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whooping-cough, 41 from measles, 31 from scarlet fever,and three from small-pox. The lowest death-rates fromthese principal zymotic diseases occurred in Plymouth, Bristol,Swansea, and Huddersfield, and the highest rates in Ports-mouth, Manchester, Burnley, Preston, Sheffield, and Hull.The greatest mortality from measles occurred in Burnley;from " fever in Portsmouth, Nottingham, Salford, and

Sheffield ; and from diarrhoea in Bolton, Manchester,Preston, Hull, and Sunderland. The mortality from scarletfever and from whooping-cough showed no marked excess inany of the large towns. The 87 deaths from diphtheriaincluded 42 in London, 11 in Sheffield, eight in Leicester,five in Liverpool, and three in Leeds. Three fatal cases of

small-pox were registered last week in Hull, but not onein any other of the 33 large towns ; and no small-pox patientswere under treatment in any of the Metropolitan AsylumsHospitals. The number of scarlet fever patients in thesehospitals and in the London Fever Hospital on Saturday last,Sept. 23rd, was 2758, against 2538, 2549, and 2640 at the endof the three preceding weeks ; 364 new cases were admittedduring the week, against 252, 298, and 336 in the three pre-ceding weeks. The deaths referred to diseases of therespiratory organs in London, which had been 170 and 133in the two preceding weeks, rose again last week to 137,but were 37 below the corrected average. The causes of 53,or 1’2 per cent., of the deaths in the 33 towns werenot certified either by a registered medical practitioner or bya coroner. All the causes of death were duly certified inBristol, Salford,. Leeds, Newcastle, and in 12 other smallertowns; the largest proportions of uncertified deaths wereregistered in Birmingham, Leicester, Nottingham, Liver-pool, and Preston.

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HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had decreased from 24’1 to 20’2 per 1000 in thethree preceding weeks, further declined to 19’0 during theweek ending Sept. 23rd, and was 1-6 per 1000 below themean rate during the same period in the 33 large Englishtowns. The rates in the eight Scotch towns ranged from10’8 in Leith and 14-2 in Paisley to 21’7 in Edinburgh and22’0 in Perth. The 581 deaths in these towns included114 which were referred to diarrhoea, 11 to " fever," eight toscarlet fever, six to measles, five to diphtheria, and three towhooping-cough. In all 147 deaths resulted from these

principal zymotic diseases, against 225 and 174 in the twopreceding weeks. These 147 deaths were equal to anannual rate of 4’8 per 1000, which was 0’4 above the meanrate last week from the same diseases in the 33 largeEnglish towns. The fatal cases of diarrhoea, whichhad been 193 and 136 in the two preceding weeks, furtherdeclined last week to 114, and included 50 in Glasgow,19 in Edinburgh, and 16 in Dundee. The 11 deaths re-ferred to different forms of fever showed a decline of fourfrom the number in the preceding week, and included fivein Glasgow, three in Paisley, and two in Edinburgh.The fatal cases of scarlet fever, which had been seven andthree in the two preceding weeks, rose again last week toeight, of which six occurred in Glasgow. The six deathsfrom measles showed a slight further increase upon recentweekly numbers, and included three in Glasgow and two inEdinburgh. The fatal cases of diphtheria, which had beenthree and seven in the two preceding weeks, declined againlast week to five, of which two occurred in Dundee. Thedeaths referred to diseases of the respiratory organs inthese towns, which had been 54 and 68 in the two precedingweeks, declined again to 64 last week, and were 21 below thenumber in the corresponding period of last year. The causesof 21, or nearly 4 per cent., of the deaths in these eighttowns last week were not certified.

HEALTH OF DUBLIN.

The death-rate in Dublin, which bad been 37’4 and35-1 per 1000 in the two preceding weeks, further declinedto 29.8 during the week ending Sept. 23rd. During thepast four weeks the death-rate in the city has averaged332 per 1000, the rates during the same period being20’5 in London and 21-7 in Edinburgh. The 200 deathsregistered in Dublin during the week under notice were35 below the number in the preceding week, and in-cluded 51 which were referred to the principal zymoticdiseases, against numbers increasing from 58 to 80 inthe three preceding weeks; of these, 23 resulted from

measles, 20 from diarrhoea, five from "fever," two fromscarlet fever, one from whooping-cough, and not lt!either from small-pox or diphtheria. These 51 deathswere equal to an annual rate of 7’6 per 1000,the zymotic death-rates during the same period being3’1 in London and 43 in Edinburgh. The deathsreferred to measles, which had increased from 14 to 23 in thethree preceding weeks, were again 23 last week. The 20 fatalcases of diarrhœa showed a decline of 25 from the numberin the preceding week. The deaths resulting from differentforms of "fever," which had been eight and nine in thetwo preceding weeks, declined again to five last week. Themortality from scarlet fever exceeded that in the precedingweek. The 200 deaths in Dublin last week included 54 ofinfants under one year of age, and 36 of persons agedupwards of 60 years ; the deaths of infants showed a decline,while those of elderly persons exceeded the number in thepreceding week. Seven inquest cases and four deaths fromviolence were registered, and 89, or nearly one-half, of thedeaths occurred in public institutions. The causes of 11,or nearly 6 per cent., of the deaths in the city last weekwere not certified.

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THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.

Inspector-General of Hospitals and Fleets Thomas Browneis placed on the Retired List at his own request; Staff-Surgeon Percy W. Bassett-Smith has been appointed toHaslar Hospital; C. S. Woodwright, to the Briton G.Welch to the Admiralty Medical Department; E. R. Dimsey,D.S.O., to the Boscawen for Sick Quarters, Portland ; andA. G. Wildey to the Alexandra. Surgeons: B. F. Parishto Malta Hospital, and G. T. S. Sichel to Haslar Hospital.

ROYAL ARMY MEDICAL CORPS.

Major A. W. P. Inman is seconded for service as Physicianand Surgeon, Royal Hospital, Kilmainham. Captain JamesW. Jennings, D.S.O., from the Seconded List to be Captain,vice J. A. Murison, resigned.Major R. J. McCormack has embarked in the transport

Zibenghla for service in South Africa. Major F. A. B. Dalyhas embarked for service abroad. Major J. Fallon hasanived at Leeds. Lieutenant-Colonel Johnstone (retiredpay) its appointed a medical officer at St. George’sBarracks, vice Lieutenant-Colonel Temple, V.C. Lieutenant-Colonel J. Latchford (retired pay) is transferred from

Galway to Bodmin.INDIA AND THE INDIAN MEDICAL SERVICES.

The services of Captain A. W. T. Buist (Bengal) and ofCaptain H. Smith (Bengal) are placed permanently at thedisposal of the Government of the Punjab. The services ofLieutenant F. D. Browne (Madras) are placed temporarilyat the disposal of the Government of Bombay for employ-ment on plague duty. The services of Captain A. D. C. Pond(5th Bengal Infantry) are placed temporarily at the disposalof the Government of Bombay for employment on plagueduty. The services of Captain H. J. Walton (Bengal) areplaced temporarily at the disposal of the Government ofBengal. Captain W. H. Gray to officiate as Superintendent,Central Prison, Lucknow.

INDIAN MEDICAL SERVICE EXAMINATION.An examination for some appointments to Her Majesty’s

Indian Medical Service will be held in London in February,1900.

’

YEOMANRY CAVALRY.

Royal North Devon (Hussars) : Surgeon-Lieutenant J. R.Harper to be Surgeon-Captain.

VOLUNTEER CORPS.

Artillery 2nd Cinque Ports (Eastern Division, RoyalGarrison Artillery) : Surgeon- Lieutenant S. McC. Boyd to beSurgeon-Captain. Rifle: 3rd (Cambridgeshire) VolunteerBattalion the Suffolk Regiment: Surgeon-Captain E. H.

Douty, resigns his commission.. Surgeon-Major A. Bakeresigns his commission and is granted the rank of Surgeon-Lieutenant-Colonel, with permission to continue to wear theuniform of the battalion on his retirement.

DEATHS IN THE SERVICES.

Surgeon-General James Macmillan Scott Fogo, on

3ept. 20th, aged 77 years. He entered the service in

908

1844, was promoted surgeon in 1855, surgeon-major in 1864,deputy surgeon-general in 1872, surgeon-general in 1879,and retired in 1882. He served with the Royal Artilleryin the Crimea and was in medical charge of the left siegetrain at the fall of Sebastopol (medal with clasp andTurkish medal).The Government of India is considering a scheme for the

sanitary improvement of Quetta cantonment.

Correspondence.

" KISSING THE BOOK."

I I Audi alteram partem."

To the Editors of THE LANCET.

SIRS,-Referring to your annotation in THE LANCET ofSept. 23rd, p. 853, it would appear that the witness did notexpress his desire to be sworn with uplifted hand and itcannot be too widely known that this must be done by thewitness in accordance with the words of the Oaths Act,1888, 51 and 52 Victoria, ch. 46, section 5 :

" If any person to whom an oath is administered desiresto swear with uplifted hand in the form and manner inwhich an oath is usually administered in Scotland he shallbe permitted so to do, and the oath shall be administered tohim in such form and manner without further question."

It is not enough to object to kissing the book on sanitarygrounds, the words of the Act must be used. I wouldsuggest that, if you are kind enough to publish this letter,such of your readers as are liable to be called upon to takean oath should cut out the section and paste it on to a cardor piece of stiff paper to be carried in the waistcoat pocketfor use if necessary. Any coroner after being legally askedto administer the Scotch oath-i.e., with uplifted hand-is atonce bound to administer it; any question is illegal, while arefusal could be met by an intimation on the part of thewitness that he would apply for a mandamus to compel thecoroner to administer it.Fourteen years have all but elapsed since the dangers of

kissing the book were first pointed out in THE LANCET.1Three years later the Oaths’ Amendment Act was passedwith its memorable fifth section and I blush to think howoften I have asked you to reproduce it and how often youhave done so. Articles and letters innumerable have appearedand yet the indifference displayed even by members of theprofession is to me amazing. Repeatedly have I seen theTestament kissed by a witness well known to be sufferingfrom constitutional syphilis, the same book being handledand kissed by a succession of witnesses. Other diseases

might be named as liable to be transmitted from mouth tomouth, but this is quite unnecessary. The Scotch oath is not

only free from any risk but it is more solemn, more impres-sive, and in every way preferable.

T <1m c vmira fniflifilllv-

Liverpool, Sept. 25th, 1899. FRED. W. LOWNDES.

THE REGISTRATION OF THE DENTALSTUDENT AS A MEDICAL STUDENT.

To the Editors of THE LANCET. ;SIRs,-With your permission I should like to draw the i

attention of dental students to an important regulation of Ithe General Medical Council which will soon come into force. ’On and after Jan. lst, 1900, a dental, or medical, student 1will be required before registration to produce a certificate :of having passed the first-class College of Preceptors exa-mination (or its equivalent), whereas until the above-named 1date the second-class certificate will suffice. ’

It is probable that a large number of men now regis- (

tered as dental students only with the lesser certificate

may subsequently desire to take medical qualifications j Jand the question is, Will the first-class certificate j ibe demanded by the Council or will the dentalstudent registered before January, 1900, be exempted 2I have interviewed the Registrar of the General MedicalCouncil who has promised to lay the matter before the I

1 THE LANCET, Oct. 17th, 1885, p. 732.

Education Committee at an early date, and he says theywill probably meet in November. In order to avoid anydifficulty arising I would advise all dental students registeredwith second-class certificates, who do not intend enteringa medical school during this year, to take out a course ofchemistry from October next at one of the recognised institu.tions throughout the kingdom and forthwith to becomeregistered as medical students. Apart from the considera-tion of medical registration a course of chemistry is necessaryfor the dental licence and the instruction and examinationin this subject are best taken during pupilage.

I Tarn. Sirs. VOlH faithfnllv.

Hanover-square, W., Sept. 22nd, 1899. W. A. MAGGS.

" THE INFLUENCE OF HEREDITY UPONTHE DRINK HABIT."

To the Editors of THE LANCET.

SIRS,-There appears to be some ambiguity in Dr. SimsWoodhead’s account of what is meant by the hereditarytransmission of alcoholism. 1 Dr. Woodhead strongly main.tains "that a direct transmission of the taste for alcoholnever occurs " and later he informs us that thedisease [alcoholism] was not transmitted, but only the

weakly and unbalanced condition of the tissues, as a resultof which, however, the patient was more susceptible to themain exciting cause of the disease ; in a word, the pre-disposing cause might be transmitted, but the excitingcauses never." To take the first statement first, what doesit mean ? 7The appetite for alcohol appears to be deeply rooted in

human nature, for even among abstaining peoples such asthe Mahometans it seems necessary to fix a canon againstthe use of alcoholic liquors and to enforce observance by thethreat of extreme pains and penalties. Again, the fact thataboriginal races take to alcohol with such avidity is surelyan evidence that the appetite is not acquired but is thereready waiting for its appropriate satisfaction. Surely thisappetite is inherited-is an inheritance, in fact, of thehuman race ; and if it be urged that the appetite isacquired, but acquired very readily, I do not see thatit alters the case much, for by an acquired taste we

mean merely the cultivation of an appetite alreadypossessed. Again, what does Dr. Woodhead mean by atransmitted condition of the tissues rendering a patient moresusceptible to the main exciting cause of the disease? Isthis greater susceptibility an index of the patient’sdiminished bottle power ? 7 If so, it is probably true thatpeople of unstable nervous balance have a lessened toleranceof alcohol, but this is not what is usually meant by analcoholic heredity. Then surely no one has ever been foundto assert that the exciting cause of alcoholism is hereditary.What is usually meant by an alcoholic heredity, I take it, isan inherited inability to regulate the appetite for alcoholin accord with the needs of the individual. It maybe paradoxical in speaking of aboriginal races to describethem as having an innate alcoholic heredity, but thatsuch is the case is shown by Dr. Woodhead when he

says, speaking of the Red Indians: "Give them alcohol andyou take away the one virtue of their lives-self-control."Of course, you cannot take away what they never possessed.The aborigines’ appetite for alcohol is like that of theinebriate in this-that it is beyond his control, and it is forthis reason that the introduction of alcohol among theseraces spells such profound disaster. Sooner or later theraces which cannot deal with alcohol as masters are bound togo by the board, and the remark applies equally to thosewho have acquired and lost this mastery as to those whoby their insulation have hitherto been protected from theadvent of the demon they have yet to chain.

It is in this connexion that Dr. Woodhead appears to missthe whole significance of the facts with which he is dealing." Was it worth while," he asked, speaking of the possibilityof acquiring an immunity against drunkenness&mdash;"was itworth while to sacrifice the work of the next few generationsfor a very problematical good in generations to come 1" Itis not a question of sacrificing the work of the nexb fewgenerations, it is a question of the lines on which that workis to be directed. Dr. Archdall Reid, Dr. Berry Haycraft,and others have pointed out that the way of social salvationdoes not lie in combating alone the environmental enemies

1 THE LANCET, July 29th, 1899, p. 259.