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from all causes included 462 which were referred to the

principal infectious diseases ; of these, 210 resulted frommeasles, 19 from scarlet fever, 22 from diphtheria, 128from whooping-cough, 8 from enteric fever, 1 fromill-defined pyrexia, and 74 from diarrhoea, but notany from small-pox or from typhus. The lowest death-rates from these infectious diseases last month were

recorded in ;Kensington, St. Marylebone, Hampstead,Holborn, and-Wandsworth; and the highest rates in Finsbury,Shoreditch, Bethnal Green, Southwark, Bermondsey, andCamberwell. The 210 deaths from measles were 19 fewerthan the corrected average number in the correspondingperiod of the five preceding years ; this disease was pro-portionally most fatal in Hackney, Shoreditch, BethnalGreen, Southwark, and Bermondsey. The 19 fatal casesof scarlet fever showed a decline of 30 from the correctedaverage number ; of these 19 deaths, 3 belonged to BethnalGreen, 3 to Bermondsey, and 2 each to Hammersmith,Stepney, and Camberwell. The 22 deaths from diphtheriawere 20 below the corrected average number, and in-cluded 2 each in St. Pancras, Bethnal Green, Stepney,Poplar, Bermondsey, and Deptford. The 128 fatal cases of

whooping-cough were slightly fewer than the corrected averagenumber; among the several metropolitan boroughs thisdisease showed the greatest proportional mortality in Chelsea,St. Pancras, Finsbury, Shoreditch, Southwark, and Battersea.The 9 deaths referred to ’’ fever " were 5 below the corrected

average, and belonged respectively to Paddington, Hammer-smith, St. Marylebone, Islington, Holborn, Finsbury,Battersea, Camberwell, and Woolwich. The 74 fatal casesof diarrhoea were 15 below the corrected average ; thisdisease was proportionally most fatal in Hammersmith,Fulham, Bethnal Green, Stepney, Southwark, and Bermondsey.In conclusion, it may be stated that the aggregate mortalityin London last month from these principal infectious diseaseswas nearly 18 per cent. below the average.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments are notified:—Staff-Sargeons:

J. H. Fergusson to the President, additional, for temporaryservice at the Admiralty Recruiting Department; and D. W.Hewitt to the Kood.

’ ARMY MEDICAL SERVICE.

Colonel Henry J. W. Barrow is placed on retired pay(dated July 7th, 1910).

Lieutenant-Colonel Thomas J. O’Donnell, D.S.O., from theRoyal Army Medical Corps, to be Colonel, vice H. J. W.Barrow (dated July 7th, 1910).

ROYAL ARMY MEDICAL CORPS.

Colonel A. Peterkin, Principal Medical Officer of theLondon District, has been selected to act as AdministrativeMedical Officer of the Second (Aldershot) Division during theArmy manœuvres. Colonel H. J. Waller Barrow, PrincipalMedical Officer of the Third (Lahore) Division, hasarrived home from India. Lieutenant-Colonel W. E.

Berryman has been transferred from Delhi to Fyzabadand appointed to command the Station Hospital. Lieu-tenant-Colonel T. W. O’H. Hamilton, C.M.G., Staff Officer tothe Principal Medical Officer of the Aldershot Command, hasnotified his intention to retire from the service. Lieutenant-Colonel C. E. Nichol, D.S.O., has arrived home on leavefrom India. Major M. P. C. Holt, D.S.O., surgical specialistat Ambala, has been transferred to Kasauli. Major J. W.Jennings, D.S.O., from Warrington, has taken over medicalcharge of the troops in Trawsfynydd camp. Major W. A.Ward has been transferred from the London District to theEastern Command, and appointed a specialist in Derma-tology and Venereal Disease at the Alexandra Hospital,Cosham. Captain J. W. L. Scott and Captain E. D. Cadellhave arrived home on leave from India. Captain F. J.

Brakenridge, from the London District, has taken up duty atDover. Captain H. M. Nicholls has been transferred fromDeolali to Colaba. Captain V. C. Honeybourne, from RawalPindi, has been appointed to the Station Hospital at Mhow.Captain G. E. Ferguson, from Alexandria, has arrived at

Cyprus for a tour of duty. Captain A. H. Bond hasbeen transferred from Rangoon to Naini Tal. Captain

E. G. Anthorisz has joined at Bangalore from Madras.Captain J. D. Richmond has been appointed for duty atKilkenny from Fermoy. Captain H. Harding, from Portland,has been posted to Cosham. Captain T. S. Blackwell hasleft Secunderabad for a tour of duty in Burma and has beenposted to Bhamo. Captain W. McConaghy has been postedto the Southern Command. Lieutenant A. P. Hart has beenappointed a specialist in Dermatology and Venereal Diseaseto the Burma Division.

INDIAN MEDICAL SERVICE.

Lieutenant-Colonel W. D. Sutherland has been confirmedas a Civil Surgeon, first class, vice Lieutenant-Colonel J. L.Poynder, retired. Lieutenant-Colonel H. H. Hendley hasbeen granted two and a half months’ extension of his com-bined leave. Lieutenant-Colonel W. H. Quicke has arrivedhome on leave. Major A. Leventon has been placed ondeputation to the commission to inquire into the-labourconditions in the Indian Tea Gardens, being relieved ascivil surgeon, Rampore, Baulia, by Captain D. P.Goil. Major J. C. Robertson has been appointed toofficiate as Sanitary Commissioner of the United Provincesduring the absence on leave of Lieutenant-ColonelJ. Chaytor-White. Majors E. V. Hugo and G. Hunt havearrived home on leave. Captain H. H. G. Knapp has beenappointed Superintendent of the Central Prison at Rangoonin place of Lieutenant-Colonel G. J. H. Bell, who has beenappointed Inspector-General of Prisons in Burma. Captain0. St. J. Moses, civil surgeon, of Parneah, has been appointedto officiate as Police Surgeon, Calcutta, during the absenceon deputation of Major W. D. Hayward. Captain D. N.Anderson, officiating civil surgeon of Nagpur, CentralProvinces, has been granted furlough on medical certificatefor one year. Captain W. L. Harnett has been appointed incharge of the brigade laboratory, Jubbulpore, and to theofficiating medical charge of the 22nd Punjabis. CaptainG. A. Jolly, after a residence of two years in Japan,has qualified as an interpreter in the Japanese language.Captain J. N. Walker, civil surgeon, on being relieved atMussooree, has been posted to Rae Bareli. Captain A. S.Leslie has joined the Jail Department of Burma and hasbeen appointed Officiating Superintendent of the InseinCentral Jail in place of Captain H. H. G. Knapp, transferred.On return from leave, Captain H. M. Mackenzie has takenover the appointment of Health Officer and District MedicalOfficer for plague prevention, Simla, relieving Lieutenant-Colonel H. B. Melville. Lieutenant A. M. Jukes, in chargeof the brigade laboratory at Shillong, has been appointed aspecialist in the Prevention of Disease. Lieutenant C. G.

Jolly has been appointed a specialist in Radiography andElectrical Science to the Second (Quetta) Division.

SPECIAL RESERVE OF OFFICERS.

Royal Army Medical Corps.No. 18 Field Ambulance : The under-mentioned officers of

the Royal Army Medical Corps, Territorial Force, are

appointed in the ranks as stated against their names (datedMarch 7th, 1910) :-Lieutenant-Colonel John B. Mann, lstEast Lancashire Field Ambulance, Royal Army MedicalCorps, to be Lieutenant-Colonel; Major William B. Pritchard,lst East Lancashire Field Ambulance, Royal Army MedicalCorps, to be Major; Major Fred D. Woolley, 2nd EastLancashire Field Ambulance, Royal Army Medical Corps,to be Major ; Captain George Ashton, 2nd East LancashireField Ambulance, Royal Army Medical Corps, to be Captain;Captain Charles Roberts, 1st East Lancashire Field Ambu-lance, Royal Army Medical Corps, to be Captain ; CaptainHenry G. Smeeth, lst East Lancashire Field Ambulance,Royal Army Medical Corps, to be Captain ; Lieutenant A. E.Hodder, from the List of Officers Attached to Units otherthan Medical Units, to be Lieutenant; Lieutenant ThomasCarnwath, 2nd East Lancashire Field Ambulance, RoyalArmy Medical Corps, to be Lieutenant; Lieutenant WilliamH. P. Hey, 3rd East Lancashire Field Ambulance, RoyalArmy Medical Corps, to be Lieutenant.

TERRITORIAL FORCE.

Royal baeld Artillery.2nd West Riding Brigade : Supernumerary Surgeon-Captain

John C. Wright is restored to the establishment (datedJan. 17th, 1910).

Royal Engineers.Lancashire (Fortress) : -, Surgeon-Captain John Wesley

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Lloyd to be Surgeon-Major (dated April 1st, 1908). Surgeon-Lieutenant John Owen to be Surgeon-Captain (datedOct. 5th, 1908).

Royal Army Medical Corps.3rd East Anglian Field Ambulance : Major and Honorary

Surgeon-Lieutenant-Colonel Harry Thornton Challis takes

precedence next above Major Josiah Oldfield.2nd Northern General Hospital : Leonard Ralph Braith-

waite to be Captain, whose services will be available onmobilisation (dated May lst, 1910).2nd Western General Hospital: Archibald Donald to be

Captain, whose services will be available on mobilisation

(dated March 6th, 1910). George Redmayne Murray to beCaptain, whose services will be available on mobilisation

(dated March 7th, 1910).Attached to Units other than Medical Units.-Captain

John F. Crombie to be Major (dated May 26tb, 1910).Captain Robert Rannie to be Major (dated June lst, 1910).Lieutenant John B. Rous resigns his commission (datedJuly 13tb, 1910).

For d7lty with Units other than Medical Units.-ArthurHill Burnett to be Lieutenant (dated June lst, 1910). PercyLuke Armstrong to be Lieutenant (dated June 3rd, 1910).Alfred Sigismund Bruzaud to be Lieutenant (dated June 4th,1910).

Unattached List.-Cadet Louis Lawrence Cassidy, fromthe Royal College of Surgeons (Ireland) Contingent, SeniorDivision, Officers Training Corps, to be Lieutenant, forservice with the Royal College of Surgeons (Ireland) Con-tingent, Senior Division, Officers Training Corps (datedJuly 9th, 1910).

TERRITORIAL TRAINING.The First Eastern General Hospital (Territorial Force)

carried out their annual training at Colchester from June 25thto July 9th under the command of Colonel Joseph Griffiths.The camp was located close to the Military Hospital,Colchester, by the side of a section of a field ambulanceoccupied by No. 9 Company, R.A.M.C. Reveille soundedat 5 o’clock each morning, followed by company and stretcherdrill until 7.30 A.M., when breakfasts were served. Lecturesand demonstrations on field medical equipment were givenfrom 9 to 10 o’clock, after which the duties varied.The general scheme employed was to attach the Territorialpersonnel to the respective posts they would occupy onmobilisation. This was carried out by allotting some

to nursing duties in the wards of the military hospitals,others to cooking, store-keeping, and other routine duties. Halfthe regularpersonnel of the military hospital was withdrawn, toallow of the Territorials being trained, and sent out for fieldtraining under canvas with the sections of a field ambulance.Demonstrations were given in practical camp sanitation,methods of cooking in camp, the conservancy of drinking-water supplies, the means of disposal of excreta, refuse, andso forth. Major F. E. A. Webb of Cambridge acted as

registrar of the general hospital, and Captain W. A. Woodside,R.A.M.C., of Ipswich, who is the adjutant of the East

Anglian Division, Territorial Force, was present in campthroughout the entire training. Inspections were carried outby Colonel Sir James R. A. Clark and Colonel C. E. Elliston,principal medical officer of the East Anglian Division.

THE NAVAL MEDICAL SUPPLEMENTAL FUND.At the quarterly meeting of the directors of the Naval

Medical Supplemental Fund, held on July 12th, Inspector-General W. H. Lloyd, R.N., in the chair, the sum of L40was distributed among the several applicants.

WE regret to announce the death of Dr. J.Hougham Bell at his residence at Ventnor, Isle of Wight, inhis 65th year. Dr. Bell, who for many years was surgeon tothe Royal National Hospital for Consumption and Diseases ofthe Chest, Ventnor, received his medical education at King’sCollege, London, of which he was an Associate and Warne-ford scholar, at the University of Edinburgh, and in Paris.He became a Member of the Royal College of Surgeons ofEngland in 1866, and in the following year took the degree ofDoctor of Medicine at the University of Edinburgh. At onetime he held the post of assistant medical superintendent atSt. Andrew’s Hospital for Mental Disease?, Northampton,and was also a resident clinical assistant at the BethlemRoyal Hospital.

Correspondence.

AN AMBULANCE SERVICE FOR LONDON.

I I Audi alteram partem."

To the Editor of THE LANCET.

SIR,—That no adequate organisation exists at the presenttime for dealing with cases of accident or sudden illness inthe streets and public places of the metropolis outside theCity of London is a sufficiently astonishing fact. For some

years past, alike in Paris and in Berlin, in New York andBoston, as also in Liverpool and Manchester, arrangementshave been made by the concerted action of the police, thetelegraph and telephone, ambulances and hospitals, to givethe sufferers from street accidents the advantage of the latestresources of surgical science, and to convey them with theleast risk of life or limb to the receiving wards of hospitalsor to their own homes. Since 1907 the City of London hasalso been well provided for in this respect. It has a motor-ambulance, well provided with surgical appliances for acci-dents, and accompanied by an attendant skilled in givingfirst aid, which can be summoned by telephone by any Citypoliceman. Call-boxes to the number of 52 are fixed in theprincipal streets, of which each City constable has a key, andby means of telephone apparatus fixed in these he can alsosend special messages to the chief office in Old Jewry ifnecessary. Outside the City boundaries, however, where thecontrol of street traffic is in the hands of the metropolitanpolice, the most haphazard system, or want of system,prevails.Some ancient and out-of-date wheeled stretchers are pro-

vided at police-stations and elsewhere, but the metropolitanpolice constable, when called to a case of accident, has nomeans of obtaining these in a hurry when wanted, and usuallytrusts to a passing cab, cart, or van, rather than wait hdf anhour or so while a messenger can be despatched to, and returnfrom, the nearest police-station. In consequence of theincrease in motor vehicles of all sorts in London there hasbeen a very considerable rise in the number and severity ofstreet accidents in the metropolis during the last few years.In 1907 the number of persons known to the metropolitanpolice to have been killed or injured in street accidents was17,055, an increase of 6515, or 62 per cent. over 1905. Atthe same time an increase in the gravity of the accidents isindicated by the fact that the number of fatal accidentsincreased from 155 to 283, or 80 per cent. in the three years1905-07.

Dealing with this subject in 1904, the chairman of theAmbulance Committee of the London County Council statedthat nearly 70 per cent. of the street casualties at presentconveyed to hospitals by some vehicle or other are taken incabs and carts, and not in ambulances of any kind, and onthis basis it has been calculated that from 8000 to 10,000severe accidents were taken to London hospitals or elsewhereannually in cabs, carts, or other unsuitable conveyances. Itmust be remembered that these figures mainly representpersons constituting a large mass of the inhabitants-artisansand labourers-who are the most liable, by reason of theiroccupations, to sudden accidents; those, in fact, who are

least able to provide for emergencies of that kind, and who,along with their families and dependents, suffer the morewhen thus overtaken, and especially when, from lack ofproper provision at the time of the accident, their recoveryand wage-earning power are unnecessarily delayed. On theother hand, it must not be entirely forgotten that the well-to-do citizen of Greater London might in like manner besuddenly struck down and rendered unconscious in the street,ana thus have cause to remember with gratitude the pre-servation of his life or limb by the timely arrival of a well-equipped ambulance at the moment when the bystanders werewondering who he was and where he came from.

Representations on the subject having been made to theLondon County Council in 1904 by a body of medical men,they thereupon appointed an Ambulance Sub-Committee withSir William Collins as chairman, and in 1906 applied toParliament for powers to enable them to establish and main-

tain, or contribute to the establishment and maintenance of,an ambulance service for street accidents in London, but itappears that the ambulance clauses of their Bill (General