340 FINANCES OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.

THE FINANCES OF THE ROYAL COLLEGEOF SURGEONS OF ENGLAND.

THE finance committee of the council of the Royal Collegeof Surgeons of England presented to the council at the lastmeeting on July 27th a report on the financial position of theCollege dated July 24th, 1893.

1. From this report it appears that the income of the

College for the past year has varied very slightly in theseveral sources from which it is derived from that ofthe previous year, and that altogether there is only a

difference in favour of 1891-92 of 665. On the one handthere is a decrease of £70 in the receipts from the member-ship examinations, of £19 in the receipts from the Fellow-ship examinations and of .6197 from invested funds owingto the loss of dividends from stock sold in the previousyear. On the other hand there is an increase of 663 on thedental examinations, of 673 chiefly derived from the hire ofthe rooms of the examination hall and of £85 on the receiptsfrom house property, a full year’s rent at an increased ratehaving now been received from the new tenants at 37,Lincoln’s-inn-fields.

2. The total expenditure is 6344 less than the expenditurein respect of revenue for the previous year, and on beingdeducted from the total income leaves a balance of 6730.Last year there was a balance of nearly 6451, the receiptshaving been 665 more. The expenditure hows a derease ofE283 in respect of examiners’ fees, of .6250 in respect of thelaboratories and of 6310 in respect of the general workingexpenses. The law expenses are considerably smaller andthe absence of any large payment for catalogues has reducedthe total of museum expenditure £136 below the amount forthe previous year. On the other hand, the expenses of thelibrary are about 635 more and there is an increase of .6384in the expenses of the examination hall, due almost entirelyto heavy legal expenses which are not likely to recur. The

expenditure for alterations and repairs is again heavy owingto drainage repairs at 37, Lincoln’s-inn-fields and structuralrepairs at 44, Lincoln’s-inn-fields. The extraordinary expendi-ture paid out of current income has amounted to 62109 18s.This expenditure has included .61318 for the alteration of thesystem of drainage, £1150 having been paid for this workin 1891-92 ; balance of expenses of Hunterian dinner,£129 2s. 4d. bust of John Marshall, £157 10s. ; catalogueof busts and pictures, .1::54 17s. ; instruments for membership ’,examinations, E35 2s. 4d. furniture and fittings, chieflyfor the common-room for Fellows and Members, E415 5s. 10d.

3. Out of the balance in the hands of the bankers thecommittee recommend the purchase of £1500 Manchester

Corporation 3 per cent. stock.4. For the ensuing year, 1893-94, the committee anticipate

that there will be a profit balance of about £2000. Thisassumes that the receipts from the several examinationsremain about the same as last year and that no large expendi-ture is incurred by the council beyond the ordinary or

standing expenses. In fact, unless anything unforeseenoccurs the committee expect that the ensuing year will furnisha good example of the average yearly income and expenditureof the College. It is not thought probable that within thenext twelve months, or indeed for some time to come, anylarge demand will be made upon the resources of the Collegefor expenditure on new buildings or extensive structural alte-rations to the present buildings. The year 1892-93 was thefirst year since 1884-85 on which sale of stock was not ren-dered necessary by expenditure of the kind.

5. It is satisfactory to observe that the committee are aliveto the importance of making annual additions to the invest-ments of the College. We pointed out last year1 that if thereceipts from examinations and trust funds are set aside andregard paid only to the fixed income and necessary expendi-ture there is a considerable annual deficit. The income of theCollege from rents and stock in 1892-93 amounted to 6643119s. 4d., whilst the necessary expenditure-i.e., the expen-diture for maintenance of the establishment-was (in-cluding pensions) f,9655 5s. 9d. Not a single item of

extraordinary expenditure is included in this sum. There istherefore a deficit of £3224 6s. 5d., or without the pensions£2654 13s. 5d. The committee are relying entirely upon thesurplus receipts from the examinations, but they are alive tothe fact that such receipts are liable to considerable variation.

1 THE LANCET, Feb. 27th, 1892.

If the receipts fell off, as they might do in a few years, wherewould the surplus be ? The finance committee of 1891-92,of which Sir W. S. Savory was chairman, called specialattention to the fact we are now emphasising. Their reportstated that " the assured income does not even now cover the

expenses which are absolutely necessary for the maintenanceof the College, and it is therefore most desirable that, as soonas the buildiogs now fast approaching completion are finished,the expenditure should be so controlled as to admit of anaddition each year to the investments of the College." Some-

thing has been done in 1892-93 towards a reduction of

expenditure. A few hundred pounds have been saved, butthe pruning-hook will have to be applied still more vigorouslyif the deficit of £2600 is to be seriously lessened.

BUCKS SANITARY CONFERENCE.

WHATEVER additional powers, as regards sanitary matters,county councils may eventually obtain the Sanitary Com-mittee of the Bucks County Council, under the able chairman-ship of Mr. P. W. Verney, have set an excellent example ofwhat may be done under the present system. By way ofarriving at some sort of unity of action and methods ofadministration amongst the various sanitary authorities of thecounty, a meeting was held at the Paddington Hotel, London,on July 3rd. It was attended by many of the largest andmost influential landowners in Buckinghamshire ; and inaddition to a most suggestive and conciliatory speech bythe chairman (Mr. Verney), an address was delivered by SirDouglas Galton, K.C.B , F.R.S. (chairman of the SanitaryCommittee of the Worcestershire County Council). The Con-ference had been also successful in procuring the attend-ance and advice of Dr. Theodore Thomson, of the MedicalDepartment of the Local Government Board, and of Mr.Fosbroke, county medical officer of health for Worcester-shire.Some papers of considerable interest were read, and amongst

others one dealing with the disposal of village sewage by Mr.De’Ath, medical officer of health for Buckingham. In this

paper the writer advocated the acquisition by rural sanitaryauthorities of a plot of land within a reasonable distance ofeach village, upon which could be deposited the pail contentsof cottages that were not provided with sufficient garden spacefor their utilisation. Mr. De’Ath would allow the cottagers toutilise the pail contents upon their gardens should they so de-sire, but in the event of this not being performed in accordancewith local regulations he would have them removed periodi-cally by the sanitary authority to the muck acre." Thereis little doubt that in purely agricultural districts muchstore is set upon the manurial value of excrement bythe cottagers, and this fact not uncommonly leads to a

distinctly undesirable conservation of the privy or pail con-tents until they are required for the purpose of manuring thesoil. This is especially the case where the occupiers ownallotments at some distance from the villages, when they arein the habit of storing up excrement &e. in a small gardenattached to the cottages until the allotments are ready fortheir dressing. The difficulties of sewage disposal unfortu-nately are not entirely overcome by the separate removal ofexcrement, as there still remains the question of slop-water,and for this Mr. De’Ath’s proposal for treating it in practicallythe same way as the contents of the pail seems to be somewhatdiflicult to properly carry into effect. However, as Dr.Theodore Thomson pointed out, it is hardly possible to

lay down any hard-and-fast rule as regards the disposalof village sewage and each case must be decided uponits own merits. Much depends, as several speakers showed,on the water-supply, as the disposal of excrement in a garden,where the water-supply is derived from a shallow and imper-fectly protected well, is certainly unsafe in spite of theassistance of the nitrifying organisms. A paper was alsoread by Mr. A. J. Southey, medical officer of health forthe Eton and Slough district. He confined his remarks to twoimportant subjects-namely, the provision of means ofisolation and disinfection for each sanitary district or com-bined districts and to the very difficult one of "recurringnuisances. " With regard to the latter question Mr. Southeymakes a very good suggestion with a view to enablesanitary authorities to better enforce "the periodical empty-ing of cesspools before they overflow "-i.e., that increas-

ing penalties should be inflicted by the authorities on

341VITAL STATISrrCS.

persons again and again causing nuisances of this soit.Tbis would certainly seem to offer a good means of com-pelling attention to any by-laws on the subject of privatescavenging which might be in force in a district and the prin--ciple of cumulative penalties is well worth developing in con-nexion with recurring nuisances in general. Sir Douglas IGalton, in his coacise address, showed how important, or Irather how absolutely indispensable, the services of a medical.officer of health are for the successful administration of a

- county council. It is true that much useful wolk may bedone by an energetic chairman of a sanitary committee, andas an instance of this we may mention Mr. Silvanus Trevailof the Cornwall County Council. There are, however, so

many points connected with the scientific aspect of publichealth that a layman, energetic though he may be, can onlyat best form a temporary substitute for a county medicalofficer of health.

The Bucks sanitary committee must be congratulated onthe success of their conference.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

In thirty-three of the largest English towns 6205 births and’4478 deaths were registered during the week endingJuly 29th. The annual rate of mortality in these towns,which had risen in the preceding nine weeks from 17’5to,25.1 per 1000, declined again last week to 22 -6 In Londonthe rate was 21-0 per 1000, whilst it averaged 23-8 in the

thirty-two provincial towns. The lowest rates in these townswere 11 -2 in Derby, 12’3 in Huddersfield, 14 4 in Bristol, 15.0 inPlymouth and 15’3 in Halifax ; the highest rates were 29’7 inWolverhampton, 31’2 in Burnley, 31-5 in Liverpool, 34-1 inBlackburn, and 40’2 in Preston. The 4478 deaths included1257 which were referred to the principal zymotic diseases,against numbers increasing from 415 to 1554 in the pre-ceding eight weeks ; of these, 850 resulted from diarrhoea.06 from diphtheria; 94 from whooping-cough, 87 from measles,69 from scarlet fever, 45 from "fever" (principally enteric), and.16 from small-pox. The lowest death-rates from these zymoticdiseases were recorded in Bristol, Halifax, Huddersfield,Brighton and Derby, and the highest rates in Liverpool,Leicester, Blackburn, Burnley and Preston. The greatestMortality from measles occurred in Liverpool, Burnley and131,ickburn ; from scarlet fever in Leicester and Bolton ; from’whooping-cough in Swansea and Gateshead ; from " fever

" in

Derby ; and from diarrhoea in Nottingham, Liverpool, Wolver-hampton, Portsmouth, Hull, Leicester, Blackburn, Burnley andPreston. The 96 deaths from diphtheria included 72 in Londonand 5 in Manchester. Eight fatal cases of small-pox wereregistered in London, 4 in Bradford, 2 in West Ham, 1 inBolton, and 1 in Manchester, but not one in any otherof the thirty-three large towns ; 280 cases of this diseasewere under treatment in the Metropolitan Asylum Hospitalsand in the Highgate Small-pox Hospital on Saturday last,against numbers declining from 570 to 328 at the end of thepreceding eleven weeks; 38 new cases were admitted duringthe week, against 61 and 53 in the preceding two weeks.The number of scarlet fever patients in the MetropolitanAsylum Hospitals and in the London Fever Hospital at theend of the week was 2966, against 2885, 2924 and 2968 onthe preceding three Saturdays; 282 new cases were admittedduring the week, against 348 and 390 in the preceding twoweeks. The deaths referred to diseases of the respiratoryorgans in London, which had declined from 252 to 200 in thepreceding five weeks, iurther fell to 182 last week, but were’7 above the corrected average. The causes of 71, or 1’6

per cent , of the deaths in the thirty-three towns were not.’certified either by a registered medical practitioner or bya coroner. All the causes of death were duly certified inBristol, Cardiff, Oldham, Newcastle-upon-Tyne and in nineother smaller towns; the largest proportions of uncertifieddeaths were registered in West Ham, Birmingham andHalifax.

____

HEALTH OF SCOTCH TOWNS.

’The annual rate of mortality in the eight Scotch towns,which had been 21’9 and 20’8 per 1000 in the preceding twoweeks, further declined to 19’1 during the week ending July29h and was 3’5 per 1000 below the mean rate during thesame period in the thirty-three large English towns. The ratesin the eight Scotch towns ranged from 14-4 in Edinburgh and

14-5 in Dundee to 22-7 in Leith and 29’2 in Perth. The 539deaths in these towns included 52 which were referred to

diarrhoea, 20 to measles, 18 to whooping-cough, 9 to "fever,"6 to scarlet fever, 5 to diphtheria, and not one to small-

pox ; in all, 110 deaths resulted from these principal zymoticdiseases, against 118 and 132 in the preceding two weeks.These 110 deaths were equal to an annual rate of 3 9 per 1000,which was 2 5 below the mean rate last week from thesame diseases in the thirty-three large English towns. Thefatal cases of diarrhoea, which had been 59 and 57 in thepreceding two weeks, further declined to 52 last week, ofwhich 30 occurred in Glasgow and 6 in Dundee. The deathsreferred to measles, which had been 23 and 24 in the pre-ceding two weeks, declined again to 20 last week, and in-cluded 12 in Glasgow and 6 in Greenock. The 18 fatalcases of whooping-cough showed a marked decline from thoserecorded in recent weeks, and included 14 in Glasgow. Thedeaths referred to different forms of "fever," which hadbeen 6 and 5 in the preceding two weeks, rose to 9 last week,of which 5 occurred in Paisley and 2 in Glasgow. The 6fatal cases of scarlet fever included 3 in Glasgow and 2 inLeith, and of the 5 deaths from diphtheria, 2 occurred inGlasgow. The deaths referred to diseases of the respiratoryorgans in these towns, which had been 77 in each of the pre-ceding two weeks, were 78 last week, and were 36 below thenumber recorded in the corresponding week of last year.The causes of 42, or nearly 8 per cent., of the deaths in theseeight towns last week were not certified.

HEALTH OF DUBLIN. ,

The death-rate in Dublin, which had increased in thepreceding three weeks from 24-6 to 30’3 per 1000, declinedagain to 29-2 during the week ending July 29th. During thepast four weeks of the current quarter the death-rate in thecity has averaged 27 ’8 per 1000, against 22 ’2 in London and 17 ’5in Edinburgh. The 196 deaths registered in Dublin during theweek under notice showed a decline of 7 from the number in the

preceding week and included 43 which resulted from the prin-cipal zymotic diseases, against numbers increasing from 34to 45 in the preceding three weeks ; of these, 35 were referredto diarrhoea, 4 to whooping-cough, 2 to diphtheria, 1 to

measles, 1 to "fever," and not one either to small-pox orscarlet fever. These 43 deaths were equal to an annual rate of6 ’4 per 1000, the zymotic death-rate during the same periodbeing 5-0 in London and 1’6 in Edinburgh. The fatal cases ofdiarrhoea, which had increased from 22 to 36 in the pre-ceding three weeks, were 35 last week. The deaths referredto whooping-cough, which had been 2 in each of the pre-ceding three weeks, rose to 4 last week. The mortality frommeasles and from I I fever" showed a decline from that re-corded in recent weeks, whilst the 2 fatal cases of diphtheriaexceeded the number recorded in any week since the begin-ning of April last. The 196 deaths registered in Dublin lastweek included 69 of infants under one year of age and 36 ofpersons aged upwards of sixty years ; the deaths of infantsexceeded those recorded in recent weeks, whilst thoseof elderly persons showed a further decline. Four inquestcases and five deaths from violence were registered ; and 52,or more than a fourth, of the deaths occurred in publicinstitutions. The causes of 13, or nearly 7 per cent., of thedeaths in the city last week were not certified.

CALCUTTA.

According to a memorandum issued by Dr. W. J. Simpson,the health officer of Calcutta, for the month of March last itappears that the total numbers of births and deaths and thebirth-rate and death-rate per 1000 of population per annumduring that month were as follows : The total number ofbirths registered was 1199, giving an annual birth-rate of 21 1per 1000. In urban Calcutta the births registered amountedto 742, giving an annual rate of 19 ’0, which exceeds all thecorresponding figures of the past decade excepting 1888 andalso surpasses the decennial average by 71. In suburbanCalcutta there were 457 births registered during the month,giving an annual ratio of 254 per 1000 of the popu-lation. The total number of deaths (exclusive of still-

births) registered in Calcutta for March was 1278, show-ing an annual death-rate of 22-5 per 1000 of the population.Out of these 49 were from cholera, 5 from small-pox, 481from fevers, 151 from bowel complaints, 41 from tetanus Inurban Calcutta the deaths amounted to 808, giving an annualratio of 20’7 per 1000 of population. The proportion of maleto female deaths was 125 to 100. There were 31 deaths from