1095THE SERVICES.

The causes of 59, or 1-6 per cent., of the deaths inthe thirty-three towns were not certified, either by a

registered medical practitioner or by a coroner. All thecauses of death were duly certified in Oldham, Salford,Bradford, Newcastle-upon-Tyne, and in ten other smaller

towns; the largest proportions of uncertified deaths wereregistered in Birmingham, Liverpool, Sheffield, and Hull.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 21’2 and 19 7 per 1000 in the preceding twoweeks, further declined to 17’5 during the week endingApril 21st and was 0’7 per 1000 below the mean rate duringthe same period in the thirty-three large English towns. Therates in the eight Scotch towns ranged from 13’3 in Greenockand 14.6 in Aberdeen to 19’0 in Dundee and 23 8 in Leith.The 499 deaths in these towns included 18 which werereferred to whooping-cough, 10 to diarrhoea, 6 to "fever,"4 to diphtheria, 3 to scarlet fever, 2 to measles, and 2 tosmall-pox ; in all, 45 deaths resulted from these principalzymotic diseases, against 59 and 64 in the preceding twoweeks. These 45 deaths were equal to an annual rate of1-6 per 1000, which was 1’0 below the mean rate last weekfrom the same diseases in the thirty-three large Englishtowns. The fatal cases of whooping-cough, which hadbeen 33 and 34 in the preceding two weeks, declinedagain to 18 last week, of which 12 occurred in Glasgowand 3 in Aberdeen. The deaths referred to differentforms of "fever," which had declined from 9 to 5 in thepreceding three weeks, were 6 last week, of which 5 wererecorded in Glasgow. The 4 fatal cases of diphtheria werebelow those registered in any recent week and included 2in Leith. The deaths from scarlet fever, which had been 4and 6 in the preceding two weeks, declined to 3 last week,of which 2 occurred in Glasgow, where the 2 fatal cases ofsmall-pox were also recorded. The deaths referred todiseases of the respiratory organs in these towns, whichhad been 125 and 107 in the preceding two weeks, were105 last week and were 17 below the number in the cor-responding week of last year. The causes of 33, or nearly7 per cent., of the deaths in these eight towns last weekwere not certified.

___

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 23’1 and26’1 per 1000 in the preceding two weeks, declined againto 23’3 during the week ending April 21st. During thepast three weeks of the current quarter the rate of mortalityin the city has averaged 24’2 per 1000, against 18’8 in Londonand 17’0 in Edinburgh. The 156 deaths registered in Dublinduring the week under notice showed a decline of 19 from thenumber in the previous week, and included 4 which werereferred to the principal zymotic diseases, against 17 and 9in the preceding two weeks ; of these, 2 resulted from

whooping-cough, 1 from diphtheria, 1 from diarrhoea, butnot one either from small-pox, measles, scarlet fever, or

"fever." " These 4 deaths were equal to an annualrate of 0-6 per 1000, the zymotic death-rate during thesame period being 3’3 in London and 0’6 in Edinburgh.The fatal cases of whooping-cough, which had been 5 and 2in the preceding two weeks, were again 2 last week. The156 deaths in Dublin last week included 28 of infantsunder one year of age and 41 of persons aged upwards ofsixty years ; the deaths of infants corresponded with thenumber in the preceding week, while those of elderlypersons were below those recorded in any recent week.Seven inquest cases and 5 deaths from violence were

registered ; and 56, or more than a third, of the deathsoccurred in public institutions. The causes of 11, or nearly7 per cent., of the deaths in the city last week were notcertified..

‘

THE SERVICES.

MOVEMENTS OF THE MEDICAL STAFF.SURGEON-MAJOR ADAMS has been granted sick leave from

India. The following officers have arrived from India, oncompletion of a tour of service: Surgeon-Captains Cumminsand Russell. The arrival of Surgeon-Captain Hamilton atthe Cape is reported. Surgeon-Captain Saw has been trans-ferred from Liverpool to Chester, and Surgeon-Captain

Trotter has joined in Dublin for duty. Surgeon-Lieutenant.C. M. Fleury is posted to the Medical Division of the Royal!Victoria Hospital, Netley.

INDIA AND THE INDIAN MEDICAL SERVICES.The undermentioned officers of the Army Medical Staff;-’

expected from England for duty in India have been postedto the Bombay Command : Surgeon-Major Woodhouse, insuccession to Surgeon-Major Morris, transferred to the Bengal

Presidency, and Surgeon-Lieutenant Read, in succession to,Surgeon-Major B. W. Wellings. The appointment of Surgeon-Captain G. R Wills, Army Medical Staff, to the Bombay Com--mand is cancelled. Surgeon-Lieutenant-Colonel J. O’Brien,M.D., C.M., is appointed to be Professor of Surgery in the-,Medical College, Calcutta, and ex-officio first Surgeon to the,.College Hospital. Surgeon-Captain R. H. Charles, M.D.,M.Ch., F.R. C.S.I., Professor of Anatomy in the LahoreMedical College, is appointed to be Professor of Surgical andDescriptive Anatomy in the Medical College, Calcutta, andex-officio second Surgeon to the College Hospital. Surgeon-Captain J. C. Lamont, M.B., I.M.S. (Bengal), Civil Surgeonof Dhubri, Assam, is appointed to be Professor of Anatomyin the Lahore Medical College, from April 1st, 1894. Sur--

geon-Major W. G. H. Henderson, L.R.C.S., is appointed tobe Civil Surgeon, Superintendent, Lunatic Asylum, anc&

Superintendent, Medical School, Hyderabad, and Surgeon-Major H. W. Stevenson to be Civil Surgeon, Ahmednugger,.vice Surgeon-Major Henderson, continuing to act as Superin-tendent, Mahableshwar. The undermentioned Surgeon-Lieutenant-Colonels are promoted to Brigade-Snrgeon-Lieu--tenant-Colonels : R. C. Sanders, M.D., R. T. Wright, M.D.,and G. MacBride Davis, M.D. Brigade-Surgeon-Lieutenant-Colonel C. T. Peters, M.B., and Surgeon-Captain S. E. Prall,M.B., B.S., have respectively delivered over and received-Charge of the Bijapur District Gaol. Brigade-Surgeon-Lieutenant- Colonel D. F. Keegan, M.D., and Surgeon-Colonel E. 0. Tandy, retire from the service. The Queen’s.approval to the retirement of Surgeon-Lieutenant-ColonelJames Reid, Bengal Medical Establishment, and Brigade-Surgeon-Lieutenant-Colonel Edward Forster Drake-Brock-man, Madras Medical Establishment, appears in the London.Gazette, April 24th.

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Captain William Duncan, M.D., having vacatedhis Medical appointment in the Yeomanry Cavalry, ceases-

to be an Omcer of the Army Medical Reserve of Officers..Surgeon-Captain Charles Knott, 3rd (Duke of Connaught’e.Own) Volunteer Battalion, the Hampshire Regiment, to.be Surgeon-Major. Surgeon-Lieutenant Walter AlexanderAtkinson, M.B., lst Surrey Rifle Volunteer Corps, to be-Surgeon-Lieutenant.

NAVAL MEDICAL SERVICES.

Fleet-Surgeon W. B. Drew has been appointed to the-Mersey.

VOLUNTEER CORPS.

Royal -Engineers. The Tyne Division : Surgeon-LieutenantW. H. Brown, to be Surgeon-Captain.-Rifle : 2nd Volunteer-Battalion, the Essex Regiment: Sidney Arthur Mugford,Gent., to be Surgeon-Lieutenant.—1st Middlesex (Victoria.and St. George’s) : Surgeon-Major F. J. Pearse to be Surgeon--Lieutenant- Colonel.

DEATH IN THE SERVICES.

Surgeon-Colonel H. Wakefield, late of the Bombay Medical’Service, died on the 12th inst. in his sixty-fifth year.

ARMY MEDICAL SERVICE.There are several questions being discussed at the present.

time affecting the Army Medical Service-to wit, the want ofcontinuity of administration under a system which gives riseto such frequent changes of administrative medical officers ;the care of wounded in war ; the practical training of medical.officers and men of the Medical Staff Corps in the workingof field hospitals ; the conduct of official and professionalbusiness at the headquarters office of the department ; the-refusal of the Government of India to grant charge allowanceto medical officers in charge of large station hospitals of’that country, and other matters of a more subordinate-kind. With such a sheaf of subjects for consideration..and comment we can only touch upon one or two.Altogether the headquarters staff have a gocd manythings to occupy their attention at the present time.We think, and always have thought, that the principle-of selection for the upper ranks should be applied

1096 ORGANS OF ANIMALS IN THE TREATMENT OF DISEASE.

umore frequently than it is. It is in strict accordance with*the spirit and letter of the regulations ; it would act as astimulus for exertion, help to do away with the existing- dead-level condition of affairs, and tend to give a longer,tenure of office in the administrative ranks by the promotionof officers who had a longer time to serve before they werecompelled by age to retire. This would prevent to some"extent those constant changes which are now the subjectof frequent complaint. The system of selection is said tofacilitate favouritism and to be attended in practice with noond of difficulty in the way of opposition on the part of all,,officers who are passed over for promotion. Still, we do notthink that a pure system of seniority is consistent with either"efficiency or the intention of those who framed the warrants.Seniority is one of the factors to be considered, no doubt, but it:should not be the only or always the dominating one.

"We cannot take up all the other points at present, but weshould like to add that, in regard to one-viz., a charge payto medical officers in charge of large station hospitals inIndia-we are of opinion that it should be granted. The’introduction of the station hospital system into India saved..:the Government of that country a very large sum of money,and the head of the British Medical Service is stated to have

put this forward very strongly at that time. The work and

,.responsibility connected with the care and management of alarge station hospital in India are very great, and the officersfilling such posts certainly deserve to be rewarded for theirservices, which are of a special kind.

INDIAN FINANCE, SANITARY WORKS, AND MILITARY PAY.In the Indian Budget discussion at Calcutta on March 26th

’last General Brackenbury, the Military Member of Council,entered very fully into the subject of military expenditure inIndia under the three heads of Indian budget estimates,{military works, and special defence estimates. The pointof interest to medical and other officers and Governmentofficials generally is in regard to exchange compensationallowance. General Brackenbury thought it absolutely neces-sary that it should be given to all the officers of the army.In the days of the Honourable East India Company theBritish pay was converted into Indian currency at the rateof 2s. 6d. to the rupee. With the rupee at or below ls. 3d.,as at present, he pointed out that the rate of pay hadfallen 50 per cent. and that of allowances upwards of.37 per cent. So great was the hardship from which officerswere suffering that some measure of relief had become, notonly an act of elementary justice, but of absolute necessity.The cost also of living in India to a British officer had risenrather than fallen. As everyone knows, India is at the

- :present time in a state of great financial depression, and theanost rigid system of economy must be the policy of theIndian Government for some time to come. There is a greatreduction in the estimate for military works ; but there arecertain things which must, nevertheless, be done. The moreurgent demands of sanitary science will have to be met some-how if the health of troops, native and European, is to be’conserved. Suitable accommodation in the way of barracksand huts and a pure water-supply are essentially necessary.Practically no new works can be undertaken, and there willbe an almost complete stoppage of sanitary improvementsthat are not very pressing until the financial difficulties of,India are relieved or removed.

SCALE OF INVALID PENSIONS.

The Times of India of the 7th inst. publishes the scale ofinvalid pensions for the Indian Staff Corps and IndianMedical Service. We are only concerned, however, with the’latter. An officer who has become invalided for furtherservice in India on account of unfitness caused by duty may,after he has been two years on the temporary half-pay list,be granted an invalid pension according to the following.scale :

It is stated that Surgeon-Major F. F. Perry, Professor of Surgery, and Surgeon-Captain R. H. Charles, Professor ofAnatomy, in this college, are about to vacate their presentappointments for others in the Calcutta Medical College.

THE MEDICAL STAFF CORPS AND ARMY MOBILISATION.Our readers will have seen that Mr. Campbell-Bannerman,

in reply to a question by Mr. Arnold Forster in the House ofCommons, stated that arrangements had been made for fourfield hospitals and four bearer companies at Aldershot thissummer, which were to be on a war footing, except in regardto the number of horses. The War Minister added that thiswould be as much as could be done, and as near an approachto mobilisation as could be under existing conditions. Thisis unquestionably a step in the right direction. The acquisi-tion of experience in the working of field hospitals is anessential matter.

Surgeon-Major-General John Pinkerton, M.D., BombayRetired List, has been appointed Honorary Physician to theQueen, in the place of the late Deputy Surgeon-GeneralW. Walker, M.D.Two field hospitals and two bearer companies will train at

Aldershot during the latter half of next month, and a similartraining will take place in the first half of June. Thismeasure is specially designed to meet the long-felt want ofpractising medical officers in the duties that would be requiredof them on mobilisation.

Correspondence.

ORGANS OF ANIMALS IN THE TREATMENTOF DISEASE.

" Andi alteram partem."

To the Editors of THE LANCET.

SIRS,—In the admirable lecture on pharmacology by myfriend Professor Stokvis, published in THE LANCET ofApril 21st, he observes that ten years ago it was not

"imagined that the essential extracts of the organs ofanimals, of which the late Professor Brown-Sequard andM. C. Paul were the earliest to explain the therapeutic value,would find a place in materia medica nor cultures ofmicrobes." I think that Professor Stokvis would not havemade this statement in so unqualified a form had he beenacquainted with some observations that I made in 1873.1 Pro-fessor Stokvis is so well read in medical literature that if heis not acquainted with my observations I may take it for

granted that no one else is, and I may therefore be excusedfor bringing them forward again, especially as I believe theattempts I then made to treat diabetes were the first inwhich the cure of a disease was sought to be effected by theadministration of ferments or, as they would now be

called, enzymes, derived from solid organs and notfrom glands connected with the digestive canal. Aftergiving my reasons for believing that diabetes is due insome cases to the non-decomposition of sugar in the bodyfrom the want of a ferment, I shortly stated my observationsand the result in the following passage: "Several monthsago I attempted to increase the decomposition of sugar indiabetics by supplying the ferment which I supposed to bewanting. Since sugar is probably decomposed chiefly in themuscles, the ferment which splits it up is probably containedto a much greater extent in them than in any other part ofthe body. By giving the patient raw meat we may hope thatthe ferment contained in it will be absorbed from the intes-tine into the blood and there act on the sugar. It is necessarythat the meat be given raw, for the heat to which meat isexposed in cooking completely destroys all ferments. The

patients on whom I tried this plan of treatment were underthe care of Drs. Black, Andrew, and Duckworth, and I take thisopportunity of expressing my thanks to these gentlemen forthe readiness with which they afforded me the means ofmaking observations and their kindness in supplying me withevery facility, as well as to Messrs. Russell and Sawtell forthe assistance they rendered me. The meat was finelychopped up in a sausage-machine, mixed with pepperand salt, and was either spread on bread and’ bntter,German fashion, or was made into a paste with bread andmilk. Shortly after I began the treatment of one case

I learned from Dr. Duckworth that it had been tried empiri-cally with complete success by the captain of a merchant

1 Brit. Med. Journ., Jan. 3rd and 10th and Feb. 21st, 1874.