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round. But when vent is required the tap is turned halfway, which, by an ingenious contrivance, admits as muchair as is just necessary to allow the liquor to run out, andby turning on’ the tap the vent is effectually shut off again.This ensures beer in good condition, even, it is stated, whenthe barrel is nearly empty.

Messrs. J. Lumley and Co. exhibit some very finequality corks as well as syphons for aerated water, thefittings of which are made of pure tin, an important point’because of the well-known action of carbonic acid uponmany common and injurious metals. Many improvementsin screw stoppers are also shown. Whittingham andRamsey exhibit a stopper, having a lock stud made of purelignum vitt, which, when placed beneath the flange in thebottle neck, by a half turn makes the bottle air-tight.Then there is Shepherd’s patent screw valve. The thread ison the outside of the bottle, so that the rubber pressesagainst the top of the bottle, diminishing the possibility ofexposure of the liquid to any substance but glass. TheTelescope Tap Company exhibit their ingenious barreltap. Crawford and Co. show a carbon enamel as an

’effectual means for cleansing musty casks, &c. Avery neat and simple bottle wrapper is shown by J.Deaton, quick packing and non-liability of the con-

tents to fracture are claimed for it. The well-knownfirm of Stevenson and Howell exhibit their solubleessences of ginger, lemon, &c., as do also Duckworth andCo., manufacturing chemists, of Manchester. Amongst thefilters exhibited for which special claims are made may bementioned Maignen’s Filtre Rapide and the Hamburg RapidFilter of Jensen and Co., Hamburg. Metallic capsules,manufactured by the London Metallic Capsule Company,form quite a pretty exhibit. Non-intoxicant ales. chief ofwhich is one called "Anti-Burton," a fermented drink con-taining less than ; per cent. proof spirit, are exhibited byCox and Co. And, lastly, there are the drinks, neither of I

which is the result of brewing or artificial aeration-viz.," Distil Coffee Extract,"prepared by Beare, Gosnall, and Fry,Bouillon Fleet, Bovril, and the Beef Bouillon of Brand ofMayfair.

CALENDAR OF THE ROYAL COLLEGE OFSURGEONS OF ENGLAND.

FROM the Calendar of this institution, which has justbeen published by the Council, it appears there are 1138Fellows of the College (of whom 737 obtained the Fellow-ship by examination, 11 were elected as Members of twentyyears’ standing, and 2 are ad eundem Fellows), 17,170Members, 866 Licentiates in Midwifery, and 676 Licentiatesin Dental Surgery. The holders of the Diploma in PublicHealth (granted in conjunction with the Royal College ofPhysicians) number 29. During the past collegiate year79 candidates presented themselves in Elementary Anatomyand Physiology, 478 of whom passed in both subjects, 79in Elementary Anatomy, and 56 in Elementary Physiology,66 candidates were referred in both subjects ; 56 candidatespresented themselves in Elementary Anatomy, 43 of whompassed ; 98 candidates presented themselves in ElementaryPhysiology, of whom 73 passed. The examiners are

appointed in conjunction with the Royal College ofPhysicians. The fees received from candidates for this-examination amounted to f:3937 10s the examiners re-

ceiving in fees E559 5s. Of 879 candidates who presentedthemselves in Chemistry, 552 passed and 327 were referred.*0f 804 candidates who presented themselves in MateriaMedica, 493 passed and 301 failed. The examiners inChemistry and Materia Medica are elected by the RoyalCollege of Physicians.The examiners in Anatomy and Physiology for the

Second Examination are appointed in conjunction with theRoyal College of Physicians; they have conducted thePrimary Examination under the Old Regulations, as wellas the Second Examination of the Examining Board. Ninehundred and seventy-three candidates presented them-selves for examination in Anatomy; 582 passed and 391were referred ; and 1069 candidates presented themselvesin Physiology, of whom 579 passed and 490 were referred.The fees received for these examinations from candidatesamounted to £ 504 16s., the examiners receiving in fees£1972 5s.

The Board of Examiners in Anatomy and Physiologyfor the diploma of Fellow, elected by the Council fromthe Fellows of the College, held during the past yeartwo examinations, and 179 candidates presented themselves, of whom 73 passed and 106 were rejected. Thefees received amounted to £ 1176, and the fees to the Boardto £ 805 10s.The Court of Examiners, elected by the Council from the

Fellows of the College, conduct the Third or Final Examina-tion in " Surgery" of the Examining Board, as well as thePass or Final Examination under the Old Regulations andthe Pass or Final Examination for the Fellowship. Duringthe year the Court has held two examinations for theFellowship, and four for the Membership; at the formerthere were 83 candidates, 48 of vibom passed and 35 werereferred. For the Membership 864 presented themselves,of whom 476 passed and 388 were referred. The fees paidby candidates amounted to £ 10,133 18s., and the fees paidto the Court of Examiners and the Examiners in Midwifervamounted to £ 5513 17s. The Examiners in Medicineunder the Scheme for an Examining Board in England areelected by the Royal College of Physicians ; of 466 candi-dates who presented themselves for this examination duringthe year, 334 passed and 132 were referred. The Examinersin Midwifery under the Scheme are elected in conjunctionwith the Royal College of Physicians, and have examined541 candidates, of whom 365 passed and 176 were referred.The Board of Examiners in Dental Surgery has held two

meetings for the examination of 48 candidates, 31 of whomreceived the diploma. The fees paid by them amounted toi325 10s., the Board receiving i151 4s.With regard to the finances of the College, it appears that

the income from all sources amounted to 121,337 14s. 5d.,derived principally from sale of stock-viz., £ 87,462 Is. 3d.-the next largest receipt being, as already shown, from feespaid by candidates for the diplomas of the College-viz.,jE20,587 14s.; rents from chambers adjoining the College,fl360 15s. ; investments, £ 5696 13s. 9d. ; trust funds,j6273 7s. 7d. ; incidental receipts, public health examina-tion, hire of rooms, fees from Council, &c., £ 558 6s. lld.;fees retained for candidates, £ 933 5s.

The expenditure for the year amounted to £ 121,16613s. 6d.,leaving a balance at the bankers’ of £ 171 Os. lld., the largestitem being 83,892 Is. 6d., for purchase of stock, the nextlargest amount being for fees paid to examiners-viz.,i8902 18.; extension of College premises, .66861 15s. 4d.;Savoy estate (half outlay), extension of Examination Hall,£ 4200; salaries, wages, and pensions for officers and servantsin the three departments, museum, library, and office,amount to £5219 3s. 6d. ; fees to Council, i302 8s.; rates,taxes, and insurance absorb the sum of £ 112610s. 6d.;extraordinary expenditure-i.e., Hunterian Festival, con-

versazione, furniture, &c.—£1326 Os. 8d. ; fees returned tocandidates, £ 1051 5s. ; half general working expenses ofExamination Hall, £ 4260 11s. 7d. Under miscellaneous items,alterations and repairs, fuel, light, trust funds, lectures,&c., about E4000 appears to have been expended.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5801 birthsand 3204 deaths were registered during the week endingOct. 26th. The annual rate of mortality in these towns,which had been 17’5 and 18’7 per 1000 in the precedingtwo weeks, declined again last week to 17’5. During thefirst four weeks of the current quarter the death-rate inthese towns averaged 17’3 per 1000, and was 2-3 below themean rate in the corresponding periods of the ten years1879-88. The lowest rates in these towns last week were9’7 in Birkenhead, 10’5 in Norwich, 11-7 in Derby, and 11’8in Portsmouth. The rates in the other towns rangedupwards to 24’0 in Manchester, 27’6 in Newcastle-upon-Tyne, 28’0 in Plymouth, and 29’0 in Preston. The deathsreferred to the principal zymotic diseases, which had been352 and 414 in the preceding two weeks, declined againlast week to 356; they included 83 from scarlet fever, 60from diarrhoea, 58 from " fever " (principally enteric), 54from whooping-cough, 53 from diphtheria, 48 from measles,and not one from small-pox. These zymotic diseases caused

the lowest death-rates in Leicester and Wolverhampton,and the highest rates in Sunderland, Preston, and

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Plymouth. The greatest mortality from scarlet feveroccurred in Liverpool and Plymouth ; from diarrhoea inNorwich and Preston; from whooping-cough in Preston;from measles in Preston, Newcastle-upon-Tyne, andSunderland; and from ° fever " in Nottingham andHalifax. The deaths from diphtheria included 37 inLondon, 3 in Salford, and 2 in Cardiff. Small-pox causedno death in any of the twenty-eight great towns ; andno small-pox ’patient was under treatment at the end ofthe week either in the Metropolitan Asylum Hospitalsor in the Highgate Small-pox Hospital. The number ofscarlet-fever patients in the Metropolitan Asylum and theLondon Fever Hospitals at the end of the week was 1450,against numbers increasing in the preceding seventeenweeks from 559 to 1394 ; 182 cases were admitted to thesehospitals during the week, against 177 and 188 in theprevious two weeks. The deaths referred to diseases ofthe respiratory organs in London, which had increased in Ithe preceding five weeks from 142 to 300, declined again ’Ilast week to 281, and were 125 below the corrected average.The causes of 75, or 2’3 per cent., of the deaths in the ’,twenty-eight towns last week were not certified either bya registered medical practitioner or by a coroner. All thecauses of death were duly certified in Hull, Nottingham,Portsmouth, and in four other smaller towns; the largest

proportions of uncertified deaths were registered in Halifax,Leicester, Blackburn, and Bolton.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 18’3 and 20’5 per 1000 in the precedingtwo weeks, declined again to 19’3 in the week endingOct. 26th; this rate exceeded by 1’8 the rate that prevailedduring the same week in the twenty-eight large Englishtowns. The rates in the Scotch towns ranged from 14’1 ’,and 15’4 in Paisley and Edinburgh to 22-2 in Perth and23’2 in Glasgow. The 494 deaths in the eight towns showed a decline of 30 from the number in the previous week, and included 13 which were referred to diphtheria, 12 to diarrhoea, 10 to whooping-cough, 9 to measles, 6 to "fever" "(typhus, enteric, or ill-defined), 6 to scarlet fever, and notone to small-pox; in all, 56 deaths resulted from theseprincipal zymotic diseases, against numbers declining in thefour previous weeks from 74 to 61. These 56 deaths wereequal to an annual rate of 2’2 per 1000, which exceededby 0’3 the mean rate last week from the same diseases inthe twenty-eight English towns. The deaths referred todiphtheria, which had been 13 and 6 in the previous twoweeks, rose again last week to 13, of which 6 occurred inGlasgow, 3 in Edinburgh, and 2 in Leith. The 12 deathsattributed to diarrhoea showed a further decline from recentweekly numbers, and included 5 in Glasgow, 3 in Dundee,and 2 in Greenock. The 10 fatal cases of whooping-coughwere also fewer than in any recent week; 5 were returnedin Edinburgh and 4 in Glasgow. The deaths from measles,which had been 7 and 9 in the previous two weeks, wereagain 9 last week, and included 3 in Aberdeen, 3 in Leith,and 2 in Edinburgh. The 6 deaths referred to " fever," ofwhich 4 occurred in Glasgow and 2 in Aberdeen, showeda decline of 5 from the number in the previous week.Two of the 6 deaths from scarlet fever were returned inGlasgow. The deaths referred to acute diseases of therespiratory organs in the eight towns, which had been87 and 118 iu the preceding two weeks, further rose lastweek to 122, and were 1 above the number in the corre-sponding week of last year. The causes of 67, or nearly14 per cent., of the deaths registered in the eight townswere not certified.

___

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 23’2 and 26 ’5per 1000 in the preceding two weeks, declined to 21’0 inthe week ending Oct. 26th. During the first four weeksof the current quarter the death-rate in the city averaged24’2 per 1000, the mean rate during the same period being16-3 in London and 17’1 in Edinburgh. The 142 deathsin Dublin showed a decline of 37 from the number in the

previous week; they included 9 which were referred to

diarrhoea, 6 to "fever," 1 to measles, 1 to diphtheria, 1 towhooping-cough, and not one either to small-pox, or scarletfever. Thus the deaths from these principal zymoticdiseases, which had been 23 and 19 in the two previousweeks, further declined last week to 18 ; they were equal

to an annual rate of 2-7 per 1000, the rate from the samediseases being 1’7 in London and 2’3 in Edinburgh. The9 deaths attributed to diarrhoea exceeded the number inthe previous week by 3; while the deaths referred to"fever," which had been 7 and 10 in the preceding twoweeks declined again last week to 6. The deaths of infantsshowed an increase of 6 upon the number in the previousweek, while those of elderly persons showed a decline of17. Five inquest cases and 4 deaths from violence wereregistered; and 41, or considerably more than a quarter,of the deaths occurred in public institutions. The causesof 16, or more than 11 per cent., of the deaths in the citywere not certified.

Correspondence.ON THE APPLICATION OF ICE TO THE CHEST

IN HÆMOPTYSIS.

°‘ Audi alteram partem."

To the Editors of THE LANCET.SIRS,—In the discussion which followed the reading of

Sir Andrew Clark’s paper on the " Haemoptysis of ElderlyPersons" before the Medical Society, Dr. Quain stronglycondemned the practice of applying ice to the chest wall,saying that it did no good, but rather harm, by inducingbronchitis. This statement, coming from so high anauthority, seems to me worthy of consideration. As a rule,when called to a case of blood spitting we find ice in bagsor bladders lying upon the patient’s chest. The practice is.a routine one, and appears to commend itself to both theprofession and the public. For my own part, I look withincreasing distrust on the prolonged application of ice as ameans of arresting pulmonary hemorrhage. Many yearsago I was with a gentleman who had recurring haemoptysisvery severely, and down his back was hanging a bag full ofice. After some time for observation, I remarked to his wifethat I believed the ice-bag was doing no good, but possiblyharm, and I removed it. After its removal we got on better,the bleeding ceased, and the man is alive and well now. Itappears to me that the sudden shock of the ice at firstcontracts the vessels and may do good, but its continuousapplication does not maintain this contraction, but isvery likely to cause congestion and bronchitis. The lateDr. Gooch, in his works on Midwifery, relates how he wascalled to a lady nearly dead from haemorrhage, and whoseabdomen was covered over with ice. He says: "I sweptall the ice away, and from a height I poured a douche ofcold water suddenly on the abdomen, with the effect ofimmediately arresting the bleeding." Again, as was sug-gested by the President of the Medical Society, if I caughthis words correctly, ice over the heart may slow that organ,and so help to arrest a flow of blood. Dr. Walshel says hehas seen the cautions application of ice to the spine andover the heart repeatedly almost instantaneously arrestthe flow of blood. My own practice has been to try thesudden application of ice, but, as a matter of experience,I have learned to distrust the prolonged and continuouscontact of ice with the chest or back as a means of stoppinga blood spitting. Dr. Lauder Brunton2 has found thatwhen ice is applied to the abdomen of an animal the mucousmembrane of the trachea and larynx becomes in half aminute deadly pale from contraction of the vessels. Thoughthe ice is allowed to remain on the abdomen, the trachealmucous membrane quickly changes colour, and to the pale-ness succeeds, first, slight redness, then deep congestion, andin ten minutes lividity. These observations appear to meto show how prolonged application of ice may, as Dr. Quainsaid, prove a powerful inducer of bronchitis.

I am, Sirs, yours obediently,JOHN C. THOROWGOOD, M.D., F.RC.P.,

Physician to the City of London HospitalWelbeek-street, W., Oct., 1889. for Diseases of the Chest.

JOHN C. THOROWGOOD, M.D., F.R.C.P.,Physician to the City of London Hospital

To the Editors of THE LANCET.SIRS,—I have read with much interest the able and sug-

gestive remarks on arthritic haemoptysis by Sir AndrewClark, Bart., which appeared in your last number. Withyour permission I should like to mention a case of pul-

1 Diseases of the Lungs, p. 408.2 Page 252 of his Pharmacology and Therapeutics.