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and in many houses all members of the family havebeen stricken simultaneously. Coming on to Carlisle, it issaid to be more widely prevalent than ever. Most of theChurch of England clergymen have been already down withit and are on the road to recovery. It is said now that mostof the Methodist ministers in the town are also stricken.The places of worship are so poorly attended that it isevident that a great proportion of the inhabitants areafflictedwith thescourge. Thedeath-rate of thecityof Carlislehas been very high for the past two weeks-nearly doublethe average. Upon the various large works of the city andin the post-office and other institutions work is severelycrippled by the large number of hands on sick leave. AtHexham the medical officer of health, Dr. Jackson, reportedthat the death-rate of the last quarter of 1891 was equalto 42 per 1000, and was the highest noted since 1875.This high rate was principally due to whooping-cough,measles, and various diseases of the respiratory organs.At Kendal and Wigton influenza is reported to be verybad.

Influenza is prevalent about Middlesbrough, and Dr.Ketchen, one of the oldest practitioners in the town, fell avictim to pneumonia following influenza after a briefillness. Dr. Ketchen was attended by various medicalfriends, and was also seen by Dr. Eddison of Leeds. Medicalmen are so low now in their stock of vitality from continuedoverwork that they stand a poor chance of recovery whenattacked with pneumonia. Ib would be well for them toremember that the strain is very great to their constitu-tions, and the epidemic exceptional, and they should inthe case of large practices secure efficient assistance in time.A horse even cannot be kept running continuoasly, norcan a medical man go on without rest, food, and sleep.I mention this because many have told me of the largeamount of work they are doing just now, often single-handed, or with their ordinary assistance-but at what acost to health and risk to life !With regard to the importation of influenza from foreign

ports, it was mentioned at the last meeting of the Teessanitary authority that 179 vessels had been inspectedduring the past month, and that no case of influenza orinfectious disease had been noticed. This, it was men-tioned, was contrary to the popular opinion that it wasimported by vessels from foreign ports. The outbreak ofthe disease in isolated dwellings shows, I think, very clearlythat it is malarious or atmospheric, and the prevalence ofthe disease amongst the lower animals supports this view.Newcastle-on-Tyne, Jan. 21st.

SCOTLAND.{FROM OUR OWN CORRESPONDENTS.)

The Death of H.R.H. the Dulze oj Clarence.TOMORROW (Wednesday) being the funeral day of H.R.H.

the Duke of Clarence, the classes will not meet) either inthe University or in the Extra-mural School of Medicine.

Edinburgh Royal Infirmary.An adjourned meeting of the contributors to the Royal

Infirmary was held on Monday last, to consider the plan, ofwhich an outline has already been given here, for the ex-tension of the infirmary buildings as proposed by themanagers. A good deal of discussion took place, and theplans and proposals were objected to, and it was finallyagreed that the plans be recommitted to the managers forconsideration, their report to be laid before a meeting ofcontributors to be specially convened to consider them amonth hence.

Health of E, dinbitrgli.The mortality last week was 93, making the death-rate

18 per 1000. Diseases of the chest accounted for 51 deaths,and zymotic diseases for 4. The intimations for the weekwere typhoid fever 6, diphtheria 5, scarlatina 24, andmeasles 20.

Examinerships in Edinburgh University.Of the examinerships which fell to be filled by the Univer-

sity Court the following are among the appointments :-Prof. Stirling to Physiology, Dr. W. Craig to Materia Medica,Dr. A. Bruce to Pathology, and Dr. Beatson to Surgery.

Aberdeen City Hospital.The sub-committee of the Public Health Committee of

the Aberdeen Town Council appointed to investigate intocertain charges made against the City Hospital, have sub-mitted their report to the Town Council, and concludethat they have every reason to believe that the manage.ment of the hospital is thoroughly efficient, and that, asfar as possible, every care is exercised for the purpose ofseeing that both children and adult patients are kindlyand properly treated. The whole of the patients whowere examined bore testimony in favour of their kindlytreatment in the hospital.Jan. 19th.

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

Dublin Hospital Sunday Fund.THE total receipts for the collections in aid of the Dublin

Hospital Sunday Fund held last November amounted toX3982 19s. 5d., which includes a sum of £66 17s., theproceeds of a match between the Leinster Branch of theIrish Rugby Football Union and the Hospitals’ Team. Thetotal shows a falling off of £205 3s. 6d. as compared withthe year previous.

Proposed National Hospital for Consumption for Ireland.The promoters of the proposed hospital for phthisis

point out the necessity for a hospital of the kind in th&vicinity of Dublin. During the last few years greatadvances have been made in the knowledge of this disease;its method of spreading infection has been clearly demon.strated, and its treatment has been much improved. Itfollows that there is great need of a hospital where phthisiscan be properly treated, and which will be both a curativeand preventive institution. The malady is a very commonand very fatal one in Ireland, accounting for about one-tenth of the deaths from all causes. It is proposed that thescheme shall include the establishment of a hospital for atleast 100 beds, which shall be vested in a Board of Trustees.appointed by contributors to the building fund. If thescheme is carried it will materially benefit the generalhospitals, relieving them of their phthisical cases, the treat-ment of which, necessarily of a lengthy and costly character,cannot be successfully carried out in such hospitals.

Poor- law Returns for 1891.

By a recent return of the Local Government Board itappears that the total expenditure in 1891 for the poor-lawservices was f:l,407,886, or an increase of :E6014 over 1890.The expenditure was under the heads of in-maintenance,out-door relief, expenses under the Medical Charities Actand under the Public Health and Superannuation Acts, &c.

Death of Mr. Zachariah Johnson, A.M., -b’.B.C.S.I.,of Kilkenny.

I referred last week to the serious condition of this gentle-man, who at a very advanced age was a sufferer frominfluenza.. I regret to state that his death took place on thel2oh inst., at the age of eighty years. Mr. Johnson wa&

surgeon for many years to the County Infirmary.Cork Poor-law Medical Officers Association.

A meeting of this Association was held on Saturday lastto consider what action should be taken in reference to theBill entitled Medical Charities Amendment Bill, 1893,about to be brought in by the Irish Medical Association.Mr. Keating proposed the following resolution: "That weregard the drafb Bill of the Irish Medical Association(entitled Medical Charities Amendment Bill, 1892) as anattempt to delay useful legislation on the subject of poor-law medical reform in Ireland ; if such a Bill be introducedinto Parliament we pledge ourselves to give it every opposi-tion in our power; and we decline to accept any Bill as asettlement of our claims which does not deal with thequestions of pay, pension, and annual holiday." Dr. Sandi-ford also spoke in opposition to the proposed Bill, andseconded the resolution, which was’adopted. The Associa"tion now numbers over seventy members.

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Barrington Hospital, Limerick. The efficiency and increasing benefits bestowed by this

Charity are well maintained. During the past year 501patients were received into the hospital (the highesbrecord of intern patients), and 2530 were treated as externcases in the dispensary. The parts of the house and groundwhich were formerly held by the City Dispensary havebeen improved and put in good order. The old dispensaryrooms have undergone necessary renovation and cleansing,4lnd, as soon as the furniture has been supplied, will beready for the reception of private patients.

Union Medical Officers.At a largely attended meeting of the County Limerick

Branch of the Irish Medical Association, Dr. Thomas Hayes(Rathkeale) in the chair, the following resolutions werepassed without dissent:—" That union medical oiiicersshould be permitted to retire on a pension of two-thirds ofsalary and emoluments at twenty years, and upon full valueat thirty years’ service. That the fees for registration andvaccination should be equalised with those obtaining in Eng-land and Scotland. That we are unanimously of opinionthat the present salaries of Poor-law medical officers arewholly inadequate, and should be increased by 75 per cent."Jan. 19th.

PARIS.(FROM OUR OWN CORRESPONDENT.)

Influenza in France.ALTHOUGH Paris itself may be congratulated on being

’comparatively exempt from theseourge which is playing suchsad havoc in different parts of England, other districts ofFrance have not been so fortunate. In the coal-miningdepartment of the Pas-de-Calais quite a fifth of the popula-tion is hors de combat. At Cherbourg, seventy-three personssuccumbed to influenza in the first week of this month, and atSaint-Etienne the mortality has increased 45 per cent. Lille,Roubaix, Tourcoing, and Dunkerque are being severelytried; and at Prades, in the Pyrenees-Orientales, the meanmortality is tripled, in one instance four out of a familyof five persons having died. I may mention that in thefew mild cases I have been called upon to treat lately inParis, I have found five-grain doses of phenacetin every fourhours answer capitally, the pain ceasing and the temperaturebeing lowered rapidly.

The Length of the Urethrtt.To judge by the varying figures given by different

authorities, it would seem to be advisable to allow a largemargm when asked at an examination to state the lengthof the male urethra. The Union Med. du Nord-Est pub-lishes a list of measurements gathered from the writings oftwenty-one different anatomists, from which it appears thatwhile Richeb gives the length as 15 centimetres, Heisterallows more than its double-viz., 33.5. Sappey states thatthe length varies not only in different individuals, but alsowith age. Richet denies this latter assertion. A definiteunderstanding on this moot point is urgently required,seeing the popularity of Guyon’s instillation method oftreatment for gleet.

Yet another New Medical Society in Paris.In last week’s correspondence it was announced that an

association of foreign doctors practising in Paris had beenrecently founded, and reference was made to the two.year-old Continntal Anglo-American Medical Society. It is feltby English practitioners residing in this city that both theabove bodies are open to the same reproach in beingsomewhat too heterogeneous in the matter of membership,and it is thought that some effort should be made to bringmore closely together those British practitioners residing inFrance who, in addition to being subjects of Her Majesty,are possessed of British diplomas. It is accordingly incontemplation to create an association whose business itshall be to give such information to the public through itspublished official list as to enable them to distinguishbetween the real and the pseudo-English physicians, asalso to promote good-fellowship between men hailing fromthe London, Edinburgh, Dablin, and provincial schools of

medicine in the old country. I heartily wish the newsociety the success it deserves.

Breton Ignorance.M. 11’enan’m compatriots enjoy, rightly or wrongly, the

reputation of being rather behindhand in civilisation. Alocal doctor has just addressed a report to the Prefet ofMorbihan. from which it would appear that these primitivepeople have not been altogether maligned, at least in so faras ignorance of the laws of health are concerned. In 1884typhoid fever made its appearance in the commune ofLangoëlan, whose inhabitants, distributed over numeroushamlets, number 1350. Twenty-three hamlets and themarket town have been visited by the scourge, some ofthem several times in succession since the first outbreak, andtyphoid fever has evidently taken up permanent quarters inthe unlucky commune. Add to this that the mortality isenormous (at Kervoten seven cases with four deaths, andat Cosquer eight with five deaths), and it will be concededthat the state of affairs is serious. The reason is not far toseek; I give it in Dr. Langlais’ own words : "Les dejectionssont repandues it la porte, sur le fumier de la cour ; aumilieu de cette cour est creusé le puits, veritable drain quipompe tous les liquides et tous les germes. Chaquemaladeest un objet de curiosité qu’il faut visiter, n au’il fautserrer la main, qu’on doit embrasser, et l’on boit au m6meverre que lui." What a happy hunting ground for the livelytyphoid bacillus, and what scope for the sanitary reformer

Paris, Jan. 20th.

BERLIN.(FROM OUR OWN CORRESPONDENT.)

Influenza.ACCORDING to official statistics, only 25 persons died in

Berlin of influenza between 1878 and 1889. Of these years1887 had the highest influenza mortality-namely, 7. Thenumber of deaths in 1889 was 54, in 1890 90, and in 1891,before Dec. 12bh, 286. Those are all the cases in whichinfluenza was expressly given as the cause of death in thedeath certificateq. In 1890 only June and November hadno deaths from influenza.; in 1891 only July and September.There were 5 deaths from this cause in the second week oflast November, 36 in the next, 61 in the next, 88 in thenext, and 80 in the next. The Berlin horses are said tobe suffering pretty severely from influenza. Kitasato, whoworks under Pfeiffer in the scientific department of Koch’sinstitute, has succeeded in cultivating Pfeiffer’s influenzabacillus in pure cultures to the tenth generation. In severaluncertain cases the diagnosis of influenza has been con-firmed by the finding of Pfeiffer’s bacillus in the blood.

An Explanation oj the Effect of Quinine.An explanation of the therapeutic effect of quinine in

malaria has at last been found. So long ago as 1867 Dr. KarlBinz, professor of pharmacology at Bonn, gave an explana-tion which was little noticed at the time, but has now beensignally confirmed by the discovery of the germ of malaria.He showed that quinine hydrochlorate, with neutral or

slightly basic reaction, is a strong poison for the protoplasmsof decomposing plants, and great)y hinders many fermentingand putrescent processes. A. Laveran, the discoverer ofthe plasmodium malariæ, has demonstrated that thisorganism disappears from the blood of malaria patientsafter the administering of quinine, and that quinine, ifpermitted to act upon it directly, kills it.

The Berlin Medical Society.At the general meeting of the Berlin Medical Society on

the 12th inst. Professor Virchow was appointed Presidentby an enormous majority. Of 137 votes, 135 were given forhim, one for Professor von Bergmann, and one for Professorvon Bardeleben.

New Books.

"Evolution" (a new view of Darwinism), by WilhelmRussbuldt; " On the threatening Physical Degenerationof civilised Mankind and the Nationalisation of the MedicalProfession," by Dr. Schallmayer ; "The Tasks and Aims ofHygiene," by Dr. Krocker; "On the Sanitation of Heli-goland in the years 1886-1889," by Dr. Lindemann ; " Onthe recently proposed Measures of Sanitary Police for