407

THE LANCET.

LONDON: SATURDAY, SEPTEMBER 21, 1878.

REORGANISATION OF THE ARMY MEDICAL DEPARTMENT.

WE have been favoured with a copy of the Report of theCommittee appointed by Lord CRANBROOK to inquire intothe causes which prevented candidates coming forward inaumcient numbers for the Army Medical Department. The

Committee consisted of Mr. THOMPSON, the Assistant

Under-Secretary of State ; Sir W. MulR, the Director-

General of the Army Medical Department ; and Mr.

ROBINSON, the Actuary in the War Office. They appear tohave gone very fully into the subject, and to have inquiredcarefully into the alleged grievances of the medical officers,the discouragements arising out of the present system, themode in which these may best be overcome, and the cost to

the public of the changes which seem advisable. The reportoccupies about twenty-five folio pages, with an appendix ofthirty pages, in which are detailed the reasons assigned bythe various parties to whom the Committee applied, for thereluctance manifested to enter the Department; some tablesare also given showing the pay and allowances of medicalofficers under the different Warrants which have been pro-mulgated since 1848, the probable earnings of civil medicalpractitioners, and the actuary’s report on the relative

cost of the existing and proposed scales of pay and retire-ment.

The following brief sketch will show the leading featuresof the proposed scheme of reorganisation. It is suggestedthat the now unified department should receive a distinctivedesignation, such as "Royal Army Surgeons, or "RoyalMedical Staff"; that it should be recruited by the admissionof probationers, of whom one half are to be nominated by the"medical teaching bodies" of the United Kingdom, Canada,and Australia, and the other half to be admitted by opencompetitive examination-.both classes to consist of gentle-men registered under the Medical Act, and the nominationsto be subject to the approval of the Director-General. The

Committee state that they are unwilling to recommend

the abolition of the competitive examination until somemeans of securing a common standard of proficiency areadopted, such as (in their opinion) would be the result ofthe " one-portal system of admission to the profession.The probationers thus obtained should be sent to one of thelarge military stations to learn their drill and stretcher-

bearer and ambulance duty till the next course of instructionat Netley begins, when they would join the school there.During this period, and until they have completed theircourse at Netley, they are to rank as Lieutenants, and toreceive 8s. a day pay. It is proposed that the maximumage on admission should be reduced to twenty-eight. The

" ten-years system is pronounced to be a failure, and istherefore to be abolished, and a life system to be resumed ;but medical officers are to have the option of retiring, if theydesire to do so, at any time after the completion of tenyears’ service, with a gratuity varying from E1250 to f:2500,according to length of service. On retirement after twenty

years’ service, they will, as at present, be entitled to retiredpay.The Committee recommend the creation of a new rank, to

be called Brigade-Surgeon, which will correspond somewhatwith that of Fleet-Surgeon in the Royal Navy. They areto be executive officers, but employed, as far as possible, as" seconds" to the administrative officers, or, where there arenone, as principal medical officers. They are to be pro-moted by selection from the Surgeons-Major, and from themthe Deputy Surgeons-General are to be selected. The Com-

mittee recommend an increase in the rate of pay and retired

pay to all ranks. The following table shows the rates pro-posed for the different ranks :—

Surgeons and Surgeons-Major retiring after ten years’service, are to receive a gratuity of E1250, after fifteen years’of 91800, and after eighteen years’ service of 2500.Retirement is to be compulsory, as at present, from the

executive ranks at fifty-five, and from the administrative atsixty years of age. It is recommended that, as in the caseof military officers generally, all medical officers retiringunder the age of fifty-five shall be liable to be called up forduty until they attain that age, in case of declared nationalemergency,-in other words, that they will form part of theReserve Forces.

With regard to the grievance of medical officers beingplaced on half-pay after six months’ leave granted in con-sequence of ill-health, it is proposed to extend the period ofsuch leave to one year, and after that time to place themunder the same regulations as to temporary half-pay as theother officers. It is proposed to meet the difficulty withregard to quarters for medical officers who are unavoidablystationed in barracks with troops, by allotting a suitablequarter which shall be always retained as the " MedicalOfficers’ Quarter." But it is at the same time suggested,as a proper subject of inquiry, whether there is any neces-sity for such close personal medical attendance on soldiersas is implied in compelling the medical officer to reside inbarracks. We regret to say that the Committee do notrecommend the restoration of forage to medical officers,but " think a sufficient number of suitable riding horsesshould be provided at large stations by the Army ServiceCorps for the use of officers requiring to be temporarilymounted." They do not say what medical officers are to doat smaller stations under similar circumstances. The Com-

mittee have considered at some length the question of

honours and relative rank. They point out, with regard to

408 WORK.

the first, that the medical officers do not receive a share at the process than the result obtained. This mistake is veryall in proportion to the other corps. For instance, the short-sighted. The workman needs to learn the use of his

officers of the Royal Engineers, though numerically fewer tools, and the methods of his calling, and the way of learningthan the medical, have 35 enjoying the honours of the these is in the end as important as the information and skill

Bath, the Star of India, and of St. Michael and St. George, gained. The student of the medical science will in a signalwhile of the medical officers 10 only are thus decorated. sense mould his mind and formulate his future as a practi-With regard also to good-service pensions, 1’5 per cent. of tioner by the method he adopts in pursuing the studies ofthe officers of the Royal Artillery (active and retired) and his curriculum. New faculties will be created, and pre-

1’7 per cent. of the Royal Engineers have received them, existent powers and functions of the intellect trained and

while they have fallen to the lot of only ’6 per cent. of the developed ; and the direction thus given to his habits of

Medical Department. This injustice they recommend thought and mind-exercise will remain influential to the

should be remedied. They also recommend that the end. It is therefore of self-evident importance that thehonorary appointment of physician or surgeon to the culture to which he now submits his faculties should be

Sovereign should, as in the case of Her Majesty’s Aides-de- judiciously directed.camp, carry a step of rank, the officer to be borne as super- There are almost as many ways of working as there arenumerary until he would have been promoted in ordinary men who work. This will not be in the least surprisingcourse. With regard to relative rank, it is proposed that when we reflect that no two minds are identical in construe-the probationer shall rank as a lieutenant, the surgeon on tion, and consequently it is impossible that they should takeappointment as captain, and the surgeon-major of twenty in knowledge in precisely the same fashion. The fact justyears’ service as lieutenant-colonel, according to the date of stated, and which is abundantly evident, explains the failure,commission, instead of being always junior of that rank. and demonstrates the uselessness, of seeking to impose a uni-A suggestion is made that, with a view to compensate for form method of working on any multitude of dissimilarly con-

the social losses to regimental medical officers at the larger stituted men. Although the curriculum in vogue has thestations, "a medical institute might be established to act as sanction of use and authority, it is idle to expect to acquirea club, a library, and a scientific resort," Government the mass of information indispensable for the successful

finding a room, with fuel and light, and contributing a practice of medicine and surgery by simply fulfilling itslimited annual grant towards the formation of a station requirements. Each student must for himself discover

library. At smaller stations facilities might be afforded, the best method of storing his mind with the knowledge,and encouragement given, for the formation of a mess for and obtaining the personal skill, which his future career

the officers of the several departments. will require. The curriculum lays down the broad out-Such is a brief sketch of the principal recommendations of lines of a course, like the dotted markings on a sailing

the Committee. They appear, with the exception of the chart, but how to keep the track must be determined

forage question, to be conceived in a liberal spirit, and with by the individual mariner; and, although it is the custom to>a sincere desire to promote the best interests of the service. sail under convoy, each craft will need to be steered and

There is much in the report which deserves study, and we worked according to its special size and build and sea-goinghope to bring several of the subjects treated in it more fully capabilities. Serious and irreparable mischief is not un-

under consideration hereafter. The very short time at our dis- frequently done by crowding on canvas, or generallyposal has prevented our entering at present upon these topics, handling a mind that calls for peculiar treatment in tooas we felt that our readers would be anxious to know what close conformity with some regulation method, which doe&

was recommended rather than to have a discussion on points well enough for many, but will not suit all. The primary, inwhere we may differ from the Committee. We would merely many senses the most important, business of the student’s.remark that the report confirms the opinion we lately ex- first session will be to find how best he can perform the taskpressed as to the improbability of the restoration of the regi- of personal instruction while broadly following the lead givenmental system, the Committee remarking upon it : "We by his teachers and those around him. Unless this duty oflook upon that question as having passed beyond the stage forming a plan of work is recognised and discharged thus,of argument, and as not being within the scope of our in- early by the pupil, his period of study will be troubled, andquiry." It must not be forgotten that these proposed changes end unsatisfactorily. It is worth while to spend time andare still merely the recommendations of a Committee, and pains in the avoidance of such a calamity.that it remains to be seen to what extent and with what The problem is to find a means of storing the mind withmodifications the Secretary of State for War will be pre- carefully selected, co-ordinated, and well-placed knowledge.pared to carry them out. While he has them under con- The selection of information is one of the most importantsideration the profession will have an opportunity of ex- functions of an intelligent mind. The man who learns all

pressing their opinion whether the Department reorganised the principle that "all is fish that comes to his net," is

on these principles is likely to be deemed an eligible opening likely enough to find that while his memory is overburdened,for the younger members, and whether, consequently, the his stock of assimilated knowledge is essentially small. The

object Lord CRANBROOK had in view in the appointment of capacity of the human mind is naturally great, and, like everythe Committee is likely to be attained. otherpart of the physico-mental organism, it grows by use, but0 the vital energy available for mind purposes is not boundless,

IT is a misfortune that the term " work " stands for the and every foot-pound of force expended in the acquisition ofthing done or the task accomplished, as well as the act of useless knowledge is so much power wasted. Too many

doing it. There is a regrettable tendency to think less of men forget this, and cram in all sorts of information on the-

409THE DEGENERATION AND REGENERATION OF NERVES.

chance that a fair proportion of the stock accumulated will ledge-the sort of pride which, whether or not it begetsprove of value. This reckless procedure is one of the ways in vanity, prompts a man to treat those he holds less well-which mind-power is squandered and opportunity lost. The informed or able than himself with discourtesy. Thestudent will do wisely to remember that he has only a mistakes the best of us are too prone to make about meritlimited quantity of force to spare, and everything will should inspire caution in the formation of a judgment. The

depend upon how he employs it. Knowledge must be famous rejoinder, "Sir, I have forgotten more than you everselected ; and this brings us face to face with the difficulty knew," might well be borrowed by many a member of ourthat the eclectic faculty is not, as a rule, well-developed in profession upon whom his fellows look somewhat con-

the youthful mind. It is mainly in this particular the temptuously, and students are tempted to despise. The wisestudent needs help. If lecturers and teachers would devote student will be gentle, modest, and respectful to everybody,especial attention to the sifting of information, and the in- to his seniors and fellows, and he will be very cautious ofdication of proper lines of inquiry, they would render more forming any opinion of the attainments of others until heuseful aid than by striving vainly to compass the whole has at least made sure of his own. True work has a

field of knowledge. The result of the common mistake of wondrously humanising effect on the worker, and brings outIelivering " complete courses of lectures, and traversing his better nature; that which does not so react on the mindthe whole area of a department of science, is that the student will probably prove to be false work, and, despite its

can only pick up fragmentary scraps of information at random, brilliancy, will fail.and has no practical notion how to piece them together.If teachers would simply point to the subjects that can be SOME months ago we called attention to an interestingstudied in private, and so frame their lectures and instruction series of investigations on the histology of the process of theas to assume and necessitate this personal work on the part union of divided nerves, which elucidated the details of the

of pupils, the progress made at the end of a session would process by which the adventitial structures of a dividedbe more real and permanent, if less pretentious, than that nerve-trunk effect its reunion. The changes which theeffected by the method of instruction at present nerve-fibres themselves undergo in consequence of division,pursued. Without direction how to select the facts he and those by which their repair after injury is effected, haveneeds to appropriate, the student is left wandering and lately been studied with much care by Dr. KORYBUTT-DASZ-bewildered in a field too vast to be explored, and at the KIEWICZ, of Strasburg, and his observations add considerablyclose of his curriculum he too often finds, to his cost, that to our knowledge of the processes. A few hours after the

his strength has been expended on the acquisition of a stock division of a nerve, an opacity and swelling of its medullaryof knowledge which, though brilliant and bulky, consists of sheath is visible, together with a multiplication of the

unconsidered trifles of little or no worth. In this way it nuclei of its primitive sheaths. These changes, which con-- comes to pass that a mind wearied with the toil of re- stitute the first stage of the well-known process of nerve

membering the minutiae of botany, materia medica, degeneration, are visible in both peripheral and central endschemistry, and physiology, is confounded by a simple question of the divided nerve-fibres, as far as the first of the constric-in either of these branches, and fails utterly when the test tions which RANVIER discovered. The process does not passof practical every-day knowledge is roughly applied. over this limit, or, if it does, only extends as far as the next

Again, knowledge must be co-ordinated, and this implies constriction. Simultaneously with this change in the nerve-that it is acquired with a purpose. Nothing is more mis- fibres red and white corpuscles aggregate in the neighbour-chievous than the notion that any good can come of knowing hood of the incision. The latter multiply, and assume anthings which are unnecessary. The really well-trained mind appearance very like that of the nuclei of the nerve-sheath.

is one that knows how to find the answer to any question The nuclei become surrounded by protoplasm, and, in thew’?1Ích may arise, rather than that which burdens itself with course of the next few days, form knob-like projections atevery conceivable commodity in case it may be wanted. each end of the nerve, which projections, when the loss of"Such and such questions have been asked at examinations, substance in the nerve has been small, ultimately becometherefore they may be asked again, and I must be pro- fused together. The cells which thus bridge the gap betweenvided " ! Better make it the business of student days to the two ends acquire ultimately a spindle shape, becomeobtain a masterly insight into the rationale of the system transformed into connective-tissue fibres, and do not assistof facts, and trust to the logic of reason to supply the in the regeneration of the nerve-fibres themselves.details. When the stock of knowledge has been acquired, If the so-called paralytic degeneration goes on in the peri-or while it is being stored, much depends on arrange- pheral end of the nerve, a fresh series of changes commence,ment. A great error is committed when the student packs consisting in the segmentation of the medullary sheath,his goods with a single eye to the convenience of displaying which takes place either simultaneously in the entire lengththem at the examination-table. Knowledge should be de- of a fibre, or only in parts, now near the wound, now nearposited in the mind with a view to the life-long future, and the periphery. The portion of the fibre affected first presentspractical work. The episode of the examination-day is only incurvations which give it somewhat the appearance of anan incident by the way, and the less it engrosses the learner’s embryonal condition of nerve-fibre. The affected segmentsattention the more efficient will his education prove. break up into globules, which often present distinct con-

Lastly, the work required of the student must be per- centric striation. If the degeneration progresses further, theformed with a loyal and reverent devotion to those who have e outer layer of the globules becomes liquefied, and breakslaboured and now lead. There is no more deadly and up into fat-globules, which become distributed more or less

besetting sin of scientific pupilage than the pride of know- uniformly within the old sheath. Wherever the myelin has

410 EDUCATION OF PAUPER CHILDREN.

thus broken up, nuclei accumulate; whereas at those parts however, after the division of a nerve, the axis-cylinderwhich are still normal no nuclei are to be seen. At the cut remains intact in its entire length, and the medullary sheathend of the nerve it is not difficult to trace the passage of degenerates, the appearance of several fibres in the samenuclei from the cicatricial tissue into the interior of the fibre-sheath is never seen. If the division of the nerve

sheaths of the degenerated nerve, but it is less easy to trace entails a considerable loss of its substance, the appearancethe origin of the nuclei which are seen within the sheaths of of a multiple endogenous regeneration of fibres is rarelythe peripheral portions of the degenerated nerves. It seems, seen, many fibres not being regenerated at all. This seg-

however, legitimate to assume here also that they have mentation of the axis-cylinder is not the only mode in whichwandered in, because cases were repeatedly observed in the fibres degenerate. The grey fibres, for example, some-which white blood-corpuscles passed into the sheaths at the times present no change, and the smaller medullated fibres,constrictions of RANVIER. However they have entered, the regarded as young nerve-fibres, ordinarily only lose theirnuclei multiply, at first rapidly, until they have attained a medullary sheath; and, lastly, under certain favourablecertain number, and then commences their individual-deve- conditions, most of the fibres, large and small, present onlylopment. They acquire distinct contours, assume a rounded medullary degeneration.form, and nucleoli become visible within them. During the The regeneration of the extremities of the nerves in thefirst few hours after the operation, and before the white cor- muscle and skin occurs much later than the regeneration ofpuscles commence to pass in, the fixed nuclei of the wider the peripheral trunk, as the axis-cylinders of the terminal

nerve-sheaths take part in the transformation of the myelin. extremities of the nerves usually undergo complete degene-The nuclei enlarge, a zone of protoplasm becomes visible ration. On simple division of a nerve, the adjacent axis-around them, and into others often pass minute spherules of cylinders of the central stump do not degenerate, but growmyelin, blackening with osmic acid. into the cicatricial tissue, where they become narrowed and

In the central end of the nerve the changes are different. clothed with a deposit of young medulla. Attaining theAfter the inflammatory degeneration has extended as far as peripheral portion of the trunk, they become wider, andone of the constrictions of RANVIER, a change in the myelin grow into it between the old and the new fibres. The pathis visible in a certain proportion of the fibres, the number of they take through the cicatricial tissue is evidently that ofwhich increases the greater the loss of substance. Either least resistance, being often sinuous. They often apparentlythe medulla assumes a wavy contour, or it becomes liquefied attach themselves to vessels, which afterwards disappear.in a segment lying between two constrictions, without the If the peripheral portion is absent altogether, as in extirpa-process invading adjacent parts. An. increase of nuclei is tion of a nerve, the fibres growing from the centre commonlyconstantly observed in the latter form of degeneration, either attach themselves to a vessel, or widen out irregu-After the liquefaction of the old myelin there commences larly, or form knobby swellings analogous to the "bulbousthe formation of a new nerve-medulla, with the peculiar nerves" of amputated limbs, which are formed by a con-appearance that between two former constrictions one or volution of medullated fibres and cicatricial tissue. When

two new ones are formed. The nuclei of the sheath of the loss of substance has been considerable, the regenerationSCHWANN also undergo changes in the central end. Near of the fibres which degenerate in the central end occursthe division of the nerve they swell up, become surrounded much more quickly than that of those in the peripheral end,by granular protoplasm, and, after becoming separated from but takes place by a similar process.the fibres, assume an elongated form; whether finally deve- 0

loping to nerve-fibres could not be definitely ascertained. THE education and training of the ever-increasing numberThe axis-cylinders in the peripheral part break up into more of poor children in our towns and cities is one of the most

or less numerous fragments during the segmentation of the urgent questions of the day, since on the right solution ofmedulla, and of these some apparently liquefy and partici- the problem it depends whether the present generation ofpate in the same changes as the myelin, while others persist pauper children are to be developed into useful, prosperous,and clothe themselves with a new medullary sheath. In and intelligent citizens, or to remain for ever members ofsome cases the myelin remained upon some fragments of the "sunken sixth," a burden on the rates and resourcesaxis-cylinders until regeneration. Before the degenerated of the country, perpetual inmates of our workhouses andmyelin began to lessen the fragments of axis-cylinders prisons. Some attempt has already been made to deal withwhich persisted began to lengthen in each direction, this difficult and important question-chiefly as yet, how-the nuclei persisting within the sheath began to elongate, ever, through the channels of charitable enterprise. Still it

and lay at certain distances from each other. Simul- is satisfactory to find, limited as the attempt has been, that

taneously with this process, the new medullary sheath the system of "home and cottage training for the childrenmade its appearance as a varicose or a uniform deposit of the poor" has attracted the attention of Parliament, andupon the axis-cylinder. Thus the fragments of axis- called forth a report on the subject. This report, which has

cylinder remaining serve as the starting-point for a new been prepared by Dr. F. J. MOUAT and Captain BOWLEY,endogenous formation of nerve-fibres. They present no R.E., is founded upon observations made at such schools as

tendency, in their farther growth, to blend with one another, the Princess Mary’s Village Home at Addlestone, Surrey,but remain in contiguity, growing in the same general the Home for Little Boys at Farningham, Kent, and othersheath, close to one another, and ultimately, after the dis- schools of the same class, baed more or less strictly on theappearance of the old sheath of SCAWANN, they develop as "home or family system," and intended to bring upindependent fibres. Hence, at a certain time, there is an destitute or criminal children in habits of religion andappearance as of several nerve-fibres in a single sheath. If, virtue, with such industrial and mental training as will fit.

411THE CASUALTY INCIDENTS OF THE DAY.

them to earn their livelihood in independent positions andto become useful members of society. To judge from thereport, the success that has attended the endeavours hasbeen most encouraging. The standard of health in these

institutions appears in all cases to be exceptionally good,and the cost of maintenance moderate, averaging from six-teen to twenty pounds per head. The advantages claimedfor the " home system" are : " obtaining an exactness ofoversight, and a dealing with individual temperamentsaccording to special peculiarities"-in other words, esta-

blishing an intimate sympathy and bond of union amongthe inmates which " reproduces as nearly as may be thathome life which is GOD’S grand device for the education,in the best meaning of the term, of the human race." It

is evident that such benefits can only be secured by thesubdivision of children in small groups, under the specialand constant care of a suitable head. In short, the

condition of the schools reported on, and the brightand happy life of the inmates, contrast strongly withthe state of things at the workhouse schools in the

northern, eastern, and midland districts, as shown bythe reports furnished by the inspectors. Thus Mr.

BOWYER writes, during the long vacation of " Christmasand Midsummer, the workhouse children pass their dayswithin four walls of their day-rooms and yards, in drearyindolence and listlessness only relieved by a formal walkunder the guardianship of an industrial trainer or ’ re-

spectable inmate !"’ And Mr. MOZLEY remarks : " One

of the most defective points in workhouse schools hithertohas been the care taken of the children out of school." In

fact, both boys and girls are " frequently superintended bya pauper alone!" Mr. MOZLEY, moreover, bears strongtestimony to the unfavourable influence workhouse con-

straint has upon the mental development of the children."A child normally shut within four stone walls, whatever bethe excellence of the appliances within those walls, will beblunted in some of the most progressive faculties of its

nature." " I confess," he says, " I should be glad to

see workhouse children, especially those that live in the

country, able to enjoy an occasional liberty, to run about

the lanes and streets like other children."

Can the sentences we have quoted really apply to work-house schools of the present day ? Do they not rather referto the Oliver Twist experiences of thirty years past?Alas! no. Imprisoned within four dull stone walls, withno experiences of fresh open country life and the lessonsNature insensibly teaches, his very hours of play darkenedby the shadow of failure and misery in the person of theattendant pauper, without interest in the present or hope forthe future, such is the lot of a pauper child at the presentmoment in a country professing to be foremost in culture,humanity, and civilisation. In the neglect of our duty in Iproperly training and educating our pauper children wehave incurred a grave responsibility, and the penalty willbe reaped for many years to come in a rich harvest of crimeand misery.

DR. H. W. BELLEW, C.S.I., Sanitary Commissioner ofthe Punjaub, will probably accompany Sir Neville Chamber-lain in his expedition to Cabul. Dr. Bellew is well knownin India as a linguist and very experienced frontier traveller.

Annotations." Ne quid nimis’"

THE CASUALTY INCIDENTS OF THE DAY.

THREE leading incidents, all of a specially melancholycharacter, are just now occupying public attention in a veryconspicuous manner. Amiserable catastrophe has occurred onthe Thames, in the immediate vicinity of the metropolisqresulting in the loss of at least 650 lives. The cities and

ports of Central America are being devastated-indeed, well-nigh decimated-by yellow fever ; and a fearful explosionin one of the largest coal-mines of Wales has caused the-death of 257 persons, besides an enormous destruction ofmuch valuable property.As regards the Princess Alice collision, the number

drowned and recovered is reported to be 652. In all thoselast recovered, decomposition appeared to have advancedwith unusual rapidity, and the appearance of most of thecorpses was hideous in an intense degree. As far as wehave learnt during the past week, there are no precisegrounds for stating that the limbs, or any special limb, werefound to be much flexed. These observations could only ofcourse have been made during the first two or three dayssubsequent to the catastrophe, when the evidence of one ofour correspondents certainly pointed to the fact that all thelimbs of some fourteen bodies (seen by him as they were beingtaken from the water) were flexed in a very marked degree,the skin being covered with a sort of creamy slime. This

latter, it has been suggested, may have been due to the

presence of diluted sewage, or of liquid refuse from theBeckton Gas Works, just above which the collision took place.Several so-called disinfectants were used in the dockyardincluding carbolic acid and chloride of lime, with, as itseemed to us, very fair success, as far as their deodorisingpower was concerned. But the signs of unusually rapiddecomposition were, on this occasion, conspicuously manifest.The roll of mortality from Central America has, since we

furnished the last brief report, increased with fearful

rapidity. No less than 87 deaths occurred on the 10th inNew Orleans, and 112 at Memphis, which, for a diurnal rateof mortality, is appalling. And the telegram that we copyfrom The Times reports 115 deaths as having occurred atMemphis on the 10th, and out of 1000 nurses 800 are nowill with the fever.The British consul at New Orleans telegraphs that he has

in his own district 17,000 British subjects registered, thatthe distress among them is terrible, and that they are com-pelled to find means through the help of the St. George’sSociety to bury their dead. Help from abroad is thereforeurgently required, both in the city and elsewhere. Thelatest accounts from New Orleans say that the weather hasbecome warmer, and that on the 16th instant 111 deathsoccurred at Memphis, and 23 at Vicksburg. And, as we go<to press, 22 deaths are reported to have occurred on the 18th,.at Vicksburg, the sanitary condition of Memphis being stillvery bad.The system of quarantining has been adopted now as

regards inland places, and in some places even the mailsfrom New Orleans are refused a passage. We have, in fact,yet to devise and adopt, for international purposes, somerational system of sanitary surveillance that shall be suit-able for such terrible emergencies as that with which we are-confronted at the present time. As the commerce betweenLondon and most of the infected ports is constant if not

considerable, the Port Sanitary Authority has re-issued anofficial notice, originally published in 1874, warning themasters of vessels that no clothing or bedding should belanded in the dock until due notice has been given to the