801ROYAL COLLEGE OF PHYSICIANS OF LONDON.-THE SERVICES.

medical officer solely for the purpose of communicationwith them in connexion with their treatment, and under nocircumstances to be divulged to any third person.

Dr. Mearns Fraser has made a provisional estimate of thecost of such a scheme for the first year. Portsmouth has

over a quarter of a million inhabitants, and is, to boot, animportant naval and military centre. The provision musttherefore be adequate. The expenses come under two

heads : (1) the adaptation of suitable premises at the RoyalHospital, together with the necessary instalment of apparatusand instruments ; and (2) the annual maintenance. The

Royal Hospital authorities did not propose to make anyprofit out of the scheme, and the following estimate isconsidered to be the outside cost of treatment

1. Adaptation of premises, <E17 ; purchase of instrumentsae60j total, .E77.

2. Maintenance for one year, JE40; laundry and cleaning,ae50 j fuel, heat, and lighting, jE5; domestic, ;E40; generaladministrative charges, &pound; 100 ; total, jE235.

3. Payment of medical officer at rate of 10s. per hour, notexceeding &pound; 25 per month, JE300.

4. Nurses and orderly, jE250.5. Drugs, including salvarsan issued to practitioners, JE200.6. In-patients’ board, jE30.7. Cost of pathological laboratory facilities, fitting of room,

water, gas, &c., =E50; appliances and instruments, E120; total, 170.

8. Payments for pathological reports at rates to be agreedupon, minimum 100, all50.

9. General: Apparatus for collecting material, printing,post, literature, lectures, &c., ;E50.

Grand total, &pound;1462.Of this expenditure, as Dr. Mearns Fraser points out, the

council will only bear 25 per cent., the Local GovernmentBoard being responsible for the remaining 75 per cent.

Notwithstanding the claims of economy at the presentmoment, he advises the council to undertake the additional300 a year without hesitation.

ROYAL COLLEGE OF PHYSICIANS OFLONDON.

MEETING OF COMITIA.A COMITIA was held on Oct. 26th, Dr. FREDERICK TAYLOR,

the President, being in the chair.The following candidates having passed the required exa-

mination were admitted Members of the College : EdgarDouglas Adrian, M.B. Camb. ; James Froude Flashman,M.U.Sydney ; and Charles Putnam Symonds, L. R. C. P.Licences to practise physic were granted to 89 candidates

who had passed the necessary examinations.A letter was received from Dr. W. Pasteur resigning the

office of censor owing to his proceeding to France on activeservice. Dr. Sidney Phillips was elected a censor.The following resolutions were passed :-1. That in the opinion of this College administrative

measures for the diagnosis and treatment of venerealdiseases will only attain their maximum effectiveness inprotecting the public health when the treatment of suchdiseases by unqualified persons is prevented by law.

2. That it is desirable that the recommendations 58 (iii.)of the Patent Medicines Committee of the House ofCommons, endorsed by the Royal Commission on VenerealDiseases, should at once be carried into effect.

3. That a copy of the above resolutions be sent to thePrime Minister, to the Home Secretary, and to the Presidentof the Local Government Board.The President was re-elected a member of the Committee

of Management.The PRESIDENT drew the attention of the College to the

fact that the 400th anniversary of the foundation of theCollege will occur in 1918.A report dated Oot 3rd was received from the Committee

of Management which announced : (1) That the GrammarSchool, Ilkley, had been added to the list of institutionsrecognised by the Examining Board in England for instruc-tion in chemistry and physics ; (2) that the University ofAllahabad had been added to the list of Universities recog-nised by the Examining Board in England, and thatgraduates in medicine of the University be admissible tothe Final Examination of the Board under the conditions ofParagraph IV., Section III., of the Regulations.

After some further formal business the PRESIDENT dissolvedthe Comitia.

THE SERVICES.

ROYAL NAVAL MEDICAL SERVICE.

To be temporary Surgeons : G. E. Burton, S. N. Scott,J. E. Phillips, S. R. Johnston, A. H. Flannery, and J. R. B.Robb.The following appointment has been made :-Temporary

Surgeon : D. J. Max to Vivid.

ARMY MEDICAL SERVICE.Temporary Colonel H. M. Rigby (Captain, R.A.M.C., T.F.),

having resigned his appointment as Consulting Surgeon,relinquishes his temporary commission.

ROYAL ARMY MEDICAL CORPS.

Temporary Lieutenant-Colonel E. A. Hanly relinquisheshis commission on account of ill-health.Majors C.A.M.C. to be Temporary Lieutenant-Colonels:

A. B. Osborne and C. H. Gilmour.

Temporary Captain A. C. Renwick relinquishes hiscommission.Captains C.A.M.C. to be temporary Majors: G. P. Howlett

and H. Smith.To be temporary Captains: Lieutenant A. D. Dyas,

C.A.M.C., and Hon. Major C. J. Stewart, C.A.M.C.SPECIAL RESERVE OF OFFICERS.

Supplementary to Regular Corps or Units.Lieutenants to be Captains: J. F. W. Meenan, D. H.

Paterson, G. Irving, C. A. Whittingham, G. C. L. Woodroffe.A. L. V. Davin to be Lieutenant.

TERRITORIAL FORCE.

London Mounted Brigade Field Ambulance: Captain T. H.Chittenden to be temporary Major.West Lanes. Field Ambulance : N. J. Allan to be Lieu-

tenant., London Sanitary Company : Lieutenant L. Griffiths to beCaptain.

TERRITORIAL FORCE RESERVE.

! Captain K. S. Storrs and Captain B. N. Ash, from Attachedto Units other than Medical Units, to be Captain.

SOCIETY OF MEMBERS OF THE ROYAL COLLEGE OFSURGEONS OF ENGLAND.-The annual general meeting of theFellows and Members will take place at the College,Lincoln’s Inn-fields, W.C., on Thursday, Nov. 16th, at3 P.M. The following resolutions have been sent in onbehalf of the Society :-

1. That this Thirty-second Annual Meeting of Fellows and Membersagain affirms the desirability of admitting Members to direct repre-sentation on the Council of the College, which as now constituted onlyrepresents those Members who also hold the Fellowship ; and that itdoes so in order that the constitution of the Council of the Royal Collegeof Surgeons of England shall be in keeping with modern ideas of truerepresentation.

2. That as the Royal College of Surgeons is composed of about 19,000persons, of whom nearly 18,000 are engaged in general practice, thisannual meeting requests the President and Council to nominate atleast two Members and (or) two Fellows in general practice to representthe interests of general practitioners in the management of Collegeaffairs.

3. That the President is hereby invited to make a statement to thismeeting on the subject of the above resolution.

ANNUAL REPORT OF COUNTY MEDICAL OFFICER FORABERDEEN.-The report for the year 1915 of Dr. J. P. Watt,county medical officer for Aberdeen, shows a birth-rateof 23’4 per 1000 for the year, as compared with 24’1 in1914 and an average of 24-5 for the preceding five years.The percentage of illegitimate births was 16-3, as com-pared with 17-0 for 1914, 18-2 for 1913, and 19-3 for 1912. Themarriage-rate was 3-7 per 1000, the same as for 1914. Theexcess of birth- over death-rate was 9-3 per cent. Thedeath-rate of children under 1 year was 87-8 per 1000 births,as compared with 74 per 1000 in 1914. The number of deathsfrom all forms of tuberculosis was 112, compared with 97 in1914. Scarlet fever was again prevalent, though less so than in1913, the rise being coincident with an epidemic in the cityof Aberdeen, where scarlet fever reached the highest levelsince 1896. In the county 1913 saw the highest level of therecent wave, with an incidence of 625 cases per 100,000, ascompared with 350 in 1914, and 433 in 1915. During the 23years from 1892 to 1915, the average annual number of casesfor the county was 339 per 100,000, and for the city 531 per100,000. The case mortality was 5’2, as compared with 2-8for 1914 and an average of 2-2 for the five preceding years,the type of the disease both in the city and in the countyduring the year 1915 being unusually severe.

802 VITAL STATISTICS.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN the 96 English and Welsh towns with populationsexceeding 50,000 persons at the last Census 7691 births and4268 deaths were registered during the week ended Saturday,Oct. 28th. The annual rate of mortality in these towns,which had declined from 13’5 to 11’8 per 1000 in the four pre-ceding weeks, rose in the week under notice to 12-9 per 1000of their aggregate civil population estimated at 17,312,295persons for the year 1915. During the first four weeks of thecurrent quarter the mean annual death-rate in these townsaveraged 12-4, against 12-0 per 1000 in London. Among theseveral towns the death-rate last week ranged from 4-1 inSouthend-on-Sea, 6-9 in East Ham, 7-0 in Hornsey, 7-2 inActon, and 7-4 in Wimbledon, to 18-1 in Bury, 18-6 inGreat Yarmouth and in Gateshead, 18-7 in Middlesbrough,and 18-8 in Bournemouth.The 4268 deaths from all causes were 349 above the

number in the previous week, and included 316 which werereferred to the principal epidemic diseases, against numbersdeclining from 594 to 306 in the six preceding weeks. Ofthese 316 deaths, 221 resulted from infantile diarrhcealdiseases, 53 from diphtheria, 13 each from measles andwhooping-cough, 11 from enteric fever, and 5 from scarletfever, but not one from smail-pox. The annual death-ratefrom these diseases was equal to 1-0, against 0-9 per 1000 in theprevious week. The deaths of infants (under 2 years)from diarrhoea and enteritis, which had steadily declined from477 to 221 in the six preceding weeks, were again 221last week, and included 51 in London, 28 in Liverpool,11 in Manchester, 10 in Birmingham, and 6 each in Stoke-on-Trent and Hull. The deaths referred to diphtheria, whichhad been 52, 45, and 40 in the three preceding weeks, rose to53, of which 13 were registered in London, 4 each in Stoke-on-Trent and Birmingham, and 3 each in Liverpool andMiddlesbrough. The fatal cases of measles,which had been25, 21, and 17 in the three preceding weeks, further fell to 13,and included 5 in London and 2 each in Liverpool andManchester. The deaths referred to whooping-cough, whichhad been 15, 23, and 10 in the three preceding weeks,rose to 13, and included 2 each in London, Stoke-on-Trent,and Manchester. The 11 deaths attributed to enteric feverwere equal to the average in the three preceding weeks, andincluded 2 each in London, Manchester, and Hull. The fatalcases of scarlet fever, which had been 13, 9, and 7 in thethree preceding weeks, further declined to 5, of which 3occurred in London.The number of scarlet fever patients under treatment in

the Metropolitan Asylums Hospitals and the London FeverHospital, which had been 1037, 1074, and 1067 at the endof the three preceding weeks, rose to 1130 on Saturday last;197 new cases were admitted during the week, against159, 167, and 125 in the three preceding weeks. Thenumber of cases of diphtheria, which had increased from1262 to 1429 in the six preceding weeks, further rose to 1490;231 new cases were admitted during the week, against 228,194,and 188 in the three previous weeks. These hospitals also con-tained on Saturday last 56 cases of measles, 47 of whoop-ing-cough, and 40 of enteric fever, but not one of small-pox.The 1053 deaths from all causes in London were 93 above thenumber recorded in the previous week, and corresponded toan annual rate of 12-7 per 1000. The deaths referred to diseasesof the respiratory system, which had been 132 in each of thetwo preceding weeks, rose to 142 in the week under notice.Of the 4268 deaths from all causes in the 96 towns, 158

resulted from violence, 362 were the subject of coroners’inquests, and 1308 occurred in public institutions. The causesof 34, or 0-8 per cent., of the total deaths were not certifiedeither by a registered medical practitioner or by a coronerafter inquest. All the causes of death were duly certified inLondon and in 13 of its 14 suburban districts, in Sheffield,Leeds, Bristol, Bradford, and in 60 other smaller towns. Ofthe 34 uncertified causes, 8 were registered in Liverpool,4 in Manchester, 3 each in Birmingham and Gateshead, and2 each in South Shields and Tynemouth.

HEALTH OF SCOTCH TOWNS.

In the 16 largest Scotch towns with an aggregate popula-tion estimated at 2,372,000 persons at the middle of this year993 births and 587 deaths were registered during the weekended Saturday, Oct. 28th. The annual rate of mortality inthese towns, which had been 15-1, 13-6, and 13-0 per 1000 inthe three preceding weeks, fell to 12-9 per 1000 in the weekunder notice. During the first four weeks of the cnrrentquarter the mean annual death-rate averaged 13-7, against acorresponding rate of 12-4 per 1000 in the large Englishtowns. Among the several towns the death-rate last weekranged from 3-1 in Ayr, 7-7 in Falkirk, and 8-3 in Leith, to16-8 in Kilmarnock, 17-0 in Aberdeen, and 18-7 in Hamilton.

The 587 deaths from all causes were 2 below the numberin the previous week, and included 53 which were referredto the principal epidemic diseases, against numbersdeclining from 92 to 53 in the three preceding weeks. Ofthese 53 deaths, 19 resulted from infantile diarrh&oelig;aldiseases, 18 from measles, 5 from scarlet fever, 4 each fromenteric fever and diphtheria, and 3 from whooping-cough,but not one from small-pox. The death-rate from thesediseases was equal to 1’2, against 1’0 per 1000 in the largeEnglish towns. The deaths of infants (under 2 years) fromdiarrhcea and enteritis, which had been 66 30, and 29 in thethree preceding weeks, further fell to 19, and included 9in Glasgow, and 2 each in Edinburgh, Dundee, and Clyde-bank. The deaths referred to measles, which had been 8,16, and 2 in the three preceding weeks, rose to 18, andcomprised 13 in Dundee and 5 in Glasgow. The fatal casesof scarlet fever, which had been 7, 7, and 3 in the threepreceding weeks, rose to 5, of which 2 occurred in Glasgow.The 4 deaths from enteric fever, which comprised 3 inKilmarnock and 1 in Greenock, were slightly in excess ofthe average in recent weeks. The deaths attributed todiphtheria, which had been 5, 4, and 12 in the threepreceding weeks, fell to 4, but showed no excess in anyparticular town. The 3 fatal cases of whooping-cough wererecorded in Glasgow, Dundee, and Aberdeen respectively.The deaths referred to diseases of the respiratory system,

which had been 94, 90, and 74 in the three preceding weeks,rose to 87 in the week under notice, but were 71 below thenumber registered in the corresponding week of last year.The deaths from violence numbered 30, against 17 and 26 inthe two preceding weeks. -

HEALTH OF IRISH TOWNS.

In the registration area of Dublin 179 births and 142deaths were registered during the week ended Saturday,Oct. 28th. The annual rate of mortality, which had been18’7, 17’7, and 17-5 per 1000 in the three preceding weeks, roseto 18-7 in the week under notice, against 12-7 and 11’8 per1000 in London and Glasgow respectively.The 142 deaths from all causes included 35 of infants under

1 year and 40 of persons aged 65 years and upwards.Eleven deaths (of infants under 2 years) were referred todiarrhoeal diseases, and 1 each to enteric fever, scarletfever, and whooping-cough. The causes of 5 deaths wereuncertified, and those of 4 others were the subject ofcoroners’ inquests, while 48, or 34 per cent., of the totaldeaths occurred in public institutions.During the same period 167 births and 118 deaths were

registered in the city of Belfast. The deaths correspondedto an annual rate of 15’8, or 2’7 per 1000 above that recordedin the previous week, and included 24 of infants under1 year and 21 of persons aged 65 years and upwards. Sevendeaths were referred to infantile diarrhoea and 2 each toscarlet fever and whooping-cough. The causes of 2 deathswere uncertified, and those of 4 others were the subject ofcoroners’ inquests, while 25 of the total deaths occurred inpublic institutions.

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VITAL STATISTICS OF LONDON DURING SEPTEMBER, 1916.

In the accompanying table will be found summarisedcomplete statistics relating to sickness and mortality inthe City of London and in each of the metropolitan boroughs.With regard to the notified cases of infectious diseases, itappears that the number of persons reported to be suffer-ing from one or other of the 10 diseases specified in the tablewas equal to an annual rate of 4’9 per 1000 of the civil popula-tion, estimated at 4,310,030 persons in the middle of theyear; in the three preceding months the rates had been4-8, 4-9, and 4-0 per 1000 respectively. The lowest ratesfor September were recorded in Kensington, Hammer-smith, the City of Westminster, St. Marylebone, Finsbury,and Lewisham; and the highest rates in the City ofLondon, Shoreditch, Bethnal Green, Stepney, Southwark,and Deptford. The prevalence of scarlet fever showed aconsiderable increase over that recorded in the precedingmonth; among the several boroughs this disease was pro-portionally most prevalent in Paddington, the City ofLondon, Bethnal Green, Stepney, and Poplar. TheMetropolitan Asylums Hospitals contained 1007 scarletfever patients at the end of September, against 1256, 1201,and 991 at the end of the three preceding months ; the weeklyadmissions averaged 143, against 163 and 120 in the twopreceding months. Diphtheria also was much more pre-valent in September than it had been in August; thegreatest proportional prevalence of this disease was recordedin Holborn, the City of London, Shoreditch, Bethnal Green,Stepney, and Southwark. There were 1287 diphtheriapatients under treatment in the Metropolitan AsylumsHospitals at the end of September, against 1280 and 1236 atthe end of the two preceding months; the weekly admis-sions averaged 167, against 153 and 135 at the end of thetwo preceding months. The prevalence of enteric fevershowed a slight rise; of the 43 cases notified during