1494

these towns, which had been 14-0, 14-7, and 14-0 per 1000in the three preceding weeks, rose to 16’2 per 1000 inthe week under notice. During the first seven weeksof the current quarter the mean annual death-rate in thesetowns averaged 14-6, against 13-7 per 1000 in the 96 largeEnglish towns. Among the several towns the death-rate lastweek ranged from 7’6 in Motherwell, 10’5 in Kilmarnock,and 11’0 in Clydebank, to 19-3 in Perth, 19’5 in Greenock andin Kirkcalcly, and 21-4 in Ayr.The 701 deaths from all causes were 93 in excess of the

number in the previous week, and included 84 which werereferred to the principal epidemic diseases, against 82 and 55in the two preceding weeks. Of these 84 deaths, 36 resultedfrom measles, 21 from infantile diarrhoeal diseases, 10 fromdiphtheria, 9 from scarlet fever, 5 from enteric fever, and 3from whooping-cough, but not one from small-pox. These 84deaths from the principal epidemic diseases were equal to anannual death-rate of 1’9, against 1.1 per 1000 in the 96 largeEnglish towns. The deaths attributed to measles, which hadbeen 12, 17, and 11 in the three preceding weeks, rose to 36last week; of this number 16 occurred in Glasgow, 8 inEdinburgh, 4 in Paisley, and 4 in Clydebank. The deathsof infants (under 2 years of age) referred to diarrhoeaand enteritis, which had been 19, 34, and 19 in thethree preceding weeks, slightly rose to 21 last week,and included 12 in Glasgow, 2 in Dundee, and 2 inLeith. The fatal cases of diphtheria numbered 10,against 11 in each of the three preceding weeks, and included6 in Aberdeen and 2 in Dundee. The deaths attributed toscarlet fever, which had been 11, 14, and 10 in the three pre-ceding weeks, were 9 last week, of which number 3 wererecorded in Aberdeen and 2 in Greenock. The 5 deathsreferred to enteric fever, of which 2 occurred in Perth, were2 in excess of the average in the earlier weeks of this quarter,while the 3 fatal cases of whooping-cough were equal to theaverage number from this cause in the same period.The deaths referred to diseases of the respiratory system,

which had been 92, 99, and 84 in the three preceding weeks,rose to 97 last week; 24 deaths resulted from various formsof violence, against 32 and 29 in the two preceding weeks.

HEALTH OF IRISH TOWNS.

In the 27 town districts of Ireland with an aggregate popu-lation estimated at 1,199,180 persons at the middle of thisyear, 616 births and 432 deaths were registered duringthe week ended Saturday, Nov. 15th. The annual rate ofmortality in these towns, which had been 17’8,17’2, and 17’6per 1000 in the three preceding weeks, further rose to 18’8 per1000 in the week under notice. During the first seven weeksof the current quarter the mean annual death-rate in thesetowns averaged 17’5 per 1000; in the 96 large English townsthe corresponding rate did not exceed 13’7, while in the 16Scotch towns it was equal to 14-6 per 1000. The annualdeath-rate last week was equal to 20-1 in Dublin (against13-4 in London and 17’3 in Glasgow), 18’3 in Belfast, 21-1 inCork, 22’9 in Londonderry, 24’4 in Limerick, and 17’1 inWaterford, while in the 21 remaining smaller towns the meandeath-rate did not exceed 14-9 per 1000.The 432 deaths from all causes were 28 in excess of the

number in the previous week, and included 41 which werereferred to the principal epidemic diseases, against numberssteadily declining from 132 to 34 in the nine preceding weeks.Of these 41 deaths 15 resulted from infantile diarrhoealdiseases, 7 from scarlet fever, 7 from diphtheria, 6 fromwhooping-cough, 3 from enteric fever, and 3 from measles,but not one from small-pox. The mean annual death-ratefrom these diseases last week was equal to 1’8 per 1000; in the96 large English towns the corresponding rate did not exceed1-1, while in the 16 Scotch towns it reached 1-9 per 1000. Thedeaths of infants (under 2 years of age) attributed to diarrhoeaand enteritis, which had steadily decreased from 111 to 16 inthe nine preceding weeks, further declined to 15 last week, ofwhich number 8 occurred in Dublin and 3 in Cork. Thedeaths referred to scarlet fever, which had been 9, 5, and 8 inthe three preceding weeks, were 7 last week, and were allregistered in Belfast. The 7 fatal cases of diphtheria, com-prising 5 in Dublin and 2 in Belfast, were 3 in excess of theaverage in the earlier weeks of the quarter. The 6 deathsattributed to whooping-cough were also slightly above theaverage in recent weeks, and comprised 3 in Belfast, 2 inGalway, and 1 in Lisburn. Of the 3 deaths from entericfever, 2 were registered in Dublin and 1 in Cork. The fatalcases of measles occurred in Dublin, Belfast, and Galwayrespectively.The deaths referred to diseases of the respiratory system,

which had been 53, 61, and 69 in the three preceding weeks,further rose to 73 in the week under notice. Of the 432deaths from all causes 125 or 29 per cent., occurred in publicinstitutions, and 7 resulted from various forms of violence.The causes of 20, or 4-6 per cent., of the total deaths were notcertified either by a registered medical practitioner or by acoroner after inquest; in the 96 large English towns the pro-portion of uncertified causes of death did not exceed 0-9 percent.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments have been notified :-Fleet-

Surgeon: J. W. W. Stanton to the Colossus, on recommission-ing. Staff-Surgeons: F. C. B. Gittings to the Apollo, on

recommissioning, and as Acting Interpreter in German ; andF. G. Wilson to the Colossus, on recommissioning.

ROYAL NAVAL VOLUNTEER RESERVE.The undermentioned has been appointed Surgeon : Donald

Aldridge Macpherson (dated Nov. 14th, 1913).ARMY MEDICAL SERVICE.

Colonel Tom P. Woodhouse, on completion of four years’service in his rank, is placed on the half-pay list (datedNov. 17th, 1913).Lieutenant-Colonel Henry N. Thompson, D.S.O., from the

Royal Army Medical Corps, to be Colonel, vice T. P.Woodhouse to half-pay (dated Nov. 17th, 1913).

ROYAL ARMY MEDICAL CORPS.

Major Francis W. Begbie to be Lieutenant-Colonel, viceH. N. Thompson, D.S.O., promoted (dated Nov. 17th, 1913).Colonel G. D. Hunter, D.S.O., has been appointed

Assistant Director of Medical Services to the Allahabad andFyzabad Brigades of the Eighth (Lucknow) Division of theNorthern Armv.Lieutenant-Colonel H. N. Thompson, D.S.O., has been

selected for appointment as Deputy Director of MedicalServices to the Scottish Command. Lieutenant-ColonelC. W. R. Healey has been appointed to the London Districtfor a tour of duty. Lieutenant-Colonel H. M. Adamson hasbeen placed under orders for India and will be appointedto the Sixth (Poona) Division of the Southern Army.Lieutenant-Colonel 0. R. A. Julian, C.M.G., has taken upduty at the Royal Hospital, Chelsea.Major F. M. Mangin has been selected for appointment as

Specialist in Ophthalmology to the Poona Division of theSouthern Army in India. Major P. S. O’Reilly has beenappointed to the Eastern Command for duty. Major G. S.Mansfield has taken over charge of the Military Hospital atSt. Peters, Jersey. Major C. C. Cumming has embarked forMalta. Major St. J. B. Killery has been granted six months’general leave of absence home from India. Major T. C.MacKenzie, D.S.O., has taken up duty as Deputy AssistantDirector of Medical Services to the Northumbrian Division.Major H. Herrick has been transferred to the HomeEstablishment from India. Major E. M. Williams has beenselected to hold charge of the Military Hospital at Leicester.Major N. H. Ross has embarked for India, and will beappointed to the Lucknow Division of the Northern Army.Major F. S. Walker has taken over charge of the MilitaryHospital at Fort Camden, Queenstown. Major W. P. Gwynnhas been appointed to the Irish Command on return homefrom Shwebo. Major H. E. M. Douglas, V.C., D.S.O., hastaken up duty with the Egyptian Army.Captain F. W. W. Dawson has been transferred from the

Military Hospital at Kasauli Cantonment to Jullundur.Captain R. G. H. Tate, Captain E. D. Caddell, and CaptainT. H. Scott have been appointed for duty on board the trans-port s.s. Rohilla, which left Karachi on Nov. 19th. CaptainJ. C. C. Carmichael has been appointed to the MilitaryHospital at Khanspur. Captain W. J. Tobin has beengranted six months’ general leave of absence home fromIndia. Captain A. H. Hayes has been placed under ordersfor a tour of service with the Third (Lahore) Division of theNorthern Army in India. Captain T. E. Harty has embarkedfor a tour of duty in the Sierra Leone Protectorate. Anexchange has been approved between Captain J. B. Meldon,who will proceed to Gibraltar, and Captain T. H. Dickson,who will go to India. Captain B. G. Patch takes up duty atNottingham. Captain F. M. M. Ommanney has joined atArmagh. Captain A. T. Frost has been appointed for a tourof duty with the Lucknow Division of the Northern Army inIndia. Captain R. J. Cahill has been appointed to the MilitaryHospital at Belfast. Captain J. A. Anderson has taken up dutyas Company Officer to No. 13 Company of the Royal ArmyMedical Corps at Edinburgh. Captain J. A. Bennett has beengranted leave of absence on medical certificate. CaptainW. P. MacArthur has taken up duty as Specialist SanitaryOfficer in Mauritius. Captain P. S. Stewart has joined theMilitary Hospital at Malta. Captain M. Keane has beenplaced under orders for a tour of duty in India. CaptainC. J. A. Balck has taken up duty as a Specialist in PhysicalTraining at Dublin. Captain C. R. Millar has been grantedleave of absence home from the Sierra Leone Protectorate.Captain W. A. Spong has been appointed to hold charge ofthe Military Families and Followers Hospitals at KarachiCantonment. Captain H. Stewart has taken over charge ofthe Military Hospital at Halifax. Captain F. H. Bradley hasbeen appointed Specialist in Operative Surgery to the

1495

Lucknow Division. Captain C. G. Sherlock has been ap-pointed to hold charge of the Cantonment General Hospital Iat Dalhousie. Captain C. J. Wyatt has taken up duty atPort Lokkoh, Sierra Leone Protectorate. Captain A. Dawson thas been transferred from Wicklow to the Military Hospitalat the Curragh.Lieutenant B. H. H. Spence has been placed under orders

for a tour of service in India. Lieutenant A. L. Urquharthas been appointed for duty to the Queen Alexandra Military °

Hospital. Lieutenant R. G. Shaw has been appointed to the Dublin District. Lieutenant H. R. L. L’Estrange has joined at Newbridge. Lieutenant C. M. Ingoldby has been appointedto the Military Hospital at Fermoy. Lieutenant F. C. Davidson has been appointed to the Scottish Command. Lieutenant W. 0. W. Ball has taken up duty at the Military aHospital, Aldershot. Lieutenant A. G. Brown has joined the t

Irish Command. Lieutenant B. Biggar has been transferred 1from the Military Hospital at Cairo to Alexandria. LieutenantJ. F. O’Connoll has been appointed to the Military Hospitalat Aldershot. Lieutenant J. M. Elliott has been transferredfrom the Military Hospital at Hilsea to Winchester. Lieu- *:

tenant C. V. Thorndon has been appointed to the Irish ‘

Command. Lieutenant E. C. Deane has been appointed tothe Military Hospital at Chester. Lieutenant R. T. Vivianhas taken up duty in the Military Hospital at the CurraghCamp.

’

INDIAN MEDICAL SERVICE.Lieutenant-Colonel J. Crimmin, V.C., C.B., C.LE., Presi-

dency Surgeon, Second District, Bombay, has arrived homeon leave of absence from India. Lieutenant-Colonel T.Jackson has been selected for appointment as Surgeon Super-intendent of St. George’s Hospital, Bombay. Lieutenant-Colonel W. H. Ogilvie, medical officer of health and civilsurgeon of the notified area at Delhi, has been granted sixmonths’ combined leave of absence home from India.Major J. Williams has been selected for appointment as

Civil Surgeon at Dera Ismail Khan. Major W. E. McEechniehas been transferred to Etawah on completion of special duty.Major A. W. Overbeck-Wright, superintendent of the LunaticAsylum at Agra, has been appointed to officiate as Super-intendent of the District Jail at Agra. Major J. H. Husbandhas taken up duty as Civil Surgeon to the Wano Agency.Major A. C. MacGilchrist has been placed on special dutyunder the Director-General, Indian Medical Service. MajorC. A. Lane, officiating civil surgeon at Darjeeling, has beenappointed to act as a Civil Surgeon of the First-class duringthe absence of Lieutenant-Colonel R. H. Hall. Major H. de V.Condin has been selected for appointment as Civil Surgeonat Hazara. Major E. C. MacLeod has been appointed toofficiate as Inspector-General of Civil Hospitals and Prisonsand Sanitary Commissioner in Assam during the absence ofLieutenant-Colonel H. E. Banatvala. Major J. N. Walker,civil surgeon at Aligarh, has been granted combined leave ofabsence home from India for one year.Captain M. D. A. Kureishi has been appointed to officiate

as civil Surgeon at Aden during the absence on leave of

Major A. F. W. King. The services of Captain R. A. Need-ham, medical officer of health at Simla, have been placed atthe disposal of the Sanitary Department of the Governmentof India in connexion with the All India Sanitary Conferenceto be held at Lucknow next January. Captain A. F. Babonauhas been transferred to Ambala as Plague Medical Officer.Captain P. M. Rennie has been appointed to officiate asMedical Officer of Health and Civil Surgeon to the notifiedarea at Delhi. The services of Captain G. Holroyd,officiating superintendent of the Bhagalpur Central Jail,have been replaced at the disposal of the Government ofIndia in the Home Department. Captain N. S. Simpsonhas been appointed to hold charge of the plague operations atLucknow on transfer from Kasauli. Captain J. H. Taylorhas been appointed to officiate as Assistant Director of theBombay Bacteriological Laboratory during the absence onleave of Captain W. D. H. Stevenson. Captain R. H. Leehas returned to India on completion of leave of absence.The services of Captain ’H. C. Brown have been replaced atthe disposal of the Education Department of the Govern-ment of India. Captain W. E. Brierley has been selected forappointment as Specialist in Operative Surgery.

SPECIAL RESERVE OF OFFICERS.

Royal Army lledictil Corps.Lieutenant Morton W. Ruthven to be Captain (dated

Oct. 31st, 1913).TERRITORIAL FORCE RESERVE.

Royal Army Medical Corps.Major William Owen Evans, from the Unattached List for

the Territorial Force, to be Major (dated Oct. llth, 1913).6th London Field Ambulance, Royal Army Medical Corps:

Lieutenant Walter B. Parsons resigns his commission (datedNov. 19th, 1913).

lst North Midland Field Ambulance, Royal Army MedicalCorps: Captain Edwin A. Wraith to be Major (dated Nov. 19th,1913).

Attached to Units other than Medical Units.-LieutenantLionel H. Moiser to be Captain (dated Sept. llth, 1913).

Unattached List.-Major Joseph McGregor Robertson ceasesto hold a commission in the Territorial Force (datedNov. 19th, 1913).

THE INDIAN AMBULANCE GAZETTE.The October issue of this gazette, which is the official

organ of the Indian branch of the St. John AmbulanceAssociation, has just reached us. It contains much matterof interest to ambulance workers in all parts of the Empire,and in addition to association news there are articles onsanitation, malaria, and mosquitoes, the dangers of thehouse-fly, and an interesting note on the resuscitation of theapparently drowned, the first recorded cases of which appearto have been made in " Derham’s Physico-Theology " ashaving occurred at Troningholm and Oxford about the year1650. The illustrations include groups of ambulance workersand pictures of the St. John Ambulance Association Head-quarters at Malta and of the British Ophthalmic Hospital atJerusalem. The Indian Amlmlance Guzette is published atJutogh, Simla, India, price 6 annas, post free.

FIRST AID IN THE ROYAL NAVY.1Under this title a little book has just been officially issued,

and both the service and the author are to be congratulated, .

the first mentioned in possessing such an excellent and ’cheap manual, and the second on the terse, clear, andpractical manner in which he has treated the subject. Inthe introduction it is stated that Everyone in the Navy,especially the officers, must know enough ’ First Aid’ to beable to help themselves and others in case of need. The objectof first aid is not to teach surgery, but to teach purelytemporary measures to save life or relieve pain till the doctorcomes. First aid should always be very simple in methods andin wording, so that anybody can understand. It is, therefore,not always absolutely scientifically the best treatment, but isrough and ready, and the best under the circumstances."We quote the above admirable definition and explanationbecause they indicate exactly how the author, who certainlyknows how to teach, has written his book. First aid at sea.

necessarily differs in some respects from first aid on land byreason of the difference in environment and the presence orabsence of makeshift appliances due to that environment, aswell to the nature of the accidents likely to happen. This isclearly shown in the text and in the many illustrations withwhich the book abounds. The anatomical and physiologicalillustrations and diagrams, some of them coloured, are exactlysuited to the purpose of elementary instruction.The King has granted Captain J. Powell, R.A.M.C., per-

mission to accept and to wear the Imperial Order of theOsmanieh (Fourth Class) conferred on him by the Khedive ofEgypt in recognition of valuable services rendered.

1 First Aid in the Royal Navy. London: H.M. Stationery Office,Messrs. Wyman and Sons. Messrs. Eyre and Spottiswoode, Messrs.Fisher Unwin; Edinburgh : E. Ponsonby; and agents abroad.Pp. 190. Price 9d.

MEDICO-LEGAL SOCIETY.-The next meeting ofthis society will be held at 11, Chandos-street, Cavendish-square, London, W., on Tuesday next, Nov. 25th, at8.30 P.M., when a paper on the Urgent Necessity for theTreatment of Early or Threatening Insanity, and the Needfor Immediate Legislation, will be read by Dr. Robert Jones.Members willing to exhibit medico-legal specimens or con-tribute papers, &c., to the Proceedings of this session shouldcommunicate with the honorary secretaries, Mr. J. HowellEvans, 25, Berkeley-square, W., and Mr. G. W. CooperKing, 9, Gray’s Inn-square, W.C.

SCARLET FEVER IN LONDON.-London is suffer-ing from a severe epidemic of scarlet fever, and the Metro-politan Asylums Board are finding some difficulty in

immediately removing to their hospitals every notified case.There are plenty of vacant beds, but the supply of nurses ofthe lower grades is difficult to maintain and at presenttotally inadequate to meet the demands made upon theBoard. To some extent the situation is being dealt with byengaging institutional nurses, and steps are being taken tomake the conditions under which the nursing staff servemore attractive. At a meeting of the managers of the Boardheld on Nov. 15th it was reported that all the notified caseshad been taken in, save one at Tottenham. It was also

reported that during the fortnight ending Nov. 8th 3699scarlet fever patients were under treatment compared with3438 for the preceding fortnight. These figures show anincrease of more than 1000 cases when comparison is madewith the corresponding weeks of 1911 and 1912.