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of diphtheria last month showed a slight decline from thatrecorded in the preceding month ; among the various metro-politan boroughs the greatest proportional prevalence ofthis disease occurred in Hackney, Finsbury, the City ofLondon, Stepney, Poplar, and Greenwich. The MetropolitanAsylums hospitals contained 681 diphtheria patients at theend of last month, against 786, 718, and 755 at the end ofthe three preceding months ; the weekly admissions

averaged 95, against 94, 97, and 113 in the three precedingmonths. The prevalence of enteric fever last month showedbut little variation from that recorded in the precedingmonth; this disease was proportionally most prevalentin Paddington, Hackney, Shoreditch, Stepney, Dept-ford, and Greenwich. The Metropolitan Asylums hos-

pitals contained 62 enteric fever patients at the end oflast month, against 86, 62, and 51 at the end of thethree preceding months ; the weekly admissions averaged12, against 11, nine, and ten in the three preceding months.Erysipelas was proportionally most prevalent in St. Mary-lebone, St Pancras, Holborn, the City of London, Shore-ditch, Bermondsey, and Deptford. The 18 cases of puerperalfever notified during the month included three in Hammer-smith, two in Paddington, two in Islington, two in Poplar,and two in Battersea.The mortality statistics in the table relate to the deaths

of persons actually belonging to the various metropolitan boroughs, the deaths occurring in public institutions havingbeen distributed among the several boroughs in which thedeceased persons had previously resided. During the fiveweeks ending July 2nd the deaths of 5562 persons be-

longing to London were registered, equal to an annualrate of 12’ 5 per 1000 ; in the three preceding months therates had been 16’ 7, 16- 2, and 13-9 per 1000. The lowestdeath-rates in London last month were 8’ in Paddington,9’5 in Hampstead, 9’6 in Lewisham, 9’8 in Wandsworth,10’liu City of Westminster, and 10’ 6 in Greenwich ; whilethe highest rates were 15 - in Chelsea, in Stepney, and inBermondsey, 15’5 in Finsbury, 15’9 in Shoreditch, 16’3 inBethnal Green, and 16’9 in Southwark. The 5562 deathsfrom all causes in London last month included 657 whichwere referred to the principal infectious diseases ; of these,two resulted from small-pox, 316 from measles, 31 fromscarlet fever, 47 from diphtheria, 130 from whooping-cough,18 from enteric fever, and 113 from diarrhoea. The lowestdeath-rates from these diseases were recorded in Paddington.Kensington, Chelsea, City of Westminster, St. Marylebone.Hampstead, and Stoke Newington ; and the highest rates inFinsbury, Shoreditch, Bethnal Green, Stepney, Southwark,and Bermondsey. Of the two fatal cases of small-poxregistered last month, one belonged to Kensington and oneto Finsbury. The 316 deaths from measles were 15below the average number in the’ corresponding period ofthe ten preceding years; among the various metropolitanboroughs this disease was proportionally most fatal in

Islington, Bethnal Green, Southwark, Bermondsey, Lambeth,and Deptford. The 31 fatal cases of scarlet fever were onlyone half of the corrected average number; the greatestproportional fatality from this disease occurred in the Cityof Westminster, Islington, Bethnal Green, Poplar, andWoolwich. The deaths from diphtheria numbered 47 lastmonth, the average number in the corresponding periods ofthe ten preceding years having been 144; among the variousmetropolitan boroughs this disease was proportionally mostfatal in Hammersmith, Hackney, Finsbury, Bethnal Green,Stepney, and Greenwich. The 130 fatal cases of whooping-cough showed a decline of 59 from the corrected averagenumber; the greatest proportional mortality from thisdisease occurred in Fulham, Chelsea, St, Pancras, Shoreditch,Stepney, Southwark, and Woolwich. The 18 deaths fromenteric fever were 14 below the average number in the corre-sponding periods of the ten preceding years; among the variousmetropolitan boroughs this disease was proportionally mostfatal in Paddington, Kensington, St. Pancras, Hackney, andCamberwell. The 113 fatal cases of diarrhoea were slightlyin excess of the corrected average number; this diseaseshowed the highest proportional mortality in the City ofLondon, Shoreditch, Stepney, Bermondsey, Battersea, andLewisham. In conclusion, it may be stated that the aggre-gate mortality in London last month from the principalinfectious diseases was nearly 26 per cent. below theaverage.

Infant mortality, measured by the proportion of deathsamong children under one year of age to registered births,

b was equal to 89 per 1000. The lowest rates of infant mor-

tality were recorded in Paddington, St. Marylebone, Hol-C born, Greenwich, Lewisham, and Woolwich ; and the highestrates in Kensington, Chelsea, the City of London, Shore-ditch, Bermondsey, and Deptford.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments are notified :-Inspector-

General H. M. Ellis to the President for temporary serviceat the Admiralty. Fleet Surgeon H. F. Iliewicz to theExcellent for the Colossus while guardship at Cowes. Sur-geons : H. V. Wells to the Dwarf on recommissioning,undated; and W. J. Codrington and H. P. Turnbull to thePresident for three months’ course of hospital study.

ROYAL ARMY MEDICAL CORPS.The undermentioned Lieutenants to be Captains (dated

June 27th, 1904) :-Frederic W. Lambelle, Martyn C.Beatty, Theodore F. Ritchie, Alexander W. Sampey, ThomasJ. Potter, Alexander J. Williamson, Ernest V. Aylen, HenryRogers, William Davis, and Denis J. F. O’Donoghue.The undermentioned Lieutenants are confirmed in that

rank :-Robert M. Ranking, Francis J. Turner, Godfrey F.Rugg, Douglas S. B. Thomson, John Fairbairn, LeonardBousfield, James H. Douglass, Arthur S. Arthur, Robert R.Lewis, Alexander L. Otway, Charles H. Turner, DumaresqLe Bas, Eugene C. Whitehead, Walter F. H. Vaughan,Richard B. Hole, Travis C. Lucas, George E. Cathcart,William Wiley, Howard Harding, John A. Turnbull,Montague F. Grant, David P. Johnstone, Edward H. M.

I Moore, Michael D. Ahern, Frederick J. Garland, Alban A.Meaden, Robert J. Cahill, and Harry B. Connell.

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Lieutenant S. M. Sloan to be Surgeon-Captain(dated July 6th, 1904); Captain H. E. Dalby, Royal ArmyMedical Corps Militia, to be Surgeon-Captain (datedJuly 20th, 1904) ; and Surgeon-Lieutenant R. C. Gayer,Surrey Imperial Yeomanry, to be Surgeon-Lieutenant (datedJuly 20th, 1904).

VOLUNTEER CORPS.

Royal Garrison Artillery (Volunteers): Ist Midlothian :Duncan Robert Macdonald to be Surgeon-Lieutenant (datedJuly 16th, 1904).Royal Engineers (Volunteers) : : lst London : Surgeon-

Lieutenant J. C. Jackson resigns his commission (datedJuly 16th, 1904).

Rifle : 1st Volunteer Battalion the Hampshire Regiment :Surgeon-Lieutenant J. A. James to be Surgeon-Captain(dated July 16th, 1904). 1st Volunteer Battalion theDurham Light Infantry : Surgeon-Lieutenant-Colonel J. W.Blandford to be Brigade Surgeon-Lieutenant-Colonel whilstholding the appointment of Senior Medical Officer of theDurham Light Infantry Volunteer Infantry Brigade (datedJuly 16th, 1904) ; and Surgeon-Captain L. J. Blandford isborne as Supernumerary whilst commanding the DurhamLight Infantry Volunteer Infantry Brigade Bearer Company(dated July 16th, 1904).

MR. ARNOLD-FORSTER’S NEW ARMY SCHEME.Mr. Arnold-Forster has now furnished Parliament with a

statement of his proposals regarding army reform and hehas outlined the skeleton of a scheme on and around whichthe new army organisation has to be moulded and filled in inorder to give it figure and form. Apart from the extremelydifficult and complicated nature of the problem in itself theWar Minister has been confronted with two conflicting, ifnot antagonistic, considerations-namely, the necessity forthe reduction of public expenditure while having to fulfil atthe same time the strongly expressed national demand forincreased military efficiency and all-round preparedness forwar. The scheme is bold in aim and design and it has, like allmeasures in which the reconstructions are of necessity of themost radical and comprehensive kind, its good and badfeatures as well as much that must be of a tentative and

provisional nature. There is a great deal in the new schemewhich strikes us as coming within the purview of medicalconsideration, comment, and criticism, but it would beimpossible to deal with it within any brief compass norwould it probably serve any useful purpose to do so at thepresent stage of the inquiry.

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THE WAR IN THE FAR EAST.As might be expected in the circumstances, there would

be much to chronicle if the number of unauthenticatedreports that have appeared regarding the war could be takeninto account. But the actual events of which we have hadofficial information during the past week have been com-

paratively few. Up to the receipt of the news of the battlein the Motien Pass caused by the Russian attack in strongforce on the Japanese position there, of the stubborn resist-ance of the Japanese, and of the ultimate rout and pursuit ofthe Russians with the loss of more than 1000 of their numberthere had been a comparative lull in the war operations. Fromall accounts it would appear that the enveloping process ofGeneral Kuropatkin’s army by the Japanese is going on, if itis not already complete, but we do not hear of the Japanesehaving yet struck at the railway which has in the meantimebeen bringing reinforcements from Russia and greatlyaugmenting the strength of the forces at Kuropatkin’sdisposal. His strategic position has apparently been im-proved. It seems still probable that we shall soon hear,however, of fighting on a large scale somewhere in the

vicinity of Tashi-chao. There is nothing of importance to berecorded regarding the siege of Port Arthur or as to thedate of the expected attack or the health of the garrison.As Port Arthur is besieged and isolated at the present timeits hospitals must contain a large number of sick andwounded. The Japanese have framed a serious indictmentagainst the Russians on the score of cruelty and barbarity ontheir part in the conduct of the war.We hear next to nothing of the health and sanitary con-

dition of the belligerent forces in the field. The lossescaused by sickness in a campaign are always far in excess ofthose caused by bullets and there must be a great deal ofinefficiency on both sides in this war from diseases of onesort and another. The cholera epidemic prevailing in Persiais giving. rise to some anxiety in Russia and precautionsare being taken to guard against its possible introductioninto that country. Orders have been given to close theland frontier at Astara for travellers, merchandise, andluggage, and at Julfa quarantine has been established forimports from Tabriz. Telegraphic reports received at Bakufrom Teheran state that "cholera is assuming alarmingdimensions. Europeans are leaving the town hurriedly,leaving their property without surveillance, and camping outon the mountains. The Teheran agent to the CaucasianQuicksilver Company has died of the disease." Personswho have arrived at Baku from Teheran state that on some

days the mortality reached a total of 900 and that the bodiesof the dead could not be removed from the streets as fastas they accumulated.The JOll’l’nal of the Association of fflilitary Surgeons for

April contains an interesting article on the Red CrossSociety of Japan by Colonel Nicholas Senn, surgeon-generalU.S.A., who is personally acquainted with the working ofthe institution, of which he is also an honorary member. In1877, when the south-western provinces of Japan rebelled, asociety was formed by the loyal party with the object ofaffording aid to the sick and wounded. It was called the.Halt2cctishcc, or Benevolent Association, and proved to be ofthe greatest utility. When the disturbance was quelled theassociation was constituted on a permanent basis and soonafterwards, when the Japanese Government joined the GenevaConvention, it became the Society of the Red Cross of Japan.Since then its progress has been remarkable. At the presenttime the society contains upwards of 800,000 members. thegeneral population of the islands having responded in aremarkable manner to the example set them in the officialworld and more especially by the Imperial family. The

president is an Imperial prince and the committee of womenis presided over by an Imperial princess, while the Emperorhimself takes the greatest interest in the transactions of thesociety and pays frequent visits to the Red Cross hospitalin his capital. Baron Ishiguro and Bron Hashimoto,very distinguished members of the medical profession in

Japan, have been the moving spirits of the society from itsinception and have everywhere received the ungrudgingcooperation of their professional brethren. In order to keepup popular interest in the undertaking an annual meeting isheld, generally at Tokio in the Uena Park. The attendanceis seldom under 200,000 persons of both sexes.On the authority of Dr. Dworetzky of Moscow, a writer

in the Archives de Midecine et de P7crcrnr.acie Militai’l’es for

July gives the following information regarding the healthof the Russian troops in Manchuria, not including the

garrison of Port Arthur. On May 25th last there were 27cases of infectious disease among the soldiers, distributed asfollows: dysentery, six; typhoid fever, eight; typhic feversnot yet diagnosed, six ; petechial typhus fever, three; small-pox, one; malignant, pustule, one ; scurvy (sic), one; andmeasles, one. Plague has not been seen anywhere. Sicknessis consequently inconsiderable, not exceeding the amountusually occurring in time of peace. It is not to be sup-posed, however, that such a condition of things willlast very long. We may soon, continues the author, expectto hear of a considerable amount of infectious disease.It must be remembered that the theatre of the present waris the home of plague, cholera, dysentery, small-pox, andtyphic maladies of every description. The Medical Societyof Moscow, being anxious to take a share in the struggleagainst these terrible scourges of armies in the field, decidedas soon as hostilities broke out between Russia and Japan tosend sanitary columns to the seat of war. It was easy toobtain recruits for these columns in Moscow where there isa flourishing bacteriological institute under the charge ofDr. Blumenthal. The society paid special attention to pro-phylactic inoculations against typhoid fever and dysenteryand also to the question of how far it was permissible toemploy serums while endeavouring to combat the epidemicsincidental to active service.At Kharbin a number of wooden and iron barges are being

prepared for the transfer of the sick and wounded along theriver Sungari to Khabarovsk. A series of rooms is fitted up inthe holds capable of receiving from 15 to 20 patients eachand on deck accommodation is provided for the medicalofficers, sisters of mercy, sanitary officers, and others, as alsofor storing linen, medicines, and drugs, besides baths andsome more wards. The wooden barges will accommodate

only about 120, as against about 200 for the iron ones, andthe latter are unfortunately too few for the whole service.The passage on the river will take four days.The R1lSHki Listok has a telegram from Newchwang stating

that the Lieutenant Bicr7n’, which has been so successfullyrunning the Port Arthur blockade, on its last return journeyto Port Arthur in the teeth of the Japanese vessels watchingfor it to come out, took a large quantity of medicaland surgical material, including surgical instruments,specially collected by the Red Cross Society at the request ofGeneral Stessel, the commander of the fort.The executive committee of the Red Cross Society, says

the Sviet, has decided to pay to the wife of Dr. Rysshkova(who was taken by the Japanese) an allowance at the rate of200 roubles per month during his captivity.

Correspondence.

THE NEW SYDENHAM SOCIETY.

"Audi alteram partem."

To the Editors of THE LANCET. SiRS,—Will you oblige me with a small portion of yourL valuable space in order to draw the attention of all interestedL in the work of the New Sydenham Society to the fact that. our annual meeting (the forty-fifth) will be held next weekb in Oxford ? 7 By the courtesy of the British Medical Associa-tion we always meet during its sittings and in one of itsL rooms. This year (see advertisement) it will take place at1 9.30 A.M. on Friday, July 29th, in room 10, ground floor ofthe schools buildings. Our President, Professor W. Osler,i will, it is expected, take the chair.r This meeting will be of somewhat especial importance.The council’s report will contain proposals calculated, it is1 hoped, greatly to extend the sphere of the society’s useful-, ness which it desires to make widely known. Encouragedi by the success which has attended the Clinical Atlas thecouncil at its last meeting decided to recommend that, whilst keeping as closely as possible to the programme3 issued, no date should at present be fixed at which the issues of the Atlas should be considered complete but that it shoulde continue so long as it is found to be acceptable to the pro-

fession. At the same time it was decided to appoint ar large and representative committee to carry on the work.r Under these arrangements the unique facilities which ourb. society ofiers for the economical, and yet liberal, employ-;) ment of pictorial art for the advancement of clinical