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this infirmary is decidedly well managed, and, in spite ofdisadvantages arising from its primary faults of construc-tion, is well worthy of the high position it takes amongstthese institutions in the provinces. It abounds in muchvaluable clinical material, and is fortunate in possessing astaff who largely avail themselves of the opportunitiesafforded them, and who work zealously in the spirit of theage. At the same time we believe that these gentlemenwould be the first to welcome any suggestions whereby thestudv and observation of these cases could be made availableto others. If it were possible to institute minor officials torecord the cases, all this valuable material would be put togood purpose. It would be even worth the while of ad-vanced students to spend some months within the wards ofsuch an institution as this, containing as they do so varieda group of examples of disease,-especially rich in thediseases of old age. But if there be one direction morethan another in which the Liverpool Workhouse Infirmaryshould be commended, it is in its nursing system. We arefar from saying that even yet is its nursing staff sufficient tocope with the vast amount of labour entailed on it, especiallyin the crowded infirm wards. Still it is always possible toincrease a staff, the great thing is to have a sound and goodworking system. The revolution effected in workhousenursing, since Agnes Jones was appointed the first super-intendent to establish a system of trained nursing, was onewhich began in Liverpool, to spread thence over the land.The experiment proved to be a success, a result in a largemeasure no doubt owing to the indefatigable labours of thatexcellent lady, whose "Memorials" contrast in their sim-plicity with one other biography of a similar kind, recentlypublished and far more widely read. Those who knew MissJones have testified in no measured language to her worth,and her premature death from typhus, contracted in the dis-charge of her duties, was deeply deplored. In the few yearsof responsible position at the Liverpool Infirmary she suc-ceeded in establishing a system of nursing which has neverbeen called in question, and which it would be well for somepresent-day reformers to imitate instead of creating im-practicable systems of their own.The separation of the sick from the ordinary infirm and

able-bodied pauper would greatly facilitate and ensure theproper treatment of the sick. And it seems to us a questionwell worth the serious consideration of the guardianswhether the construction of the buildings on another site insome other quarter might not be possible to obtain this ad-vantage. The present site must be of considerable value,and the sale of it might enable the guardians to erect a morecommodious building on cheaper land in the suburbs. Themajority of cases could then be housed and treated in betterbuildings and purer air than is at present the case ; whilstit would be only necessary to retain a comparatively smallbuilding in the city for the reception of casual inmates andacute cases of illness arising among the outside population.The ratepayers of Liverpool, are not only shrewd men ofbusiness, but have shown considerable liberality in manymatters concerning the welfare of the poor of their town, sothat the consideration of slight temporary increase in therates caused by the removal would probably not deter themif they felt convinced it was the right thing to do. Of thatwe have no doubt, and believe the question of removal ofsome of the inmates to more spacious quarters to be oneonly of time. The Liverpool guardians have earned thecredit of being the first to introduce the system of trainednursing in our workhouse iufirmaries, one of their number,Mr. Rathbone, guaranteeing a large sum, £5000 we believe,to cover expenses in case the experiment failed. With suchan instance of Liverpool muuiiicence and liberality beforeus, we shall be surprised if the guardians of that city willlong remain content with their present crowded and un-suitable building, hut will ere long vie with London andtheir neighbour, Manchester, in erecting a new workhouseand sick asylum adequate to the increasing requirementsof the city, and worthy of themselves.

A GOLD CuP and an appreciative address were inthe early part of last month presented, at the hall of theMedical Society of Victoria, to Dr. J. E. Neild, who formany years has occupied the posts of editor of the Austra-lian Medical Journal and secretary to the Society. The

meeting at which the presentation took place was attendedby a large number of the leading medical men of Victoria,and appears to have been of a very gratifying character toall present.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL INSPECTORS OF THE LOCAL

GOVERNMENT BOARD.

Southend.-Our readers will probably remember that at

the close of the past year and the beginning of the presentrumours of a serious prevalence of enteric fever in the

pleasant seaside resort of Southend, situated on the northernshore of the estuary of the Thames, became current. Therumours appeared to derive confirmation when it becameknown that Dr. Thorne Thorne, of the medical departmentof the Local Government Board, had been despatched to thespot with instructions to make inquiry as to the rumouredfever, and generally to examine the anitary condition ofSouthend. Dr. Thorne Thorne’s report of this investigationis now before us, and we may say at once that while therumours of fever proved to be well-founded, the locality inwhich the disease appeared was not the town of Southend-the health-resort of that name-but a detached hamlet,named Prittlewell, within the urban sanitary district ofSouthend. The town, in fact, escaped the outbreak of

fever, and does not appear to have suffered from the con.

tiguity of the infected locality. " Indeed," writes Dr.Thorne, "the two places (Prittlewell and Southend) are,from a sanitary point of view, quite distinct; they aresituated about a mile apart ; they have different watersupplies and distinct methods of drainage ; and thereappear to be no direct means by which such a disease asenteric fever could spread from one to the other." Thesanitary condition of the town of Southend seems to befairly attended to by the local authority. There is an ex-cellent public water-supply, but this is not yet generallydistributed ; and a system of sewerage, which needs somedetails before it will be completed. But if the localauthority think fit to be guided by Dr. Thorne’s recom-mendations, it may readily place the sanitary reputation ofSouthend beyond reproach.

Prittlewell, the scene of the outbreak of fever, is anancient detached village within the Southend urban sanitarydistrict, and at the time of Dr. Thorne’s inquiry seemsto have been wholly neglected by the sanitary authority,Here during the six months, September, 1879, and February,1880, among a population estimated at 600, no less than 100cases of enteric fever occurred. Wells, cesspools, and privy-pits are hollowed promiscuously in the same porous stratumof subsoil. The wells are at all times liable to pollution bypercolation of the contents of the cesspools and privy-pitsthrough the intervening soil ; but this liability is muchgreater at some times than others. Thus, for instance, whenthe level of the subsoil water becomes exceptionally raisedafter heavy rainfall, and encroaches upon the cesspoolsand privy-pits, the water in the wells and the filth in thecesspools and privy-pits are put in direct communication.This condition of things, it appears, happened in Prittlewellin the autumn of 1878 ; it was not general over the whole ofthe village, but from a topographical peculiarity was confinedto a particular portion of it. It was to this portion that theoutbreak of enteric fever was almost wholly confined; andthere can be little doubt that the disease was then deter-mined by an exceptionally polluted state of the water-

supply of the particular locality. The prosperity ofSouthend town must run risk of being seriously damagedby a continuance of the state of things, both as to water-

supply and drainage, which Dr. Thorne describes he foundin Prittlewell ; and as the village, by extension of buildingsin that direction, appears to be about to become a partof the town, it behoves the local authority to amend asquickly as possible the sanitary condition of the village, andremove a reproach from their district.

Edmonton.—A report has been issued by the LocalGovernment Board, containing the results of an inquiry madeby Dr. H. F. Parsons, one of their medical inspectors, on theresults of an inquiry into the endemic prevalence of entericfever and the general sanitary condition of the urban sani-tary district of Edmonton, in the northern suburbs ofLondon. The report presents a remarkable picture of the

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sanitary and structural conditions of buildings which toocommonly obtain in the rapidly extending suburbs ofLondon, where apathetic and short-sighted local authoritiesand imperfect bye-laws contribute to reproduce year afteryear the evils which it has been the aim of the sanitary Actsto obviate. "The cottages recently erected in Edmontonproper," writes Dr. Parsons, "are many of them of theflimsiest style of jerry-building. The mortar which wasbeing used at the time of the inquiry in some cottages incourse of erection mainly consisted of road scrapings-blackfetid sludge. The sanitary authority had, however, legalproceedings pending against a builder for using impropermaterials for mortar. There was no damp-course in manyinstances. In one case there were no ridge-tiles to the roofto exclude rain, the slates at the angle of the roof beingmerely nailed by their edge to the ridge piece." This beingan example of the state of matters above-ground with regardto the most numerous class of buildings, the sort of caregiven to those matters which are hidden from sight belowground may readily be conceived. Edmonton has a systemof sewers, but these appear to have been constructed afterthe manner of the cottages described, and it seems question-able whether they are more mischievous or useful. Of housedrainage (the public sewers being as hinted), it may be saidthat its main aim seems to be not to facilitate the passage ofdrainage into the sewers, but to facilitate its leakage into thesubsoil. Cesspools and privies are still common, the systemof sewerage notwithstanding. Add that almost all the watersupply is derived from shallow wells, and the mind is at noloss to conceive the conditions which make enteric feverendemic in the place. Indeed, the insanitary arrangementsof Edmonton appear to be especially designed for facilitat-ing the pollution of the soil, the water, and the air with theexcremental matter. Dr. Parsons mentions a curious indica-tionoffouling ofthe soil which we have not found noted before.In certain cottages, especially on Sundays, an offensiveeffluvium pervades the house, coming from the coal-cellars.In these cases the floor of the cellar proved to be the naturalsoil, unfloored with wood or other material. On Sundayspumping at the outlet of the sewers, for the purpose of dis-tributing the sewage on to land for irrigation ceases, and thesewage backs up in the sewers, and consequently, havingregard to their leakiness, in the subsoil. This effluvium ischiefly observed coincidently with this backing-up of thesewage, and Dr. Parsons is no doubt right in looking uponit as an indication of the weekly surcharging of the subsoilwith offensive matters.

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REPORTS OF MEDICAL OFFICERS OF HEALTH.

Leicester.—Dr. W. Johnston’s report on the health andsanitary condition of the borough of Leicester for the year18i9 is, like previous reports of this gentleman, a documentof the highest interest. Although dealing with strictlylocal subjects, it treats them in a fashion which gives themgeneral value, and makes the report one of permanent im-portance. It is not an insignificant consideration that thereport is published with a careful consideration to typo-graphy and diagrammatic illustration, which add to its in-terest and h&6.t its worth. The subjects which will chieflyarrest attention in this report relate to the working of thelocal Act requiring the giving immediate information to thesanitary authority of the occurrence of certain diseases, theobservations on diarrhœa, the immunity of Leicester from" fever," and the infant mortality of the place. The localAct referred to came into operation on Sept. 13tb, 1879.Nevertheless, short as the period was within which the Acthad been in force, Dr. Johnston reports very favourably ofthe advantages in the limitation of infectious disease whichhad been derived from it. A larger number of cases hadbeen removed to hospital; it had been possible to maintain- greater control over children from infected houses or con-valescent from infectious disease frequenting school, as wellas over the making up of goods for commercial purposes ininfected houses, and more detailed care in helping familiesas to processes of disinfection had become practicable. TheAct, notwithstanding predictions to the contrary, has workedwithout tiiction, and Dr. Johnston is obviously hopeful thatthe antagonism to the Act displayed in the first instance by:he medical profession in the borough will subside. Themarked success of operation of the Leicester Act no doubtrests largely on the fact that the borough possessed at the timethe Act came into force an excellent infectious-disease hos-pital. The possession of such a hospital ought to be made

a condition precedent to the granting of powers to anysanitary authority for the compulsory communication ofinformation as to infectious disease. The death-rate fromdiarrhoea in Leicester in 1879 was the lowest that had beenrecorded in that town. Dr. Johnston comments on thisconcurrence of a low death-rate with the low average ofmean temperature of the air, the absence of sunshine, andthe great rainfall, and shows how the facts tend to confirmthe conclusions he has formed on the influence of fermentsderived from the putrefaction of animal refuse collected incesspools and sewers in provoking diarrhoea. He againpoints out from last year’s records that the diarrhoea wasnot limited to any particular age, although chiefly fatal ininfants and young children-a distribution inconsistent withthe view that diarrhoea was the result of maternal neglectand bad nursing. The immunity from fever in Leicester isassigned to the general plan of avoiding direct connexionbetween the house-drains and the sewer, the rarity of cess-pools, the absence of "slums," and the good supply of purewater. Dr. Johnston discusses at some length the causes ofthe excessive infant mortality of Leicester, and shows thatthis mortality is especially a phenomenon of the thirdquarter of the year, and particularly relates to diarrhoea,tubercular diseases, atrophic affections, and prematurebirth. A theory of maternal neglect is wholly insufficientto account for the phenomenon, and to whatever extent suchneglect may concur in helping to the result, other and moreefficient causes must be sought for an explanation. Thesecauses, in so far as diarrhcea is concerned, must, ac-

cording to Dr. Johnston, be looked for in peculiar localconditions.

Bolton.—Mr. Edward Sergeant has had the good fortuneof having to prepare for his sanitary authoiity a quite un-eventful report of the health and sanitary condition of hisdistrict for the year 1879. The borough in that year had abirth-rate of 37’0 per 1000 proper and a death-rate of 21’2per 1000. The infant mortality was unusually low, andzymotic diseases "were accredited with fewer deaths thanin any year yet recorded." Nevertheless, Mr. Sergeant hassought to attach a special interest to his present report bygiving (after the manner of Mr. T. P. Teale) plates illus-trative of the dangers arising from sundry defective drain-age arrangements. The report has some observations on thesecond year’s operation of the Local Act for the notificationof infectious diseases to the Sanitary Authority. The Act,in the first instance, worked with so much friction that itwas found necessary last year to obtain a Provisional Orderfor amending it in several details. We fail to gather fromthe present report a clear idea of the working of the Act asamended by the Provisional Order, but it seems doubtful

. whether friction has still been satisfactorily removed. The, amount of infectious sickness reported to the Sanitary’ Authority last year (651 cases) was less than in the previous

year, but, happily, this is to be attributed to the exceptionalfreedom of the town from infectious diseases.

REPORT OF THE MEDICAL SUPERINTENDENT OF THEDEPTFORD HOSPITAL.

The report of the Medical Superintendent of the DeptfordHospital (Dr. John McCombie) for 1879 shows that, in thecourse of the year, 1634 acute cases of smuli-pox were ad-mitted, 1325 discharged recovered, and 282 died. Of thesecases 1148 were vaccinated, of 228 the vaccination wasdoubtful, and 258 unvaccinated. Of the vaccinated 83 died,of the doubtfully vaccinated 78, and of the unvaccinated 121,showing a death-rate of 7 2 per cent. in the vaccinated,34’6 per cent. in the doubtfully vaccinated, and 47 °2 per cent.for the unvaccinated. The statistics Dr. McCombie givessuggest to him that sex appears to have an importantinfluence on the mortality from small-pox in vaccinatedpersons after puberty. They show that in cases withimperfect marks two deaths occur in females as early asseven years, while in males no death occurs before twelve;and in cases with good marks deaths occur in females ateleven years of age, and there are five deaths under puberty(sixteen years) ; but in males no death occurs under nine-teen years. He thinks that these data indicate the

necessity for earlier revaccination in the case of females thanin the case of males.

Dr. McComhie records not less than ten cases of small-poxafter revaccination ; but on these cases he observes-" Itwould appear from this that cases of small-pox do occasion-ally occur after apparently successful revaccination; but I

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would remark that in nearly all the cases the primary vacci-nation was imperfect, and I would suggest that the revac-cination was in some way imperfect, since no case of small-pox has occurred here among the staff, who were successfullyrevaccinated before entering on their duties. Up to Dec. 31st,1879, 14S staff have been employed in the hospital. Of these,141 have been in more or less direct contact with patientssuffering from small-pox. All were revaccinated before

entering on their duties ; only one took small-pox. Thiswas the case of a ward servant, who developed small-poxafter entering the service, and eight days after revaccinationhad been performed. She had evidently received the infec-tion of small-pox before she was revaccinated."

THE HEREFORD SANITARY COMBINATION.

We learn from the Hereford Tirnes that the authorities ofthe Hereford Combined Sanitary District have decided tomaintain their combination, at least for a further period ofthree years, and to retain Dr. Vavasour Sandford in theappointment of Medical Officer of Health, an appointmentwhich he has now held for six years. The right-mmdednessof this action is, however, stultified by a resolution of theauthorities to reduce the salary of the medical officer ofhealth from £550 to £400 ! It is admitted by the authorities,without exception, that Dr. Vavasour Sandford has done theduties of his difficult office well, and with infinite advan-tage to the sanitary condition of the combined districts;moreover, that at least E100 of the proposed salary must bedevoted to travelling expenses. Fortunately, the resolutionof the authorities cannot be carried into effect without theconsent of the Local Government Board, and we can scarcelyconceive of that Board lending itself to a procedure which iscalculated to degrade the functions of a medical officer ofhealth, and to deter men of good standing and with therequisite qualifications from holding the post. It is high timethat some measures were taken to put an end to thesevagaries of local sanitary authorities. They betray on thepart of the perpetrators an indifference to public-healthrequirements of communities under their care, and a dis-position to behave unjustly to medical officers of health,in the highest degree disheartening, and it behoves the LocalGovernment Board to see that the designs of the Legislatureshall not be frustrated in this pitiful fashion.

THE WATER-SUPPLY OF CROMER.

A seaside town, with waterclosets and a system of drain-age into the sea, and no regular water-supply, must be re-garded as in a very unsafe sanitary condition. These arethe conditions which obtain in the charming little Norfolkresort-Cromer. A project for establishing an adequatewater-supply has been for some time in progress, but it haslately hung fire, and there is some fear that it may be re-linquished. At present the chief source of water for ordi-nary purpose is the rain. There are a few wells in the town,water from which can be purchased, but for the watercloset-supply, cleanliness, and even in many cases for drinkingpurposes, rain-water is used, collected in large tanks. Nodoubt, in a wet season, such as the present, the supply isadequate, but in a dry season the supply may fail, and thestate of affairs would then be perilous in the extreme.Perfect waterclosets, an abundant water-supply, and freeventilation of the sewers are absolutely essential for thesafety of a system of drainage into the sea, and if anyone ofthese conditions is imperfect the sanitary system becomesinsanitary, and the provision for health, a source ofdisease. It behoves those who are interested in the townto persevere in their efforts to establish a good water-

supply, or public confidence in the salubrity of the place willscarcely be maintained.

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REGISTRATION OF INFECTIOUS DISEASES.

At a meeting of the Executive Committee of the DublinSanitary Association, held recently, a resolution was adoptedin reference to this subject. The committee approvedgenerally of the principle involved in the proposal toestablish a system ot early and compulsory notitication ofinfections diseases to the Sanitary Authority, and of subse-quent official registration of the same, as they believe thatthe information f-o obtained as to the origin and spread ofepidemic diseases cannot fail to be of great value in aid of theefforts to improve public health.

THE RIVERS POLLUTION PREVENTION ACT.

A deputation from the Fisheries Preservation and otherAssociations had an interview with the President of theLocal Government Board on Tuesday, the 27tb, for the pur.pose of representing to him the necessity which, from theirpoint of view, existed for giving greater facilities for puttingthe Rivers Pollution Prevention Act, 1876, in operation, andfor making its provisions more stringent. Mr. Dodson, inreply, stated in effect that the observations of the deputa.tion furnished another illustration of the difficulties sur.rounding the subject of purifying our rivers. Governmentwas called upon to reconcile in the best way they couldthe commercial, fishery, and sanitary interests involved inthe question, each clashing with the others. The subjectwas one on which he could not give an answer on the partof the Government on that occasion, but the observa-tions of the deputation would receive his most carefulattention.

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SANITARY CONDITION OF THE NORTH DUBLIN UNION.

Dr. MacCabe, Local Government Board Inspector, recentlyinspected this workhouse, and reports in reference to itssanitary condition that the increased numbers residentduring the past six months have led to overcrowding insome of the departments, and as a result there has been anunusually large number of cases of fever and other infectiousdiseases transferred to Cork-street and Hardwicke FeverHospitals. By a recent arrangement observation wardshave been provided in the workhouse, a provision whichwill tend to prevent the spread of infectious diseases infuture ; and the guardians are considering the necessity ofproviding shed accommodation within the Union, but out-side the city, for the reception and treatment of infectiousdiseases.

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An order has been issued by the Local Government Boardwhich will remove a serious grievance which has been feltby district medical officers in various parts of the metro-polis. This order provides that, subject to the approval ofthe Local Government Board, it shall no longer be requisitethat a metropolitan district medical officer shall be calledupon in every case to reside within his district. There areparts of London where it has been found impracticable for amedical officer to secure a suitable residence within his dis-trict, and other parts where a substantial injustice has beendone to the medical officer by a strict adherence to the ruleof residence, without advantage to the working of the dis-trict. It will now be practicable to remove those difficultieson sufficient cause being shown to the Local GovernmentBoard.

Dr. Archer Farr, the medical officer of health for Lam-beth, having been called upon by the Sawers and SanitaryCommittee of his Sanitary Authority to prepare a specialreport on the number of beds Lambeth should contract for,under the Poor-law Amendment Act of 1879, in the Metro.politan Asylums Board Hospitals, has reported that heis unable to express an opinion on the subject until he canobtain some clearer knowledge of the mode in which pauperand non-pauper cases will be discriminated by the AsylumsBoard.

Mr. Clare Sewell Read has written a letter to The Times,expressing his regret that he was unable to take a part in thedeputation of the British Medical Association ) the Pre-sident of the Local Government Board on the 26th, to protestagainst the Vaccination Acts Amendment Bill. He hadbeen influential in causing a similar provision to that nowproposed being thrown out of the Amending Bill of lSil,and had he known of the proposed deputation he shouldhave volunteered to be a member of t.

Metropolitans who are desirous to study the pig-nuisancemay do so, it appears, very conveniently in Arthur-street,Chelsea, which rejoices (or rejoiced a few days ago) in 115of these interesting and useful inmates. A proposition sub-mitted to the Vestry for prohibiting the keeping of pigs inthickly populated neighbourhoods, and doing away with thisparticular relic of rural Chelsea, was, notwithstanding thatit was supported by piteous complaints of "dreadful smells,rejected by a majority of one.

It is proposed by the Metropolitan Asylum Board to makeadditions to their Deptford Hospital, so that cases of feveras well as of small-pox may be received and treated there.

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llr. Hawking the Inspector of Anatomy for the HomeOffice, attended a meeting of the Sanitary Authority forSt. Pancras on the 24th inst. with reference to the allegednuisance from the private dissecting-room in the disusedburial-ground of St. George-the-Martyr. Mr. Hawkins ex-

pressed the opinion that the complaints were not justifiedeither by the situation or the management of the building,and the Sanitary Authority passed a resolution in accordancewith this view of the question.The Medical Officer of Health for Greenock (Dr. James

Wallace) reports a mortality for the five weeks ending3rd July equal to an annual rate of 16’2 per 1000 population,compared with 18’7, 17’7, and 21’2 for the period of theyears 1877, 1878, and 1879 respectively. The returns ofinfectious sickness included six cases of typhus (and pro-bably four other cases), all, with one exception, connectedwith cases noted in previous reports.A batch of twenty persons were recently summoned before

the Bedford Borough Bench of magistrates for refusing tohave their children vaccinated. In each instance the defenceof "conscientious scruples" was urged, and apparently ac-cepted, for the Bench inflicted, it is reported, a nominal fineof sixpence in every case, remitting the costs altogether !This lenient course in cases of this class has been followedby the Bedford Bench, it is asserted, for some time back.Clapham, it appears, objects to having an apparatus for

the disinfection of clothes within its precincts. Things thatrequire disinfection, according to the local magnates, shouldbe destroyed by fire. Besides, an apparatus would cost £100.Of course, destruction of infected things is not to be effectedwithout cost, as proprietors have to be indemnified. Ob-viously the way out of this economical difficulty is neither todestroy nor disinfect !The Metropolitan Asylum Board, at the request of its

solicitors, drew a cheque the other day for £1989 16s. lOd.,the taxed costs of the plaintiffs at the last hearing of theHampstead Hospital case. It was stated that it was ex-tremely doubtful whether the pending further proceedingsin this case would be heard before the adjournment of Par-liament.

The Local Government Board have approved of the schemeproposed by the Cavan Town Commissioners for supplyingthis town with water. The Commissioners have selectedBeaghy Lake as the source of supply, and from it a sufficientamount can be obtained for all necessary purposes.

VITAL STATISTICS.

HEALTH OF LARGE ENGLISH TOWNS.

THE fatality of infantile summer diarrhoea showed afurther increase last week, but the total mortality wasagain considerably below the average. In twenty of thelargest English towns, estimated to contain in the middle ofthis year seven and a half millions of persons, or neaily one-third of the entire population of England and Wales, 5217births and 2955 deaths were registered last week. Thebirths exceeded by 32, whereas the deaths were no lessthan 320 below, the average weekly numbers during 1879.The deaths showed, however, a further increase of 63 uponthe exceptionally low numbers returned in recent weeks.The annual death-rate per 1000, which had been but 18’9,19’2, and 20’1 in the three preceding weeks, further rose lastweek to 20’6. During the past three weeks of the currentquarter the death-rate in these twenty towns has averaged20’0 per 1000, against 23’0 and 17’5 in the correspondingperiods of 1878 and 1879. The lowest death-rates in thetwenty towns last week were 13’8 in Nottingham, 13’9 inPlymouth, 14’0 in Newcastle-upon-Tyne, and 160 in Hull.The rates in the other towns ranged upwards to 22’7 inSalford, 22-8 in Sunderland, 23’7 in Leicester, 24-7 inWolverhampton, and 26 0 in Liverpool. The high death-rates in Salford and Leicester were mainly due to excessivezymotic fatality.The deaths referred to the seven principal zymotic

diseases in the twenty towns, which had steadily increasedfrom 406 to 567 in the six preceding weeks, further rose to636 last week; these included 337 from diarrhoea, 108 fromscarlet fever, 74 from whooping . cough, and 63 from

measles. The annual death-rate from these seven diseasesaveraged 4’4 per 1000 in the twenty towns ; whereas it wasbut 0’7 in Plymouth, it ranged upwards to 7’3 and 7’6 inBrighton and Leicester. Scarlet fever showed the largestproportional fatality in Sheffield, Norwich, Salford, andBradford ; and measles in Leicester. Two deaths were re-ferred to diphtheria in Leicester. Small-pox again causedbut three deaths in London, and not one in any of thenineteen large provincial towns. The number of small-poxpatients in the Metropolitan Asylum Hospitals, which hadbeen 191 and 200 at the end of the two preceding weeks,were 198 on Saturday last; 22 new cases of small-pox wereadmitted to these hospitals during the week, against 17 and13 in the two previous weeks. The Highgate Small-pox Hos-pital contained 9 patients on Saturday last.The deaths referred to diarrhoea in the twenty towns,

which in the five preceding weeks had steadily increasedfrom 51 to 258, further rose last week to 337, and included202 which occurred in London. The annual death-rate fromdiarrhoea averaged 2’3 per 1000 in the twenty towns ; it wasequal to 2’8 in London, while it did not exceed 1’8 in thenineteen provincial towns. The highest death-rates fromdiarrhoea among these towns were 4’9 in Brighton, 3’6 inLeicester, and 3’1 in Salford.The deaths referred to diseases of the respiratory organs

in London, which had been 171 and 176 in the two precedingweeks, fell to 161 last week, and were 2 below the correctedaverage in the corresponding week of the last ten years.The annual death-rate from diseases of this class did notexceed 2’3 per 1000 in London ; it was equal to 4’9 in Liver-pool, and 34 in Salford. ___

HEALTH OF SCOTCH TOWNS.

In eight of the largest Scotch towns, having an estimatedpopulation of rather more than a million and a quarterpersons, the annual death-rate, which had been 20’9, 20’4,and 18’6, in the three preceding weeks, rose again to 20’6last week, and was identical with the average rate in thetwenty large English towns. The rates in the eight Scotchtowns ranged from 11 and 13’6 in Aberdeen and Perth, to22’9 and 29-7 in Glasgow and Paisley. The fatal cases ofthe seven principal zymotic diseases in the eight towns were107, against 97 and 109 in the two previous weeks; theyincluded 39 from diarrhoea, 21 from whooping-cough, 16from scarlet fever, 13 from measles, 12 from diphtheria, and6 from fever. The annual death-rate from these sevendiseases averaged 4’3 per 1000 in the eight towns, against4’4 in the large English towns. No zymotic death was re-gistered in Perth ; whereas the rate from these seven diseasesranged upwards to 4’4 in Leith, and 6’0 in Glasgow. Thefatal cases of diarrhoea in these eight towns further rose lastweek to 39, which were, however, not equal to a higher ratethan 1’6 per 1000 ; whereas the death-rate from this diseaseaveraged 2’3 in the large English towns. In Glasgow 27 ofthe 39 deaths from diarrhoea were recorded, showing a rateof 2-4 per 1000. Twelve of the 13 fatal cases of measles,and 10 of the 21 deaths from whooping-cough, also occurredin Glasgow. The 12 deaths referred to diphtheria included5 in Glasgow, and 5 in Edinburgh; and of the 6 deaths re-ferred to fever, 5 occurred in Glasgow. The deaths referredto acute diseases of the respiratory organs (bronchitis,pneumonia, and pleurisy) in the eight Scotch towns were69 last week, against 90 and 58 in the two preceding weeks ;the annual death-rate from these diseases was equal to 2’9per 1000, against 2-0 in London. The causes of no less than23 per cent. of the deaths registered in these Scotch townslast week were uncertified ; while in the English towns theproportion did not exceed 2’5 per cent.

THE HEALTH OF DUBLIN.

The rate of mortality in Dublin, which had declined inthe six preceding weeks from 42 5 to 30’3, further fell lastweek to 30’2, a lower rate than has prevailed in that citysince the end of October last. The average death-rateduring the past three weeks has, however, been 30’6 per 1000,against 20’2 in London and 18’3 in Edinburgh. The 182deaths in Dublin last week included 42, or 23 per cent.,which were referred to the seven principal zymotic diseases,against 53, 47, and 45 in the three preceding weeks ; 9 re-sulted from small-pox, 11 from scarlet fever, 7 from fever(including typhus and typhoid), 7 from whooping-cough,4 from diarrhoea, 3 from measles, and 1 from diphtheria.The annual death-rate from these seven diseases was