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Pilkington Special Orthopaedic Hospital at St. Helens wasexhibited by Dr. James Kerr, who explained the work ofthe hospital, and especially dealt with the system of record-ing the improvement of patients; he stated that the menwere greatly encouraged by watching the progress shownupon the records. An illustrated lecture on bee-keeping fordisabled men was delivered by Mr. H. Steven, of the ErskineHospital, Glasgow. Allusion has already been made tothe films showing the Italian method of the treatment of thestump in arm operations.The British films, shown chiefly by Mr. A. B, Malden,

included pictures of Roehampton, Brighton, the trainingworkshops for diamond cutting and polishing, the Prince ofWales’s Hospital, Cardiff, St. Dunstan’s, and the hand-loomweaving of "Blighty" " cloth at Gorgie, near Edinburgh.where the factory is being staffed entirely by disabledsoldiers, who are now being turned into expert weavers of

, doth. Films were also shown of the Lord Roberts Workshopsand Golders Green Home of Recovery.The French films included some remarkable pictures of

what has been accomplished by fitting artificial limbs to menwith double amputations by Dr. Gourdon, of Bordeaux.

The work of Canada for disabled men was explained byMajor McKeen by means of films well in keeping with therest- of the Canadian work.

’

GENERAL IMPRESSIONS.

. The impression gained by a visit to the Conference and

Exhibition was that they had adequately served their purposeof achieving an exchange of knowledge and views amongthose chiefly concerned in promoting the welfare of thedisabled men of the Allied Armies. Our French allies,owing to the existence of large trained forces, were beforeus in the field of remedial treatment, and have much whichwe can study and apply with advantage to our own conditions.The Italian work shows originality and thoroughness, whilethe Belgian work is almost beyond praise. Belgium had,of course, in its occupational training the experience ofCharleroi to draw upon; how well it has been utilised theexhibition of the work from Port Villez and Ste. Adresseshows. Our Dominions have also been able to teach uslessons, but there is now every indication that although wein this country started late we shall not allow ourselves to bebeaten in friendly rivalry on behalf of disabled fighting men.

URBAN VITAL STATISTICS.

VITAL STATISTICS OF LONDON DURING MAY, 1918. IIN the accompanying table will be found summarised complete

statistics relating to sickness and mortality in the City of London and in each of the metropolitan boroughs. With regard to thenotified cases of infectious disease it appears that the number ofpersons reported to be suffering from one or other of the tendiseases specified in the table was equal to an annual rate of4-1 per 1000 of the population, estimated at 4,026,901 persons ; inthe three preceding months the rates had been 4-8, 4’9, and 3’9 per1000. The lowest rates in May were recorded in Kensington, Chelsea,St. Marylebone, Hampstead, Holborn, and the City of London; andthe highest rates in Bethnal Green, Stepney, Southwark, Bermondsey,Deptford, and Greenwich. Three cases of small. pox were notified i

during the month, against 5, 21, and 4 in the three preceding imonths; of these. 2 belonged to Stepney and 1 to Islington.The cases of small-pox under treatment in the MetropolitanAsylums Hospitals at the end of the month numbered 3. against5, 30, and 13 at the end of the three preceding months. Theprevalence of scarlet fever was about equal to that in the precedingmonth ; this disease was proportionally most prevalent in Finsbury, ISouthwark, Bermondsey, Lambeth, Battersea, Deptford, and Woolwich.

The Metropolitan Asylums Hospitals contained 786 scarlet feverpatients at the end of the month, against 961, 931, and 898, at the endof the three preceding months; the weekly admissions averaged 129,against 111,132, and 105 in the three preceding months. The prevalenceof diphtheria was about equal to that in the preceding month; thegreatest proportional prevalence of this disease was recorded inPaddington, Shoreditch, Stepney,. Bermondsey, Deptford, andGreenwich. The number of diphtheria patients under treatment inthe Metropolitan Asylums Hospitals, which had been 1665, 1529, and1358 at the end of the three preceding months, numbered 1232 at theend of May; the weekly admissions averaged 202, against 211. 182,and 143 in the three preceding months. The prevalence of entericfever was about equal to that in the three preceding months; ofthe 36 cases notified in May, 6 belonged to Wandsworth, 5 toIslington, 3 to Camberwell, and 3 to Lewisham. There were 32 casesof enteric fever under treatment in the Metropolitan Asylums Hos-pitals at the end of the month, against 28, 23, and 23 at the end ofthe three preceding months ; the weekly admissions averaged 5.against 5, 3, and 3 in the three preceding months. Erysipelaswas proportionally most prevalent in Paddington, St. Pancras, StokeNewington, Shoreditch, Bethnal Green, Southwark, and Deptford.The 18 cases of puerperal fever included 4 in Hacknev, 4 in Wands-worth, 3 in Woolwich, 2 in Stepney, and 2 in Lambeth. Of the 22

cases of cerebro-spinal meningitis, 4 belonged to Hammersmith, 3 toANALYSIS OF SICKNESS AND MORTALITY STATISTICS IN LONDON DURING MAY, 1918.

(Specially compiled for THE LANCET.)

* Including membranoUII croup.

921

Fulham, 3 to Lambeth, and 2 to Camberwell ; while of the 8 cases ofpoliomyelitis 2 belonged to Stepney.The mortality statistics in the table relate to the deaths of persons

actually belonging to the several boroughs, the deaths occurring ininstitutions having been distributed among the boroughs in whichthe deceased persons had previously resided. During the five weeksended June 1st the deaths of 5306 London residents were registered,equal to an annual rate of 13.7 per 1000; in the three precedingmonths the rates had been 16-8, 18-1, and 17-1 per 1000. The death-rates in May ranged from 9’5 in Hampstead, 10’5 in Lewisham, 10’6in Wandsworth, 10’8 in Deptford, and 10-9 in Woolwich, to 16-2 inHolborn, 16.7 in Chelsea. 16’8 in Bethnal Green, 17’7 in Bermondsey,18’1 in the City of London, 18°9 in Finsbury, and 19’8 in Southwark.The 5306 deaths from all causes included 590 which were referredto the principal infectious diseases; of these, 252 resulted frommeasles, 8 from scarlet fever, 44 from diphtheria, 233 fromwhooping-cough, 5 from enteric fever, and 48 from diarrhoea andenteritis among children under 2 years of age. No death from anyof these diseases was recorded during the month in the City of London.Among the metropolitan boroughs the lowest death-rates from thesediseases were recorded in Kensington, the City of Westminster,Hampstead, Holborn. Wandsworth, and Lewisham ; and the highestdeath-rates in Fulham, S12oreditch, Bethnal Green, Stepney, South-wark, and Bermondsey. The 252 deaths from measles were 45 abovethe average number in the corresponding period of the five precedingyears ; this disease was proportionally most fatal last month inFulham, Bethnal Green, Southwark, Bermondsev. Lambeth, andBattersea. The 8 fatal cases of scarlet fever were 10 below the averagenumber; 2 belonged to Lewisham. The 44 deaths from diphtheria agreed with the average, and included 6 in Camberwell, 4 in St. IPaucras. 4 in Hackney, 4 in Bermondsey, and 4 in Lambeth. Themortality from whooping-cough was lower than in any precedingmonth of the present year, but still showed a large excess overthe average, the deaths from this disease numbering 233 againstan average of 121 ; this disease was proportionally most fatal inSt Paucras, Finsbury, Shoreditch, Bethnal Green, Southwark,and Greenwich. The deaths from enteric fever numbered 5, againsta corrected average of 8 ; 2 deaths belonged to Islington. The48 fatal cases of diarrhoea and enteritis among children under2 years of age showed a decline of 39 from the average; 6 deathsbelonged to Stepney, 6 to Wandsworth, 4 to St. Pancras, 3 toKensington, and 3 to Southwark. In conclusion, it may be stated thatthe aggregate mortality in London in May from these principalinfectious diseases was 22 per cent. above the average.

(Week ended June 22nd, 1918.)English and TYelsh Towns.-In the 96 English and Welsh towns,

with an aggregate civil population estimated at 16,500,000 persons,the annual rate of mortality was 11-7, against rates declining from15’0 to 11’4 per 1000 in the six preceding weeks. In London, witha population slightly exceeding 4,000.000 persons, the death-ratewas 120, or 1’0 per 1000 above that recorded in the previous week;among the remaining towns the rates ranged from 5’1 in Halifax,5-5 in Enfield, and 5.6 in Ilford, to 17-1 in Gateshead, 17-7 inSunderland, and 17’9 in Middlesbrough. The principal epidemicdiseases caused 283 deaths, which corresponded to an annual rateof 0-9 per 1000. and included 117 from measles, 73 from whooping-cough, 37 from diphtheria, 35 from infantile diarrhoea, 11 from scarletfever, and 10 from enteric fever. Measles caused a death-rate of 1-8 inSunderland, 19 in Birkenbead and in Hull, and 5’4 in Barnsley; andwhooping-cougb of 1’5 in Warrington and in Sunderland, and 1’8 inWalsal!. The 827 cases of scarlet fever and 1193 of diphtheria undertreatment in the Metropolitan Asylums Hospitals and the LondonFever Hospital were 28 and 7 above the respective numbers remain-ing at the end of the previous week. Of the total deaths in the96 towns 122 resulted from violence. The causes of 39 deaths wereuncertified, of which 9 were registered in Birmingham, 4 in SouthShields, and 3 each in Southend-on-Sea, St. Helens, and Gateshead.Scotch Towns.-In the 16 largest Scotch towns, with an aggregate

population estimated at nearly 2,500,000 persons, the annual rate ofmortality was 11’8, against rates declining from 17’0 to 10-9 per 1000in the five preceding weeks. The 260 deaths in Glasgow corre-sponded to an annual rate of 12’2 per 1000, and included 19 frommeasles, 8 from whooping-eough, 4 from infantile diarrhoea. 3 fromdiphtheria, and 1 from scarlet fever. The 72 deaths in Edinburghwere equal to a rate of 11’3 per 1000, and included a fatal case eachof measles, scarlet fever, and infantile diarrhcea.

Irish Towns.-The 129 deaths in Dublin corresponded to an annualrate of 16 9, or 0’1 per 1000 below that recorded in the previous week, andincluded 3 from infantile diarrhoea, 2 from whooping-cough, and 1 fromdiphtheria. The 191 deaths in Belfast were equal to a rate of 25’3 per1000, and included 9 from whooping-cough, 2 from measles, and 1 frominfantile diarrhoea.

LEEDS UNIVERSITY.-At a meeting of the Council,held on June 19th, Captain M. J. Stewart, M.B. Glasg.,M.R.C.P. Lond., was elected Professor of Pathology andBacteriology in the University. Captain Stewart wasappointed in 1910 clinical pathologist at the Leeds GeneralInfirmary, and in 1912 honorary demonstrator in clinicalpathology at the University.THE LATE DR. MALCOLM MACKINTOSH.-Dr.

Mackintosh, who died at his residence, Frankfort House,West Side, Clapham Common, on June 18th, a well-knownpractitioner in South London, was educated at the Univer-sity of Glasgow, where he graduated M.B., C.M., withcommendation, in 1880, taking the M.D. degree in 1893. Hewas an ex-president of the South-West London MedicalSociety and physician to the Hostel of God, ClaphamCommon. His contributions to THE LANCET included a Case of Empyema, Primary Sarcoma of the Kidney, and Pancreatic Glycosuria, which he wrote in the years 1895-96.

Correspondence.

THE BELGIAN DOCTORS’ AND PHARMACISTS’RELIEF FUND.

" Audi alteram partem."

To the Editor of THE LANCET.

SIR,-I am writing on behalf of the distressed doctors andpharmacists in Belgium, whose need at the present time issore. In the early days of the war there was a generousresponse to our appeal. Nearly .620,000 was subscribed ;but this is almost exhausted, and although you, Sir, keepthe matter constantly and vividly before us, there is nowlittle or no dancing to your piping.

In 1916, at the earnest entreaty of Mr. Herbert Hoover,who at that time was the Director of the Commission forRelief in Belgium, we began to send every month £800 to acommittee in Brussels called the Aide et Protection auxMedecins et Pharmaciens Sinistres Belges. These monthlyremittances were continued until December, 1917, but sincethen they have been reduced to £400, and if we cannot raisemore funds even these must stop after July of this year.Do British doctors and pharmacists really know-1. That money is urgently needed ’?2. That it goes to Belgium and not to doctors and

pharmacists in this country ?3. That it really reaches the Belgians and is not grabbed

by the Germans ?If they did I cannot believe that they would allow the

stoppage of these remittances, even though their own pursesmay be light and the prices of all commodities may beconstantly rising.

In order to satisfy those who are holding back becausethey are uncertain on these points, we have obtained themost recent information from the Commission for Relief in

Belgium. Writing on June 18th, Mr. Lewis Richards, theAssistant Director, says :-" There has been no change in the method of sending in

these subsidies, a method with which your society is alreadyfamiliar. I need hardly remark that the charities thus inreceipt of subsidies through our channels are most carefullyadministered, and there is no possibility of any leakage onthe way. I would like, however, to repeat, nor can weemphasise this point too strongly, that the need of help forBelgium grows with every day, and the reports which wereceive from all branches of the work are nothing short ofheartrending. In this connexion we think you will beinterested in reading an appeal which we recently receivedfrom a commission of doctors in Belgium asking for variousmedicines. You will see from this letter the difficultiesagainst which the medical profession in all its branches haveto contend.Your Fund is one which reaches a class which cannot be

helped in any other way. For the most part the professionalmen are too proud to come to the public soup-kitchens, andafter four years of terrible privation, any little savings whichthey may have had are by now exhausted. But they will,and do, most gratefully receive help from your Fund, andwith the assistance thus given them goes a most comfortingfeeling that their happier colleagues overseas are notforgetting them, a feeling which brings moral support, asthe money brings them material comfort.We most warmly beg you to continue your splendid

support to the Belgian doctors and pharmacists, whoseMed is unquestionably terrible and whose gratitude, althoughander present conditions it cannot be expressed directly toyou, is most real and heart-felt."

The appeal which be encloses is a request "for the

lmportation into Belgium of a certain amount of medicalsupplies of both vegetable and chemical origin of whichthere is a total lack, and the absence of which constitutesa real danger to the public health." It is backed by a)recise explanation of the manner in which the needs ofihe population are gauged and the way in which thelistribution is carried out.This supplies an excuse for approaching the general public,

which our committee are now reluctantly compelled to do.a has been asked why the public should assist the medicalnore than any other profession, but it may be answered thathe existence of doctors and the supply of drugs are essentialo the public welfare. May I suggest that if your readersvould not only themselves give what they can spare, but