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the greatest proportional prevalence of this disease lastmonth was recorded in Kensington, Fulham, the City ofWestminster, Bethnal Green, Poplar, and Wandsworth.The number of enteric fever patients under treatment inthe Metropolitan Asylums Hospitals, which had been 32at the end of each of the two preceding months, was 33 atthe end of last month ; the weekly admissions averaged 6,against 7, 8, and 7 in the three preceding months. Ery-sipelas was proportionally most prevalent in Holborn,Finsbury, Shoreditch, Stepney, Poplar, Southwark, and

Bermondsey. The 33 cases of puerperal fever notified duringthe month included 6 in Stepney, 5 in Lambeth, 4 in BethnalGreen, 3 in Poplar, 3 in Bermondsey, and 2 in Fulham.The 15 cases of cerebro-spinal meningitis included 3 in

Islington and 3 in Stepney ; and of the 26 cases notifiedas poliomyelitis 4 belonged to Islington, 3 to St. Pancras,3 to Stepney, and 2 each to Paddington, the City of

Westminster, Stoke Newington, Southwark, and Camberwell.The mortality statistics in the table relate to the deaths of

persons actually belonging to the several boroughs, thedeaths occurring in institutions having been distributedamong the boroughs in which the deceased persons had pre-viously resided; the death-rates from all causes are furthercorrected for variations in the sex and age constitution of thepopulations of the several boroughs. During the five weeksending August 3rd the deaths of 4867 London residentswere registered, equal to an annual rate of 11- 8 per 1000 ;in the three preceding months the rates had been 14’ 3,13-3, and 11-6 per 1000. The death-rates last monthranged from 7.7 in Hampstead, 8-3 in Lewisham, 8. 6in the City of London, 9-1 in Deptford, 9-4 in Wands-worth, and 9.5 in Greenwich, to 13. 6 in Poplar,13-7 7 in St. Pancras, 16. 1 in Finsbury, 16. 4 in

Shoreditch, 16.6 in Holborn, and 16.7 in Bermondsey.The 4ob/ deaths from all causes included 492 whichwere referred to the principal infectious diseases ; ofthese, 170 resulted from measles, 18 from scarlet fever, 46from diphtheria, 83 from whooping-cough, 13 from entericfever, and 162 from diarrhoea and enteritis among childrenunder two years of age. The lowest death-rates fromthese diseases in the aggregate were recorded last month inthe City of Westminster, Hampstead, Stoke Newington,the City of London, Wandsworth, and Woolwich ; and thehighest rates in St. Pancras, Holborn, Finsbury, Shoreditch,Poplar, Southwark, and Bermondsey. The 170 deathsfrom measles were 22 in excess of the corrected averagenumber in the corresponding period of the five precedingyears ; this disease was proportionally most fatal lastmonth in St. Pancras, Holborn, Finsbury, Poplar, South-wark, and Bermondsey. The 18 fatal cases of scarletfever were equal to only one-half of the corrected

average number, and included 4 in Fulham, 3 in Camberwell,2 in Kensington, and 2 in Greenwich. The 46 deaths from

diphtheria were 4 above the corrected average number ; thegreatest proportional mortality from this disease was

I I . -1 - - I- 1 - 1 -1 1-1 1

recorded in St. rancras, Islington, Finsbury, Snoreditch,Greenwich, and Lewisham. The 83 fatal cases of whooping-coiigh were 11 fewer than the corrected average ; this diseasecaused the highest death-rates in Chelsea, Fulham, Holborn,Shoreditch, Stepney, and Battersea. The 13 deaths fromenteric fever were 4 above the average, and included 2 inFulham and 2 in Battersea. The mortality from diarrhoeaand enteritis among children under two years of age was

proportionally greatest in Paddington, Finsbury, Shoreditch,Stepney, Southwark, and Bermondsey. In conclusion, it

may be stated that the aggregate mortality in London lastmonth from the principal infectious diseases was equal tothe average.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments have been notified :-Staff-

Surgeons : J. D. S. Miller and A. Woollcombe to ChathamHospital, both temporary; A. J. Wernet to the Pembroke, forRoyal Naval Barracks ; E. Cox to the Ponaone, additional,for Royal Naval College, Dartmouth, temporary ; and G. D.Bateman to Sick Quarters, Queensferry. Surgeons : H. E.Scargill to the Royal Arthur and for group of ships of ThirdFleet; S. H. Vickery to the Hebe; F. H. Holl, C. H. L.Petch, J. H. Wright, G. A. S. Hamilton, G. P. Adshead,

S. F. Dudley, C. R. M. Baker, and H. M. Langdale all tothe President, additional, for five months’ course of instruc-tion ; H. W. Nicholls to the R.M. Division, Portsmouth; ;,K. H. Hole to the Pomone, additional, for Royal Naval

College, Dartmouth ; and J. Hadwen to Haslar Hospital.ROYAL ARMY MEDICAL CORPS.

The undermentioned Captains to be Majors (datedAugust 14th, 1912) :-Joseph F. Whelan, William M. Power,and Robert B. Black.The undermentioned Lieutenants (on probation) are con-

firmed in their rank :-Thomas A. Weston, Roy K. Mallam,William McNaughtan, David T. M. Large, William F.Christie, Alexander Hood, Edward A. Strachan, Cuthbert J.Blaikie, James H. M. Frobisher, Walter Stevenson, John L.Ritchie, David T. Richardson, Owen W. J. Wynne, ChristopherM. Ingoldby, Sidney J. Higgins, Percy A. With, Stephen J.Barry, and Henry R. L’Estrange.

Colonel R. I. D. Hackett, principal medical officer of theAbbottabad Brigade of the Northern Army in India, hastaken up duty at Sialkot. Lieutenant-Colonel H. D. Rowan,at present holding charge of the Military Hospital at Tid-worth, Salisbury Plain, has been selected for the increasedrate of pay under Article 317 of the Royal Warrant. Lieu-tenant-Colonel A. P. Blenkinsop has taken up duty at ArmyHeadquarters, Simla, as Assistant Director of MedicalServices, British Troops, in succession to Brevet-ColonelR. S. F. Henderson, honorary physician to His Majesty theKing, transferred to Quetta to command the Station Hos-pital. Lieutenant-Colonel A. E. Tate, commanding theStation Hospital at Rawal Pindi Cantonment, has been.transferred to Peshawar to officiate as Principal MedicalOfficer of the First (Peshawar) Division, in succession toColonel S. C. B. Robinson, placed on retired pay. Lieu-tenant-Colonel R. H. Hall, senior medical officer at Bermuda,has arrived home on leave of absence. Lieutenant-ColonelE. Eckersley, Deputy Assistant Director-General, ArmyMedical Services, has been placed under orders to proceedto India during the ensuing trooping season, for duty withthe Northern Army.

Major H. S. Thurston has arrived home on leave of absencefrom the Military Hospital, Valletta, Malta. Major J. W.Langstaff has been transferred from the Aldershot Commandto the London District for duty. Major S. de C. O’Gradyhas been appointed to officiate as Sanitary Officer to theBritish Troops in Egypt, in succession to Major M. F. G.Fell. An exchange on the roster for service abroad hasbeen approved by the Director-General of the ArmyMedical Service between Major J. E. Carter, CompanyOfficer No. 10 Company of the Royal Army Medical Corps atChatham, and Major E. C. Hayes, sanitary officer, Ports-mouth District. Major G. G. Delap, D.S.O., assistantinstructor at the Royal Army Medical Corps School of

Instruction, Aldershot, has embarked for a tour of servicein South Africa. Major J. E. Hodgson, at present servingin the London District, has been placed under orders toproceed to India for duty with the Southern Army duringthe ensuing trooping season. Major C. B. Lawson has beentransferred from the Royal Victoria Hospital at Netley tothe Military Hospital at Shorncliff, and appointed Specialistin Operative Surgery.

Captain C. G. Thomson has taken up duty in the ScottishCommand. Captain G. De la Cour, specialist in operativesurgery, has arrived home on leave of absence from

Bangalore. Captain J. S. Pascoe has been selected for

appointment as Specialist in Midwifery and Diseases ofWomen and Children to the Woolwich District, in successionto Major R. H. Fuhr, D.S.O., whose tenure of the appoint-ment has expired. Captain E. H. M. Moore has beenappointed to the Eastern Command for duty. Captain D. S.Skelton has left Strensall for a tour of service at Zanzibar.Captain T. S. Dudding has returned to the Military Hospitalat Colchester on completion of duty at Ipswich. CaptainT. S. Eves has been transferred from the Station Hospital atBenares to Lucknow for duty. The following officers atpresent stationed in Ireland have been selected to attend acourse of instruction for promotion to the rank of Major atthe Royal Army Medical College, Grosvenor-road, London,commencing on Oct. 31st next :-Captains O. levers, M. C.Wetherell, A. A. Meaden, N. Low, C. J. Coppinger, J. E.Hoar, C. W. O’Brien, G. G. Tabuteau, R. F. Hnmfrey,G. Ormrod, J. H. Graham, W. Benson, C. E. W. S. Fawcett,

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V. 4H. Symons, E. L. Moss, M. J. Cromie, and E. T. Potts.Captain W. Mitchell has been transferred from the MilitaryHospital at Ambala Cantonment to Subathu, Simla Hills.

Captain T. Scatchard, on return from a tour of service atRanikhet, India, has been appointed for duty as MedicalOfficer in Charge at Ad Fines Camp. Captain C. W. O’Brienhas taken up duty at Kilbride on transfer from Dublin.

Captain W. F. H. Vaughan has been selected for appoint-ment as Specialist in Operative Surgery to the Cork District,Irish Command, in succession to Captain R. M. Ranking,whose tenure of the appointment has expired. CaptainR. D. O’Connor has joined for duty at Cliffden on returnfrom a tour of service in India. Captain E. Ryan has beenplaced under orders to proceed to India for a tour of dutywith the Southern Army during the ensuing troopingseason.

Lieutenant O. W. J. Wynne has been appointed to theLondon District for duty at the Queen Alexandra MilitaryHospital, Grosvenor-road. Lieutenant G. H. Dive hasembarked for a tour of service in North China. LieutenantA. G. Jones and Lieutenant F. R. Laing have been placedunder orders to proceed to India for a tour of duty with theNorthern Army during the ensuing trooping season.

Lieutenant W. Stewart has been transferred from the

Military Hospital at Bedford to Colchester, on relief byLieutenant-Colonel A. P. Poynder.

INDIAN MEDICAL SERVICE.Colonel J. Smyth, principal medical officer of the Secun-

derabad Brigade, Southern Army in India, has been

appointed to officiate as Surgeon-General with the Govern-ment of Madras Presidency during the absence on leave of

Surgeon-General W. B. Bannerman. Lieutenant-Colonel S.Henderson has been selected for the increased rate of pay inthe list of advanced Lieutenant-Colonels, in succession toLieutenant-Colonel P. Hehir, promoted to the rank ofColonel. Lieutenant-Colonel B. B. Grayfoot has been ap-pointed Civil Surgeon at Karachi, in succession to Major H.Bennett, placed on special duty. Lieutenant-Colonel C. H.

James, medical adviser to Patiala State, has taken up dutyas Offciating Civil Surgeon at Simla West.Major .R:. U. MacLeod, civil surgeon at Dacca. has been

granted combined leave of absence home from India for ninemonths. Major F. A. L. Hammond, civil surgeon at

Maymyo, Burma, has been appointed to officiate as a First-class Civil Surgeon. Major L. P. Stephen has been per-mitted to extend his furlough by the Secretary of State forIndia. Major E. F. G. Tucker has been appointed to officiateas Professor of Pathology and Morbid Anatomy at the GrantMedical College, Bombay. Major W. Selby has taken upduty as Principal and Professor of Surgery at King George’sMedical College, Lucknow.The services of Captain F. P. Wernicke have been placed

at the disposal of the Government of the Central Provinces.Captain W. J. Fraser has been selected for appointment asCivil Surgeon at Chindwara. Captain S. C. Pal, seniormedical officer at Farrukhabad, has been appointed to holdcivil medical charge of the station in addition to his militaryduties during the absence on leave of Captain F. W. Sumner.Captain H. Watts has been appointed Civil Surgeon atWardha, Central Provinces. Captain R. D. MacGregor hasbeen granted an extension of his leave of absence for sixmonths on medical certificate. The services of Captain A. W.Greig have been placed at the disposal of the PunjabAdministration by the Government of India for employmentas Superintendent of the Central Jail at Montgomery. CaptainR. B. Lloyd has been appointed probationer in the ChemicalExaminers’ Department, and has been posted for duty to theChemical Laboratory at Calcutta. The services of CaptainW. a. Collinson, medical officer of the 63rd (Palamcotta)Light Infantry, have been placed at the disposal of theGovernment of India, Department of Education, for employ-ment on Plague Prevention duty in the United Provinces ofAgra and Oudh. ,

TERRITORIAL FORCE.

Yeomanry.Lincolnshire Yeomanry: Surgeon-Lieutenant Robert B.

Purves to be Surgeon-Captain (dated Nov. 14th, 1910).

Infantry.5th Battalion, The King’s Own (Royal Lancaster Regi-

ment) : Norman Stuart Jeffrey (late Captain 3rd West

Lancashire Field Ambulance, Royal Army Medical Corps) tobe Lieutenant (dated August 17th, 1912).

Royal Army Medical Corps.Yorkshire Mounted Brigade, Field Ambulance, Royal Army

Medical Corps : Lieutenant John Hepple to be Captain(dated July lst, 1912).

3rd West Lancashire Field Ambulance, Royal ArmyMedical Corps : Captain Norman S. Jeffrey resigns his c-om-mission (dated August 17th, 1912).

3rd South Midland Field Ambulance, Royal Army MedicalCorps : Lieutenant Cyril C. Lavington to be Captain (datedJuly 15th, 1912).2nd Northern General Hospital, Royal Army Medical

Corps : The undermentioned officers, from the list of officerswhose service will be available on mobilisation, to be

Captains in the permanent personnel (dated May lst, 1912)Captain Joseph F. Dobson and Captain James A. Coupland.The undermentioned Captains to be Majors (dated May lst,

1912) : Joseph F. Dobson and James A. Coupland.3rd Scottish General Hospital, Royal Army Medical

Corps : Major Archibald G. Hay to be Lieutenant-Colonel(dated April 19th, 1912).2nd London (City of London) Field Ambulance, Royal

Army Medical Corps : Robert Eric Barnsley (late Cadet,Cambridge University Contingent, Senior Division, Officers

Training Corps) to be Lieutenant (dated July 22nd, 1912).Attached to Units other than Medical Units.-Lieutenant

Robert Thornton to be Captain (dated Feb. 3rd, 1906).Captain John F. F. Parr to be Major (dated May 28th, 1912).Godfrey Kindersley Maurice to be Lieutenant (datedJune 23rd, 1912). William Thomas Briscoe to be Lieu-tenant (dated July 8th, 1912). Lieutenant Leonard B. Caneto be Captain (dated May 22nd, 1912). Captain AndrewFowler to be Major (dated June 22nd, 1912). James ArthurMorris to be Lieutenant (dated July llth, 1912).

Por Attachment to Units other than Medical Units.-John Francis Edmiston to be Lieutenant (dated June 3rc1,1912). Robert Glover Wills to be Lieutenant (dated July 27th,1912).

ROYAL ARMY MEDICAL COLLEGE.Colonel Bruce M. Skinner, M.V.O., to be Commandant and

Director of Studies, vice Colonel E. J. E. Risk (datedAugust 15the,1912).

Correspondence.

THE MEDICAL PROFESSION AND THENATIONAL INSURANCE ACT.

" Audi alteram partem."

To the Editor of THE LANCET.

SIR,-I should be obliged if you will publish inTHE LANCET the enclosed reply to a letter received from theMedical Secretary of the British Medical Association, re-

questing the medical members of the Advisory Committee toresign their seats on that committee.

, I am, Sir, yours faithfullv,Leicester, August 20th, 1912. C. J. BOND.

ENCLOSURE. JTo the slledical Secretary of the British Medical Association.DEAR SIR,-I beg to acknowledge the receipt of your

letter of to-day conveying the wish of the British MedicalAssociation that I should resign my seat on the AdvisoryCommittee in connexion with the National Insurance Act.

In answer I should like to point out that I was appointedby the Commissioners to advise in regard to matters affect-ing the interests of county hospitals without medical schools.In view of the important relationships between theseinterests and those of the medical profession and thepublic, and bearing in mind that in all probability agree-ments, requiring the approval of the Insurance Commis-sioners, will be entered into between Insurance Committeesand the boards of general hospitals, especially in regard tothe treatment of non-pulmonary cases of tuberculosis, I

have, after very careful consideration, and with a full senseof responsibility, formed the opinion that it is my duty toremain at present a member of the Advisory Committee.