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every year a similar record can be given of progress in oneor other directions, the ultimate good will be considerable.During 1890 the general rate of mortality is given by Dr. J.W. Cook as 16-7 per 1000 living.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5849 birthsand 5153 deaths were registered during the week endingMay 2nd. The annual rate of mortality in these towns,which had been 22-5 and 24’3 per 1000 in the precedingtwo weeks, further rose to 26’8 last week. The rate was23’3 in London and 29-7 in the twenty-seven provincialtowns. During the first four weeks of the current quarterthe death-rate in the twenty-eight towns averaged 24-1

per 1000, and exceeded by 2’5 the mean rate in the cor-responding periods of the ten years 1881-90. Thelowest rates in these towns last week were 15’0 inBirkenhead, 16’8 in Norwich, 17’3 in Bristol, and19’5 in Brighton; the highest rates were 36’1 inLeeds, 38’5 in Blackburn, 42’1 in Halifax, and 70’5in Leeds. The exceptionally high rates in the last-mentioned towns were due to a severe epidemic ofinfluenza. The deaths referred to the principal zymoticdiseases, which had been 420 and 428 in the preceding twoweeks, further rose last week to 462; they included188 from whooping-cough, 127 from measles, 53 fromdiarrhoea, 37 from diphtheria, 31 from " fever " (principallyenteric), and not one from small-pox. These diseasescaused the lowest death-rates in Derby, Birkenhead,Norwich, Bristol, and Sunderland, and the highest ratesin Leicester, Blackburn, Manchester, and Portsmouth.The greatest mortality from measles occurred in Plymouth,Preston, Huddersfield, Blackburn, Bolton, and Ports-mouth ; from scarlet fever in Halifax ; and from whooping-cough in Halifax, Newcastle-upon-Tyne, Plymouth, Man-chester, and Leicester. The mortality from "fever" showedno marked excess in any of the twenty-eight towns. The37 deaths from diphtheria included 21 in London, 5 in Man-chester, and 3 in Newcastle-upon-Tyne. No fatal case ofsmall-pox was registered lastweek in any of the twenty-eighttowns; 21 small-pox patients were under treatment in theMetropolitan Asylum Hospitals and 1 in the HighgateSmall-pox Hospital on Saturday last. The number of scarletfever patients in the Metropolitan Asylum Hospitals andin the London Fever Hospital at the end of the week was927, and showed a slight further decline from recent weeklynumbers; the patients admitted during the week were 100,against 84 and 85 in the preceding two weeks. The deathsreferred to diseases of the respiratory organs in London,which had been 504 and 471 in the preceding two weeks,increased last week to 588, and exceeded by 219 the correctedweekly average. The causes of 105, or 2’0 per cent., of thedeaths in the twenty-eight towns were not certified eitherby a registered medical practitioner or by a coroner. Allthe causes of death were duly certified in Plymouth,Preston, Sunderland, and in three other smaller towns; thelargest proportions of uncertified deaths were recorded inLiverpool, Leicester, Sheffield, and Halifax.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had declined from 26’7 to 22-1 per 1000 in the precedingfive weeks, rose again to 23-1 during the week end-ing May 2nd, but was 3-7 below the mean rate thatprevailed during the same period in the twenty-eight largeEnglish towns. The rates in the eight Scotch towns rangedfrom 14’3 in Greenock and 16’1 in Leith to 27-7 in Glas-gow and 38-8 in Paisley. The 603 deaths in these townsshowed an increase of 17 upon the number in the precedingweek, and included 30 which were referred to measles,25 to whooping-cough, 10 to diarrhoea, 9 to scarlet fever, 4to diphtheria, 2 to "fever," and not one to small-pox.In all, 80 deaths resulted from these principal zymoticdiseases, against 81 and 90 in the preceding two weeks.These 80 deaths were equal to an annual rate of 3-1 per1000, which exceeded by 0-7 the mean rate from thesame diseases in the twenty-eight English towns. Thefatal cases of measles, which had increased from 33to 43 in the previous three weeks, declined to 30 lastweek, of which 16 occurred in Paisley and 13 in Glasgow.The deaths from whooping-cough, which had been 25 and32 in the previous two weeks, declined last week to 25,

and included 12 in Glasgow, 5 in Dundee, 3 in Edinburgh,and 3 in Leith. The 9 fatal cases of scarlet fever exceededthose recorded in any week since the beginning of Marchlast; 5 occurred in Glasgow, 2 in Edinburgh, and 2 in.Aberdeen. The deaths from diphtheria, which had been9 and 4 in the preceding two weeks, were again 4 lastweek, and included 2 in Glasgow. The deaths referred todiseases of the respiratory organs in these towns, which hadbeen 142 and 143 in the preceding two weeks, were 14Slast week, but were 13 below the number in the corre-sponding week of last year. The causes of 76, or nearly13 per cent., of the deaths in the eight towns last weekwere not certified.

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HEALTH OF DUBLIN.

The death-rate in Dublin, which had declined in the pre--ceding three weeks from 30-6 to 23-0 per 1000, rose again to-24’4 during the week ending May 2nd. During the first,four weeks of the current quarter the death-rate in thecity averaged 26’4 per 1000, the rate for the same periodbeing 21-2 in London and 18-9 in Edinburgh. The165 deaths in Dublin during the week under notice-showed an increase of 9 upon the number in the precedingweek, and included 2 which were referred to "fever,"2 to diarrhoea, and not one either to small-pox, measles,scarlet fever, diphtheria, or whooping-cough ; in all, only 4-deaths resulted from these principal zymotic diseases,against numbers declining from 8 to 6 in the preceding threeweeks. These 4 deaths were equal to an annual rate of0’6 per 1000, the rate from the same diseases being1’9 in London and 1-3 in Edinburgh. The 2 fatal cases of" fever," and the 2 deaths referred to diarrhœa, exceededthose recorded in either of the preceding two weeks. No fatalcase of scarlet fever has been registered in Dublin since thebeginning of February last, and not one of measles sincethe first week in March. The 165 deaths in Dublin lastweek included 21 of infants under one year of age and 43 ofpersons aged upwards of sixty years; the deaths both ofinfants and of elderly persons showed a decline from thenumbers in recent weeks. Five inquest cases and 3 deathsfrom violence were registered during the week, and only15, or 9 per cent., of the deaths occurred in public institutions. The causes of 16, or nearly 10 per cent., of the deathslast week in the city were not certified.

CALCUTTA AND ITS AREA OF SUBURBS.

According to a memorandum published by the healthofficer’s department Dr. W. J. Simpson states that thetotal number of births registered in January last was 665agiving an annual ratio of 18’4; the total number of deaths(exclusive of stillbirths) was 1264, against 1337 in the pre-ceding month, showing an annual ratio of 35’0 against37’0 per 1000 of the population. The monthly total exceeds.all the corresponding figures of the past decade excepting1883. There were 134 deaths from cholera, against 157 inthe preceding month, which exceeds the correspondingfigures in six of the last ten years, and in excess of thedecennial mean by 23 In the amalgamated area of thesuburbs there were 336 births, giving an annual ratio of23’9 per 1000. The total number of deaths registeredin January was 893, giving an annual ratio of 63’7 per1000. Of these deaths 126 were from cholera. Fromthe weekly sick return ending March 7th it appearsthat the general death-rate of the week for the town ofCalcutta was 33’0 per 1000 ; that for the amalgamated areaof suburbs was 52-1 per 1000, the general death-rate ofthe combined area being equal to 38’3. The general death-rate of the week ending March 28th was, for the town ofCalcutta, 26’5 per 1000, against 27’9, the mean of the lastfive years; that of the amalgamated area of suburbs was50’6 per 1000 per annum, against 44.7, the mean of the lastfive years. The general death-rate of the combined areawas equal to 33 °2.

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THE SERVICES.

ARMY MEDICAL RESERVE OF OFFICERS. - Surgeon.-Major Thomas John Aubin, M.D., 3rd Regiment, RoyalJersey Militia, to be Surgeon-Major, ranking as Major(dated May 6th, 1891); Surgeon Frederick Vasey Adams,1st Lanarkshire Rifle Volunteer Corps, to be Surgeon,ranking as Captain (dated May 6th, 1891); Acting SurgeonDavid Thomas Key, lst London Artillery Volunteers, tobe Surgeon, ranking as Captain (dated May 6th, 1891).

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NAVAL MEDICAL SERVICE.—Fleet Surgeon Walter Reid,M.D., has been promoted to the rank of Deputy Inspector-’General of Hospitals and Fleets in Her Majesty’s Fleet’{dated May 1st, 1891).-In accordance with the provisionsof Her Majesty’s Order in Council of April 1st, 1881, FleetSurgeon Wm. Brown has been placed on the Retired Listof his rank at his own request (dated April 25th, 1891).-Thefollowing appointments have been made at the Admiralty :-:Staff Surgeon James T. W. S. Kellard, to the Invincible(dated May 5th, 1891). Surgeons: Geo. A. Dreaper to theDefiance (dated May 28th, 1891); George D. Trevor Roperto Haslar Hospital (dated May 7th, 1891); John S Fogerty,M.D., to Plymouth Hospital (dated June 6th, 1891); andEdgar R. Dimsey to the Vivid (dated June 6th, 1891).VOLUNTEER CORPS.—Royal Engineers: 1st Lanarkshire:

Harry Watt Robinson, M.B., to be Acting Surgeon (datedMay 6bh, 1891).—1st Sussex: Charles Lenox Cunningham,Gent., late Surgeon, Royal Navy, to be Acting Surgeondated May 6bh, 1891).-Rifle.- 2nd (Prince of Wales’s)Volunteer Battalion, the Devonshire Regiment: ActingSurgeon W. Square resigns his appointment (dated May 6th,1891).

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Correspondence.

THE RECONSTITUTION OF LONDONUNIVERSITY.

11 Audi alteram partem."

To the Editors of THE LANCET.SIRS,—The attitude you have taken up on this question in

your recent leading articles has been so reasonable and j usb,and is evidently in harmony with the views of some elevenhundred and more of the members of Convocation, that it is.not surprising that those who have attacked* your positionhave failed to upset it. Sir Philip Magnus, in the columns ofThe Times, has warned graduates to study well the reportof their Special Committee before committing themselves toan opinion upon the new charter. Such a warning isscarcely well timed, when we remember that an expartememorandum in favour of the scheme was circulated by theSenate more than a month ago. Moreover, by StandingOrder 14, Section 3, relating to business of Convocation, theproposal to approve the Dratt Supplemental Charter will, un-less other wise determined by special vote, have precedence ofthe reception and discussion of the report of the Special Com-mitteeon May 12th. Indeed, on the agenda paper now to handthe proposal of Lord Herschell and Sir R. Qaain to approvethe new Charter stands immediately after the formal busi-ness, and the Special Committee’s report follows that of theAnnual Committee, neither of which is likely to come on fordiscussion at all. Will Sir Philip Magnus move that thereception of the report of his Special Committee have pre-cedence of the motion to approve the Draft Charter, so asto give Convocation "an opportunity of discussing thewhole situation as he has always promised and advised?If not, then the House will be asked to concur in approvinga complete resolution of the University without anyopportunity of effective discussion or amendment. Sucha course might be fair if the Special Committee’s reportwere unanimous, but it is not so. The resolution " gene-rally approving" the last revised scheme on Feb. 9bb,1891, was carried in committee by 6 to 2; the adoptionof the report of the Special Committee on April 16bh lastwas carried by 10 to 2, or, deducting senators, 6 to 2, nomedical graduate being amongst the six. On the otherhand, the memorandum appended by the minority objectingto the adoption of the scheme and the report is signed bysix members, of whom three are medical graduates. Nodoubt Lord Herschell, in proposing the approval of theCharter, will say, and say well, all that there is to be saidan favour of the scheme, "admittedly a compromise," in" opposition t) the report of the Royal Commission," andnot approved by University and King’s Colleges.

Sir Richard Quain’s support of the reconstitution is lessclear; before tne Royal Commission he appeared as theapologist for things as they are, and he rebutted thecharges of Sir Andrew Clark upon the medical examina-tions. Then, at any rate, he had scant sympathy forcollegiate courses and examinations; "his own experiencewas that he lost rather than gained by attending lectures ;""he would prefer that students came up, as they do now,

to the University of London to show the knowledge theyhad acquired with very little reference to where they hadgained it"; he was not deceived by the phrase " a teachinguniversity." " The London Colleges will be no more of ’ateaching university’ than they may be now if they thinkfit to continue for the purpose," he said (Q. 1985, page 211).He went on to demonstrate that London University exa.minations, especially the medical, "were as thoroughlypractical as they could be made (2002), and that it turnedout as many doctors as it should, and of excellent quality(2001 and 2003). It is true he did not wish to see anotherlicensing body in London, but he pointed out that, if suchshould be created, the " University of London, which isprovided for by the State, is in no fear of failing; it will nothave to battle." Many like myself thought the abovecontentions were sound in 1888, and think that they arestill sound to-day, but would hardly consider them con.sistent with the retrograde policy embodied in the DraftCharter. I am, Sirs, yours faithfully,

W. J. COLLINS, M.S., M.D., B.Sc.Lond.Albert-terrace, Regent’s-park, May 5th, 1891.

To the Editors of THE LANCET.SIRS,—It may interest you to know that we are issuing

to-morrow a second list of members of Convocation whohave "expressed their dissent from the proposed reconstitu-tion of the University of London upon the lines of theSenate’s scheme." The first list contains 709 and the second316 names, a total of 1055. The two lists contain thenames of about 290 medical graduates, 21 of whom are onthe full staff of one or other of the twelve London hospitalswith medical schools attached, and two on the consultingstaff.-I am, Sirs, yours faithfully,

J. WALTER CARR, M.D., Hon. Sec.Bloomsbury-square, W.C., May 6th, 1891.

J. WALTER CARR. M.D.. Hon. Sec.

THE "MEDICAL GRIEVANCE" AND ITSREMEDY.

1:0 0 Me Editors of THE LANCET.

SIRS,—Stated briefly, the " medical grievance " is that thedegrees of M.D. and M.B. are to the medical student in Londonrelatively less accessible than to the students in othercentres of medical education, and that in consequencestudents who otherwise would come to the London schoolsgo elsewhere. The remedy advocated for this unsatisfactorystate of things is the establishment in London of a degreeof lower standard than the present M.B. Lond., on theargument that the examinations for the degree of theexisting university are too severe for the average student.Particularly, it is argued that the so-called PreliminaryScientific Examination is too difficult. From seven or eightyears’ experience of teaching biology to students for thisexamination I claim to be able to speak authoritativelyon this point, and I say emphatically that this examinationis not too difficult for the average student, if he is properlytaught. If an academical year is given to the study ofelementary science under proper teachers, 80 to 90 per cent.of the students will pass, and this has been the averagepercentage of passes amongst my students for the pastseven years. If, then, as I contend, the scientific parts ofthe curriculum for the M.B. Lond. are not too severe,what is the cause of the relative inaccessibility of thedegree? It is, in my opinion, to be found in the fact that,speaking in general terms and without reference to anyparticular school, the education in the more scientificportion of the curriculum is at fault, and the remedyis to be found, not in any attempt to lower the exist-ing University degree, but in making proper pro-vision for educating the students up to its require-ments. If London, as a centre of medical education, werea2 efficient in the way of appliances for the more

scientific education-i.e., were provided with suitablescientific teachers and properly equipped laboratories-as isthe case in Cambridge, Oxford, Edinburgh, Manchester,Durham, and the other provincial centres, the "medicalgrievance" would gradually vanish. Speaking in generalterms, the provincial universities, colleges, and schools aremuch better equipped for the scientific parts of medicaleducation than London, and vice versd. London hasfacilities for clinical work which none of the provincial orScotch centres can possibly possess. The proper policy,then, is clear : the London schools should remedy their