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coltrlbutea by riirn, sent a rarr ot very trandaume stiver46 -boving Cups" of Irish workmanship. Sir Somers Vinesent a unique collection of savage implements, weapons,ornaments, and articles of clothing from all parts ot theworld. Mr. Victor Horsley, assisted by Mr. Hawksley,- exhibited his new trephining instrument worked by a smallmotor and a portable battery. We have only space to givea list of the ocher exhibits’, interesting or beautiful, as mostof them are already pretty well known. Dr. BraxtonHicks : Tassie’s lotaglios and Medallion Portraits.-Mr.Francis Galton : " Thumb Markings."-Dr. George Harlev :Comparative Collection of Calculi and Pebbles.-Dr.Theodore Williams: Photographs.Mr. Edison’s Phonograph was, as always, a great attrac-

tion, and was rendered specially interesting on this occasionas the company, with characteristic enterprise, made sometresh records on Tuesday morning from some uncommoncases at Guy’s Hospital.

THE CONTAGIOUS DISEASES ACTS.

THOSE who are interested in the results of the ContagiousDiseases Acts in reducing venereal diseases in general, andsyphilitic diseases in particular, will remember that theseActs were in force, with less or more stringency, from thelatter half of the year 1861 to May, 1883. In that monththe periodical examinations of the prostitutes in the sub-jected districts were suspended, and as this was alwaysregarded by the officials of the army and navy and by themetropolitan police officials employed in these districts asthe most valuable part of this legislation, it was felt certainthat the result of this suspension would be an increase ofdisease. In 1885 the Acts were wholly repealed. A sufficientinterval has therefore elapsed to enable us to study three setsof statistics: (1) those showing the prevalence of venerealdiseases prior to the passing of the first Act-that of 1864;<2) those showing the various ratios of disease at the fourteenstations under the Acts compared with those of fourteenstations never under the Acts and with those of all thestations never under the Acts ; (3) those showing the ratios of- disease since the suspension of the periodical examinationsand the repeal of the Acts. Dr. F. J. Mouat, the Pre-’sident of the Royal Statistical Society, having wished thatan authentic relation of the facts shown by these returns,which may be regarded as a most inteiesting experimenton public bealtb, should appear in the journal of theSociety, invited Dr. Robert Lawson to prepare it. Thiswas done in a most exhaustive paper (accompanied by avery elaborate diagram), which was read by Dr. Lawson ata meeting of the ;Society on Jan. 20th, 1891. Fall detailsof this, so far as related to the army, were given in THELANCET of Feb. 7th. pages 319 and 320, and in thatof Feb. 14tb, pages 377 and 378 In the present article itis proposed to give the returns showing the influenceof the Acts on the prevalence of the different forms ofvenereal affections in the Royal Navy; and the pro-gress of syphilis among the civil population, both ofwhich were also dealt with in Dr. lawson’s admirablepaper.

In the "Statistical Report on the Health of the Navyfor 1881 there is a table detailing the strength and admis-sions for primary venereal sores, and secondary syphilis andgonorrhoea,, year by year from 1860 to 1881, in the variousships at the ports on the home station where the Acts werein force, and at those which were never under them. Dr.Lawson added to these the results for 1882 from the report ofthat year, so as to complete the period like that for the army(Table III.) already given. The ports referred to are : Thosewhich came under the Acts-Dartmouth, Plymouth, Ports-,mouth, Southampton, and Queenstown; tboseBeverundertbeActs-Hull, Liverpool, Kmgston (Dublin), Greenock, andLeith. How very unfqually the force was distributedbetween these two groups may be judged by the fact of 87per cent. of it being at places under the Acts, and onlythirteen at those never under them. Therefore the pointsof contact with the unprotected population being so few andthe numbers at them &o limited, much greater irregularitymust be looked for than was found in the army returnsunder such diffeient conditions.

l’he naval returns inciudtd primary venereal sores andsecondary yphilis under the -ame heading from 1860 to1865 inclusive ; afterwards they were shown f-eparately. Ithad been the practice in the navy not to enter slight casesof gonorrhoea on the sick list until the discussions on theAct arose and attention was drawn to the subject, wheninstructions were issued for all to be included; this seemsto have taken place about 1870 In the appendix toDr. Lawson’s paper is a table (V.) which embodies thedetails for the twenty-three years 1860 to 1882, arranged ina similar manner t&uacute; tba’: of Table III for the army, formerlynoticed, but the conditions jast mentioned will show thatthe analysis of the results cannot be expected to be so closeas was found in the army. Proceeding on the same plan,however, Dr. Lawson compares the period 1860 to 1863.before any restrictive measures were in force, with that of1870 to 1873, when they were in full operation; 1861 tot8t)9, being a transition period, may be omitted, as wasdone with the army. The following shows the relativefrequency of primary sores and secondary syphilis takentogether, and gonorrhoel in the force, under the Acts andnot under them, in the two periods :-

"Had the increase of 52 per cent. of the syphilitic diseaseat the stations never under the Acts been due to greaterepidemic incidences, the improvement under them wouldhave amounted to 39 + 52, or 9 per cent.’’ This remark ofDr. Lawson shows how careful he is to credit the Actswith exactly as much as they deserve, neither more norless. "But," he observes in continuation, "as shown bythe army returns, there was a sensible decrease of epidemicinfluence over the country in the latter period ; and in faceof this it is probable that the large increase ot 52 per cent.was due to some of those irregularities presented by smallnumbers. All that can be proved bythii comparison, then,is that where the restrictive measures were in operation amaterial reduction of disease took place. As to gonorrhoea,the remarks made above obviate further comment."A very remarkable and -ianificant circumstance is that

in the next period, 1874 to 1879, where the stoppage of payderanged the admission rates in the armv. there was nosuch interference with those in the navy. The results fromthe same table (V.) are these:-

I i I

Thf percentage of reductions in syphilis has here increasedfrom 39 in 1870 to 1873 to 52 at the protected stations; but itbas fallen from 32 at the former date to 26 at the latter, atthose not under the Acts, corresponding with what tookp!ace among the trofps in duration, though not so closelyin quantity.

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In the years 1880-82 the following were the results :

The decrease at the protected ports in 1880-82 as hereshown was still 29 per cent. of that between 1860-63, Not-withstanding the much greater prevalence of syphilis overthe conntry at large, as is obvious from the military expe-rience, as well as that of the navy, in the general Tables III.and V. for the respective services. The naval returns didnot give the force at the protected stations and at those neverunder the Acts separately after 1882, but the strength andadmission for the whole force at home last year are given inTable V. in the appendix to Dr. Lawson’s paper. From this itappears th at syphilis reached its bighes t point in 1884, the sameyear as in the army, though the ratios in the latter weremuch higher than in the former, being for primary sores 124per 100U and for i-econdary syphilis 30 2, while for the navythey were 83’2 and 26 9 only. Subsequently to 1884 the dis-ease diminished considerably though irregulally, but con-trasting remarkably in these respects with the large andmore regular fall in the army. From all these Dr. Lawsonfinds that syphilitic affections are considerably more fre-quent among the troops than among the seamen at the pro-tected stations than would have been expected. Thus theadmissions per 1000 for primary venereal sores, secondarysyphilis, and gonorrhoea were at these stations for the under-mentioned periods :-

"This immunity may be due," Dr. Lawson suggest?,"in part, at least, to the seamen living on board Ehip alarge portion of their time, and so being less exposed tosource&raquo; of infection than soldiers, who are always on shore,and possibly, to some extent, to their employing ablutionearlier after such exposure than is customary amongsoldiers. Under any circumstances it is worthy of note."The prevalence of syphilis among the civil population

and its increase or decrease in recent years would be mostinteresting and valuable information could it be obtained.But it cannot. Lock hospitals in the United Kingdom areso few and far between that they could be easily countedupon the fingers of both hands. Lock wards, too, exist inonly a very small proportion of general hospitals, and con-tain very few beds. Hospital statistics, therefore, couldonly relate to a few districts so far as in-patients are con-cerned, and the statistics of out-patients would be hardlyreliable. There are, however, some returns available-viz, those of the Regiatrar-General, which give the deathsregistered from syphilis. As, however, deaths from thisdisease are often registered under some other heading, therecord must be vezy far from perfect. Still they furnishsome approximation to the tTuth, and some years after thepassing of the Contagious Diseases Acts it was found thatchere was a considerable difference between the number ofdeaths from syphilis in those of the Registrar-Gtlleral’sdistricts which comprised the protected stations and thosewhich did not. Dr. La-fen has given these and otherdetails in Tables VI. and VI [. of the App ndix to his paper,

from which we give the following extracts. From 1860 to1889 there died from syphilis 56,551, of whom 41828 werechildren under one year of age ; of the remainder, 3955 werebetween one and five years of age, and 10,768 above fiveyears, being respectively very nearly 74-7 and 19 per cent.of the whole. Table VII. gives the distribution of thedeaths from syphilis among the civil population of thedifferent divisions of the Registrar General, which havebeen arranged so as to throw the whole country into fivecontinuous groups, the metropolis forming one of them, theperiod being for the six quinquenniads from 1860 to 1889:The first, being a transition one, has been passed overas affording no secure basis for generalisation. The second(1865 to 1869) embraces the first introduction of the Con-tagious Diseases Acts, and with those that follow enablesthe influence of these Acts on the frequency of deathsfrom syphilis to be traced. The deaths per million livingin each of these groups in the respective quinquenniadswere as under :-

That the beneficial action of the Contagious Diseases Actwas not confined to the troops and seamen, but had reducedthe mortality from syphilis among the civil population inthe districts wbere they came into operation to a material-extent since 1870, will be seen by the following facts. Tenof the twelve protected stations in England are in the.counties south of the Thames and Bristol Channel, consti.tuting the second and fifth divisions of the Registrar-General ; one station, Woolwich, is in the first or metro--politan division, and one, Colchester, is in the fourthdivision. Taking the quinquenniads 1865-69, 1870 74, and1875 79, the mortality at all ages from syphilis in the second!and fifth divisions was 68 per million living in the first period,declining to 62 in the second and to 60 in the third, sreduction of 12 per cent. In the third, fourth, andsixth divisions, extending from the east coast to theWelsh border, immediately north of the second andfifth divisions, the mortality from syphilis in 1865-69was 67 per million, almost the same as in the twosouthern divisions ; but, instead of falling in the nex5

quinquenniad, it rose to 72 and to 77 in the followingone, a rise of 15 per cent. In the next group to the nortb,comprising the seventh and eleventh divisions, the deathsfrom syphilis in 1865-69 were 44 per million, rising to 49 inthe following quinquenniad and to 58 in 1875-79, a rise of32 per cent. In the remainder of England, to the north,the deaths rose from 85 in 1865-69 to 88 in the succeedingperiod, and to 97 in 1875-79, an increase of 14 percent.London presented the only exception to the general rise; this,with the neighbouring county, comprised in the first division?had amortalityof 144per million from syphilis in 1865-69; thisfell to 127, or 12 per cent., in 1870-75, and virtually reomained at the same rate. From all this it is clear that theContagious Diseases Acts diminished materially the moretality from syphilis, not only in the immediate localitieswhere they were enforced, but to a large distance aroundthem; while in London there had been a smaller reduction,and in the rest of the country a very marked increase. Inthe quinquenniad 18b0-84 there were indications of a com-mencing change, which went on to the great decreaseobserved in the country generally in 1885-89, and in everygroup of divisions as well. The fall in 1880-84 was muchaccelerated in the second and fifth divisions, where the com-pulsory examination was continued until May, 1883.Those who have defended these Acts through evil report

and through good report will now have the satisfaction ofseeing that they do not deserve the reproach of beingclass legislation for the benefit of soldiers and sailors. Theirbeneficial results extended also to the civil population ofthe districts where they were enforced and to a large dis-tance around them. Had their application been as generalas it was limited the results wculd have been perceptible

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apart altogether from the Rpgistrar-Gpneral’s returns. The

persistent efforts of a factitious opposition led to theirxepeal, and so the United Kingdom must continue to bearthe reproach of being almost the only civilised country inwhich the hospital accommodation for venereal diseases is,comparatively, nil, and no other steps are taken to preventthe spread of these loathsome and deadly diseases.

METROPOLITAN HOSPITAL SUNDAY FUND.

THE following were among the principal amounts re-ceived at the Mansion House up to Thuisday last in aid cfthis Fund. The total sum received at that date amountedto nearly jE3S.OOO :&mdash;

7

THE PUBLIC HEALTH MEDICAL SOCIETY.

TnE annual meeting of this Society was held on the15th inst. at the offites, 101, Great Russell-street, London.Professor W. R. Smith, M.D., presided.The report for the year shows that the Society maintains the

confidence of diplomates in Public Health. Sir Charles A.Cameron was unanimously re-elected President, Dr. AllanHon. Secretary and Treasurer, and the following gentlemenwere added to the Council :&mdash;Surgeon-Major Compigne,Drs. F. W. Alexander, Herbert Goude, C. A. James,Crauford Maclearn, H. C. Tweedy, and Fallon P. Wight-wick. The Society has lost during the year three membersof its Council-viz., Drs. W. W. Day, Henry Smith, andW. E Steavenson, gentlemen whose services to the Societyhad been of the greatest value from its very inception.Attention was called to a letter from the Local Goveinment I

Board to certain London vestries, calling upon them toappoint their newly elected medical officers of health for aperiod of twelve months only, unless they were prepared todevote themselves entirely to the duties of the office. Itseemed to the meeting to be more conducive to the inde-pendence of the office that, with the exception of generalmedical practice, he should not be precluded from otherwork. and that the insistance by the Local GovernmentBoard of this condition will have the tendency to makethe officer a mere vestry official. It was resolved that thePresident of the Local Government Board be memorialisedvn the unsatisfactory state of affairs.The annual dinner of the Society will be held on Wednes-

day, August 12th.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Brighton Urban District -On the basis of the Registrar-General’s estimate of the population the general death-rateof Brighton for last year was 17’8 per 1000 ; and, so far asphthisis records can be regarded as comparable for differentperiods, ic is noteworthy that the rate per 100,000 living hascontinuously gone down from 295 in 1861-70 to 164 for thepast three ears. There remain, however, conditions inBrighton the removal of which might be expected to befollowed by a still further lessening of this mortality.Enteric fever never showed a smaller rate of death thanlast year, and it is evident that the zymotic rate is largelykept up by measles and whooping-cough, as to which noprecautions are taken by parents. The sanatorium, thoughby no means a building such as Brighton requires,received 162 cases of scarlet fever and 22 cases of otherdiseases. Schemes are in view for improving the housing ofthe poor, sanitary inspections are actively maintained, andthe general record of current work is one with which Dr.Newsholme may well feel satisfied.Lowestoft Urban District.-A very corefiil report has

been issued by Dr. W. A. S. Wynne on the need for theprovision of a new isolation hospital for Lowestoft. Hestates that the main objections to the present hospital areits inability properly to receive simultaneously cases of morethan one disease in both sexes, the absence of proper accom-modation for the staff, and the structural unlitness of thebuildings to resist alternations of cold and heat. In short, theexisting hospital presents many of those features which actas a deterrent to the use of an infectious hospital, and thusdefeat the very object for which they have professedly beenprovided-namely, the protection of the public from risk ofinfection by the prompt isolation of firab attacks of the in-fectious fevers.

Liverpool.&mdash;The discussion which is going on as to thetrue population of Liverpool necessitates calition in accept-ing the death-rate for 1890 as 23’3 per 1000, and it mustleave many statistical considerations as undecided. Thenotification system revealed last year, amongst otherdiseases, 1975 cases of scarlet fever, 251 of fnteuc fever, 39oftyphus fever, ai’d 79 of diphtheria ; and the three isolationhospitals included amongst their patients 997 cases of scarletfever, 201 of enteric fever, 80 of typhus fever, but only 4 ofdiphtheria. There is a mortality chart for enteric fever andtyphus fever; but, now that the localisation of attacks is pos-sible, it is a pity that only fatal cases are shown, and this themore since the residences of people who mainly died at ahospital away from their homes has but little interest etio-logically or otherwise. The mass of material issued underthe heading of the Liverpool Sanitary Amendment Act, andwhich specifies the back-to-back houses, the court tene-ments, and other unhealthy dwellings included in the tfnthpresentment made in this matter, may be uninterestingreading outside Liverpool, but it indicates an amount oflabour and of advance in the matter of improved dwellingsthe value of which it would be difficult to overrate, and weare glad to find that Dr. Taylor prefses on s3stematicprogress in this respect; for it is work which, above allother, will tend to tree Liverpool of typhus fever, and tolowpr the general mortality.Oldham Urban District -Dr. James Niven always con-