under treatment in the Metropolitan Asylum Hospitals at the end of March, against 283, 320, and MOVEMENTS OF THE MEDICAL STAFF. 303 at the end of the preceding three months ; the SURGEON-COLONEL COGAN has, on arrival from the Straits weekly admissions averaged 64, against 64 and 65 in the Settlements, been appointed Principal Medical Officer at preceding two months. The prevalence of enteric fever Belfast. Surgeon-Major Dick has arrived from Singapore on showed a further decline during last month ; among the completion of a tour of foreign service. Surgeon-Major various sanitary districts this disease was proportionally Mitchell has embarked for India on return from leave. most prevalent in Chelsea, Clerkenwell, Limehouse, and Brigade - Surgeon - Lieutenant - Colonel O’Reilly has been Greenwich. Erysipelas showed the highest proportional appointed to the charge of the Station Hospital at Gosport, prevalence in St. Pancras, St. Luke, Shoreditch, Bethnal relieving Brigade-Surgeon-Lieutenant-Colonel White, who has. Green, and Battersea sanitary districts. Three cases of been appointed Disembarking and Recruiting Officer. Sur- puerperal fever were notified in Marylebone, in Islington, in geon-Captain Wilson has embarked for service on the West Lambeth, and in Wandsworth sanitary districts. Coast of Africa, and Surgeon-Captain O’Callaghan has The mortality statistics in the accompanying table relate arrived in England from Cyprus on completion of tour. to the deaths of persons actually belonging to the various Surgeon-Major Irvine has obtained leave of absence from sanitary districts, the deaths occurring in the institutions of Gibraltar. London having been distributed among the various sanitary ARMY MEDICAL STAFF. districts in which the patients had previously resided. Clement Sumner Robinson is placed on The distribution of these of those Surgeon-Captain deaths, especially temporary half-pay on account of ill-health. resulting from zymotic diseases, affords the most trust- INDIA AND THE MEDICAL worthy data upon which to calculate reliable rates of INDIAN SERVICE. mortality. During the four weeks ending Saturday, The following appointments are announced : Brigade- March 31st, the deaths of 6597 persons belonging to London Surgeon-Lieutenant-Colonel C. T. Peters, M.B., to act as ’ were registered, equal to an annual rate of 19’8 per 1000, Civil Surgeon, Satara ; Surgeon-Captain S. E. Prall, M.B., against 23-0 and 19-1 in the preceding two months. The B.S., to act as Civil Surgeon, Bijapur. Surgeon-Captain lowest death-rates during March in the various sanitary J. M. Crawford, Officiating Civil Surgeon, Azamgarh, to districts were 11’7 in Wandsworth, 12 6 in Hampstead and officiate as Superintendent, Central Gaol, Allahabad, pro tem. in Stoke Newington, 15’2 in Plumstead, 15’3 in Battersea, Surgeon-Captain L. J. Pisani, Civil Surgeon, Jaumpur, to hold 15’7 in Lewisham, and 16’4 in Lee ; the highest rates were Visiting Medical Charge of the Azamgarh District, in addition 26’2 in Bermondsey, 26-5 in St. George Southwark, 27-0 in to his other duties. Surgeon-Captain J. C. S. Vaughan, of Limehouse, 27’7 in Mile End Old Town, 28-2 in St. George- Monghyr, to act as Resident Physician, Medical College Hos- in-the-East, and 36-8 in St. Martin-in-the-Fields. During pitals, and Professor of Pathology, Medical College, Calcutta, the four weeks of March 979 deaths were referred to the pro tem. Surgeon-Captain Narendra Prosunno Sinha, Deputy 970 NEW SOCIETY OF FELLOWS OF THE ROYAL COLLEGE OF SURGEONS.

Sanitary Commissioner, Western Bengal Circle, to act ass H.M.S. Serapis sailed from Bombay on March 27th with Civil Surgeon of Jessore. Surgeon-Captain H. M. Morris,, 367 patients for Netley. Officiating Civil Surgeon, Jessore, to act as Civil Surgeon The Drugs Commission met at Calcutta from of H. E. Hemp Monghyr. Surgeon-Captain Drake-Brockman,’ March 28th to April 5th. Civil is transferred from to Officiating Surgeon, Mirzapur The Broad Arrow states that the of Muttra. G. A. Emerson, Civil Surgeon, isg appointment Registrar Surgeon-Major and to the Medical Officer at is transferred from.Muttra to Mirzapur. Surgeon-Captain R. C.- Secretary Principal Netley Macwatt, M.B., I.M.S, Bengal Establishment, Medical now vacant, and it is probable that Surgeon-Major Pope, now in that will be confirmed in this Officer, 6th Bengal Infantry, employed on probation ass officiating capacity, Superintendent of the Central Gaol, Raipur, is confirmed in appointment. that appointment. Surgeon-Captain Melville, in succes- The annual dinner in connexion with the Liverpool Volun- sion to Brigade-Surgeon-Lieutenant-Colonel Lyons, A.M.S.,, teer Medical Staff was held at Liverpool on April 5th, Sur- whose tour has expired, expected from England for duty geon-Colonel T. M. Wills, V.D., in the chair. There was a in India, has been posted to the Bombay Command. The3 large attendance, and among the guests were Surgeon. of services Brigade - Surgeon- Lieutenant- Colonel Stephen,, Colonel Muir, P.M.O., Brigade-Surgeon Nicholson, Surgeon ’Sanitary Commissioner, Punjab, have been temporarily placed MacSwiney, R.N. ; Surgeon-Majors Hopper (8th L.V.A.), at the disposal of the Military Department. Surgeon-Lieu-- Fleetwood (4th V.B.), Westby (2nd V.B.), Surgeon-Captains tenant-Colonel W. A. C. Roe officiates as Sanitary Com-- Damer Harrisson (Duke of Lancaster’s Own Yeomanry .missioner, Punjab. Brigade-Surgeon-Lieutenant-Colonel Cavalry), Roberts (lst V.B.), Barnes (6th V,B.), Crozier Professor of in the Medical Raye, Surgery College, Calcutta,, (lst V.B.), Archer; Surgeon-Lieutenants Cornett (lst L.V.A.), will act for Surgeon-Colonel Cleghorn, Inspector-General off Gemmell, and Stevenson (2nd L.V.A.), and Dr. Sutherland. Civil Hospitals, Bengal, who proceeds home on eight months’ leave. NAVAL MEDICAL SERVICE. The following appointments are notified: Staff-Sur- geons : R. Bentham to the Colossus; T. R. Pickthorn to the Undaunted; Surgeons : R. F. Bowie to the Calypso ; T. D. Correspondence. Halahan to the Wildfire. " Audi alteram partem." ARMY MEDICAL RESERVE OF OFFICERS. Surgeon-Major George Wyndham Murphy, having resigned THE NEW SOCIETY OF FELLOWS OF THE his Volunteer appointment, ceases to be an officer of the Army ROYAL Medical Reserve of Officers. COLLEGE OF SURGEONS OF ENGLAND. YEOMANRY CAVALRY. To the Editors of THE LANCET. Lanarkshire (Queen’s Own Royal Glasgow) : Surgeon-Lieu- tenant (Honorary Surgeon-Major) J. C. Woodburn, M.D., SIRs,-I attended the meeting held on April 5th, under resigns his commission. Mr. Page’s presidency, about the formation of the new Society VOLUNTEER CORPS. of Fellows of the College of Surgeons of England. My was to if the views of 6th Volunteer the Scots object chiefly ascertain, possible, Rifle: Battalion, Royal (Lothian those who wish to form such a I of A. to be Sur- society. was, course, Regiment) : Surgeon-Major Ballantyne, M.D., aware that if its formation had been determined on no Volunteer the geon-Lieutenant-Colonel. -4th Battalion, which the members of the Association Devonshire Second Lieutenant Cornelius Fredk. opposition existing Regiment : of Fellows could offer would the trial of a rival Glinn to be Volunteer prevent Surgeon-Lieutenant.-3rd (Dumfries) society ; but I thought that a plain statement to the Battalion, the King’s Own Scottish Borderers: Surgeon-Lieu- meeting of the objects contemplated by the Fellows’ tenant R. Baillie Macbean, M.B., resigns his commission.- which have been secured ’2nd Volunteer Battalion, the East Lancashire Association-objects partly by Regiment : the perseverance of that body through ten years of Andrew Macgregor Sinclair, M.B., to be Surgeon-Lieutenant; arduous have elicited from the of Thomas to be Volun- struggle-must proposers Holt, M.B., Surgeon-Lieutenant.-3rd the new some indication whether adhere to or teer Battalion, the Queen’s Own West Kent society they (Royal Regi- differ from those objects. I was ably seconded in this effort ment) : Lewis Thomas Fraser Bryett, M.D., to be Surgeon- Mr. and the circular issued the Association had Lieutenant. by Norton, by I believe Fellow in the room. But VOLUNTEER OFFICERS’ DECORATION. recently reached, every my expectations were wholly disappointed. No word fell from At time in the House of Commons on question Tuesday Mr. Page or his associates to indicate whether they agree or TMr. of the of State for Birkmyre inquired Secretary War differ with us. The vague and unmeaning words of Mr. whether it was case the that the decorations given to Volun- Page’s circular were supplemented by speeches equally teer officers of were twenty years’ standing withheld from vague. We were told that it was very improper to have any officers who had served of that time in the part ranks, and, definite opinions or objects, and "quite fie-fie " to take steps if whether so, he proposed to adopt a plan by which the for the purpose of getting such opinions supported by votes decoration would be conferred on all officers who had com- in Council. We are left, then, to our own interpretation of pleted twenty years’ service as volunteers, altogether irre- the language and action of the founders of this society. spective of the rank they had held during any part of their Fortunately this is very easy. Apart from the questions of of his period service.-In reply, Mr. Campbell-Bannerman detail which crop up from time to time, there are two definite that the case was not as Mr. said quite Birkmyre supposed. parties among the Fellows-the one which wishes for a new ’The Royal Warrant expressly stated that half the time in the charter by which a larger share in the management of the ranks counted as service towards the twenty years’ service College shall be given to the general body, and the other necessary to qualify for the Volunteer officers’ decoration. which is satisfied with the existing order of things. In Officers of twenty years’ service in all, who might not be order that there might be no mistake as to which side the qualified for the officers’ decoration, would be eligible for the promoters of the new society belong, we put the views and 1fong service badge which is to be given to Volunteers of the claims of the present association prominently before the twenty years’ service. meeting, and urged those who are in favour of our views to THE RUPEE AND EXCHANGE. join us. As no reply was vouchsafed either by the chairman or the other we can officers and others in and by speakers, only conclude, that they To European serving India, par- think that the charter the Fellows in their to married medical officers, the rate of is a present puts ticularly exchange in the in which case their serious to the Times India there is proper position College, society question. According of will be an obstacle to all substantial reform. I am not no of immediate for that of the promise improvement, journal motives or blame. 24th ult. states that " the looks as if it would fall as imputing any implying any They may rupee have the most towards us I believe ’the thermometer here rises. " friendly feelings (and many of them really have), but the existence of a society THE NAVAL SUPPLEMENTAL FUND. of this kind must necessarily strengthen the obstructive At the quarterly meeting of the directors of this fund, held party. I hope, therefore, you will allow me to use your on Tuesday, April 10th, Inspector-General T. Russel Pick- powerful aid in urging on all the Fellows who think with us thorn in the chair, the sum of E53 was distributed among the necessity of joining the association and promoting the the several applicants. election into the Council of Fellows who o will support their