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VITAL STATISTICS

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49 Lookíng Back. FROM THE LANCET, SATURDAY, Jan. 3rd, 1829 SECALE CORNUTUM. To the Editor of THE LANCET. SIR,-The following case, the treatment of which, though some may be induced to censure, I consider may be useful to the profession at large, I submit to your disposal. A lady, in the sixth month of pregnancy, after some pre- monitory symptoms, which had then vanished, was suddenly seized with labour, and as her medical attendant resided at some distance, a neighbouring practitioner was called in. The fœtus was quickly born ; but, unluckily, in attempting the extraction of the placenta, which adhered very firmly, the umbilical cord was broken near, if not at its placental extremity. After some time the pains left, and the Doctor also ; one, two, three, and even five days passed, yet still the placenta was retained, and was evidently a source of con- i siderable irritation. It was absolutely necessary that some- ’, thing should be done ; and having heard of the extraordi- nary effects of the secale cornutum on the uterus it was determined to give it a trial. Accordingly four scruples were boiled, in four ounces of water, down to two, and half an ounce given every half hour, until some effect was produced. Two doses occasioned a very slight pain only; but, after the third, the uterus acted most powerfully, ex- pelling a quantity of coagula, together with the after-birth. The patient remained in a very weak state, but soon re- covered, and, in most expressive language, extolled this invaluable medicine. The pains, she observed, were of a severer kind, and gave considerably more torture than any experienced during previous confinements. This, probably, might be owing to the revival of the action of the uterus so soon after delivery, which always produces some soreness of that organ, and also to the presence of a substance, which though formerly natural, had become foreign to the cavity. It has been said that the ergot becomes inert by keeping ; that used in this instance was above twelve months old, and it certainly possessed all its virtues. That it varies in quality, seems much more plausible. Dec. 6, 1828. ________________ M. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN 76 of the largest English towns 8707 births and 5780 deaths were registered during the week ending Dec. 22nd, 1906. The annual rate of mortality in these towns, which had been equal to 15.8 and 17’4 per 1000 in the two preceding weeks, further rose during the week to 19’1. During the first twelve weeks of the past quarter the death-rate in these towns averaged 15 - 9 per 1000 ; the rate during the same period in London was 15’6. The lowest death-rates in the 76 towns during the week under notice were 5’7 in King’s Norton, 6. 7 in Northampton, 7. 8 in Hornsey, and 9’6 in Tyne mouth ; the rates in the other towns ranged upwards to 25’ 9 in Oldham, 26 - 0 in Newport, 28-3 in Smethwick, and 30 5 in Rochdale. The 5780 deaths in the 76 towns showed a further increase of 509 upon the low numbers returned in recent weeks, and included 425 which were referred to the principal epidemic diseases, against 399 and 411 in the two preceding weeks ; of these, 166 resulted from measles, 76 from whooping-cough, 62 from diphtheria, 46 from diarrhoea, 42 from scarlet fever, 33 from " fever " (principally enteric), and not one from small-pox. The deaths from these epidemic diseases were equal to an annual rate of 1 - 4 per 1000 in the 76 towns; the rate did not exceed 1-1 in London. No death from any of these diseases was returned last week in Northampton, York, Blackburn, Merthyr Tydfil, or in seven other of the 76 towns; the annual death-rates therefrom, however, ranged upwards to 5’ 3 in Warrington, 6’0 in Wigan, 7 . 0 in South Shields, and 9’4 4 in Rotherham. The fatal cases of measles, which had be3n 114, 121, and 128 in the three preceding weeks, further rose during the week to 166 ; the highest annual rates from this disease in the 76 towns were 3’ 3 in Oldham, 3’ 8 in Warrington, 4’ 3 in Rotherham, and 4. 8 in Wigan. The 76 deaths from whooping-cough also showed a further con- siderable increase upon recent weekly numbers ; they were proportionally most numerous in Preston, Middlesbrough, South Shields, and Rotherham. The deaths referred to diphtheria, on the other hand, showed a further decline; this disease caused, however, annual rates equal to 1 ’5 both in Grimsby and Warrington, 1. 6 in Smethwick, and 4’ 6 in Reading. The fatal cases of diarrhoea also showed a further declive. Scarlet fever caused the highest death-rates in Handsworth and Rotherham and "fever " the highest rate in Wigan. No case of small-pox has been under treatment in the Metropolitan Asylums Hospitals since the end of June last. The number of scarlet fever patients under treatment in the Metropolitan Asylums Hospitals and in the London Fever Hospital, which had been 4063 and 3988 in the two preceding weeks, further declined to 3807 at the end of the week under notice ; 334 new cat es were admitted to these hospitals during the week, against 419 and 359 in the two previous weeks. The deaths in London referred to pneumonia and other diseases of the respiratory organs, which had been 312, 345. and 408 in the three preceding weeks, further rose to 543 in the week under notice, and exceeded the corrected average in the corresponding week of the last four years, 1902-05, by 132; 82 deaths were also referred to influenza. The causes of 51, or 0’9 per cent., of the deaths registered during the week were not certified either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in London, Manchester and Salford, Leeds, West Ham, New- castle-on-Tyne, and in 43 other of the 76 towns; the pro- portion of uncertified deaths, however, again showed a considerable proportional excess in Liverpool, Birmingham, Wanington, St. Helen’s, and South Shields. In 76 of the largest English towns 5721 births and 5988 deaths were registered during the week ending Dec. 29th. The normal rate of mortality in these towns, which had been equal to 15 - 8, 17 - 4, and 19’1 1 per 1000 in the three pre- ceding weeks, further rose last week to 19-7. During the 13 weeks of the past quarter the death-rate in these towns averaged 16 - 2 per 1000 ; the rate during the same period in London was 16’ 0. The lowest death-rates in the 76 towns during the week under notice were 9. 8 in Handsworth, 10’ 6 in Devonport, 11’ 3 in Grimsby, and 11 - 6 in Willesden ; ;. the rates in the other towns ranged upwards to 28’ 8 in Newport, 29’ 0 in Rotherham, 29’ 9 in Merthyr Tydfil, and 31’ 7 in Rochdale. The 5988 deaths in the 76 towns showed a further increase of 208 upon the numbers returned in recent weeks and included 430 which were referred to the principal epidemic diseases, against 411 and 425 in the two preceding weeks ; of these, 136 resulted from measles, 89 from wht oping-cough, 84 from diphtheria, 53 from diarrhoea, 40 from scarlet fever, 27 from " fever" (principally enteric). and one from small-pox. The deaths from these epidemic diseases were equal to an annual rate of 1 - 4 per 1000 in the 76 towns, corresponding with the rate in each of the two preceding weeks ; the rate in London from the same ; diseases was l’ 3. No death from any of these diseases was returned last week in Burnley, Stockport, Northampton, York, or in ten other of the 76 towns ; the annual death rates ! thetefrcm, however, ranged upwards to 3’5 in Merthyr Tydfil, 3. 6 in Wigan, 4. 0 in Norwich, 4’1 1 in Oldham, and 6’ 0 in Hull. The fatal cases of measles showed a decline from the high number in the previous week, but showed a i marked excess in Rochdale, Oldham, Wigan, and Hull. The . deaths from whooping-cough were proportiorally mcst . numerous in East Ham, Norwich, and Willesden. The 84 fatal cases of diphtheria again showed an increase, and tbe fatality of this disease was most marked in Wolverhampton, i Blackburn, Rhondda, and Walthamstow. The deaths attributed to diarrhoea showed a further decline from recent , weekly numbers, but were in marked excess in Merthyr : Tydfil. The death-rates both from scarlet fever and i "fever" were generally below the average ; three deaths . from "fever" were, however, recorded in Rhondda. The l fatal case of small-pox occurred in Hull. No case of small- pox has been under treatment in the Metropolitan Asylums l Hospitals since the end of June last. The number of scarlt t I fever patients under treatment in the Metropolitan Asylums l Hospitals and in the London Fever Hospital, which bad l been 4063, 3988. and 2807 in the three preceding weeks, r rose again to 3846 at the end of the week under notice ;
Transcript

49

Lookíng Back.FROM

THE LANCET, SATURDAY, Jan. 3rd, 1829

SECALE CORNUTUM.

To the Editor of THE LANCET.

SIR,-The following case, the treatment of which, thoughsome may be induced to censure, I consider may be useful tothe profession at large, I submit to your disposal.A lady, in the sixth month of pregnancy, after some pre-

monitory symptoms, which had then vanished, was suddenlyseized with labour, and as her medical attendant resided atsome distance, a neighbouring practitioner was called in.The fœtus was quickly born ; but, unluckily, in attemptingthe extraction of the placenta, which adhered very firmly,the umbilical cord was broken near, if not at its placentalextremity. After some time the pains left, and the Doctoralso ; one, two, three, and even five days passed, yet still theplacenta was retained, and was evidently a source of con- isiderable irritation. It was absolutely necessary that some- ’,thing should be done ; and having heard of the extraordi-nary effects of the secale cornutum on the uterus it wasdetermined to give it a trial. Accordingly four scrupleswere boiled, in four ounces of water, down to two, andhalf an ounce given every half hour, until some effect wasproduced. Two doses occasioned a very slight pain only;but, after the third, the uterus acted most powerfully, ex-pelling a quantity of coagula, together with the after-birth.The patient remained in a very weak state, but soon re-

covered, and, in most expressive language, extolled thisinvaluable medicine. The pains, she observed, were of aseverer kind, and gave considerably more torture than anyexperienced during previous confinements. This, probably,might be owing to the revival of the action of the uterus sosoon after delivery, which always produces some soreness ofthat organ, and also to the presence of a substance, whichthough formerly natural, had become foreign to the cavity.

It has been said that the ergot becomes inert by keeping ;that used in this instance was above twelve months old, andit certainly possessed all its virtues. That it varies in

quality, seems much more plausible.Dec. 6, 1828.

________________

M.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8707 births and 5780deaths were registered during the week ending Dec. 22nd,1906. The annual rate of mortality in these towns,which had been equal to 15.8 and 17’4 per 1000 inthe two preceding weeks, further rose during the weekto 19’1. During the first twelve weeks of the pastquarter the death-rate in these towns averaged 15 - 9per 1000 ; the rate during the same period in Londonwas 15’6. The lowest death-rates in the 76 towns

during the week under notice were 5’7 in King’s Norton,6. 7 in Northampton, 7. 8 in Hornsey, and 9’6 in Tynemouth ; the rates in the other towns ranged upwards to 25’ 9in Oldham, 26 - 0 in Newport, 28-3 in Smethwick, and 30 5in Rochdale. The 5780 deaths in the 76 towns showed afurther increase of 509 upon the low numbers returned inrecent weeks, and included 425 which were referred to theprincipal epidemic diseases, against 399 and 411 in the twopreceding weeks ; of these, 166 resulted from measles, 76from whooping-cough, 62 from diphtheria, 46 from diarrhoea,42 from scarlet fever, 33 from " fever " (principally enteric),and not one from small-pox. The deaths from these epidemicdiseases were equal to an annual rate of 1 - 4 per 1000 inthe 76 towns; the rate did not exceed 1-1 in London.No death from any of these diseases was returnedlast week in Northampton, York, Blackburn, MerthyrTydfil, or in seven other of the 76 towns; the annualdeath-rates therefrom, however, ranged upwards to 5’ 3in Warrington, 6’0 in Wigan, 7 . 0 in South Shields, and9’4 4 in Rotherham. The fatal cases of measles, which hadbe3n 114, 121, and 128 in the three preceding weeks, further

rose during the week to 166 ; the highest annual rates fromthis disease in the 76 towns were 3’ 3 in Oldham, 3’ 8 inWarrington, 4’ 3 in Rotherham, and 4. 8 in Wigan. The76 deaths from whooping-cough also showed a further con-siderable increase upon recent weekly numbers ; they wereproportionally most numerous in Preston, Middlesbrough,South Shields, and Rotherham. The deaths referred to

diphtheria, on the other hand, showed a further decline;this disease caused, however, annual rates equal to 1 ’5 bothin Grimsby and Warrington, 1. 6 in Smethwick, and 4’ 6 inReading. The fatal cases of diarrhoea also showed a furtherdeclive. Scarlet fever caused the highest death-rates inHandsworth and Rotherham and "fever " the highest rate inWigan. No case of small-pox has been under treatmentin the Metropolitan Asylums Hospitals since the end ofJune last. The number of scarlet fever patients undertreatment in the Metropolitan Asylums Hospitals and in theLondon Fever Hospital, which had been 4063 and 3988 inthe two preceding weeks, further declined to 3807 at theend of the week under notice ; 334 new cat es were admittedto these hospitals during the week, against 419 and 359 inthe two previous weeks. The deaths in London referred topneumonia and other diseases of the respiratory organs,which had been 312, 345. and 408 in the three precedingweeks, further rose to 543 in the week under notice, andexceeded the corrected average in the corresponding weekof the last four years, 1902-05, by 132; 82 deaths werealso referred to influenza. The causes of 51, or 0’9 percent., of the deaths registered during the week were notcertified either by a registered medical practitioner or bya coroner. All the causes of death were duly certified inLondon, Manchester and Salford, Leeds, West Ham, New-castle-on-Tyne, and in 43 other of the 76 towns; the pro-portion of uncertified deaths, however, again showed aconsiderable proportional excess in Liverpool, Birmingham,Wanington, St. Helen’s, and South Shields.

In 76 of the largest English towns 5721 births and 5988deaths were registered during the week ending Dec. 29th.The normal rate of mortality in these towns, which had beenequal to 15 - 8, 17 - 4, and 19’1 1 per 1000 in the three pre-ceding weeks, further rose last week to 19-7. During the13 weeks of the past quarter the death-rate in these townsaveraged 16 - 2 per 1000 ; the rate during the same period inLondon was 16’ 0. The lowest death-rates in the 76 townsduring the week under notice were 9. 8 in Handsworth,10’ 6 in Devonport, 11’ 3 in Grimsby, and 11 - 6 in Willesden ; ;.the rates in the other towns ranged upwards to 28’ 8 inNewport, 29’ 0 in Rotherham, 29’ 9 in Merthyr Tydfil, and31’ 7 in Rochdale. The 5988 deaths in the 76 towns showeda further increase of 208 upon the numbers returned inrecent weeks and included 430 which were referred to theprincipal epidemic diseases, against 411 and 425 in the twopreceding weeks ; of these, 136 resulted from measles, 89from wht oping-cough, 84 from diphtheria, 53 from diarrhoea,40 from scarlet fever, 27 from " fever" (principally enteric).and one from small-pox. The deaths from these epidemicdiseases were equal to an annual rate of 1 - 4 per 1000 in the76 towns, corresponding with the rate in each of the twopreceding weeks ; the rate in London from the same

; diseases was l’ 3. No death from any of these diseases wasreturned last week in Burnley, Stockport, Northampton,York, or in ten other of the 76 towns ; the annual death rates

! thetefrcm, however, ranged upwards to 3’5 in MerthyrTydfil, 3. 6 in Wigan, 4. 0 in Norwich, 4’1 1 in Oldham, and6’ 0 in Hull. The fatal cases of measles showed a declinefrom the high number in the previous week, but showed a

i marked excess in Rochdale, Oldham, Wigan, and Hull. The. deaths from whooping-cough were proportiorally mcst. numerous in East Ham, Norwich, and Willesden. The 84

fatal cases of diphtheria again showed an increase, and tbefatality of this disease was most marked in Wolverhampton,

i Blackburn, Rhondda, and Walthamstow. The deathsattributed to diarrhoea showed a further decline from recent

, weekly numbers, but were in marked excess in Merthyr: Tydfil. The death-rates both from scarlet fever andi "fever" were generally below the average ; three deaths. from "fever" were, however, recorded in Rhondda. Thel fatal case of small-pox occurred in Hull. No case of small- pox has been under treatment in the Metropolitan Asylumsl Hospitals since the end of June last. The number of scarlt tI fever patients under treatment in the Metropolitan Asylumsl Hospitals and in the London Fever Hospital, which badl been 4063, 3988. and 2807 in the three preceding weeks,r rose again to 3846 at the end of the week under notice ;

50

237 new cases were admitted to these hospitals during theweek, against 419, 359, and 334 in the three previous weeks.The deaths in London referred to pneumonia and otherdiseases of the respiratory organs which had steadilyincreased in the four preceding weeks from 312 to 543,further rose to 561 in the week under notice, and exceededthe corrected average in the corresponding week of the lastfour years by 129 ; 55 deaths were referred to influenzaagainst 82 in the previous week. The causes of 88, or

l’ 5 per cent., of the deaths registered during the week werenot certified either by a registered medical practitioner or bya coroner. All the causes of death were duly certified inLeeds, Bristol, West Ham, Newcastle-on-Tyne, and in 43other of the 76 towns ; the proportion of uncertified deaths,however, again showed a considerable proportional excess inLiverpool, Birmingham, Sunderland, Bootle, St. Helen’s,Tynemouth, and King’s Norton.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in eight of the principalScotch towns, which had been equal to 18’ 4 and 18’1 1 per1000 in the two preceding weeks, rose again to 19’ 9 inthe week ending Dec. 22nd, and exceeded by 0 - 8 the meanrate during the same week in the 76 English towns. The ratesin the eight Scotch towns ranged from 12’ 0 and 17’ 9 inLeith and Edinburgh to 21 - 1 in Perth and 25’ 3 in Dundee.The 681 deaths in the eight towns showed an increase of 61upon the number in the previous week and included 69which were referred to the principal epidemic diseases,against 68 and 55 in the two previous weeks. These 69 deathswere equal to an annual rate of 2’ 0 per 1000, which ex-ceeded by 0. 6 the rate from the same diseases in the 76English towns ; they included 19 which were referred towhooping-cough, 21 to diarrhoea, 11 to diphtheria, seven to"fever," six to scarlet fever, five to measles, and not oneto small-pox. The 19 fatal cases of whooping-cough showedan increase on recent weekly numbers, and included 14 inGlasgow and two in Aberdeen. The 21 deaths referred todiarrhoea also showed an increase ; nine occurred in Glasgow,four in Dundee, three in Edinburgh, and two in Aberdeen.Of the 11 deaths from diphtheria, five were returned in

Glasgow and three in Dundee. All the seven deaths referredto "fever " were returned in Glasgow, and included five certi-fied as cerebro-spinal meningitis. The fatal cases of scarletfever included two both in Glasgow and in Dundee ; andthree of the five deaths from measles occurred in Abardeen.The deaths in the eight towns referred to diseases of therespiratory organs, including pneumonia, which had been126 and 133 in the two preceding weeks, declined againduring the week under notice to 119, and were 11 below thenumber returned in the corresponding week of last year.The causes of 30, or 4 4 per cent., of the deaths registeredduring the week were not certified or not stated ; the meanproportion of uncertified deaths in the 76 English townsduring the week did not exceed 0 - 9 per cent.

HEALTH OF DUBLIN.

The annual death-rate in Dublin, which had been

equal to 23 - 8, 22 4, and 22’ 3 per 1000 in the three pre-ceding weeks, rose again to 28’ 8 in the week endingDec. 22nd. During the first 12 weeks of the pastquarter the death-rate in the city averaged 24’ 3 per 1000,the mean rate during the same period being only 15’ 6in London and 16’ in Edinburgh. The 209 deaths ofDublin residents during the week under notice showed anincrease of 47 upon the number returned in the previousweeks ; they included nine which were referred to the

principal epidemic diseases, against nine and 13 in the twopreceding weeks. These nine deaths were equal toan annual rate of 1 - 2 per 1000, against 1 1 1 and0’9 respectively from the same diseases in London andEdinburgh. The nine deaths from these epidemic diseasesin Dublin during the week included two each from measles,diphtheria, whooping-cough, and diarrhoea, one from.. fever," and not one either from scarlet fever or small-pox.The fatal cases of diphtheria, whooping-cough, and diarrhoeashowed a decline from the numbers in the previous week.Eight inquest cases and five deaths from violence were regis-tered ; and 87, or 41.6 per cent., of the deaths occurredin public institutions. The causes of eight, or 3. 8 percent., of the deaths registered in the city during the weekwere not certified ; the percentage of uncertified causes of

death during the same week did not exceed 0. 8 in Edin-burgh, and in London all the causes of death were dulycertified.The annual death-rate in Dublin, which had been equal

to 22’ 3 and 28’ 8 per 1000 in the two preceding weeks,declined to 18 - 4 in the week ending Dec. 29th. During the13 weeks of last quarter the death-rate in the city averaged23’ 9 per 1000, the mean rate during the same period inLondon being only 16-0. The 129 deaths of Dublinresidents during the week under notice were fewer by 80than the high number in the previous week ; these includedfive which were referred to the principal epidemic diseases,against 13 and nine in the two preceding weeks. These fivedeaths were equal to an annual rate of 0’ 7 per 1000, against1’ 3 in London. The five deaths from these epidemic diseasesin Dublin last week included two from whooping-coughtwo from diarrhoea, one from diphtheria. and not one,either from measles, scarlet fever, "fever," or small-pox.The fatal cases of whooping-cough and diarrhoea correspondedwith the numbers in the previous week, while the deathfrom diphtheria compared with five and two in the two pre-ceding weeks. Four inquest cases, but no deaths fromviolence, were registered during the week; and 32, or 24’ 8per cent., of the deaths occurred in public institutions. Thecauses of but one, or 0’ 8 per cent., of the deaths registeredin the city during the week were not certified, against 7’ 4and 3’ 8 per cent. in the two preceding weeks.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.Fleet Surgeon W. G. K. Barnes has been appointed to the

Royal Marine Depot at Deal.ROYAL ARMY MEDICAL CORPS.

Captains W. A. Ward, P. J. Bodington, and G. G. Delap,D.S.O., from the Royal Army Medical College, have beenappointed to the London district for duty. LieutenantG. De la Cour has been appointed for duty in London.The undermentioned Lieutenants are confirmed in that

rank : Percy Farrant, Augustus S. Williams, and TimothyW. 0. Sexton,

ROYAL ARMY MEDICAL CORPS IN INDIA.The following officers are appointed to the command of

station hospitals noted against their names :-Major G. A. T.Bray, Shwebo ; Major A. J. Luther, Bhamo ; Lieutenant-Colonel S. C. B. Robinson, Ahmednagar ; and Lieutenant-Colonel S. Westcott, Mhow. Lieutenant-Colonel H. P. G.Elkington is posted to Jubbulpore in charge of the BrigadeLaboratory. Major T. H. J. C. Goodwin is posted to Quetta.Captain H. B. Kelly has arrived at Bombay per s.s. Oriental.Extension of leave has been granted to the following

officers :-Lieutenant R. B. Hole, from Nov. 26th, 1906, toMay 25th, 1907. Lieutenant W. Wiley, from Nov. 26th,1906, to date of embarkation for India. Lieutenant R. J.Cahill, from Nov. 25th, 1906, to date of embarkation forIndia. Captain R. B. Ainsworth has been granted sixmonths’ leave from the date he reports his arrival inEngland. Lieutenant-Colonel S. G. Allen has been grantedgeneral leave on private affairs from April lst to Sept. 30th,1907.

Lieutenant T. J. Wright is appointed a specialist in the, prevention of diseases from Sept. llth, 1906, and trans-. ferred from Colaba to Belgaum. Colonel 0. Todd, principal

medical officer 6th (Poona) Division, is transferred in thesame capacity to the Bangalore and Southern Brigades.

: Lieutenant-Colonel J. R. Forrest is transferred from the, Western to the Eastern Command. Captain R. B. Ainsworth, is detailed for duty on the Plassy, which sailed from. Bombay on Jan. 4th.

VOLUNTEER CORPS.! Royal, Garrison Artillery (Volunteers): 7th Lancashire

(The Manchester Artillery) : Surgeon-Lieutenant-Colonel. R. A. S. Daly is granted the honorary rank of Surgeon-, Colonel (dated Nov. 27th, 1906). Surgeon-Lieutenant-

Colonel and Honorary Surgeon-Colonel R. A. S. Daly. resigns his commission, with permission to retain- his rank and to wear the prescribed uniform (datedl Nov. 28th, 1906).’ Royal Engineers (Volunteers): Ist Lancashire : Surgeon-

Captain H. Halton resigns his commission (dated Nov. 15th,E 1906).


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