381VACANCIES.-BIRTHS, MARRIAGES, AND DEATHS.

Vacancies.For jurther information regarding each vacancy reference should be

made to the advertisement (see Index).

dsaaaTI FIELD FORCE.-Experienced Dressers for six months in theColony, with pay at the rate of 220 a month, and other money, & c.,arrangements. Address to the Assistant Private Secretary, ColonialOffice.

BIRMINGHAM WORKHOUSE.-Medical Officer for three weeks from themiddle of August. Board, apartments, laundry, and attendanceprovided. Apply, ’,stating terms, to the Clerk to the Guardians,

, Birmingham.BOOTLE BOROUGH HOSPITAL.—Junior Resident Medical Officer. Salary

;C80 per annum, with board, laundry, &c.

BOROUGH ASYLUM, Portsmouth.-Junior Assistant Medical Officer.Salary £120 per annum, increasing to .B150 by three equal annualincrements, with board, lodging, and washing.

BRECON INFIRMARY, No. 6, Bulwark, Brecon, South Wales.-ResidentHouse Surgeon, unmarried. Salary £100 per annum, with fur-nished apartments, board, attendance, fire, and gas.

BRISTOL EYE HOSPITAL.-Locum Tenens for the House Surgeon fortwo months. Salary 221 guineas a week, without residence.

BRISTOL ROYAL INFIRMARY.—Honorary Ophthalmic Surgeon.CITY OF BOMBAY.—Executive Health Officer for five years, renewable

conditionally. Monthly salary arranged.-Apply to the MunicipalCommissioner for City of Bombay, care of Mr..John Lithiby, LocalGovernment Board, Whitehall.

CITY OF SHEFFIELD.—Assistant Resident Medical Officer for the twoCity Hospitals. Salary B120 per annum, with board, lodging, andattendance. Apply to the Town Clerk, Town-hall, Sheffield.

CORNWALL COUNTY ASYLUM, Bodmin.-Junior Assistant MedicalOfficer, unmarried. Salary £120, rising 210 annually to £150,with board, furnished apartments, &c.

COUNTY ASYLUM. Dorchester.-Second Assistant Medical Officer,unmarried. Salary B140, rising to :E160 the second year.

CUJIBERLAND INFIRMARY, Carlisle.-House Surgeon for one year.Salary t70 per annum, with board, lodging, and washing. AlsoAssistant House Surgeon for seven months trom Oct. 1st. Salaryat the rate of £40 per annum, with board, lodging, and washing.

DENBIGHSHIRE INFIRMARY, Denbigh.-House Surgeon for 12 months.. Salary £100, with board, residence, and washing.

DEVONSHIRE HOSPITAL, Buxton, Derbyshire.-Assistant HouseSurgeon. Salary E50 per annum, with furnished apartments,board, and washing.

DOVER HOSPITAL.—House Surgeon, unmarried. Salary Z100 a year,with an increase after twelve months’ service. Board, lodging, andwashing provided.

DUMFRIES AND GALLOwAY ROYAL INFIRMARY, Dumfries.-HouseSurgeon. Salary E50 per annum, with board and washing.

DURHAM COUNTY ASYLUM, Winterton, Ferryhill.-Junior AssistantMedical Officer. Salary £140, rising :E1O annually to £160, withboard, laundry, and attendance.

EAST SUFFOLK AXD IpSWICH HOSPITAL, Thorofare, Ipswich.-SecondHouse Surgeon, unmarried. Salary:E60, with board, lodging, andwashing. ,

EASTERN DISPENSARY, Leman-street, Whitechapel.-Resident MedicalOfficer, unmarried. Salary B105 per annum, with turnished resi-dence, coals, and attendance. Applications to the Secretary, 60.Great Prescot-street, London, E.

EYE, EAR, AND THROAT HOSPITAL FOR SHROPSHIRE AND WALES,Shrewsbury.-Surgeon. Honorarium of 2150 per annum will begiven for three years.

GRovE HALL ASYLUM, Bow, London.-Junior Assistant Medical Officer.Salary :E120 per annum, with board, furnished apartments, andwashing.

LONDONDERRY COUNTY BOROUGH.—Medical Officer to act as MedicalSuperintendent Officer of Health and Medical Attendant at FoyleHill Infectious Diseases Hospital. Salary £350 per annum. Applyto the Executive Sanitary Officer’s Office, Guildhall, Londonderry.

MACCLESFIELD GENERAL INFIRMARY.—Junior House Surgeon. Salaryt70 per annum, with board and residence at the Infirmary.

MANCHESTER EAR HOSPITAL.—Clinical Clerkship for a Senior Studentfor six months. Honorarium 10 guineas.

MANCHESTER ROYAL EYE HOSPITAL.—Junior House Surgeon. Salary£80, with residence, board, and washing.

XEWCASTLE-upON-TvNE CITY AsvLUM, Gosfortb, Newcastle-upon-Tyne.-Assistant Medical Officer, unmarried. Salary 2130 a year, withfurnished apartments, board, &c., rising £10 annually to :E150.

NORTH CAMBS. HOSPITAL, Wisbech.—Resident House Surgeon. Salary£130 per annum, with furnished house.

NORTH-EASTERN HOSPITAL FOR CHILDREN, Hackney-road, Shoreditch.-Resident Medical Officer for 12 months. Salary £120 per annum,

. with board, residence, and washing, Apply to the Secretary, CityOffice, 27, Clement’s-Iane, Lombard-street, E.C.HAM CITY ASYLUM.—Second Assistant Medical Officer, un-

married. Salary £150 per annum, with board, apartments, andwashing.

NOTTINGHAM GENERAL DISPENSARY.—Assistant Resident Surgeon,unmarried. Salary £140 per annum, all found except board.

OLDHAM INFIRMARY.-Junior House Surgeon for one year. Salary.875, with board, residence, and washing. Also Locum Tenens.Terms 4 guineas per week, with board, washing, and residence.

PARISH OF RousAY AND EGILSHAY, Orkney.-Resident Medical Officer.Salary .851 sterling per annum. Apply to Inspector of Poor,Rousay, Orkney.

ROTHERHAM HOSPITAL.—Senior House Surgeon. Salary £105 perannum.

ROYAL HALIFAX INFIRMARY.—Senior House Surgeon, unmarried.Salary £120 per annum, with residence, board, and washing. AlsoSecond House Surgeon, unmarried. Salary JE100 per annum, withresidence, bard, and washing. Also Third House Surgeon, un-married. Salary :C3D per annum, with residence, board, andwashing.

ROYAL HANTS COUNTY HOSPITAL, Winchester.-House Physician, un-married. Salary ;865 per annum, rising tJ £75, with board,residence, &c.

ROYAL NATIONAL HOSPITAL FOR CONSUMPTION AT VENTNOR.-ClinicalAssistant. Salary :B40. with board and residence Apply to theSecretary, London Office, 34, Craven-street, Strand, W.C.

ROYAL UNITED HOSPITAL, Bath.-House Surgeon, for one year.Salary JE100, with board, lodging, and washing.

RUBERY-HILL AsYLuvr, Barnt Green, Worcestershire.-Junior AssistantMedical Officer, unmarried. Apply to Medical Superintendent.

STAMFORD-HILL AND STOKE NEWINGTON DISPENSARY, 189, High-street,Stoke Newington.—Assistant Resident Medical Officer. Salary£100 per annum, with board.

SURREY DISPENSARY, Great Dover-street, Southwark, S.E.-ResidentMedical Officer. Apply to the Secretary, 53, Borough High-street.

THE CHIFF INSPECTOR OF FACTORIES gives notice of vacancies as

Certifying Surgeon under the Factory Acts at Bradford-on-Avonin the county of Wilts, and at FreshfOld in the county of Somerset

TOTTENHAM HOSPITAL, N.-House Surgeon for six or 12 months.Honorarium at the rate of .E20 per annum, with board, resi-dence, and laundry.

UNIVERSITY OF GLASGOW.—Chair of Clinical Medicine.

VICTORIA HOSPITAL FOR CONSUMPTION, Craigleith, Edinburgh.-Resident Physician. Residence and board and nominal honorariumin lieu of conveyance. Also non-resident Clinical Assistant.Honorarium at the rate of £60 per annum. Both appointments forsix months. Apply to the Hon. Sees., 1, North Charlotte-street,Edinburgh.

VICTORIA HOSPITAL, Folkestone.-House Surgeon. Salary .E80 perannum, with board, residence, and washing.

WEST BROMWICH DISTRICT HOSPITAL.-House Surgeon, unmarried.Salary £100 per arinum, with board, residence, and washing.

WEST HAM HOSPITAL, Stratford, E.-Junior House Surgeon for oneyear. Salary £75, with board, residence, &c.

WILTS COUNTY ASYLUM, Devizes. -Assistant Medical Officer, un-

married. Salary £150, rising E10 a year to £280, with board, resi-dence, and washing.

Births, Marriages, and Deaths.BIRTHS.

COPEMAN.—On July 29th, 1900, at Wakebiirqt Place, Sussex, the wifeof Sydney hlonekton Copeman, M.D., F.R.C.P., of a son.

EWBANK.—On July 23th, at 13, Rockstone-place, Southampton, thewife of Arthur George Ewbank, of a son.

HOSFORD.—On July 24th. at St. John’s-road, Upper Holloway N., thewife of B. Hosford, M.A., M.D., of a son.

SEARS.—On July 25th, at Lee-terrace, Blackheath, the wife of AlfredErnest Sears, M.R.C.S., L.R.C.P., of a son.

MARRIAGES.HALL—GEDDES.—On July 25th, at St. John’s Church, Ryde, Isle of

Wight, Bdmunr) Stokes Hall, M.B. Lond., M.R.C.S., L.RC.P.,second son of John Selby Hall, of Stoneleigh, Ryde, to JessieAlexandra, onlv daughter of Robert Geddes, of Trotton, St. John’s-park, Ryde, Isle of Wight.

MADDEN—Cox.—On July 25th, at All Saints’, Margaret street, London,W., Frank Cole Madden, M.B., B.S. Melb, F.R.C.S., of Cairo, toMadeline Alice, second daughter of William Cox, M.R.C.S., Winch-combe, Gloucestershire.

PARSONS—PARKER.—On July 28th.at Holy Trinity Church, LlandudnoFrederick Gymer Parsons, F.R.C.S., son of Tbos. Parsons, of LeeKent, to May, elder daughter of Henry R. Parker, LL.D., of SywellHouse, Llandudno.

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DEATH.STEELE.—On July 25th, at Byford House, York-road, Southend-on-Sea,

Ernest A. T. 6feel(,, M.R.C.S., L.R.C.P.. Surgeon to St. Mary’Hospital for Children, Plaistow, E., aged 34 years.

N.B.—A fee of 58. charged for the insertion of Notices ol Births,Marriages, and Deaths.

382 NOTES, SHORT COMMENTS, AND ANSWERS TO CORRESPONDENTS.

Notes, Short Comments, and Answersto Correspondents.ZYMOTIC DIARRHCEA.

MR. WILLIAM BERRY, medical officer of health of the borough ofWigan, has circulated the following letter among the medical menpractising in the district of which he has sanitary charge, his objectbeing to obtain an accurate account of the deaths from summerdiarrhoea -.-

"My DEAR SIR.—As the period for summer diarrhœa, is at handI venture with some degree of diffidence to call your attention tothe alteration in the mode of certification in this disease, as recom-mended by a Committee of the Royal College of Physicians."Diarrhoea is a symptom of some other disease; it occurs in

intestinal cancer, tuberculosis of intestines or lungs, diseases ofthe liver and pancreas, &c., &c., and in such cases the primary causeshould be stated in the death certificate so as to prevent the deathbeing registered as one from diarrhœa." From a public health point of view the deaths that should be

registered as caused by diarrhoea are those which are preventableand which arise suddenly, as a rule, at this time of the yearand the two following months-namely, August and September.For these the Committee of the College of Physicians recommendone of the following terms as the best designation: (1) epidemicenteritis, (2) zymotic enteritis, or (3) epidemic diarrhoea, all othersynonyms to be entirely discarded."The synonyms in previous use were: simple cholera, cholera

nostras, cholera infantum, choleraic diarrhoea, dysenteric diarrhoea."As our infantile mortality is high I am anxious to have as

correct a certification as we can possibly get. Therefore I shall feel

obliged if you will, in accordance with the recommendation of theCommittee, use the term of ’zymotic enteritis’ in all cases wherethere is no other pathological indication as to the cause of death.In other cases where diarrhcea has been a secondary symptom theprimary cause should be certified and the term diarrhoea,’ may beomitted as being only a symptom.

" With every apology, I remain, yours very faithfully," WM. BERRY, Medical Officer of Health.

"July 18th. 1900."

"GOLDEN SYRUP."

A CASE said to be of some interest to shopkeepers and certainly ofmuch interest to their customers was brought before the magistratesat Hyde on July 19tn. A grocer was charged with sellingadulterated syrup. The inspector under the Food and Drugs Actasked for one and a half pounds of golden syrup, for which he paidthreepence and sent a portion to the public analyst who reported i

that it contained 55 per cent. of glucose syrup which is made fromstarch, while golden syrup, which people seem to look on as a refinedtreacle, is made from sugar-cane. For the defendant it was statedthat he had never before been asked for " golden syrup," thathis customers asked for "syrup treacle," and that most likely theinspector could not purchase it in Hyde. On the other hand, theinspector said that he bought three samples in Hyde on the sameday, two of which were pure. Although this adulteration cannot beconsidered to be one of those which endanger health it ought not totake place, but the magistrates-perhaps because they have given upthe use of golden syrup-though they fined the grocer five shillings,did not apparently think it very serious as they "believed that atechnical offence had been committed." If people wish to haveglucose it should be sold as such and not as a product of tho

sugar-cane.

THE "HAGEY" SYSTEM.

To the Editors of THE LANCET.SIRS,—It may be interesting to you to know that what is called the’Hagey system for the cure of intemperance is about to be estab-lished in London. The Hagey Institute has been in existence for someyears past in Glasgow and quite recently a similar institute has been setup in Wales. From an interview which I had with the local manager itappears that the treatment consists in the administration of some tonicand the hypodermic injection of some drug at regular intervals duringthe day. It is said that if during treatment the patients take any alcoholthey become sick. My attention was called to the matter because themanagers before they commence treatment get some medical man tocertify that the patients are free from both heart and kidney disease.In this district I called the attention of the medical man in questionto the rather serious risk he was running in associating himself withan institute where unqualited men undertook medical treatment. It

appears that a very large sum of money has been expended in

purchasing the rights to use this treatment in this country. Needlessto add that it originated in America. It would be worth while to call

attention to the question in order that qualified medical men might bewarned of the danger of accepting office.

I am, Sirs, yours faithfully,Cardiff, July 20th, 1900. T. GARRETr HORDER.

A QUEEN’S CHOCOLATE BOX FOB SALE.To the Editors of THE LANCET.

SIRS,—I trust that you will pardon me for troubling you with;his. I am the widow of the late -, who resided for many years.n -. I am in very bad health and very straitened circum-stances, and my eldest son, a private in the Royal Army Medical Corps,who has been out in South Africa ever since the war began, has sentme the Queen’s Chocolate Box to dispose of for my benefit; and

knowing from experience how very good and kind you are in renderingassistance to anyone connected with the medical profession and whomay require the same, I have ventured to take the liberty to write toask if you can and will be so very good as to assist me to find acustomer for the box through the medium of THE LANCET. My healthis so bad that at times it renders me quite helpless, and if I can sellthe box it might enable me to undergo a course of treatment fromwhich I have been told by the medical man who has attended me forsome time I may derive a lot of benefit. I shall be grateful for anyassistance you can give me in disposing of the box.

I am, Sirs, yours very truly,A MEDICAL MAN’S WIDOW.

" If any of our readers care to make offers for the Queen’s ChocolateBox we shall be pleased to forward their letters to the writer of ’.heabove.-ED. L.

WANTED-A HOME.

To the Editors of THE LANCET.

SIRS.—My medical man has advised me to ask you if you can recom-mend me a school or home for a son of mine whom he describesas feeble-minded. His age is 11 years. He has been attending anordinary school for some time and I have also tried myself to teachhim, but he can learn nothing. You might possibly get him to say hisalphabet one day but the next day it is all forgotten. I do not thinkhis case is altogether hopeless because he can remember plenty ofthings that occurred a year or two ago. I may mention that my meansare limited. I cannot afford much for him.

I am, Sirs, yours faithfully,July 21st, 1900. A PARENT.

CLUB PRACTICE.

To the Editors ol TKN LANCET.

SIRS,—I should be glad if your columns could be opened to a defenceof the club system by those who advocate or practise it-often old-established men of good standing-as contrasted with the generalcontumely poured upon the head of a man who does a low-fee cash

practice of say a shilling. Naturally it may be comforting for acollector to bring periodically a more or less fluctuating sum where-with to meet current expenses when bills are paid with much delaybut as compared wih work done it is out of all proportion. First of

all, assuming that the average club subscription is five shillings perannum, which, as a matter of fact, is far above the average, while inmany places children are accepted at the starvation price of one half.penny per week. This means that two visits per year exhausts, at theordinary lowest scale of charging, that individual’s premium for thewhole of that said year, and in the case of a child, one visit in the sametime on the above scale shows a balance on the wrong side. Moreover,children are always trespassing on the practitioner’s time throughtheir special ailments, not to mention maternal neglect. Of course, thetheory is that the sound members pay for the sick ones, but in prac-tice, as ,judged by work done, this is entirely erroneous. Even underthe happiest conditions I have calculated that, taking 12 consecu6Femonths, for every Bl taken at least JB3 worth of work has been donein visits alone, as no record was kept of surgery consultations. As amatter of fact, on a certain Feb. 28th visits had been paid to the extentof the whole year’s contract receipts, thus leaving every patient afterthat date to be seen and every bottle of medicine to be dispensedgratuitously. Further, apart from the above practical experience, oil

what grounds can the system possibly be defended, except as a charity.which I do not think certain undercutting medical men would advance.when statistics quoted in Whitelegge’s Hygiene state that between theages of 15 and 65 years the average sickness to be expected is 1’31 weeksper year, and this of course does not include children’s ailments?Then, again, a practice being as shown above trebled in work done

must needs require more horseflesh and probably an assistant; con.

sequently the net income is far below the actual turnover and the

principal would be far better off with a much smaller purely privatepractice. Further, nightwork is materially increased, as a club patientscruples not to send at all hours for trivial reasons when a wholesomefear of an increased fee would deter any but a really important casesending; and when was a club patient grateful?So the question may be summed up as follows. Increased work and

impaired health thereby, net returns small, and, above all, the constantirritation of feeling that the profession.is being sweated.

I am, Sirs, yours faithfully,July 30th, 1900. M.R.C.S., L.R.C.P,

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COMMUNICATIONS not noticed in our present issue will receive attend*in our next.