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1619 LOOKING BACK.-VITAL STATISTICS. advised to resign the post she held on account of ill-health, and is now dependent on a married daughter who can ill afford to help. Relieved five times, .e50. Recommended by Mr. Stamford Felco. Voted 212 in 12 instalments. Daughter, aged 36 years, of late L.R.C.P., L.R.C.S. Edin., who prac- tised in Northumberland. Endeavours to support herself by taking resident patients but at present is without any. Relieved four times, .e35. Recommended by Sir George Hare Philipson. Voted.e5 and to be advised to obtain a situation. Widow, aged 50 years, of L.R.C.P.,L.S.A., who practised in Yorkshire. No income; lets lodgings; only child, a daughter, stays at home to assist. Husband’s means exhausted by long illness before death. Relieved six times, ;S72. Recommended by Dr. J. Gordon Black. Voted .e12 in 12 instalments. Looking Back. FROM THE LANCET, SATURDAY, Dec. 6th, 1828. HOSPICE DE LA SALPETRIERE. OSSIFIED EXTRA-UTERINE FCETUS. A FEMALE, who had been for several years at the Salpetriere, on account of mental derangement, died in her 77th year. On examining the abdomen, a small tumour was found in the pelvis, slightly adhering by some layers of cellular tissue to the mesentery, and a loop of the small intestines ; the uterus and its appendages, as well as the other abdominal viscera, were perfectly healthy. On a closer inspection of this tumour, it was discovered to be the skeleton of a fcetus, surrounded by a thin, and nearly ,, transparent, membrane ; it had an oval form, was two inches in its largest diameter, and was, by a sort of indenture, divided into two unequal halves, the largest of which contained the head, the smaller the trunk. The skull was very well formed, completely ossified, 11 inch in its antero- posterior, 1 inch in its transverse, and one inch in its vertical diameter. The bones were regularly developed; not the slightest trace of a fontanelle could be found, and all the sutures were perfectly united. The frontal bone was much arched ; the parietal bones were also very prominent, especially that of the right side ; the temporal bones were placed almost horizontally, and exhibited the rudiments of a glenoidal cavity ; that of the right side presented a sort of zygomatic arch, united to a small os malare, which terminated in a rough articular surface ; the upper and lower jaw-bones were entirely wanting ; the orbits were well formed ; the occipital bone was a little elongated I towards its upper part; its lower portion consisted of several separate pieces. The skull was united to the trunk by fibro-cartilaginous ligaments, at least an articular surface could not be found, on external examination. The trunk being somewhat curved anteriorly, showed the rudi- ments of a vertebral column ; the place of the sternum was occupied by a very thick nbro-cartilaginous mass ; the ribs, as well as the bones of the shoulder and the clavicles, were completely ossified ; the vertebral column terminated below in the sacral bone, and the rudiments of the pelvis. The extremities were wanting, with the exception of some traces of the upper-arm. On internal inspection of this skeleton, the cavity of the skull was found of a regular form, its parietes being one-twenty-fourth of an inch in thickness ; they were lined with the dura mater, the folds of which were well developed, and contained a gelatinous fluid, of a yellow colour, without any distinct organisa- tion. The cervical vertebras consisted of several pieces, of an irregular form, so that the single vertebras could not be distinguished ; the dorsal vertebras were more developed, and distinctly annular ; the lumbar vertebras, as well as the sacral bone, consisted of irregular pieces. The abdomen and thorax formed one cavity, at the upper portion of which the pleura was distinctly seen lining the ribs ; its lower half contained a greyish-yellow adipocirous mass, with apparent traces of folds, representing, no doubt, the intestines. In the centre of this mass a brown nucleus was discovered, with a small cavity, which was continued, in a thin filament of the same colour, along the vertebral column, and which were very probably the remains of the heart and aorta. On the external surface of the skull, particularly on the right side, several vessels were seen running towards the median line ; some intercostal vessels could also be distinguished.—Archiv. G&t4r. de Méàecine. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN 76 of the largest English towns 8084 births and 4799 deaths were registered during the week ending Dec. 1st. The annual rate of mortality in these towns, which had slowly increased in the five preceding weeks from 14’6 to 16’3, declined again last week to 15’ 8 per 1000. During the first nine weeks of the current quarter the death-rate in these towns averaged 15’ 4 per 1000 ; the rate during the same period in London did not exceed 14 ’ 5. The lowest death- rates in the 76 towns during the week under notice were 5’0 0 i n Northampton, 6’0 in Hornsey, 8’0 0 in Devonport, and 8’ 2 in Coventry ; the rates in the other towns ranged upwards to 22’ 3 in Salford, 22 7 in Rochdale, 26’ in Tynemouth, and 26-9 in Swansea. The 4799 deaths in the 76 towns showed a decline of 146 from the number returned in the previous week, and included 414 which were referred to the principal epidemic diseases, against numbers steadily declining from 2570 to 365 in the 12 preceding weeks ; of ’these, 114 resulted from measles, 89 from diphtheria, 75 from diarrhoea, 53 from whooping-cough, 43 from " fever " (principally enteric), 41 from scarlet fever, and two from small-pox. The deaths from these epidemic diseases were equal to a mean annual rate of 1 4 per 1000 in the 76 towns, and did not exceed 1 0 in London. No death from any of these epidemic diseases was recorded last week in Wolverhampton, Walsall, Northampton, York, or in seven other of the 76 towns ; the annual death- rates therefrom, however, ranged upwards in the other 65 towns to 33 in Oldham, 3 6 in Salford, 4’ in Bootle, and 6-1 in South Shields. The 114 fatal cases of measles showed a decline of seven from the number in the previous week, but caused an annual rate of 3’ 0 in Roch- dale, 4 - 0 in Bootle, and 4 - 7 in South Shields. The 89 deaths referred to’ diphtheria exceeded the number returned in any previous week of this year, and included 20 in London, six in West Ham, four in Gateshead, three in Nottingham, nine in Liverpool, seven in Manchester and Salford, eight in Leeds, and three in Hull. The 75 fatal cases of diarrhoea exceeded the number in the previous week by six, and were proportionally most numerous in Swansea and Middlesbrough. The 53 deaths from whooping-cough considerably exceeded the low numbers returned in recent weeks, but showed no marked excess in any of the 76 towns. Of the 43 deaths referred to "fever," seven were returned in London, three in Liverpool, five in Manchester, three in Salford, two in Burnley, two in Sheffield, and two in Hull. Scarlet fever showed the highest death-rate in Leyton, where three fatal cases were returned. The two deaths from small-pox occurred in Hull. No case of small-pox was under treatment in the Metropolitan Asylums Hospitals during the week, no case of this disease having been admitted thereto since the end of June. The number of scarlet fever cases under treatment in the Metro- politan Asylums Hospitals and in the London Fever Hospital, which had been 4150 and 4144 in the two preceding weeks, had further declined to 4053 at the end of the week under notice ; 401 new cases were admitted to these hospitals during the week, against 462 and 467 ’in the two pre- vious weeks. The deaths in London referred to pneumonia and other diseases of the respiratory organs, which had increased in the five preceding weeks from 150 to 312, were again 312 last week and were 154 below the corrected average in the corresponding week of the four preceding years 1902-05. The causes of 50, or 1. 0 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 Leeds, West Ham, Bradford, Newcastle-on-Tyne, and in 46 other of the 76 towns ; the proportion of uncertified deaths again showed a considerable proportional excess in Birmingham, Liverpool, Bootle, St. Helens, South Shields, and Gateshead. HEALTH OF SCOTCH TOWNS. The annual rate of mortality in eight of the principal Scotch towns, which had been equal to 17 ’ 0 and 19’ 1 per 1000 in the two preceding weeks, declined again to 17’ 6 in the week ending Dec. 12th, but exceeded by 1 8 the mean rate during the same week in the 76 English towns. The rates in the eight Scotch towns ranged from 9 ’ 1 and 12 ’ 6 in Perth
