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diarrhoea, and not one to small-pox. In all, 54 deathsresulted from these principal zymotic diseases, against44 and 55 in the preceding two weeks. These 54 deathswere equal to an annual rate of 1’9 per 1000, which

corresponded with the mean rate last week from the samediseases in the thirty-three large English towns. The fatalcases of diphtheria, which had been 10, 10, and 6 in thepreceding three weeks, rose again to 14 last week, ofwhich 6 occurred in Glasgow, 3 in Greenock, and 2in Edinburgh. The deaths referred to different forms of"fever," which had been 2 and 7 in the preceding two weeks, further increased to 10 last week, of which 6 wererecorded in Glasgow, 2 in Edinburgh, and 2 in Aberdeen.The 9 fatal cases of measles also showed a furtherincrease upon recent weekly numbers, and included 8 in

Glasgow. The deaths from whooping-cough, which hadbeen 5 and 8 in the preceding two weeks, were 9 last week,of which 5 occurred in Glasgow. The fatal cases of scarletfever, which had been 6 and 12 in the preceding two weeks,declined again to 7 last week, and included 4 in Glasgow.The deaths referred to diseases of the respiratory organs inthese towns, which had been 96 and 114 in the precedingtwo weeks, further rose to 144 last week, and exceeded by41 the number in the corresponding period of last year. Thecauses of 60, or more than 9 per cent.. of the deaths inthese eight towns last week were not certified.

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 18’0 and 22 4per 1000 in the preceding two weeks, further rose to 23’9during the week ending Nov. 3rd. During the past fiveweeks of the current quarter the death - rate in the cityhas averaged 21’9 per 1000, against 16’2 in London and 19’2in Edinburgh. The 160 deaths registered in Dublin duringthe week under notice showed an increase of 10 upon thenumber in the previous week, and included 11 which werereferred to the principal zymotic diseases, against 16 ineach of the preceding two weeks ; of these, 5 resultedfrom diarrhcea, 3 from "fever," 1 from small-pox, 1 frommeasles, 1 from whooping - cough, and not one eitherfrom measles or from diphtheria. These 11 deaths were

equal to an annual rate of 1’6 per 1000, the zymoticdeath-rate during the same period being 1’6 in Londonand 1-3 in Edinburgh. The fatal cases of diarrhoea,which had been 9 and 7 in the preceding two weeks,further declined to 5 last week. The deaths referred tovarious forms of "fever," which had been 7, 4, and 3 inthe preceding three weeks, were again 3 last week. Onefatal case of small-pox was recorded last week, making 13deaths from this disease within the city since the beginningof October. The 160 deaths in Dublin last week included 18of infants under one year of age, and 42 of persons agedupwards of sixty years ; the deaths of infants were fewerthan in any recent week, while those of elderly personsshowed a further increase upon those recorded in the preced-ing two weeks. Four inquest cases and 2 deaths from violencewere registered ; and 62, or more than a third, of the deathsoccurred in public institutions. The causes of 12, or nearly8 per cent., of the deaths in the city last week were notcertified.

___________

THE SERVICES.

MOVEMENTS OF THE MEDICAL STAFF.THE following officers have arrived from India in the

Ficto’l’ia: Brigade-Surgeon-Lieutenant-Colonel Williamson,Surgeon-Majors Boulger and Barnes, and Surgeon-CaptainSooct. Surgeon-Captain Morgan has arrived from Egypt oncompletion of a tour of service, and Surgeon-Major Kirk-patnck from Malta. Surgeon-Captains Pinches and Reillyhave arrived in Egypt.

ARMY MEDICAL STAFF.The undermentioned Surgeon-Majors have been appointed

Surgeon- Lieutenant- Colonels : Barnard William Wellings ;Robert Smith, M.B. ; Francis Wollaston Trevor, M.B. ;Harvie Scott, M.B. ; James McGann ; James Powell; SidneyHerbert Carter, M.B. ; William Allan May; George DeaneBourke ; John Hoysted ; William Campbell, M.B., GrenadierGuards ; James S. Forrester, F.R.C.S. Edin., 1st LifeGuards.

INDIA AND THE INDIAN MEDICAL SERVICES.

Surgeon-Captain S. H. Henderson, Officiating Civil Sur- I

geon, Banda, is appointed to officiate as Superintendent,Central Prison, Allahabad. Surgeon-Captain J. M. Crawford,Officiatii3,- Superintendent, Central Prison, Allahabad, iappointed to the Medical Charge of the Camp of his Excellencythe Lieutenant Governor and Chief Commissioner. Brigade-Surgeon C. T. Peters and Surgeon-Major C. Monks haverespectively delivered over and received charge of the officc.of the Superintendent of Mahableshwar. Surgeon-Lieu-tenant Leumann, LM.S., is transferred from Poona tG

Satara, for duty with the 10th Bombay Infantry. Brigade-Surgeon - Lieutenant- Colonel Gaffney, Surgeon - Lieutenant-Colonel Paterson, Surgeon - Colonel Cleghorn, and ColonelPennington, C.B., are granted good service pensions withspecial additional pensions of f.250. Surgeon-Major Robert-son, British Agent at Gilgit, has arrived at Simla on returnfrom leave to England. Surgeon-Major Wallis, A.M.S., onreturn from leave to England, is transferred to general duty,Sind district. Surgeon-Captain Buist, A.M.S., on arrivalfrom England, is posted to general duty, Poona district.Surgeon-Lieutenant Marder, A.M.S., on arrival from England,is posted to general duty, Aden district.

NAVAL MEDICAL SERVICES.

Staff -Surgeon Theodore Julian Preston has been pro.moted to the rank of Fleet Surgeon in Her Majesty’s Fleet.The following appointments are notified :-Staff -SurgeonHenry S. Jackson, to the Edinburgh. Surgeons : MorrisC. Langford, to the Pembroke; R. A. Kirby, B.A., to theDefiance; Edward A. Rogers, to the Lion; and Edward T.Meagher, to the Peacock.

MILITIA MEDICAL STAFF CORPS.

T. W. G. Kelly, M.D., has been appointed Surgeon-Lieu-tenant.

VOLUNTEER CORPS.

The following appointments have been notified:-Artillery: : 2nd Sussex : Surgeon-Lieutenant E. Downes,M.D., to be Surgeon. Captain. 1st Northumberland (WesternDivision, Royal Artillery) : John Wreford, Gent.. to be Sur-g-eon-Lieutenant. Rifle: 1st Roxburgh and Selkirk (theBorder) : Surgeon-Lieutenant W. Hume, M.B., resigns hiscommission. 2nd Volunteer Battalion, the Royal Sussex

Regiment : Surgeon-Captain W. M. Vores, M.B., from the2nd Volunteer Battalion, the Norfolk Regiment, to be Sur-geon-Captain. 2nd Volunteer Battalion, the Queen’s Own(Royal West Kent Regiment) : Surgeon - Lieutenant F.Croucher, Jl.LB., resigns his commission. 5th (West) Mid-dlesex : William Barter, M.D., to be Surgeon-Lieutenant.2nd Volunteer Battalion, the Durham Light Infantry : Thos.

Livingstone, M.D., to be Surgeon-Lieutenant.VOLUNTEER MEDICAL STAFF CORPS.

Surgeon-Captain Denis M. O’Callaglian, Army MedicalStaff, has been appointed as Adjutant, in succession to

Surgeon-Captain Julian P. S. Hayes, whose term of office hasexpired.

PROMOTION IN THE ARMY MEDICAL SERVICE.

The slowness of promotion in the Army Medical Staff,and, indeed, in the army generally, at the present time is asubject of general remark. The United Service GaNette

notes, as examples of the slowness cf promotion in themedical service, that the senior Surgeon-Colonel has overthirty-six years’ service and the senior Brigade-Surgeon-

Lieutenant-Colonel over thirty years’service, while the Surgeon-Lieutenant-Colonel last promoted has over twenty-six 3ears’service. According to all we have read and heard, the

prospects for those entering Woolwich with a view to com-missions in the other scientific branches of the service-the Royal Engineers and Royal Artillery-are also thereverse of exhilarating. There is at present a greatblock of promotion in these corps. More cadets havebeen taken into the Royal Military Academy than weresufficient to fill vacancies. The establishment of officerscannot be exceeded. The cadets passing out of Woolwich,instead of being commissioned, as heretofore, have con-

sequently to return to their parents and be idle for monthsand then to go through the course at Chatham or Shoebury-ness at their own expense before they are gazetted, a

thing unheard of before and unsatisfactory to all concerned.Something will have to be done, and that soon, if theArmy Medical Department and other branches of the serviceare to attract candidates. At present the supply is greatlyin excess of the demand, but this condition of affairs is not

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calculated to last under existing prospects as regards pro-motion.

THE FIGHTING ON THE AFGHAN FRONTIER.The intelligence from India-official and otherwise-

.regarding the engagement with the Waziris on the morningof the 3rd inst. shows that a determined attack was made onColonel Turner’s camp near Wano and that the fighting wassevere, as it was attended with considerable losses on bothsides. Colonel Turner’s force, which numbered about 2500,altogether lost in killed and wounded nearly 100 men. IAmong the officers Surgeon-Major Haig, 1st Punjab Cavalry,is mentioned as having been severely wounded. It is, and italways must be, the case that medical officers incur all therisks of field service to which officers of other branches of theservice are exposed, as well as other risks to which the latterare not liable. They are consequently entitled to share in allthe rewards of war service, and certainly no one can denythat they are always prompt to incur its dangers. We trustwe may soon hear that Surgeon-Major Haig is making goodprogress towards recovery from his wound. Medical officerswho took part in the last Afghan campaigns will readilyappreciate the description given of the late attack, as it will Iserve to remind them of the features and tactics that usuallycharacterise Eastern warfare-especially warfare on the hills !,- of Afghanistan. !,

THE RECENT OUTBREAK OF PLAGUE AT HONG-KONG.

We are glad to notice that the very great services renderedio the community at Hong-Kong during the recent outbreakof plague by volunteers from the Shropshire Regiment, themedical staff, the permanent committee, the civil volunteers’hospital nurses, and other;?, have been enthusiastically reco-gDÌèed at a public meeting presided over by his Excellency the’Governor of the colony. It may be, as indeed it has been,said that it forms no prt of the duty of a regiment to under-take work of this kind, but it is by manifesting a spirit ofthis sort that as a nation we are what we are. Officers andmen of the Shropshire Regiment, animated by a sense ofhumanity and public duty, at once came forward andvolunteered their aid at a time of great need and under verydifferent circumstances from, and to the majority of men moretrying than, those of war. They rendered services whichwere recognised as invaluable at the time, and by their dis-regard of the risks they encountered in the performance ofthem they displayed a spirit and set an example the effect ofthe loss of which it would not be easy to calculate.

THE SANITATION OF ALDERSHOT CAMP.

We notice that our service contemporary, the lrmaf andNavy Gazette, referring to this subject, states that the ques-tion of the disposal of Aldershot Camp sewage has been underdiscussion for some time between the Treasury authoritiesand the Aldershot local board. It seems, however, that nodefinite arrangement has yet been arrived at owing to finan-cral difficulties that are alleged to have arisen in connexionwith a conjoint scheme of sewage disposal. On this matterwe cannot, of course, presume to enter, but it does notaffect the sanitary aspect of the case, on which we have

previously expressed our opinion. The present sewage farmat AJdershot is confessedly inadequate and unsuitable for therequirements of the camp, and has been a frequent subjectof complaint. Very extensive works in the way of buildingand reconstruction have been carried out at Aldershot, andthe question of the drainage and disposal of the camp sewagehas obviously become a most important one, and one whichiJresses for settlement.

SURGEON-MAJOR-GENERAL PINKERTON, M.D.,F.F.P.S. GLASG.

Surgeon -Major- General Pinkerton, who has just beenelected a Fellow of the Faculty of Physicians and Surgeonsof Glasgow without examination, under a rule by which the0’aculty may annually admit to the Fellowship not morethan four legally qualified practitioners who may have highlydistinguished themselves in Medical Science or Practice,entered the Indian Medical Service in 1855. He wasSuperintendent-General of the Vaccination Department ofhe Bombay Presidency from 1868 to 1876, and drafted theifst Vaccination Bill for India, which became law in 1877.3e also held the charge of the European General Hospital inBombay city. When he retired in 1893 he was a member ofthe Legislative Council of the Presidency, and received thegood service pension. Since his retirement he has beenappointed Honorary Physician to the Queen.

THE TREATMENT OF WOUNDED SOLDIERS.The Commander-in-Chief has issued an army order to the

effect that officers and soldiers should be acquainted with thenature and component parts of the first field dressing.General officers commanding are consequently directed to

arrange free lectures to be given by medical officers on thesubject to officers, warrant officers, non-commissioned officers,and men during the winter months.

DEATHS IN THE SERVICES.Fleet Surgeon Frederick McClement, M.D. Q.U.I. He

entered the Navy in 1867, served in the Eclipse during theEgyptian war, and received the Egyptian medal andKhedive’s bronze medal. Surgeon Basil Robertson Clarke,M.R.C.S., L.R.C.P., R.N., of the -41-elita, died at Port Said,on the 13th ult., aged twenty-seven years.The Greenwich Hospital Pension of £ 50 a year for Staff

and Fleet Surgeons of the Royal Navy, rendered vacant bythe death of Fleet Surgeon Hugh T. S. Beveridge, M.D., hasbeen awarded to Fleet Surgeon Frederic Harvey.The Malabar sailed from Bombay on Oct. 16th with eighty-

seven patients for Netley.The hired transport Victoria arrived at Portsmouth on

Nov. lst with 116 patients for Netley.

Correspondence.

"THE PAY SYSTEM AND THE GREATNORTHERN CENTRAL HOSPITAL."

" Audi alteram partem."

I To the Editors of THE LANCET.SiRS,—It is very satisfactory to find, from a letter of

Mr. Spencer Watson’s in your last issue, that one member ofthis hospital staff, at any rate, has the courage of his con-victions. Some time ago a similar proposal was made withregard to the hospital of which I have had the honour ofbeing surgeon for many years ; but the unanimous hostilityof the medical staff was so strong as to prevent the proposalfrom being carried into effect. It is perfectly monstrous forthe physicians and surgeons of a public hospital to attendgratuitously patients who are known to be able to pay medicalfees from the very fact of their paying for hospital accom-modation. Your sagacious remarks on this subject deservemost careful consideration, and I trust the staff of the GreatNorthern Central Hospital will not be so weak as to be led tocommit such a fraud upon the neighbouring practitionersas such proposed gratuitous attendance will involve. If theydo so it is, I think, abundantly clear that the members of thestaff will be the first to suffer from their want of moral

courage-and that materially-in the estimation of their pro-fessional brethren throughout the country.

T n.m Rir, "I1OTlr1’l f:1it,hfl111v,

Hanley, Oct. 29th, 1894. ~

W. D. SPANTON, F.R.C.S.Eng.

To the EditO’l’1 of THE LANCET.SIRS,-I shall feel obliged if you will kindly insert the

enclosed correspondence in the interests of the medical pro-fession.-I am. Sirs. yours faithfullv.

H. F. BURNES, M.R.C.P.,Haycote, Dent, Yorks, Oct. 31st, 1894. Medical Officer for Dent.

LUUPLJ -J

Haycote, Dent, Yorks, Oct. 22nd, 189.GENTLEMEN,-On reading Saturday’s issue of THE LANCET I find

that your Committee has or is about to open pay wards at the hospital,and that the consulting staff will give their services free. As a memberof the Council, I beg to protest most strongly against such a procedureas manifestly unfair and unjust to both subscribers and the intendedrecipients of the charity, besides which the cruel injustice which wouldbe levied upon local practitioners, depriving them wholesale of theirpatients and making the chances of a livelihood more scanty thanbefore, is altogether intolerable. Nor does the evil to the outside prac-titioners stop here, for what is more probable than after a payingpatient has been successfully treated in the hospital he should inany future illness call in the aid of one of the visiting staffwho attended the patient in hospital, thus altogether depriving theprevious doctor of his patient, and giving to the hospital doctor anundue advantageover his professional brethren. Surely mischief enoughhas been done by the indiscriminate medical aid already afforded to thepublic, without adding this greater injury to the struggling members ofthe medical profession. On more than one occasion I have advocatedletters of recommendation, which would be some check on prostituting