General Medical Council are not delegates. No really goodman would consent to accept such a position if he is to beconsidered a delegate. In this particular Bill there is plenty ofroom for difference of opinion as to the details. It seems that

legislation for the protection of parturient women of thepoorer classes is inevitable ; instead of attempting to wreckthe Bill, supported as it is by many eminent authorities, itis better policy to concentrate all our efforts in inducingParliament to insist on clauses which will keep these womenas far as possible under the intimate supervision of themedical profession. The position of Direct Representativesat this juncture is a difficult one; Dr. Glover is an old andtried representative of the profession ; his past actions andpublished opinions surely justify us in trusting him to dowhat is best under the circumstances. He knows the

opinions of all parties and from his practical knowledge ofmedical politics is in a position to judge the best course toadopt to protect the interests of all concerned.

I am, Sirs, yours faithfully,Margate, April 23rd, 1900. BERTRAM THORNTON.BERTRAM THORNTON.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 33 of the largest English towns 6523 births and 4747deaths were registered during the week ending April 21st.The annual rate of mortality in these towns, which hadbeen 23’0 and 22 4 per 1000 in the two preceding weeks,further declined to 21-3 last week. In London the ratewas 20-6 per 1000, while it averaged 21-8 in the 32 pro-vincial towns. The lowest death-rates in these towns were12 9 in Birkenhead, 13’0 in Burnley, 13’8 in Swansea, and15’5 in Brighton; the highest rates were 26 in Liver-pool, 27-2 in Oldham, 28 8 in Manchester, and 30-6 in

Plymouth. The 4747 deaths in these towns included432 which were referred to the principal zymoticdiseases, against 500 and 477 in the two precedingweeks ; of these 159 resulted from measles, 123 fromwhooping-cough, 56 from diphtheria, 32 from diar-rhoea, 30 from scarlet fever, 29 from "fever" (prin-cipally enteric), and three from small-pox. The lowestdeath-rates from these diseases occurred last week in

Croydon, Portsmouth, Halifax, and Newcastle; and thehighest rates in Cardiff, Oldham, Plymouth, and Black-burn. The greatest proportional mortality from measlesoccurred in Plymouth, Bristol, Cardie, and Wolverhamp-ton ; from scarlet fever in Oldham ; from whooping-coughin Wolverhampton, Birmingham, Liverpool, and Man-

chester ; and from diarrhoea in Oldham, Blackburn,and Gateshead. The mortality from " fever" ’’ showedno marked excess in any of the large towns. The56 deaths from diphtheria included 17 in London,eight in Sheffield, four in Cardiff, four in Leicester, andfour in Leeds. Three fatal cases of small-pox were

registered last week in Liverpool, but not one in anyother of the 33 towns. There were four cases of small-pox under treatment in the Metropolitan Asylums Hospitalson Saturday last, April 21st, against two and four at theend of the two preceding weeks; and two new cases wereadmitted during the week. The number of scarlet feverpatients in these hospitals and in the London FeverHospital at the end of the week was 1676, against1713 and 1694 on the two preceding Saturdays ; 165 newcases were admitted during the week, against 172, 185, and189 in the three preceding weeks. Influenza was certified asthe primary cause of 60 deaths in London. The deathsreferred to diseases of the respiratory organs in London,which had increased from 378 to 501 in the six precedingweeks, declined again last week to 460, but were 92 abovethe corrected average. The causes of 59, or 1’2 per cent.,of the deaths in the 33 towns were not certified either bya registered medical practitioner or by a coroner. All thecauses of death were duly certified in Leicester, Salford,Bradford, Leeds, Hull, Newcastle, and in 13 other smallertowns ; the largest proportions of uncertified deaths wereregistered in West Ham, Birmingham, Nottingham, Liver-pool, and Sheffield.

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HEALTH OF SCOTCH TOWS.

The annual rate of mortality in the eight Scotch towns,which had been 22’8, 21 7, and 21-3 per 1000 in the threepreceding weeks, further declined to 21’0 during the week

ending April 21st, and was V-3 per IUUU less than the mean rateduring the same period in the 33 large English towns. Therates in the eight Scotch towns ranged from 18’4 in Edin-burgh and 18’6 in Paisley to 22-6 in Aberdeen and 25 3 inPerth. The 650 deaths in these towns included 19 which werereferred to whooping-cougb, 18 to measles, 14 to diarrhoea,six to scarlet fever, five to "fever," and three to diphtheria.In all 65 deaths resulted from these principal zymoticdiseases, against 63 and 66 in the two precedingweeks. These 65 deaths were equal to an annual rateof 2-1 per 1000, which was 0’2 per 1000 above the meanrate last week from the same diseases in the 33 largeEnglish towns. The deaths from whooping-cough, whichhad been 15 and 17 in the two preceding weeks, further roselast week to 19, of which 10 occurred in Glasgow, four inLeith, two in Aberdeen, and two in Perth. The fatal casesof measles, which had been 14 and 19 in the two pre-ceding weeks, declined again to 18 last week, and included11 in Glasgow, three in Edinburgh, and two in Dundee. Thedeaths from diarrhoea, which had been 19 in each of thetwo preceding weeks, declined last week to 14, of whichfour were registered in Glasgow, three in Edinburgh, twoin Dundee, and two in Greenock. The fatal cases

of scarlet fever, which had been four in each of thefour preceding weeks, rose to six last week, andincluded five in Glasgow. The deaths referred todifferent forms of "fever, which had been five and four inthe two preceding weeks, rose again last week to five, ofwhich three were recorded in Glasgow and two in Aberdeen.The three fatal cases of diphtheria corresponded with thenumber in the preceding week, and included two in Glasgow.The deaths referred to diseases of the respiratory organs inthese towns, which had declined from 172 to 134 in thethree preceding weeks, rose. again to 145 last week, andwere 26 in excess of the number in the correspondingperiod of last year. The causes of 25, or nearly 4 percent., of deaths in these eight towns last week were notcertified.

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HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 28 and34’3 per 1000 in the two preceding weeks, declined again to30-4 during the week ending April 21st. During the pastfour weeks the death-rate in the city has averaged 32 5 per1000, the rates during the same period being 21-0 inLondon and 21-7 in Edinburgh. The 204 deaths registeredin Dublin during the week showed a decline of 26 fromthe number in the preceding week, and included 12 whichwere referred to the principal zymotic diseases, against nineand six in the two preceding weeks; of these, three resultedfrom 11 fever," three from diarrhoea, two from measles, twofrom diphtheria, and two from whooping- cough. These 12deaths were equal to an annual rate of 1-8 per 1000, thezymotic death-rate during the same period being 1-6 inLondon and 1-0 in Edinburgh. The deaths referred todifferent forms of "fever," which bad been three andtwo in the two preceding weeks, rose again to three lastweek. The three fatal cases of diarrhoea showed an increaseupon the number in the preceding week. The deaths from

measles, which had been three and two in the two precedingweeks, were again two last week. The fatal cases of

whooping-cough, which had been three and one in the twopreceding weeks, rose again last week to two. The 204deaths in Dublin last week included 42 of infants underone year of age and 63 of persons aged upwards of 60years; the deaths of infants showed an increase, whilethose of elderly persons corresponded with the number inthe preceding week. Six inquest cases and three deathsfrom violence were registered, and 69, or more than athird, of the deaths occurred in public institutions. Thecauses of 10, or nearly 5 per cent., of the deaths in thecity last week were not certified.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments are announced :-Surgeons :

G. R. MacMahon to the Sphinx and James G. Watt to theEsk, additional.

ROYAL ARMY MEDICAL CORPS.

Major M. W. Kerin. Lieutenant Martin, and LieutenantSloan have left South Africa for England.

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YEOMANRY CAVALRY.Worcestershire (The Queen’s Own Worcestershire Hussars):

Julius Henry Beilby to be Surgeon-Lieutenant.VOLUNTEER CORPS.

Artillery : lst Lincolnshire (Western Division, RoyalGarrison Artillery) : Surgeon-Lieutenant L. W. Pockettto be Surgeon-Captain. 2nd West Riding of York-shire (Western Division, Royal Garrison Artillery) : Sur-geon-Lieutenant J. C. Wright to be Surgeon-Captain.4th West Riding of Yorkshire (Western Division, RoyalGarrison Artillery) : Percival Ellison Barber to be Surgeon-Lieutenant..Royal Engineers (Volunteera) : 2nd Cheshire(Railway) : Edward Gray to be Surgeon-Lieutenant.1st Hampshire: Surgeon-Lieutenant R. Emmett to be Sur-geon-Captain. jEc.’ lst Volunteer Battalion the Lincoln-shire Regiment: John Bruce to be Surgeon-Lieutenant.2nd Volunteer Battalion the Prince Albert’s (SomersetshireLight Infantry) : Second Lieutenant Penrose Lanyon Watkin-Williams resigns his commission and is appointed Sur-geon-Lieutenant. 1st Volunteer Battalion the Duke of

Cambridge’s Own (Middlesex Regiment): George Pester

Chappel to be Surgeon-Lieutenant. 15th Middlesex ; HenryBowen Perkins to be Surgeon-Lieutenant.

VOLUNTEER MEDICAL STAFF CORPS.The Manchester Companies : Joseph Collier to be Surgeon-

Lieutenant.TRANSVAAL WAR NOTES.

The first train carrying wounded and invalids from SouthAfrica steamed down the new cutting and into the stationin the rear of the Royal Victoria Hospital, Netley, onMonday, April 23rd, at 11.30. The train carried 149 patientsbrought home by the Gascon; 17 of the men were obligedto be carried into the hospital, but the majority of the menlooked perfectly well and fit to return to duty. The 11 khakitrain " is fitted up with every necessity and luxury. Thereare five carriages, each fitted with 12 beds and two sofas,besides accommodation for the medical officers and placesset aside for cooking and lavatories. The carriages runwith great smoothness, hardly any motion being per-ceptible. In addition to the 1, khaki " carriages ordinaryrailway-carriages are attached to the train for carryingconvalescents. Many of the patients are from the forceswhich relieved Ladysmith.A Times telegram, dated Cape Town, April 25th, says :

Dr. Robert O’Callaghan, who is attached to the LangmanHospital, which has been established at Bloemfontein, andis secretary to the Portland Hospital, is leaving for Englandto-day. As it has been found that the majority of the

patients to be treated were suffering from enteric, it isconsidered that a second surgeon is not required at the

hospital, and it has been decided to appoint Dr. Scholtz,a leading Cape Town physician, in succession to Dr.O’Callaghan."Mr. Herbert J. Godwin, M.B., B.S. Durh., M.R.C.S, Eng.,

L.R.C.P. Lond., has been appointed Civil Surgeon to HerMajesty’s troops in South Africa.

Surgeon James G. Fowler, R.N., was among the officersof the Ladysmith Naval Brigade who were entertained atPortsmouth on April 24th.

TRANSVAAL WAR CASUALTIES.It is officially reported that Assistant Surgeon Jackson,

21st Battery, F A., diei from typhus fever and dysentery atPretoria.

REWARDS FOR GALLANTRY IN THE R.A.M.C.The Queen has conferred the decoration of the Victoria

Cross on Major William Babtie, C.M.G., R.A.M.C., for hisconspicuous bravery at the battle of Colenso. The followingis the act of courage for which he receives the honour :-"At Colenso, on Dec. 15th, 1899, the wounded of the 14thand 66th Batteries, Royal Field Artillery, were lying in anadvanced donga close in the rear of the guns without anymedical officer to attend to them, and when a message wassent back asking for assistance, Major W. Babtie, R.A.M C.,rode up under heavy rifle fire, his pony being hit three times.When he arrived at the donga, where the wounded were

lying in sheltered corners, he attended to them all, goingfrom place to place exposed to the heavy rifle fire which

greeted anyone who showed himself. Later on in the dayMajor Babtie went out with Captain Congreve to bring inLieutenant Roberts, who was lying wounded on the veldt.This also was under a heavy fire."

DEATHS IN THE SERVICES.

Henry Stewart Archdall, M.R.C.S. Eng., L.R.C.P. Lond.,late surgeon R.N., on April 20th, aged 32 years. He enteredthe Royal Navy in 1892 and retired in 1896.

I We hear that the surgeons-on-probation for the RoyalArmy Medical Corps now attending the Army Medical School,Netley, are likely to receive their commissions at once andbe sent to do duty with the troops. These gentlemen haveattended a course of two months’ duration at Netley. Wealso understand that a second batch of nominated officers forthe Royal Army Medical Corps is to be sent to the ArmyMedical School on May lst to go through a short course ofinstruction.

The Broad Arrow states that "some 24 civilian medicalofficers are now doing duty at or about the CambridgeHospital at Aldershot, some of them having been employedfor many months, and although they are willing enoughto do duty temporarily, yet there appears to be no wishon their part to become attached to the service per-manently."

Correspondence.

THE SOCIAL FACTOR IN THE GENESIS OFCANCER.

"Audi alteram partem." "

To the Editors of THE LANCET.

SiRS,—Will you allow me the hospitality of your columnsto draw attention to a peculiar incident in the internationalvariation of the cancer rate ? I allude to the concomitant pre-valence of late marriages in countries with high cancer ratesas compared with those which are more or less cancer free. Itwill be familiar to those who have practised in the East thatcancer is practically unknown among the Brahmins and almostso among the Hindoos and Mahomedans. The Parsees and thedescendants of European settlers are not quite so fortunate.Nor is cancer so uncommon among the Baba Chinese andthe Chinese, Javanese, and Japanese coolies in the tropicalcolonies. There are not two races more dissimilar in thematter of personal hygiene, so divergent in their dailypursuits, and, in fact, in all that constitutes the summumbon2.m of life, than the Brahmin and the negro.A strict vegetarian and total abstainer, engaged in purely

intellectual pursuits or ruminating over his "mantrums" .

and "slokas," the Brahmin has lived the life of a studentfor 2000 years, in a civilisation contemporaneous withSolomon. I Astram Castrum," still almost a savage in hisnative wilds, a carnivorous, perhaps an "uncooking animal,"dependent upon the chase for his subsistence, and where incontact with the civilised world a slave under forcedlabour, the muscular negro is the perfect antithesis of thesubtle Brahmin, pre-eminently the latter’s superior in powersof physical endurance as he is undoubtedly far below theBrahmin in all that constitutes subtlety of intellect and highbrain power. Search the world over and you will not findtwo races so diametrically opposite as the Brahmin andthe negro. What one lacks the other excels in. Stillwe find they both enjoy an almost perfect immunity fromcancer, while European nations possessing the virtues of bothsuffer severely. Their common humanity excepted, perhapsthe only line in agreement between the negro and theBrahmin is that neither very seldom begins to accept theduties of the procreation of the species when past the meridianof life and their women never. The same rule holds goodmore or less with most Asiatics, and we see they do notsuffer much from cancer as a race. The nations that suffermost are those in the front ranks-the Saxon, the Gaul, andthe American. And is it not notorious that it is just amongthese great nations that more old spinsters enter into matri-mony when approaching, or are past, the menopause than isthe case with the Greek, the Turk, the Iberian, the Finn,and the Norwegian ? And is it not a fact, too, that cancer ison the increase in Europe, and so also have been these latemarriages during the last few generations? Is it a merecoincidence or is there the relation of cause and effectbetween these two concurrent waves 2Can it be the fact that when the consummation of puberty

is early attained, is accomplished in good time, that it finds