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that period suffer from excess of infectious disease, but thiscomparative immunity is certainly not due to the abundantfacilities which are within the place to secure the spreadof contagion on importation. Dr. Parsons concludes by.expressing a hope for better things.On the Sanitary State of Helston Rural District, by

Dr. PARSONS.2—The Helston rural district, including theattractions of the Lizard Promontory, was also inspectedby Dr. Parsons. After a general description of the district,it is pointed out that, although the newer houses are of asubstantial character, others built on leases held on thelives of old persons were in a very neglected and insanitaryatate. Many houses are also damp and ill-ventilated.Drains are of the rudest character as a rule, and exceptpail-privies, which have been brought into general use inthe village of Cadgwitb, the closet accommodation ismostly such as to ensure nuisance and offensiveness.The water supply is unsatisfactory, mainly on accountof its deficiency and because the sources are so oftenmere shallow dipping wells. Since Dr. Ballard’s in-spection in 1882 the Local Government Board drew theattention of the authority to the need for action underthe Public Health Water Act; but this has been with-out effect. In this district there is an active and zealoushealth officer (Mr. N. R. Haswell), and the two inspectorsof nuisances, though ill-paid, have done much in reportingnuisances that called for remedy. But little in the way ofsanitary work has been carried out by the authority, mainlybecause of the fear of incurring expense in the face of de-pression of local industries, At Coverack the authority andthe public jointly bore the expense of a water service ; andin some places, such as Porthleven, much has been done toeffect improvement in the way of excrement and refusedisposal since Dr. Ballard’s visit in 1882; but improveddrainage is still much wanted there. Summarising theresults reported, it appears that in the populous parts ofthe district very insanitary conditions prevail, especiallydefective drainage, scarcity of water, and accumulations offilth. There is also an excessive mortality, and the excessis stated to be of a sort that is probably preventable bymore energetic action on the part of the sanitary authority.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 6016 birthsand 4145 deaths were registered during the week endingJanuary 21st. The annual rate of mortality in these towns,which had been 23’8 and 233 per 1000 in the precedingtwo weeks, further declined last week to 23’0. During the- 6rst three weeks of the current quarter the death-rate inthese towns averaged 23’4 per 1000, and was 0’9 below themean rate in the corresponding periods of the ten years1878-87. The lowest rates in these towns last week were17’0 in Brighton, 181 in Hull, 18-2 in Bristol, and 18-5 inOldham. The rates in the other towns ranged upwardsto 25’5 in Plymouth, 26-8 in Manchester, 28-1 in Black-burn, and 28 8 in Portsmouth. The deaths referred to theprincipal zymotic diseases in the twenty-eight towns,which had been 493 and 476 in the previous two weeks,were last week 481; they included 195 from whooping-cough,85 from scarlet fever. 56 from measles, 50 from " fever" (prin-cipally enteric), 36 from diphtheria, 30 from small-pox, and29 from diarrhoea. Nodeath from any of these zymotic diseaseswas recorded during the week either in Huddersfield or inHalifax, whereas they caused the highest death-rates inNottingham, Bolton, and Sheffield. The greatest mortalityfrom whooping-cough occurred in Salford, London, Wolver-hampton, and Leicester; from scarlet fever in Bolton,Cardiff, Preston, and Birkenhead; and from measles in INottingham, Blackburn, Derby, and Bolton. Of the 36 deathsfrom diphtheria in the twenty-eight towns, 22 occurred inLondon, 4 in Nottingham, 3 in Liverpool, 2 in Oldham,and 2 in Newcastle-upon-Tyne. Small-pox caused 25 deathsin Sheffield, 3 in Bristol, and 2 in Nottingham, but notone in London or in any of the twenty-four other largeprovincial towns. The Metropolitan Asylum hospitals con-tained only 5 small-pox patients on Saturday last. Thenumber of scarlet fever patients in the MetropolitanAsylum hospitals and in the London Fever Hospital was

2 Ibid.

1837 at the end of last week, against numbers decliningsteadily in the preceding six weeks from 2764 to 1808;the 133 cases admitted to these hospitals showed a declinefrom the numbers in recent weeks. The deaths referredto diseases of the respiratory organs in London, whichhad increased in the preceding four weeks from 357 to579, further rose last week to 594, and exceeded thecorrected average by 29. The causes of 79, or 1’9 percent., of the 4145 deaths in the twenty-eight towns lastweek were not certified either by a registered medical prac-titioner or by a coroner. All the causes of death wereduly certified in Bristol and in four other smaller towns ;and the largest proportions of uncertified deaths wererecorded in Huddersfield, Hull, and Salford.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 27’1 and 240 per 1000 in the precedingtwo weeks, further declined to 23’3 in the week endingJan. 21st; this rate exceeded, however, by 0’3 the mean rateduring the same week in the twenty-eight large Englishtowns. The rates in the Scotch towns last week rangedfrom 17’5 and 18’2 in Leith and Greenock, to 25’7 in Aberdeenand 26’5 in Dundee. The 588 deaths in the eight townsshowed a further decline of 19 from the numbers in recentweeks, and included 24 which were referred to whooping-cough, 15 to measles, 13 to diarrhoea, 6 to "fever" (typhus,enteric, or indtfinite), 5 to diphtheria, 3 to scarlet fever, andnot one to small-pox; in all, 66 deaths resulted from theseprincipal zymotic diseases, against 91 and 78 in the precedingtwo weeks. These 66 deaths were equal to an annual rate of2’6 per 1000, which was 0’1 below the mean rate last weekfrom the same diseases in the twenty-eight English towns.The fatal cases of whooping - cough, which had been 30and 26 in the preceding two weeks, further declined lastweek to 24, of which 12 occurred in Glasgow, 5 in Aberdeen,and 3 in Edinburgh. The 15 deaths from measles showed

a decline of 11 from the number in the previous week, andincluded 6 in Edinburgh, 6 in Leith, and 2 in Glasgow. Ofthe 13 deaths attributed to diarrhoea, an increase of 3 uponthe number in the previous week, 5 occurred in Edinburghand 3 in Aberdeen ; in the corresponding week of last yearonly 7 deaths from this cause were registered. The 6 deathsfrom " fever " and the 5 from diphtheria showed a declinefrom the numbers in the previous week; those from " fever

"

included 3 in Edindurgh and 2 in Glasgow, while 3 of the 5from diphtheria occurred in Glasgow. The deaths referredto acute diseases of the respiratory organs in the eighttowns, which had been 184, 163, and 159 in the precedingthree weeks, further declined last week to 155, and were 10below the number returned in the corresponding week oflast year. The causes of 77, or nearly 15 per cent., of thedeaths registered during the week were sot certified.

HEALTH OF DUBLIN.

; The rate of mortality in Dublin, which had been 38-6 and35.8 per 1000 in the preceding two weeks, further declined to31’9 in the week ending January 21st. During the firstthree weeks of the current quarter the death-rate in the

city averaged 35’4 per 1000, the mean rate during the sameperiod being but 23’6 in London and 26-7 in Edinburgh. The216 deaths in Dublin last week showed a decline of 26 fromthe number in the previous week; they included 8 whichwere referred to "fever" (typhus, enteric, or simple), 7to scarlet fever, 5 to whooping-cough, 4 to diarrhoea, 3 todiphtheria, 2 to measles, and not one to small-pox. Thusthe deaths referred to the principal zymotic diseases, whichhad been 33 and 32 in the preceding two weeks, further de-clined last week to 29, and were equal to an annual rate of4’3 per 1000, the rate from the same diseases being 3’1 inLondon and 3 8 in Edinburgh. The deaths referred to fever,which had been 7 and 5 in the preceding two weeks, roselast week to 8, and the fatal cases of diphtheria also showedan increase; whereas the deaths from searlet fever andmeasles had declined. The deaths both of infants and ofelderly persons showed a decline from the numbers in recentweeks. Four inquest cases, but no deaths from violence,were registered within the city; and 52, or more than aquarter, of the deaths occurred in public institutions.The causes of 34, or nearly 16 per cent., of the deaths inthe city were not registered.

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THE DEATH-RATE AS A TEST OF HEALTH CONDITION INTASMANIA.

The value of the death-rate as a test of health con-dition has recently been ’under discussion at the antipodes.In April last Air. R. M. Johnston, the Registrar-General ofTasmania, read a paper before the Royal Society of thatcolony on this subject, and pointed out how the generaldeath-rate is often a very faulty index of the comparativehealth or sanitary condition of different populations. It is

very satisfactory to find that the effect of age-distributionupon the death-rate of a population is now attractinga fairer share of the attention it deserves at the hands ofvital statisticians. Mr. Johnston calls attention to the factthat, while the mean death-rate of children under five yearsof age (we presume in the Australian colonies) is 42.15per 1000, and among persons aged upwards of sixtyyears is 61’53, it does not exceed 7’73 among personsaged between five and sixty years. It is obviousthat the death-rate of a population, quite apar,t from

sanitary condition, must depend to a considerable ex-

tent upon the distribution between these three groups ofages. There is usually a kind of compensation between thenumbers of children under five years and of elderly persons;when the proportion of children is large, that of elderlypersons is small, and the reverse. The populations of newcountries, however, may be expected to show very abnormalproportions. In noticing the official Tasmanian mortalitystatistics for 1886 a few months since, we called attentionto the comparatively high recorded death-rates in the townsof Hobart and Launceston. Mr. Johnston, in the paper undernotice, calls especially attention to the very exceptionalage-distribution of the population of Hobart, and pointsout that more than 43 per cent. of the deaths in that townin 1885 and 1886 were of persons aged upwards of sixtyyears. The proportion of deaths at these ages in thetwenty-eight largest English towns in 1886 was less than22 per cent., and in other Australasian towns it rangedfrom less than 9 per cent. in Brisbane to 19 per cent. inAdelaide. It would be interesting to have some explanationof this abnormal proportion of elderly persons in the Hobartpopulation, but it is evident that this fact goes far to

destroy, for comparative purposes, the value of the death-rate at all ages in this town as a measure of its healthcondition. It is beyond question that the abnormal age-distribution of the Hobart population must be taken intoaccount before its death-rate can be compared with that ofother towns. Mr. Johnston, in his paper referred to above,suggests as a health-standard of populations the death-rateamong all persons aged under sixty years as preferable tothe death-rate at all ages, because the disturbing elementof the varying proportion of elderly persons would thus beeliminated. It must be remembered, however, that theproportion of children under five years varies as widelyin different populations as does that of elderly persons,and is fully as powerful an element of disturbance.Moreover, as has been pointed out, inasmuch as thereis generally a tendency to compensation between thesetwo sources of disturbance, Mr. Johnston’s method hasthe serious defect of making his health standard practicallydependent upon the mortality of children, or rather upontheir proportion to the population under sixty years of age.On this ground this proposed new health-standard would,generally speaking, be less trustworthy for comparativepurposes than the usual standard-the death-rate at allages. There are, indeed, only two satisfactory methods ofmeeting such exceptional cases as that of Hobart Town forthe purposes of comparative vital statistics. Calculateddeath-rates at groups of ages are always strictly comparablewith the death-rates at the same groups of ages in otherpopulations. If, however, it be desired to calculate a

general death-rate at all ages which may be trustworthyfor comparison with the death-rate at all ages in otherpopulations, it is absolutely necessary to take full accountof the whole age-distribution of the population, and of thedifference between such age-distribution and that of astandard or life table population, as regards its effect uponthe general death-rate.

TRAPP PHAR31ACEUTICAL SCHOLARSHIP. — The St.Petersburg Pharmaceutical Society has founded a scholarship

for pharmaceutical students in honour of Dr. Julius Trapp,Emeritus Professor of Pharmacy in the Military Medical IAcademy, whose jubilee year this is. /.

Correspondence.DR. POTTER OF SAN FRANCISCO AND

HOMŒOPATHY.

"Audi alteram partem."

To the Editors of THE LANCET.SzRS,-By suggestion of Dr. T. Lauder Brunton, I beg to

all attention to some erroneous statements concerning mein the Homœopathic Review of June lst, 1887, under thetitle Dr. Lauder Brunton’s Explanation." The writer

says : " Dr. Potter is a graduate of the Homaeopathic MedicalCollege of Missouri, of 1878, and was, when we met him eightyears ago, a member of the American Institute of Homceo-

pathy, and practising homoeopathically at Milwaukee.Three years later he resided at Philadelphia, where heworked as a medical publisher’s hack, and then entered theUnited States army as an assistant surgeon." The errorsto which I allude are some of omission and others of com-

mission, which I desire to correct through the medium ofyour valuable journal, as they place me in a false positionwith my relatives and friends in England. I never prac-tised " homoeopathieally at Milwaukee " or elsewhere. True.I first graduated at a homoeopathic school, and was for oneyear a member of the American Institute of Homoeopathy,but I was never in practice as a homoeopath. My residencein Philadelphia "three years later" was not 11 as a medicalpublisher’s back," but was in pursuance of my studies at aregular medical school, the Jefferson Medical College, fromwhich I graduated in 1882. The work which Dr. Pope sounkindly characterises was all done after that date while inthe United States army, and comprised the writing of twovolumes in the now well-known series of " Quiz-Compends,"the revision of my prize essay, and in writing my recentlypublished 11 Handbook of Materia Medica, Pharmacy, andTherapeutics."My object in publishing the 11 index of Comparative

Therapeutics," to which so much reference has been made byDr. Brunton’s critics, is set forth in the following extractfrom a slip which I have used for years to advertise it by.In this say that the book "vindicates regular medicinefrom the stigma of ’pathy,’ showing that the term’ allopathy’ is a misnomer, and that practitioners of the oldschool are trained in the best features of all systems;compares regular medicine and homoeopathy side by side,showing that modern homoeopaths are only so in name." Enpassant, let me say to Dr. Pope that this book was no " pub-lisher’s back work, but that I paid the entire cost of type-setting, electrotyping, printing, and binding out of my ownpocket. Of the said book THE LANCET said, on August 19tb,.1882: " The author’s selections have been made with careand discretion. The work has been’well and carefully done."And the leading regular American medical journal, the NewYork Medical Record, said : " It is a work of considerableinterest. It illustrates a conformity of practice betweenthe two schools which is not generally suspected." Whilemy predecessor in the chair I occupy at present said, inthe Pacific Medical and Surgical Journal, that thereby" Dr. Potter has done good service to medical science."

I abandoned homoeopathy before entering into practice,because my observation of the reception by homoeopaths ofDr. C. Wesselhœft’s reproving of Carbo-Vegetabilis, and Dr.Sherman’s work in the "Milwaukee Test" of 1879, proved tome that no crucial drug experimentation, conducted underscientific safeguards, could meet with any degree of appre-ciation from the majority of that sect. I was further im-pressed by finding that ninety-nine out of every hundredso-called homoeopathic physicians were in the habit ofresorting to regular therapeutics whenever there was anyactive therapy to be done. About the time when I haddecided to abandon the Hahnemaniac philosophy, I had thepleasure of entering into some literary correspondeuce withDr. Roberts Bartholow, and, yielding to his urgent advice, Ientered Jefferson Medical College, having first compliedwith the regulations of the British Medical Council in re-spect to the examination in general education. Since mygraduation from that school I have had no association orconnexion whatever with homoeopathy.

In the introduction to my " Handbook of Materia Medica.