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was a large attendance of members. The Council reportedthat since the anniversary meeting a signal victory over themonopolists of hospital appointments had been achieved atHastings, where, by a majority of 78 to 33, the governors ofthe East Sussex Hospital had repealed the rule restrictinghonorary staff appointments to those holding London

diplomas.Professor Cuming, M.D. (Belfast), proposed, Dr. Douglas

(Leamington) seconded and it was unanimously resolved :"That the Association records its satisfaction at the successof the Council’s proceedings in reference to the rule formerlyin force at the Hastings and East Sussex Hospital by whichdiplomates of the Irish Royal Colleges of Physicians andSurgeons were excluded from competition for honoraryappointments on the staff of that institution. " The Councilalso reported that Lord Sandhurst’s Committee had pub-lished as an appendix to their lately issued report to theHouse of Lords a statement prepared on behalf of theAssociation setting forth the injustice of the restrictive ruleas it exists still in the greater number of the large Londonhospitals. A vote of thanks to the Chairman concluded the

proceedings. ______________

ARMY MEDICAL DEPARTMENT REPORTFOR THE YEAR 1890;

WITH APPENDIX. VOL. XXXII., 1892.1

,

[FIRST NOTICE.THE army medical report has been issued rather earlier

this year than usual. It consists of 391 pages, 71 of whichare in the form of an appendix to the report and containpapers on the Progress of Hygiene for the year 1891, a

report from the medical and surgical divisions of the RoyalVictoria Hospital, Netley, a paper on the Etiology of MaltaFever, and another on Six Cases of Lightning-stroke. The

great bulk of the report therefore consists of the vitalstatistics of the troops at home and abroad and matter con-cerning the sanitary conditions by which they are sur-

rounded. As the primary and fundamental object in thepnblicaton of these reports is for the information of theHouses of Parliament this must necessarily be the case and ’’

very properly so. But we think it is to be regrettedthat the more strictly professional and scientific portionof the volume appears to be a diminishing quantity.Medical officers scattered all over the world have so manyopportunities of making original and interesting observa-tions that we are curious to know what are the new

diseases, if any, they have encountered and how those withwhich we are familiar at home comport themselves abroadunder different conditions of climate, to say nothing ofobservations in medico-topographical reports on natural

history, anthropology, climatology and the like. The de-

partmental reports of the past contained many really valu-able contributions to our knowledge in various directions.Without doubt the statistical portion of this volume is ablyexecuted ; the information is full, clearly arranged, andalmost every point capable of being illustrated or elucidatedby figures has been turned to account. But statistics and

reports dealing with the sanitary details of places with whichthe reader has probably no personal acquaintance are not

mentally more palatable than a water-free food diet wouldbe. The point which is looked for is apt to be lost in amultitude of figures and ratios, and it is not always possibleto say whether all the figures are really relevant to the subjectto be elucidated. Statistically considered, however, these

reports are admirable ; and we should like to be able to saythe same of the papers in the appendix in regard to theirnumber, variety and quality.With these few prefatory remarks let us now turn to the

volume itself. The average annual strength of the troopst-erving at home and abroad in 1890, as computed from thereturns, was 196,502 warrant officers, non-commissionedofficers and men (exclusive of colonial corps) ; the admissionsinto hospital in this force were 208,014 and the deaths 1787.The rates represented by these numbers are for admissionsinto hospital 1058-6, and for deaths 9-02 per 1000 of theaverage annual strength, calculated as 198,154, which in-

1 London: Printed for H.M.’s Stationery Office, by Harrison andSons, Printers in Ordinary to Her Majesty.

cludes detached men. For the previous ten years (1880 to1889) the ratios per 1000 of troops serving at home and abroadwere for admissions into hospital 1058 ’2 and for deaths 10 ’28.Examining the tabular results of sickness in the different

commands we find that the mortality-rate per 1000 amongtroops quartered in the United Kingdom for the year 1890was 5-53, at Gibraltar it was only 3-22, at Malta 9-77, inEgypt 12-47, 13-58 in Bermuda, nearly the same in Mauritiusand 14-45 in India. Compared with the results for the tenyears from 1880 to 1889 the death-rate per 1000 for troopsserving in the United Kingdom was 6 10, in Gibraltar 6 13,Malta 8-66, Bermuda 10-04 and 15-66 for India, whilst themortality rate for Egypt for the seven years 1883-89 was 25 -66.The average strength of the troops serving in the United King-dom during the year 1890 was 100,120, to which men detachedfrom these corps, computed to average 1652, have to beadded. For the United Kingdom, taken as a whole, theadmission ratio was 810 -6, the death-rate 5’53, the invalidingrate 16-72, and the constantly sick rate 44-29 per 1000 ofstrength. Compared with the corresponding ratios for thepreceding ten years, a decrease is observed in all the ratesof sickness and mortality, but there is a slight increase ascompared with the results of the previous year. The totalloss by death and final discharge from the service ors

account of medical unfitness was 2265 men, beingin the ratio of 22-25 per 1000 of strength, which is,

higher than the ratio in the previous year by 1’79. Advert

ing to some of the more important statistics of sickness.

mortality and invaliding among the troops in the United!

Kingdom it is satlstactory to iearn tnat tnere was not oncase of small-pox recorded in the year. Out of 243 admis-sions for scarlet fever 225 occurred in England and Wales,none in Scotland, and 18 in Ireland. The greatest numberof cases in any one station was 80, at Woolwich, of whichone proved fatal ; the disease was also very prevalent amongthe civil population. At Aldershot there were as many as.75 cases with 1 death, and at Devonport 28 cases with one-death. These three stations gave three-fourths of the totalnumber of admissions, the remaining fourth being scatteredamong as many as twenty stations.As regards enteric fever the admissions numbered 126 and

the deaths 30. The admission ratio was 1’3 and that of

mortality 0’29 per 1000. The percentage of mortality toattacks was 2 ’39, as compared with 17 ’8 in the previous yearand 23’1 the average for ten years. In Scotland there was-

only one admission from this disease, but that terminatedfatally ; the admission ratio was 0’3 per 1000. In only oneof the administrative districts in England-viz., the Thames.district—was there complete immunity from this disease andthe number of stations in which it appeared was 30. As inseveral preceding years, the station showing the greatestprevalence of the disease was Dublin, but in this respect the’year under report compares favourably with the preceding year,.as the number of cases and deaths were 34 and 6 respectively,as against 63 cases and 8 deaths. This great decrease in thenumber of attacks is due to the fact that, on account of thenotorious prevalence of enteric fever in the Royal barrack&they were evacuated quite early in the year. Excluding the.Royal barracks, the number of cases from the remainingbarracks continued the same. The disease seems to have

appeared in nearly all the barracks in Dublin, and the sani-tary condition of some of them was considered so unsatis-factory that they were evacuated. This looks as if some.extensive sanitary engineering works required to be under-taken for the disposal of the sewage of the city of Dublin asa whole. The station which shows the next largest number of.cases is Aldershot, where there were 18 admissions and 4,deaths, as compared with 8 admissions and 1 death in the

previous year. The cases came from different parts ofthe camp. At Caterham there were 15 attacks and 2 deaths ;:the cases came from four blocks of barracks and the out-break was probably attributable to certain important sanitary.defects, which were discovered and rectified.

Just at the close of the year 1889 a few cases of influenzahad appeared in England, which were the commencement of1’the epidemic that spread all over the country within the firstthree months of the following year. The total number ofadmissions was 6584, with eight deaths. The ratio ofadmissions was 65’7 and that of deaths 0 ’08 per 1000. Everydistrict was more or less affected with the disease, but the-greatest number of cases occurred in the Home District.Influenza also appeared among the troops stationed in Indiaand the colonies ; in fact, throughout our foreign commands.Taking all forms of venereal disease together, the admisr

280

sions in the United Kingdom for these complaints numbered:21,262 and the constantly sick 1709’35. The total ratioof admissions was 2124 per 1000, which differs only frac-tionally from the corresponding rate in the previous year, butis below the average rate for the preceding five years by 32-8.Under the head of "poisons" it may be incidentally remarkedthat there were eight admissions and two deaths. Two of the- cases were of poisoning by oxalic acid, taken with suicidalintent, one of which proved fatal, and there was a fatal caseof suicidal poisoning by cyanide of potassium. There were:21 cases of suicide during the year among the troops servingin the United Kingdom, as against 17 in the preceding year,the average number for the previous ten years being 20. Thenumber of men discharged the service during the year asmedically unfit was 1,702, being in the ratio of 16’72 per1000, which is rather higher than the corresponding rate of!the previous year, but lower than the average rate for thepreceding ten years by 2-82 per 1000.We must refer the reader to the tables showing the

-influence of age and length of service on sickness, mortalityand invaliding among the troops serving in the - United- Kingdom during the year 1890. As might, we think,be expected the occurrence of sickness was greater amongyoung soldiers than older ones, the mortality rate, on theother hand, being very low among men in their first year’saervice and the invaliding ratio being also low. The sick rateshows a steady decline during the third, fourth and fifth

years of service, followed by a slight rise among men ofbetween five and ten years’ service and falling again con-siderably among men over that period of service.

There is an interesting table showing the statistics of sick-ness and mortality among troops quartered in the large campsat Aldershot, Colchester, Shorncliffe and the Curragh, as

i .compared with those of troops quartered in thirty-seven largetowns where the average strength was over 500 non-com-missioned officers and men. According to the table the;admission- and constantly-sick rates of men in camps differ’very slightly from those among men quartered in towns. Themortality rate was a good deal higher among men quarteredin towns than among men quartered in camps. This was alsothe case in the preceding year, but to a less extent.

THE ASSOCIATION OF FELLOWS OF THEROYAL COLLEGE OF SURGEONS

OF ENGLAND.

A MEETING of the committee of the Association of Fellows- of the Royal College of Surgeons of England was held at5 P.M. on Thursday, July 21st, at 36, Grosvenor-street. Mr.

- George Pollock, the President, occupied the chair, and therewas a full attendance of members of the committee. Mr.

Vincent Bell of Rochester and Mr. J. J. Purnell ofStreatham were introduced as new members of the com-mittee. The minutes of the last meeting having been read.and confirmed, letters expressing regret at being unable to.attend were read from Mr. Holmes, Mr. George Jackson ofPlymouth and Mr. G. F. Helm of Truro. A report was

presented by the honorary secretary, Mr. Percy Dunn, inTeference to the recent meetings and the annual dinner.-After the payment of the expenses of the dinner a smallbalance remained and was handed over to the treasurer forthe general fund. Some discussion ensued about holding a’dinner in 1893 in consequence of the arrangements whichhave been made by the Council of the Royal College ofSurgeons for a Fellows dinner on the occasion of celebratingthe jubilee of the Fellowship. The decision of the matterwas deferred. A similar result was arrived at in reference to’certain points of reform at the College, such as the mode ofprocedure at meetings at the College &c., it being con-sidered advisable not to press these matters upon the Councilfor the present.Two letters from Mr. Holmes addressed to the President

were read by Mr. Pollock. They referred to an incidentwhich occurred at the meeting of Fellows of the College onthe 7th inst. and to a collateral matter of some importance tothe Association arising out of that incident. A prolongeddiscussion ensued upon these topics and ultimately a letterwas drawn up tobe signed by the President and HonorarySecretary of the Association and to be forwarded to theofficial referred to in Mr. Holmes’s letters. The object of the

communication was to secure the correction of a misstatementwhich affected the Association. Further action was deferredtill the next meeting of the committee.On the motion of Mr. W. Allingham, a vote of congratula.

tion to Mr. John Tweedy on his recent triumphant electionto the Council of the College was unanimously passed. In

thanking the committee for their congratulatory vote Mr.

Tweedy said that he had been greatly influenced in perse-vering in the reform movement and continuing to work onthe committee of the Association by the example set byMr. Pollock as President of the Association. He hoped tobe able to act on the Council of the College in accordancewith the views and principles which he had supported inthe committee of the Association. There being no otherbusiness the committee adjourned at 6.30 P.M.

FOUNDER’S DAY AT EPSOM COLLEGE.

THE annual ceremony of perpetuating the memory of thelate Dr. Propert, the founder of the Epsom Medical College,with which is associated the annual distribution of prizes tothe boys, took place on Monday last. Favoured with fine

weather, there was a large attendance of parents and friends.The head master, the Rev. T. N. Hart Smith, M.A., presided,and was supported by Dr. Lumsden Propert, son of the

founder, Dr. Holman (treasurer), Sir Joseph Fayrer, K.C.S.I.(chairman), Sir Edward Sieveking, M.D., and other membersof the council.

Prior to the distribution of the prizes the Head Masterdelivered a lengthy speech, in the course of which he re-viewed the work of the school and the achievements of thescholars during the past year. He said they could point to ayear of healthy progress, and he would like to say how

thoroughly satisfied he was with the discipline of the school.They had had a fairly clean bill of health, but unfortunatelythey had to record many a sad loss from death. Thecouncil had supported the extension of the museum, andthey had a most flourishing rifle corps, the members of whichnumbered seventy. The College was asking to be recognisedas a school of science on the grounds that the teaching ixsufficient, as shown by the list of distinctions gained,and it possessed all the requisites for science teach-

ing. Recently out of ten boys who went in for the

Preceptor’s Scholarships nine passed, and out of twenty-sevenboys who went in for the Cambridge Local Examinationstwenty-one obtained certificates. One of the great dis-

advantages of the present system was that those boys whomost required the discipline and teaching of school were veryoften sent up to the hospitals of London before they werereally fit to go to them. If some means could be adopted tokeep those boys and train them to pass the first examination,which they had to pass in London before they left school,he believed the advantages would be much greater than thoseof the present system. Six scholarships had been won bythe College at Cambridge during eighteen months, and theyhad also passed two boys direct into the army class. Hewould be very sorry, however, if the application on theirpart that the school should be registered as a school ofscience should lead anyone to suppose that they wished tomake any difference as to classical teaching. He felt andwas sure that the members of the council considered that theschool must always be conducted on a classical basis.The awards were then handed to the successful scholars by

the Head Master, the Propert Prize being presented by Mr.Lumsden Propert to F. G. Thompson and P. Levick, betweenwhom it was divided, each receiving a bronze medal and£10. The scholarship of £50 a year called the Harvey OwenScholarship, which had become available for the first timeon this occasion, had been awarded to P. Levick, and the Don-caster Gift Scholarship to Senior Prefect F. G. Thompson.

Dr. HoLMAN expressed his delight at hearing such anexcellent account of the work of the school. It was not thecase, he said, of a new broom sweeping clean, as Mr. HartSmith had not only began to work when he came there, buthad continued to work with great success. That school hadwon a repute for Epsom. A free medical scholarship to theLondon Hospital had been given to it that day and he con-gratulated the College upon the fact.

Sir JOSEPH FAYRER also addressed a few observations to