1511VITAL STATISTICS.-THE SERVICES.

380 new cases were, however, admitted to these hospitals duringthe week under notice, against 332, 368, and 353 in the threepreceding weeks. The deaths in London referred to pneu-monia and to other diseases of the respiratory organs,which had been 301, 281, and 228 in the three

preceding weeks, further declined to 198 in the week undernotice, and were 28 below the corrected average numberin the corresponding week of the five years 1903-07.The 18 deaths directly referred to influenza in London showeda decline of ten from the number returned in the previousweek. The causes of 41, or I’O 0 per cent., of the deathsregistered last week in the 76 towns were not certified eitherby a registered medical practitioner or by a coroner. Allthe causes of death were again duly certified in Leeds,Bristol, West Ham, Bradford, Newcastle-on-Tyne, Hull, andin 51 other smaller towns ; 13 uncertified causes of deathwere, however, registered last week in Birmingham, four inGateshead, and three both in Liverpool and in Warrington.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in eight of the principalScotch towns, which had been equal to 18’ 7 and 17’ 8 8per 1000 in the two preceding weeks, further declined to15’ 3 in the week ending May 16th, but exceeded by 2’ 1the low mean rate that prevailed during the same weekin the 76 English towns. The annual death-rate duringthe week under notice was equal to 14’4 in Edinburghand to 16’ 9 in Glasgow, each rate showing a considerabledecline from those recorded in recent weeks. In Edinburghthe 97 deaths included two fatal cases of diarrhoea, and oneof measles, but not one of any other epidemic disease, therate from these diseases being so low as 0’4 per 1000,against 1.in London and 0.8 in Dublin. The 279deaths in Glasgow showed a decline of 28 fromthe number in the previous week, and included 33 whichreferred to the principal epidemic diseases, of which 14resulted from measles, nine from whooping-cough, seven

from diarrhoea, and one each from scarlet fever, diphtheria,and "fever" (certified as cerebro-spinal fever), but not onefrom small-pox. These 33 deaths in Glasgow were equal toan annual rate of 2’ 0 per 1000, against 2’ 5 and 2 ’ 4 in thetwo previous weeks. The fatal cases of measles showed adecline, while the deaths from whooping-cough and diarrheeawere more numerous than in the preceding week. Thedeaths referred to diseases of the respiratory organs showeda marked decline during the week under notice, both inEdinburgh and in Glasgow. The causes of 13 deaths in

Glasgow and of seven in Edinburgh were not certified, equalto 4’ 7 and 7’ 2 per cent. respectively of the deaths

registered. -

HEALTH OF DUBLIN.

The annual rate of mortality in Dublin, which hadbeen equal to 21-1, 21-9, and 25.0 per 1000 in the threepreceding weeks, declined to 19 -0 in the week endingMay 26th. During the first seven weeks of the current

quarter the death-rate in Dublin averaged 22’ 7 per 1000 ;the mean rate during the same period did not exceed 15’ 1in London and 15 - 7 in Edinburgh. The 144 deaths ofDublin residents registered in the week under notice showeda decline of 45 from the high number in the previous week,and included six which were referred to the principalepidemic diseases, against ten and eight in the two pre-ceeding weeks. These six deaths were equal to an annualrate of 0’ 8 per 1000, the rate during the week from thesame diseases being 1 1 in London and 0’ 4 in Edinburgh.Of the six deaths from these epidemic diseases in Dublin,two resulted from measles, two from whooping-cough, onefrom diphtheria, and one from diarrhoea, but not one fromscarlet fever, "fever," or small-pox. The fatal cases of diph- ’’

theria which had been two and three in the two previousweeks, declined to one last week. The 144 deaths from allcauses in the city during the week included 18 of infantsunder one year of age (a lower number than in any previousweek of this year) and 50 of persons aged upwards of 60years. Four inquest cases and two deaths from violencewere registered, and 82, or 56.9 per cent., of the deathsoccurred in public institutions. The causes of six, or 4’2per cent., of the deaths registered in the city during theweek under notice were not certified ; the causes of all buttwo of the 1196 deaths in London last week were dulycertified, while in Edinburgh 7 2 per cent. of the causes ofdeath were uncertified.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE undermentioned Staff-Surgeons have been promoted

to the rank of Fleet-Surgeon in His Majesty’s Fleet, viz. :-Henry Baker Hall, Henry William Gordon-Green, GeorgeThompson Bishop, Edgar Fairbank Mortimer, BeauchampFrederick Parish, and Frederick Albert Capps (datedMay llth, 1908).The following appointments are notified:-Fleet-Surgeons:

H. F. Iliewicz to the Crescent; F. Fedarb to the Ocean, onrecommissioning ; and G. H. Foott to the Dreadnought.Staff-Surgeons : P. M. May to the Hannibal; and 8. H. Birtto the President, additional, for London Recruiting Head-quarters, temporary. Surgeons: H. G. T. Major to thePresident, additional, for three months’ course at WestLondon Hospital; B. S. Robson to the Viatory, additional,to be lent to the Spanker; G. E. Hamilton to the Oeean, onrecommissioning; and P. M. Rivaz to the Hannibal,temporary.

ARMY MEDICAL SERVICE.

Surgeon-General William J. Fawcett, C.B., is placed onretired pay (dated May 13th, 1908). Colonel Arthur T.Sloggett, C.M.G., to be Surgeon-General, vice W. J.Fawcett, C.B. (dated May 13th, 1908). Colonel GeorgeD. N. Leake is placed on retired pay (dated May 17th, 1908).Lieutenant-Colonel and Brevet Colonel David Bruce, O.B.,from the Royal Army Medical Corps, to be Colonel, viceG. D. N. Leake (dated May 17th, 1908).

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Major Charles L. Fraser to be Surgeon-Lieutenant-Colonel (dated May 5th, 1908).

VOLUNTEER CORPS.

Rifle: 9th Volunteer Battalion (Highlanders), The RoyalScots (Lothian Regiment): The undermentioned officer re-signs his commission :-Surgeon-Captain Kenneth MacK.Douglas (dated March 31st, 1908). lst Volunteer Battalion,The Royal Scots Fusiliers : Surgeon-Lieutenant-ColonelWilliam Frew is granted the honorary rank of Surgeon-Colonel (dated March 30th, 1908). Surgeon-Lieutenant-Colonel and Honorary Surgeon-Colonel William Frew resignshis commission, with permission to retain his rank and towear the prescribed uniform (dated March 31st, 1908).

TERRITORIAL FORCE.The following units have been reported as having attested

at least 30 per cent. of the establishment authorised andhave received the recognition of the Army Council :-2ndWelsh Field Ambulance, lst South-Western Mounted BrigadeField Ambulance, and 3rd London Field Ambulance.

AN OFFICERS’ TRAINING CORPS AT NEWCASTLE.A meeting was held on Wednesday, May 6th, at the New-

castle College of Medicine in connexion with the formationof a company of the Officers’ Training Corps. The Pre-sident of the College, Sir G. H. Philipson, was in the chair,and was supported by several members of the teaching staffof the College of Medicine and of Armstrong College.Lieutenant-General R. S. S. Baden-Powell also had travelledfrom York in order to address the students, of ’whom avery large number was present. Captain F. C. Garrett,commanding the Durham University Volunteer Company,gave an outline of the objects and proposed organisa-tion of the Officers’ Training Corps. He explained thatalthough it would be a little time before the arrangementswere completed, Senate had accepted the scheme and itwas probable that the corps would be in working order bynext term. It was hoped that three companies would beraised in the University, one at Durham, one at the Collegeof Medicine, and one at Armstrong College, each divisionof the University furnishing both cadets and officers.General Baden-Powell followed and emphasised the im-

portance of the new corps, both as providing a

reserve of men at least partially trained who would be ofservice in the event of a big war and also as insuring asupply of officers for the Territorial Army. The success ofthe latter hung on two things, its officers and its discipline ;in reality, though, on one only, for if officers were keen andknew their work men had confidence in them and disciplinefollowed as of necessity. The universities could provide alarge quota of men who would be suitable as officers, andevery man who could possibly do it should make a point of

1512 THE TREATMENT OF ENTERIC FEVER BY PEROXIDE OF MAGNESIUM.

getting the special training provided by the corps. Suchtraining would be invaluable as part of a student’s generaleducation ; it was an exceptional opportunity to acquire aspecial technical knowledge of the methods of war; andfinally, should any of those present or those who followedthem desire to enter the medical service of the army the factthat such a man had obtained the certificates of efficiency inthe corps entitled him to a considerable percentage of marksin the entrance examination.

CHOLERA IN INDIA.An India Office telegram states that 31 men of the Munster

Fusiliers have died from cholera. It will be rememberedthat this regiment was to have taken part in the expeditionagainst the Mohmands but owing to the outbreak of choleradid not go to the front.

The members of the Imperial Yeomanry Hospitals Com-mittee, staff, and some of its principal subscribers have sentto Mr. Oliver Williams, the secretary to the hon. treasurer,£221 11s. towards the " Hall-Edwards " Fund as a mark ofappreciation of the services rendered during the African Warby Mr. J. Hall-Edwards.Captain J. H. P. Graham, R.A.M.C. (Mil.), has been

appointed Staff Officer to Administrative Medical Officer, W.Lancs. Division, Territorial Force.

Correspondence.

THE TREATMENT OF ENTERIC FEVER BYPEROXIDE OF MAGNESIUM.

" Audi alteram partem."

To the Editor of THE LANCET.

SIR, -In a paper which I read last November before theStourbridge District Medical Society I gave the result of myexperiences in treating enteric fever with peroxide ofmagnesium inclosed in keratin capsules.The methods of treatment of enteric fever may be divided

into three classes. First, the treatment by anti-typhoidserum injections. By this is not meant the prophylacticvaccination against enteric fever but treatment by seruminjections given after the onset of the disease. At presentthis treatment has not met with the success which it will

undoubtedly achieve in the future, though Chantemesseclaims to have found an efficient serum and his results arecertainly striking. He treated 545 cases of the disease, witha mortality of 4 per cent., but the results are not absolutelyconclusive as he combined other methods of treatment withthe serum injections. Secondly, the expectant method, by which is meant that we do not make any attempt to attack the materies morbi but keep an alert watch for any complications ’which may arise and deal with them as they occur. This wayof treatment seems to me to be nothing but a confession ofweakness on the part of the medical attendant. Thirdly,the antiseptic method. I do not pretend that this method isideal or in any way to be compared with treatment by serum;still, while we are waiting for an efficient serum to be dis-covered it must prove of some use in helping the patient tofight the typhoid poison, and even after the efficient sprumhas been discovered it must prove useful as an adjuvant tothe serum treatment.There have always seemed to me to be two difficulties in

applying the antiseptic treatment to enteric fever. Firstly,any antiseptic which is strong enough to destroy the bacillustyphosus will probably be also strong enough to do seriousdamage to the patient. Secondly, it is not easy to be quitesure what changes may occur in the stomach and upper portionof the intestines to drugs given with this object, so that wedo not know whether we are really disinfecting the greaterportion of the intestinal tract or not. Consequently what isrequired is an antiseptic which is fatal to the bacillus andinnocuous to its host, and also some means of conveying thisantiseptic into the intestines without its undergoing anychange in its passage through the stomach.On July 2nd, 1904 (p. 44), there appeared a letter in

THE LANCET from Dr. W. Carter of Liverpool, in which hesaid that he had been greatly struck with the effect of

peroxide of hydrogen on the bacillus typhosus. A compara-tively weak solution-20 minims in one ounce of water-caused complete sterility of the bacillus. In THE LANCET

published a week later there was an article by Dr. Frenkel ofHonfleur on the effects of hopogan, or peroxide of mag-nesium, given for fermentative diarrhoea. He recommendedits administration in keratin-coated capsules, so that itshould pass unchanged through the stomach, the keratinbeing afterwards dissolved in the intestine. When theperoxide of magnesium comes in contact with the intestinaljuices it gives off peroxide of hydrogen and becomes reducedto water and a harmless salt of magnesium.

Putting these two communications together I determinedto try the treatment in enteric fever, and since then I havehad the opportunity of doing so in Hayley Green Hospitalin 51 cases, with the following results. Oat of the 51 cases

there were 44 recoveries and seven deaths. The cases were

nearly all very serious ones, which is, I suppose, the usualexperience of those who have to treat enteric fever in

hospitals, and I have no doubt at all from watching themthat the treatment had a most beneficial effect on the courseof the disease. 51 cases are, of course, far too small anumber to draw a certain conclusion from and I earnestlyhope that others who have a larger scope for observation maybe persuaded to try this treatment.

Of the seven fatal cases one was admitted into hospitalunconscious and apparently in a dying condition. This wasdone more or less as a counsel of despair, as there was nopossibility of her recovery in her home surroundings. Shedied on the third day after her admission, having never re-covered complete consciousness. Another case was alsoadmitted as a counsel of despair in a dying condition. Hewas one of a large family who occupied a single room. Hehad several haemorrhages the night before admission, andhad a bad hmmorrhage in the ambulance on the way to thehospital. He arrived in a state of collapse from which henever rallied and he died on the fourth day after his admis-sion. A third fatal case was a house painter who sufferedfrom plumbism with albuminuria, and he died from uræmicconvulsions after his temperature had become normal. Ithink it may fairly be claimed that these three cases

should be subtracted from the death roll, which would leave48 cases treated by hopogan with four deaths. For purposesof comparison, I may say that from the time the hospitalwas opened in March, 1902, until the time when we began totreat the cases with hopogan we had 30 cases with 10deaths.As to the method of administration, in every case

hopogan was given in 10-grain doses inclosed in keratincapsules. These capsules are rather bulky, and there isoften considerable difficulty in getting the patients to swallowthem, so that I have now changed the method of administra-tion and give two capsules of five grains each instead of onecontaining ten grains. The capsules are given every fourhours and in bad cases every three or every two hours. Ihave found that it is wise to continue their use for sometime after the temperature has come down to normal anduntil the tongue is perfectly clean. In some of the earliercases the temperature went up as soon as the capsules werediscontinued and came down again when they were resumed.

I am, Sir, yours faithfully,W. KIRKPATRICK, M.D. Dub.,

Medical Superintendent, Stourbridge and HalesowenIsolation Hospital.

Stourbridge, May 13th, 19)8.

A NEW METHOD OF RESTORING THECONTINUITY OF THE BOWEL IN CASES

OF EXCISION OF A GROWTH LOWDOWN IN THE SIGMOID

FLEXURE.To the Editor of THE LANCET.

SIR,—An illustrated article with the above title appears mTHE LANCET of May 16tb, p. 1403. If the writer, Mr. J. P.Lockhart Mummery, will refer to the British GynæaologiaalJournal for February, 1901, in a paper entitled Some NewMethods in Pelvic Operations in the Female," by Mr. J.Rutherford Morison of Newcastle-upon-Tyne, he willfind an exact description of the operation which he nowpublishes as new. Mr. Morison’s paper is illustrated by fourdiagrams which make the details of the operation perfectlyclear. This method was first devised and carried out by Mr.Morison in 1896 and from that time and up to the publica-tion of his paper he had performed it 14 times. Since thenit has been often resorted to by Mr. Morison and his