917 the premature exercise of the intellectual functions, the use been 16 6, 16 6, and 17’ 2 per 1000 in the three preceding of spirituous drinks, of high seasoned food, &c. ; and, on the weeks, declined again last week to 17’0 0 per 1000. In other hand, that the increase of the muscular action should London the death-rate was 17’ 2 per 1000, while it averaged be encouraged ; that cold lotions should be frequently laid 16’ 9 per 1000 in the 75 other large towns. The lowest upon the head, and that, according to ancient usage, mild death-rates in these towns were 9’ 0 in Kings Norton, 9’ 3 aperients should occasionally be given.-Journal der Prac- in Hornsey, 10 - 7 in Wallasey, 11’0 in Stockton-on-Tees, 11’ 3 tischen Heilkunde. in Devonport, 11 - 4 in Tottenham, and 11-8 8 in Walthamstow, Perhaps the Doctor’s advice may be useful in Germany, Warrington, and Rotherham ; the highest rates were 21 ’0 in but we believe it would be a difficult thing to find out a Wolverhampton and in Preston, 21’4 in Salford, 21’5 case of hydrocephalus occasioned by precocity of intellect on in Bootle, 22-2 in Smethwick, 23-1 in Burnley, 24-7 this side of the channel. The stomachs of the dear little ones in Merthyr Tydfil, 25-7 in St. Helens, and 28-5 in are more frequently crammed than their brains. Wigan. The 4905 deaths in these towns last week included 492 which were referred to the principal infec- tious diseases, against 453, 501, and 483 in the three pre- ceding weeks ; of these 492 deaths 163 resulted from measles, and 111 from whooping-cough, 72 from diphtheria, 66 from Public Health Poor Law. diarrhoea, 42 from scarlet fever, 26 from " fever " (principally enteric), and 12 from small-pox. No death from any of LOCAL GOVERNMENT BOARD. these diseases was registered last week in Hastings, Bourne- mouth, Devonport, Burton-on-Trent, King’s Norton, Barrow- or while the REPORTS OF INSPECTORS OF THE MEDICAL DEPARTMENT OF in-Furness, Halifax, York, Newport (Mon.) ; death-rates from the infectious diseases THE LOCAL GOVERNMENT BOARD. highest principal were recorded in Willesden, Tottenham, East Ham, West On the Prevalence of Diphtheria in the Risborough Bromwich, Grimsby, Wigan, Rhondda, and Swansea. The Registration Sub-distract, forming part of the Wyconebe greatest proportional mortality from measles occurred in Rural 1Jistrict, by Dr. E. P. MANBy.l-This report deals Croydon, Tottenham, East Ham, Leyton, Walthamstow, mainly with the prevalence of diphtheria during two years, Wolverhampton, Wigan, Manchester, Salford, and Swan- 1900-02, in the villages of Princes Risborough and Monks sea ; from scarlet fever in Great Yarmouth and Roch- Risborough in Buckinghamshire. During this period there dale ; from diphtheria in Hornsey, West Bromwich, and were only two months in which no cases of diphtheria were Middlesbrough ; from whooping-cough in Croydon, notified trom the Risborough registration sub-district; in all, Willesden, West Ham, Leyton, Southampton, Grimsby, 69 cases of the disease occurred among a population of some Stockport, and St. Helens ; from "fever" in Hudders- 6000. Dr. Manby pays special attention to the influence of field ; and from diarrhoea in West Bromwich and Grimsby. school attendance in fostering diphtheria. This was particu- Six fatal cases of small-pox were registered in Liver- evident in connexion with the Monks larly Risborough pool, three in Birmingham, and one each in Aston Manor, school, and it is noteworthy that in June, 1902, when the Wallasey, and Hull, but not one in any other of the 76 large prevalence of diphtheria had practically came to an end, the towns. The number of small-pox cases under treatment in children at this school showed an unusually high proportion the Metropolitan Asylums hospitals, which had been five, of "unhealthy throats " when compared with those at other six, and seven in the three preceding Saturdays, was schools in the neighbourhood. Dr. Manby gives the again seven on Saturday, the 21st inst. ; two new cases following table showing the conditions of the throat observed were admitted during the week, against two in each of by him :— the two preceding weeks. The numbeJ of scarlet fever cases in these hospitals and in the London Fever Hos- pital at the end of last week was 1789, against 1851, 1790, and 1798 at the end of the three preceding wseks ; 133 new cases were admitted during the week, against 197, 193, and 231 in the three preceding weeks. The deaths referred to diseases of the respiratory organs in London, which had been 271, 251, and 258 in the three preceding weeks, further rose last week to 282, but were 236 below the corrected average number. The causes of 45, or 0 9 per cent., of the deaths in the 76 large towns last week were not certified either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in Bristol, Nottingham, Manchester, Salford, Leeds, New- All these schools, and Monks Risborough school in particular, castle-on-Tyne, and in 49 other smaller towns ; the largest were much in need of as ventilation. improvement regards proportions of uncertified deaths were registered in Ports- Samples of dust taken from the bare brick walls were mouth, Birmingham, Liverpool, St. Helens, Preston, and examined, but no evidence of the presence of the diphtheria Sunderland. bacillus was found. Disinfection of the school buildings ____ and in appears to have been very inadequately performed HEALTH OF SCOTCH TOWNS. this and numerous other matters Dr. found the Manby The annual rate in of the administration the rural district of mortality eight principal sanitary by Wycombe Scotch which had been 18 5, and 19-7 1000 council extremely unsatisfactory. The inspector of towns, 17-7, per in the three weeks, further rose to 20’ 1 per nuisances ’’ had no book on sanitation or sanitary law to preceding 1000 during the week ending March 21st, and showed an show me of more recent date than 1873-two years before excess of 3 1 1000 over the mean rate the same the Public Health Act was The district per during present passed." in the 76 towns. The rates in the council to little heed to the advice to it period large English appears pay given I Scotch towns from 14 9 in Aberdeen and 18 3 its medical officer of Dr. J. D. who for eight ranged by health, Dickson, in to 21 6 in Leith and 21 ° in Perth. The 657 has done his best, in face of dis- Paisley, many years persistent deaths in these towns included 32 which were referred to and of a which seems couragement salary quite inadequate, 14 to to six to to obtain in the conditions of whooping-cough, diarrhoea, eight measles, improvement many insanitary scarlet five to and three to In the district. It is to be that the of fever, "fever," diphtheria. hoped publication all 68 deaths resulted from these principal infectious this report will effect a much-needed for the better. change diseases last week, against 59, 75, and 67 in the three pre- ceding weeks. These 68 deaths were equal to an annual VITAL STATISTICS. rate of 2 - per 1000, which was 0’4 per 1000 above the mean rate last week from the same diseases in the 76 large HEALTH OF ENGLISH TOWNS. English towns. The fatal cases of whooping-cough, which had been 32 and 28 in the two rose IN 76 of the towns 8501 births and 4905 preceding weeks, largest English last week to of which 19 occurred in deaths were the week March 21t. again 32, Glasgow, registered during ending seven in and two in Leith. The deaths from The annual rate of mortality in these towns, which had Edinburgh, diarrhoea, which had been 21 and 12 in the two preceding rose to last and included seven in 1 London : Eyre and Spottiswoode, East Harding-street; Edinburgh : weeks, again 14 week, Oliver and Boyd ; Dublin E. Ponsonby. Price 3d. Glasgow, three in Edinburgh, and two in Paisley. The fatal 918 cases of measles, which had been 15 in each of the two Lord of the Admiralty at page 11 of that document under preceding weeks, declined last week to eight, of which three the heading of Personnel" we glean the following points were registered in Edinburgh, two in Glasgow, and two in of interest :- Aberdeen. The deaths from scarlet fever, which had been Steps have been taken to organise an improved system of physical " four in each of the two preceding weeks, increased to training for the men and boys of the fleet, the " masts and yards six last week and included four in The fatal training which has served the navy so well in the past having become Edinburgh. no longer available. The details of the new exercises and methods of cases of "fever," which had been two, two, and three in instruction to be employed under the new scheme have been carefully the three preceding weeks, further rose last week to five, of considered and the revised handbook will shortly be issued to the fleet. which four occurred in The deaths referred to Amended regulations for the entry of surgeons have been published. Glasgow. The chief are the scale of for medical diseases of the in these which had alterations improved pay officers, respiratory organs towns, charge pay for inspectors-general in charge ot hospitals, and also of been 92, 97, and 117 in the three preceding weeks, further medical officers in charge of hospital ships, rearrangement of the increased last week to 134, but were 83 below the number subjects of examination both for entry and for promotion, increased in the of the The powers of admitting candidates by nomination of medical schools, corresponding period preceding year. colonial universities, &c., earlier promotion to those who have held causes of 20, or more than 3 per cent., of the deaths appointments of house surgeons, anti the payment of the fees of registered in these eight towns last week were not certified. medical officers for civil hospital courses. The number of candidates at the competitive examination has improved since the new regulations have been in force and the number of medical officers now on the active is at time the last of a HEALTH OF DUBLIN. list greater than any during quarter century. A consultative board of eminent medical men has been The death-rate in Dublin, which had been 25 9, 27’ 8, and formed, with the Medical Director-General as president, to decide on 26’ 6 per 1000 in the three preceding weeks, rose again to the best method of dealmg with special questions appertaining to the 27’7 1000 the week March 21st. Medical Department. Amended regulations for the employment of per during ending During temporary surgeons in case of war or emergency, by which the pay has the past four weeks the death-rate has averaged 27’ 0 per 1000, been materially raised and an equipment allowance granted, have the rates during the same period being 16 6 in London and attracted a satisfactory number of candidates. A course of training has been instituted at for sick berth staff 19 - 6 in Edinburgh. The 201 deaths of persons registered Plymouth Hospital pro- bationers and a course of training in m tssage at Haslar, with extra pay the week under notice were in excess of the during eight for those qualified on appointment to a hospital. Revised medicine number in the preceding week and included eight which chests, new field service valise, emergency surgical dressings, Roentgen were referred to the principal infectious diseases, against 14, ray apparatus to ships as well as shore establishments, new metal and 10 in the three of three aseptic operation tables, microscopes, and bacteriological outfits to H.M. nine, preceding weeks ; these, ships have been supplied and the trial of various forms of stretchers on resulted from diphtheria, two from whooping-cough, two board ship have been, and are being, carried out. Steps are being taken from "fever," one from diarrhoea, and not one from small- to provide an auxiliary sick berth staff from volunteers of the St. John Ambulance and the St. Andrew’s Ambulance Association from or from scarlet fever. These deaths Brigade pox, measles, eight Corps of Scotland. were equal to an annual rate of 1’1 per 1000, the death-rates THE ARMY ESTIMATES FOR 1903-04. last week from the same diseases being 1 - 9 in London and 2 - 7 in Edinburgh. The fatal cases of diphtheria, which had been From the remarks on Vote 2-Medical Services-in one and two in the two preceding weeks, further rose last week the explanatory memorandum of the Secretary of State to three. The mortality from whooping-cough, from "fever," accompanying the army estimates for 1903-04 we find that and from diarrhoea corresponded in each case with that there is a gross decrease in the vote for the medical services recorded in the preceding week. The 201 deaths in Dublin (Vote 2) of 495,000, but an increase on normal services of last week included 37 of children under one year of age and E25,000 due to provision for additions to the medical 63 of persons aged 60 years and upwards ; the deaths both and nursing services of the army. The total of the of infants and of elderly persons considerably exceeded the army estimates amounts to .E34, 24S, 000, which, although numbers recorded in the preceding week. Six inquest casesi less than that of last year, is still some millions in excess and three deaths from violence were registered, and 68, or of the normal estimate, but this was only to be expected more than a third, of the deaths occurred in public institu- in the circumstances. The number of men to be tions. The causes of 13, or more than 6 per cent., of the voted is 235,761, exclusive of the Indian establishment, deaths registered in Dublin last week were not certified. reserves, yeomanry, militia, and volunteers. The estimated pay of the army medical service (p. 39) for 1903-04 is £345,000, being a decrease of £15,500 on last year’s estimate. The pay of civilian medical practitioners is THE SERVICES. £42,000, which shuws a decrease of .6224,100 on 1902-03, and on the cost of medicines, &c., there is a saving of £135,000. Provision is also made in Vote 2 for the medical ROYAL NAVY MEDICAL SERVICE. services of the China Expeditionary Force and the Somali- THE following appointments are notified :-Staff Surgeon land Expeditionary Force. There is an addition of 40 officers N. L. Richards to the Dnke of Wellington for the Nelson. to the Royal Army Medical Corps and of 112 nurses to the Surgeons : S. H. Birt to Ha-lar Hospital ; J. H. Fergusson nursing service, and the number of non-commissoned officers to the D2ke of TVeUingtnn for Portsmouth Dockyard ; W. J. and men of the Royal Army Medical Corps has been con- Stitt to the B?tl?vark; W. M. Keith to the Diana; F. J. A. siderably increased. On p. 40 of the estimates setting forth Dalton to the FcyMOM and H. W. G. Green to the Hibernia the home, colonial, and Indian medical establishments, we for Malta yard, and P. L. Crosbie for the Dryad. notice that the sum of £2500 is estimated as the amount required for payments to dentists in London and elsewhere VOLUNTEER CORPS. and for the civilian members and clerical staff of the Royal Garrison Artillery (Volunteers): : lst Edinburgh Advisory Board. At p. 86 and 87 details of the estimated (City) : Alexander Morrison McIntosh to be Surgeon-Lieu- amounts required for the Army Medical School, Netley, and tenant. Dated March 21st, 1903. 6th Lancashire : Sur- for the Medical Staff College are given, amounting to Z7670 geon-Lieutenant W. T. Blackledge to be Surgeon-Captain. for the former and E9200 for the latter. The estimate for Dated March 21st, 1903. the Army Sanitary Committee now only amounts to £105. Rifle: Ist London : Surgeon-Lieutenant H. B. T. Morgan At p. 160 et seq. (Appendix 6) will be found a detailed to be Surgeon-Captain. Dated March 10th, 1903. statement of the medical establishments for army corps, and THE NAVY ESTIMATES FOR 1903-04. military commands, districts. The navy estimates, which are over .635,000,000 and show THE RUSSIAN ARMY MEDICAL DEPARTMENT. an excess of expenditure of 3,000,000 over those of last In 1901 the number of trained soldiers in Russia available year, were last week introduced into the House of Commons for service in the various arms was authoritatively estimated by Mr. Arnold-Forster in a clear and very comprehensive at 4,566,000, inclusive of officers, 1,414,000 men constituting speech. The Secretary of the Admiralty, alluding regretfulJy the regular army and the remaining 3,152,000 the militia and to the increased and unproductive expenditure, dwelt forcibly reserve. The number of recruits incorporated during the upon its having been occasioned by the rivalry and keen com- year was 308,440, or about one-third of the available youths, petition of other nations. The estimates show an increase in of whom no fewer than 603,131 were medically examined. personnel of 4600 men over last year. Vote 3 (p. 50) is The minimum height allowed in the infantry was five feet, for medical establishments and services-an estimated while the period of service with the colours, although cost of E259,000, a net increase for all heads of expenditure nominally five years, was practically not more than four of .E12.500. The details showing the distribution of the sum years. After his liberation from the active list the Russian estimated for occupy some ten pages. From the statement soldier has to serve in the reserve until he is 43 years of age, explanatory of the navy estimates published by the First but apparently his training during this long stage is limited