758

much improved, but in some central parts of the town houses were found to be in a deplorable state as regards. Public Dealth and Poor Law. water-supply and drainage. The general mortality was 15 per 1000 living, and the zymotic rate 0’5 per 1000. The LOCAL GOVERNMENT DEPARTMENT. sanitary hospital, which belongs jointly to the urban and- rural authorities, received 38 patients during the year, REPORTS OF MEDICAL OFFICERS OF HEALTH. 24 being cases of scarlatina. Such enteric fever as was found in the district was due to the use of well .-After the polluted making necessary water, and seven cases of impure water are recorded as- corrections for institutions within the district, Mr. C. Roberts having been dealt with. In the Rural District the general. gives the death-rate for last year as 15’6 per 1000. Infant mortality was at the rate of 15’6, and the zymotic mortality death is excessive, and it is held that some legislative at the rate of 0.7 per 1000. As to villages, Dr. Alford seems. to to of that interference is needed as the insurance of the lives object systems sewerage, preferring every regards householder should deal with his own on his own of born infants. The of the of sewage newly drainage village premises. But he admits that, instead of a scheme, which Norwood is now almost and it is to be completed, hoped is, as a rule, most difficult of proper application, the that the cesspits will be got rid of as speedily as possible. tendency is to large cesspits. Defects as to water-supply and drainage were in Hayes found to be associated with and enteric fever; diphtheria VITAL still remains without proper means of drainage; STATISTICS. and in other places, such as Cowley, difficulties in con- nexion with water-supply have been met with. The joint HEALTH OF ENGLISH TOWNS. isolation hospital received 33 patients during the year; IN twenty-eight of the largest English towns 5813 births and it is reported that certain sanitary improvements have and 3712 deaths were registered during the week ending been effected generally and especially in and in April 6th. The annual rate of mortality in these towns, . which had been 21-3, 20-8, and 19-9 per 1000 in the pre- Caxton and St. Neots Combioed District. - Speaking ceding three weeks, rose again last week to 20’3. During generally of the water-supply of these districts, Mr. Poyntz the thirteen weeks of last quarter the death-rate in Wright states that great difficulty is met with as regards these towns averaged 20’9 per 1000, and was 2’8 below the the rural areas; whereas, by means of the East Huntingdon mean rate in the corresponding periods of the ten years waterworks, the town of St. Neots may shortly be 1879-88. The lowest rates in these towns last week were expected to have an abundant and a wholesome supply. 12’9 in Brighton, 16’3 in Portsmouth, 17’3 in Leicester, and It is also to be hoped that several villages in the rural 17’4 in Halifax. The rates in the other towns ranged districts, through which the mains run, may before long upwards to 26’4 in Oldham, 27-8 in Manchester, 30’0 in be benefited in the same way. As to others, the different Preston, and 30’6 in Blackburn. The deaths referred to. methods of possible supply are discussed at some length, the principal zymotic diseases in these towns, which had the question being obviously an important one; and this the been 469 and 421 in the preceding two weeks, rose again last more so because of the frequent risk to which local wells are week to 464; they included 175 from measles, 125 from subjected by reason of cesspools, leaky house drains, &c. whooping-cough, 48 from scarlet fever, 48 from diarrhoea, The establishment of a small joint isolation hospital on the 47 from diphtheria, 21 from "fever (principally enteric), outskirts of St. Neots is strongly advocated. During 1888 and not one from small-pox. These zymotic diseases. the death-rates from all causes were as follows : Caxton and caused the lowest death-rates in Derby, Halifax, and Arrington rural district 14’3, St. Neots rural district 13’1, Huddersfield; and the highest rates in Blackburn, Preston, and and St. Neots urban district 13’3 per 1000 living. Bolton. The greatest mortality from measles was recorded. Ilkley Urban District.—Dr. Thomas Scott contrasts the in Bristol, Norwich, Manchesier, Preston, Blackburn, and present sanitary state of Ilkley with that which prevailed Bolton ; from whooping-cough in Birmingham, Nottingham, in 1871 as regards water-supply, sewerage, burial ground, Wolverhampton, Plymouth, Bolton, Oldham, Bradford, and and hospital provision, all these matters being now in an Preston; from scarlet fever in Oldham, Blackburn, and efficient state; and he may justly lay claim to a share in Sheffield ; and from "fever" in Preston. The 47 deaths promoting measures such as these, which have tended from diphtheria in the twenty-eight towns included 26 in to the health and well-being of the town. Last year the London, 4 in Salford, 3 in Manchester, 3 in Liverpool, and death-rate, after elimination of visitors, was only 10’4 per 2 in Sunderland. No death from small-pox was registered 1000; the cold summer having been more favourable to the in any of the twenty-eight great towns; and only 1 small- vital statistics than to the financial prosperity of this holiday pox patient was under treatment at the end of the week resort. in the Metropolitan Asylum Hospitals and in the High- Teignmouth Urban District. - Though much sanitary gate Small-pox Hospital. The number of scarlet-fever work is reported to have been effected in this district patients in the Metropolitan Asylum and London Fever during the past year, much still remains, according to Hospitals at the end of last week was 580, against 569 and Dr. Piggott, to be done. A new bore-hole for water has 579 in the preceding two Saturdays; 47 cases were admitted been completed, and the supply now available is stated by to these hospitals during the week, against 58 and 41 in tha Dr. Frankland to be of the nrst quality. The new sewerage preceding two weeks. The deaths referred to diseases of system works well in all the localities to which it has been the respiratory organs in London, which had declined in tha applied, but the internal sanitary state of a large number of preceding four weeks from 402 to 332, rose again last week houses remains most defective. For a town like Teignmouth, to 364, but were 110 below the corrected average. The it is most discreditable to find that in 307 houses having so- causes of 82, or 2-1 per cent., of the deaths in the twenty- called waterclosets there is no flushing apparatus whatever eight towns last week were not certified either by a regis- to the closets, and some of these structures have not un- tered medical practitioner or by a coroner. All the causes naturally been found to be the medium of spreading the of death were duly certified in Sunderland, Leicester, Bolton, contagium of enteric fever. A large amount of highly useful and in five other smaller towns. The largest proportions. work is shown to have been performed in the nuisance of uncertified deaths were registered in Halifax, Bradford, and disinfection is carried out and Hull. department, efficiently by ___ means of a solution of perchloride of mercury coloured with aniline blue. Making a deduction for visitors, the annual HEALTH OF SCOTCH TOWNS. death-rate from all causes is given as 14’6 per 1000; the The annual rate of mortality in the eight Scotch towns, so-called zymotic rate was 0’41 per 1000; and the deaths of which had been 25’4,23’4, and 22’1 per 1000 in the preceding infants under one year of age were at the rate of 111 per three weeks, further declined to 21-8 in the week ending 1000 registered births. April 6th; this rate exceeded, however, by 1’5 per 1000 the Taunton Urban District,—Dr. Alford congratulates the mean rate during the same period in the twenty-eight large borough on a low death-rate, and this especially from English towns. The rates in these Scotch towns ranged last zymotic diseases, which in former years were somewhat week from 7’3 and 15’4 per 1000 in Greenock and Aberdeen, formidable. The water-supply is pure and abundant, and to 22-4 in Paisley and 28 -8 in Glasgow. The 558 deaths the flushing of sewers is well carried out. But sewer in the eight towns showed a further decline of 7 from the ventilation is far from satisfactory, and advice to deal with numbers in recent weeks, and included 41 which were re- the matter is disregarded. Dwelling accommodation has ferred to whooping-cough, 31 to measles, 8 to diphtheria, 759 6 to diarrhoea, 3 to "fever" (principally enteric), 1 to scarlet fever, and not one to small-pox; in all, 90 deaths resulted from these principal zymotic diseases, against 85 and 92 in Correspondence. the preceding two weeks. These 90 deaths were equal to an annual rate of 3’5 per 1000, which exceeded by 1 ’0 the mean rate from the same diseases in the twenty-eight ROYAL COLLEGE OF SURGEONS: THE English towns. The fatal cases of whooping-cough, which had been 31 and 37 in the preceding two weeks, further DRAFT BILL. rose last week to 41, and included 29 in Glasgow, 5 in Edin- To the Editors of THE LANCET. and 4 in Dundee. The deaths from which burgh, measles, honour to the amended had been and 36 in the three declined SiRS,—I have the forward you 45, 33, previous weeks, draft of the Bill to into Parliament to amend last week to of which 28 occurred in The 8 be introduced 31, Glasgow. the constitution of the of The deaths referred to showed an increase of 4 Royal College Surgeons. diphtheria upon is form a full of the the number in the and included 6 in enclosed the finally adopted at meeting previous week, Glasgow Committee the of and 2 in Dundee. The fatal cases of "fever" and of Parliamentary appointed by meeting Fellows and Members of the 28th the committee scarlet fever were below the average ; and the ult., considerably been on 4th Mr. 6 deaths attributed to diarrhoea included 4 in and meeting having held Thursday, the inst., Glasgow T. Holmes in the chair. is once to 2 in Aberdeen. The deaths referred to the diseases It intended at press the principal Bill forward in the House of Commons. of the respiratory organs, which had been 173, 132, and 137 in the three further declined last week I am, Sirs, your obedient. servant, preceding weeks, WM. ASHTON to and were 18 below the number in the ELLIS, 124, corresponding Hon. Sec. to the Committee. week of last year. The causes of 62, or more than 11 Grosvenor-road, Westminster, April 10th, 1889. of the deaths the week were per cent., registered during Bill to Amend the Constitution the not certified. Draft of Royal College of Surgeons of ___ England. Whereas it is expedient to amend the constitution and government of HEALTH OF DUBLIN. the Royal College of Surgeons of England and to declare and give effect The rate of in which had been 26’ to certain of the rights of the Members thereof, be it enacted, &c. mortality Dublin, of said shall and 27’6 in the two declined to 25’7 ir 1. No Member the College hereafter be disqualified from preceding weeks, being elected to, or holding, any place or office in the College by reason the week ending April 6th. During the thirteen weeks oi of his not being a Fellow of the College, except as hereinafter provided. last quarter, the death-rate in the city averaged 28’6 pei 2. The President, Vice-Presidents, and Council of the College shall be elected the Members of the but the Council shall be em- 1000, the mean rate the same 19.5 in by College, during period being powered to provide by bye-law that no Member who shall be of less than London and 19.0 in Edinburgh. The 174 deaths in Dublin ten years’ standing shall exercise the said electoral franchise unless he showed a decline of 13 from the number in the preceding has been admitted to the Fellowship of the College. are and week; they included 2 which were referred to measles, 3. The Members shall be entitled freely to meet together 2 to 2 to 1 to and not within the College at all reasonable times, to consider and resolve con- "fever," whooping-cough, diphtheria, cerning the affairs of the College, and any resolutions passed at any one either to small-pox, scarlet fever, or diarrhoea. Thus Snch meeting by a two-thirds majority of the Members voting, concern- the deaths from these principal zymotic diseases, which ng the bye-laws or the expenditure of the College, shall be binding on had in the four weeks between 15 and 8, jhe Council. ranged previous 4. Section 17 of the bye-laws of the College, and all action taken or to further declined last week to 7 ; they were equal to an annual )e taken thereunder, is hereby declared to be invalid. rate of 1’0 per 1000, the rates from the same diseases being 5. So soon as may be after the next annual election for the Council, 2’3 in London and 1’2 in The 2 deaths from he Council shall make such provision by bye-law as may be necessary Edinburgh. or fully out the of this and shall have "fever" showed a further decline from the numbers in carrying provisions Act, power ,herein to provide that not more than a fixed number of places on the recent weeks; and the 2 from measles were fewer by 2 council, not being less than six, shall be filled by Members who are than the number in the previous week. The fatal case of not Fellows of the College, and that such Members shall be of twenty ’ears’ or of such less as the Council deem was the first recorded in the since standing standing may diphtheria city and the Council shall forthwith for the of the The deaths infants ufficient, provide by bye-law voting beginning year. of ,t any election by voting papers, and shall have power from time to showed a marked decline from the number in the pre- ime, by bye-law, to amend the manner of election of Examiners, and to vious week, while those of elderly persons exceeded the Iter the said distribution of places on the Council, and to shorten the number in the week 3. Five deaths from erm of office of the members of the Council-provided always that no previous by uch bye-law shall be binding until it shall have been adopted by a violence and 4 cases were and 67, or eneral of the inquest registered; meeting College. - more than a third, of the deaths occurred in public institu- tions. The causes of 15, or more than 8 per cent., of the To the Editors of THE LANCET. deaths in the city were not certified. SIRS,—At the special meeting of the Birmingham and Midland Counties Branch of the British Medical Associa- tion, held on the 3rd inst., Mr. Lawson Tait, in moving his THE SERVICES. resolution approving of the Bill about to be introduced into Parliament, made the following statement, which, in spite )f contradiction, was not adhered to him, but ARMY MEDICAL Herbert Dent only by STAFF.-Surgeon Crowley accepted by very many of those present--viz., "that the has retired half on account of ill health upon temporary pay najority of the Members of the College were precluded from dated March 31st, 1889). )btaining the Fellowship by the extra certificates required ARMY MEDICAL RESERVE OF OFFICERS.-Acting Sur- f them prior to admission to the examinations, including geon Geo. Gordon Sparrow, 1st Volunteer Brigade, Southern me of two years’ extra study at a hospital recognised by Division, Royal Artillery, to be Surgeon, ranking as Captain he College." In order to correct this erroneous impression, (dated April 10th, 1889). fhich, to my surprise, I found to exist in the minds of INDIAN ARMY.—The Queen has approved of the retire- liany who should be better informed, I ask you to kindly ment of Surgeon-Major R. Crossing Thorpe, M.D., Bombay nsert the enclosed letter from the Secretary of the Royal Medical Establishment, being antedated to April 14th, 1883. ;ollege of Surgeons of England. ADMIRALTY.-In accordance with the provisions of Her I am, Sirs, yours faithfully, Majesty’s Order in Council of April lst, 1881, Deputy Birmingham, April 10th, 1889. Inspector-General of Hospitals and Fleets Francis William [COPY.] Davis has been placed on the Retired List, at his own Royal College of Surgeons of England, Lincoln’s-inn-Fields request, with permission to assume the rank of Inspector- London, W.C., 9th day of April, 1889. General of Hospitals and Fleets (dated April 4th, 1889). MY DEAR SllR,-In reply to your letter of the 8th inst., VOLUNTEER CORPS.—The London Gazette of the 9th inst. inquiring what are the conditions on which Members of the contains the names of 341 medical men who have been College are admissible to the examinations for the Fellow- granted rank under Army Order 77 of 1889. The rank in ship, I have to refer you to Section II. of the enclosed each case will bear date Feb. 1st, 1889. The appointments Regulations, from which you will see that a Member of the areas follows :-65 Surgeons-Major, ranking as Lieutenant- College is admissible to the first professional examination Colonels ; 101 Surgeons-Major, ranking as Majors; 1 Hono- without the production of any certificates and to the rary Assistant Surgeon, promoted to the rank of Sur- second professional examination, after passing the first geon ; and 174 Acting Surgeons, promoted to the rank of examination, on producing evidence of having been en- ’Surgeon. gaged not less than six years in the study or study and