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referred to a number of features of the analysis he had madein regard to the relationship between house-room and death-rate, and in summarising the results of his inquiry he askedwhether the several groups of population under considera-tion could be regarded as permanent sections of a population.He thought the death-rates which prevailed among themforbade that assumption. They were too low, and were notthe rates of a stationary population, but suggested rather anebb and flow of families caught in successive waves of goodor evil fortune. That interchange was actually takingplace to a recognisable extent in the case of the one-

apartment population and the Poor-law. To what extentit was also in progress between the occupants of threeand four apartments and upwards there were no presentmeans of determining. That it did occur was evidentfrom the low range of death-rates which the larger-sized houses presented. It might be urged that selectiveforces were in operation determining the movement of thepopulation in the direction of one size of house, and thatthese rather than the surroundings in which they were recog-nised were the determining factors for the death-rate incertain diseases of digestion and of the nervous system. Itwas otherwise with regard to infectious diseases. Here thehouse element predominated, for in one-apartment houses thedeath-rates from the principal infectious diseases of child-hood and from pneumonia at the ages 1-5 were 16 and 6,12 and 6 for two-apartment houses, but only 7 and 2 forthree-apartment houses, and 3 and 1 for four apartments andupwards. Before reaching these ages, however, the childrenborn in the smaller houses displayed evidence of a seriousphysical handicap, which was related to some extent tothe food-supply. The handicap was not extinguished bythe high rate from prematurity, but might be traced in thedisorders of digestion associated with low innervation, andin the diseases of early life associated with an unstablenervous system. In later life the influence of the birthsurroundings did not wholly disappear, but these were

obscured by the influences of adult life, which, as in thecase of diseases of the nervous system, tended to becomedegenerative in type, and appeared more frequently amongthe occupants of houses of larger size. In conclusion, Dr.Chalmers pointed out that the analysis he had submittedmight serve to emphasise the need for carrying an inquirybeyond the falling death-rate at all ages to a discrimina-tion of the age-periods at which it principally occurred.It might incidentally also serve to suggest that the wholeeconomic condition of the poor among the population andnot their housing only was a subject of national importance.

Aberdeen and the National Insurance Act.There are still about 5000 insured persons who have not

chosen their doctor. It is understood that the medical sub-committee has decided that these shall be allocated amongstpanel doctors having not more than 1500 on their lists.

Presentation to a Montrose Practitioner.

On the occasion of his leaving Montrose to take uppractice in Aberdeen Dr. Middleton Connon was presentedwith a silver salver and a surgical cabinet. The presentationtook place in Montrose council chamber before a largecompany, Provost Thomson being in the chair. Dr. Connonhas been in practice for 14 years in Montrose. In makingthe presentation Provost Thomson said that it would not doto let such a good official and good friend of the communityleave the district without expressing in some tangible waytheir appreciation of his services. Their good wishes wouldfollow him in his new sphere of duty and influence inAberdeen. Dr. Connon suitably replied.

Militiamen and Measles.At a general meeting of the county council of Inverness-

shire held in Inverness last week, Dr. J. Macdonald, medicalofficer of health, in submitting his report drew attention tothe fact that Dr. Murdo T. Mackenzie, of North Uist, in hisreport had stated that disbanded Militiamen had broughtmeasles to Grenitote, Sollers, and Beleshare. Consideringthe serious loss occasioned almost annually by schoolclosures and in the other ways through the introduc-tion of these diseases by the men attending the Militiatraining, he strongly urged that when any epidemic Joccurred in camp the men should be kept in quaran- tine long enough to make it certain beyond a possi-bility of doubt that none of them would be carriers of iinfection. Dr. Macdonald said the same complaint was i

i made in Ross-shire as to men coming back from camp’ and developing measles. Some representation should beL made to the War Office on the matter.’

Kingseat Asylum Annual Report.Dr. H. de M. Alexander, medical superintendent of Kingseat

’

Asylum, in his annual report states that on Dec. 31st, 1912,’

there were 460 patients on the register, the same number asthe previous year. 576 were under treatment, an increase of16 as compared with the previous year. The admissionsnumbered 52 men and 64 women. Of these, 39 men and 49women were certified as insane for the first time, and 28 hadsuffered from one or more previous attacks. Of thoseadmitted, 38 were curable, 59 were absolutely incurable,and in 19 the prospect of recovery was doubtful. The

discharges during the year numbered 64. The per-centage of recoveries on the admissions was 37’9-which was higher than last year. The majority ofpatients discharged as recovered suffered from melancholia.One man had recovered who had been insane for 15 years:He had been transferred from another mental hospital, wherehe had been resident for 10 years. He was now in steadyemployment. The deaths numbered 52-24 men and 28women, a large increase on the previous year. Eighteenof the patients who died were over 70 years of age. Thecost of maintenance of each patient was £26 7s. 6d., com-pared with £26 12s. 3d. for the previous year. The staff wasnow under the provisions of the National Health InsuranceAct, and the board had resolved that in case of sickness thesalary-less the sum allowed by the Act for sick benefit-should be paid for a period of two months. Reasons were

given for the proposed extension of the asylum, which hadbeen recommended by the Commissioners in Lunacy for someyears.May 6th.

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

Royal College of Surgeons in Ireland.Mr. J. B. Story, senior surgeon to the Royal Victoria Eye

and Ear Hospital, Dublin, has been elected to the vacantseat on the Council of the Royal College of Surgeons inIreland. The five other candidates were Mr. Coady, ColonelF. G. Adye-Curran, A.M.S. (retired), Mr. G. M. Fox, Mr.H. B. Goulding, and Mr. T. O’C. Redmond. Mr. Story wasfor many years on the Council of the College, but retired lastyear on becoming a candidate for the vice-presidency. Hehas recently been nominated as president of the IrishMedical Association.

Interference with a Medical Officer of Health.At the last meeting of the Kingstown urban council a

resolution was carried directing the medical officer of healthwhen reporting a dwelling unfit for occupation to saywhether he knew of any better dwelling to which thetenant could remove. One gentleman, supporting the reso-lution, declared that it was necessary to limit the powerof the medical officer." The intention of the council is, asfar as can be judged, to conceal from themselves the insani-tary condition of their district and from the public the needfor further provision of housing.

-Deat7t of Dr. Robert Browne, of Rcctlzgar.The death of Dr. Robert Browne, of Rathgar, Dublin,

occurred very unexpectedly last week. Few knew that hehad suffered from heart disease for some years, and as hewas going about until within two days of his death the newsgave a shock to his many friends. Dr. Browne graduated asM.B. at Trinity College in 1868, and became a Fellow of theRoyal College of Surgeons in Ireland in 1876. For manyyears past he was medical officer of health of the townshipof Rathmines and Rathgar, the most important suburb ofDublin. He was a painstaking officer and a man of highcharacter and ability.

The Late -Dr. J. B. Simpson.In the Common Hall of the Royal Belfast Academical

Institution on April 28th a memorial brass, erected by theOld Instonians Association in memory of the late Mr. ThomasAndrews, jun., and Dr. J. E. Simpson, who lost their lives.n the Titanic disaster on April 14th, 1912, was unveiledn the presence of a large and representative gathering.

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Sir John Byers, speaking on behalf of the medical

profession, said that Dr. Simpson, an old college:student of his, by his heroic conduct had maintainedthrough the greatest of sea tragedies the very highesttraditions of the medical profession and of the humanrace. He quoted from a letter written by the second officerof the Titanic, the last person to speak to Dr. Simpson andDr. W. F. N. O’Loughlin, the chief surgeon of the WhiteStar Line.

The National Insicrance Act.The much-talked-of conference between the Treasury Com-

mission appointed to inquire into the question of the.extension of medical benefits to Ireland, representatives ofthe Approved and Friendly Societies, and members of themedical profession from the six county boroughs in Ireland,took place in London on April 30th, but ended in no agree-ment. The Commission offered 9s. per insured person, exclu-sive of drugs, but to include attendance on the dependents.If this offer was not accepted the Commission threatened torecommend the establishment of a whole-time medicalservice, the administration thereof to be vested in the IrishInsurance Commission, who would have to organise such aservice in detail. At this conference the medical menabsolutely refused the 9s. offer for insured persons and theirdependents, but they agreed to place the matter before themedical practitioners of each of the six county boroughs.At a largely attended meeting of the medical practitionersof co. Tyrone on May lst it was stated that only 11 doctorsin the county had agreed to act on the insurance panel, and.of these six had already withdrawn and two more wouldwithdraw, so that only three doctors remained on the panel.A resolution was carried refusing to go on the panel, anddeclining to grant certificates on the terms recommended bythe Insurance Commissioners. It was stated that laymenand clergymen were traversing the country examiningpatients and giving them sick benefits without any medicalcertificate. The chairman, Dr. E. C. Thompson, of Omagh,pointed out that if societies granted benefits without medical.certificates they ran the risk of becoming bankrupt.May 6th.

________________

PARIS.

(FROM OUR OWN CORRESPONDENT.)

A Prize for Ophthalnaology.AN anonymous donor has given 5000 francs for a prize to

be awarded in 1914 for the best work on the etiology, prophy-laxis, and treatment of those forms of iritis, iridocyclitis, orcyclitis, arising from causes other than syphilis. Onlyassays that have been communicated to a French or foreignophthalmological society will be eligible. The award will beentrusted to three judges chosen from among the ophthal-mologists of the chief Parisian ophthalmological institutions.The essays, which must be typewritten or printed in French,English, or German, must be received before August 15th,1914, at the Bureau des Annales d’Oculistique, 26, BoulevardRaspail, Paris.

A Legacy for the Academy of Medicine.The permanent secretary of the Academy of Medicine has

been authorised to accept on behalf of the Academy alegacy made by Mlle. Morand, the proceeds to be distributedat the discretion of the Academy among the societies orinstitutions engaged- in treating children suffering from ormenaced by tuberculosis.

Nerve Suture in the Upper Limb.On April 22nd M. Mignon communicated to the Academy

of Medicine the results of certain cases of nerve suture in theupper limb. The suture was ineffective in some cases ofrecent wound, but succeeded in others in which the dividednerve had for a long time had its lower extremity atrophied.In two cases of suture of the radial nerve following onfracture of the humerus, that which had been performedunder the least favourable conditions succeeded, while theother was a failure. The best result had been obtained in asuture of the radial nerve above the elbow, performed aftera wound which involved the bone.

Town Planning from a Hygienic Standpoint.In a very interesting work Dr. Gabalda points out how

important it is that towns should make such provision that

in their future expansion they may not only furnish themaximum of comfort and salubrity, but also maintain acertain harmony. Town planning is a new science. Whenthe massing together of houses occurs, it produces the over-crowding that is the dominant characteristic of cities. Thedegree of this overcrowding in a given city may be deter-mined by estimating the density of its population. Forinstance, Paris in 1909 covered an area of 7936 hectares, witha population of 2,722,731, thus showing a density of 343inhabitants to the hectare. The mean density of the

principal cities of the world is as follows: London, 158 ;Berlin, 334 ; Vienna, 115; New York, 60; St. Petersburg,157 ; Madrid, 157 ; Rome, 93; Buenos Aires, 66 ; Tokio, 139;Brussels, 184; Chicago, 38. If the increase in the great citiesis more closely scrutinised, its progressive rise, especiallysince the beginning of the last century, is noticeable. InParis the increase in the decade 1886-1896 was 7’1 percent. During the same period it was in Berlin 37 per cent. ;London, 18 ; St. Petersburg, 15; New York, 33; andChicago, 106.5 per cent. The increase is especially markedin German towns. In a third of a century the populationof Berlin has increased by 1,214,000 inhabitants, or at therate of 146 per cent. No other capital shows so rapid anincrease.

Heliotherapy in Surgical Therape2cties.At the recent Congress on Gynaecology, Obstetrics, and

Pasdiatry M. Doche opened the discussion on this importantsubject by praising highly the treatment of tuberculousarthritis by means of immobilisation and heliotherapy.M. Verdelet supported him in this view, claiming credit fora part of the result for the climate of Arcachon. M. Vidalsaid that at the dispensary of the Union des Femmes de Franceat Algiers tumor albus had long been treated by exposure tothe sun’s rays. The sittings at first lasted only for fiveminutes, but finally reached eight or even nine hours. M.Delearde said that exposure to the sun’s rays gave excellentresults in the rachitic and in tuberculous adenitis, resultssuperior to those of opotherapy. M. Froelich noted with

pleasure the return to the ancient therapeutic methodwhich permitted the subjects of morbus coxæ to walk, thus avoiding their confinement in quarters closed to the sun’srays. In any case, the important matter was to keep thepatients as much as possible out of doors. M. Menciere rightlyremarked that the danger in medicine was the applicationof a particular therapeutic method to each individualcase. They must not pin their entire faith on heliotherapy.It was a good adjuvant, but too much must not be demandedfrom it. M. Gaudier supported M. Menciere, and thoughtthat while there was much good in heliotherapy the tendencyto exaggeration must be avoided.

The Water Question at the Faculty of Medicine.Many fatal cases of typhoid fever have made their appear-

ance in the quarter in which the Faculty of Medicine issituated. After a diligent search for the cause it wasfound that these cases were due to the absorption of thewater of the Seine in place of the city water-supply gatheredfrom the watersheds. This was brought about as follows.At the Congress of Hygiene, recently held at this Faculty,various works were carried out, and water from the Seinewas carried into pipes communicating with the water-supplyfrom the watersheds. A high official of the Faculty ofMedicine has declared that the Faculty is not responsible forthe serious error which has given rise to the typhoid feverepidemic now raging, but that on the contrary, the Facultywas its first victim. The Faculty, he said, according to itscontracts with- the city, of which it is a ratepayer,ought to receive only potable water. The water usedin the laboratories, in the practical schools, and inthe living rooms ought to be water from the main, andit was paid for as such. During the establishment ofthe exhibition of sports annexed to the Congress ofHygiene and Physical Education, the Faculty of Medicinehad deemed it a prudent precaution to increase the waterpressure for the fire service by simply opening the stopcockof a pipe connecting with the water-supply from the mainNo other communication or adjustment was made, but thepipes thus opened, in place of supplying water from themain furnished water from the Seine. This water, however,was paid for as purified water. The Faculty of Medi-cine was thus the first victim of the error, if itwas not a fraud, committed by the city, for a partof the personnel of the Faculty had been very seriously