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836 bye-laws regulating the construction of all such structures in the future, as also a public system of scavenging, are urgently needed. The population of Bollington is estimated at 3666 ; and although the present death-rate-namely, 18 per 1000-is below that which has prevailed during the past six years, it is clear that for such a district even this diminished rate is excessive. The defective conditions of house drainage, of privy and ashpit accommodation, and of water-supply, &c., must be dealt with more energetically before any permanent improvement can be expected. Withington.—The general death-rate in this urban district of 15,234 inhabitants was 14’3 per 1000 during the past year, a rate which, though by no means high, exceeded that for the previous five years, the excess being mainly due to deaths amongst infants from so-called zymotic causes. Scar- latina was somewhat prevalent during the year, 61 cases being reported to Dr. Railton, the medical officer of health ; but little could be done to prevent the spread of the disease by isolation, because the only hospital for infectious diseases which was available is the one at Monsall, belonging to the Manchester Infirmary, and this was far too distant. The same remark evidently applies to an outbreak of diphtheria, which attacked some twenty, and killed seven, persons ; and it is to be hoped that the inadequacy of the present hospital provision, a matter which was pointed out as regards this and other districts around Manchester in the official report on the " Use and Influence of Hospitals for Infectious Diseases," will receive the attention of the sanitary authority, for if early cases of infectious disease cannot be received on the ground of distance from the hospital, it is obvious that disease is almost certain to spread. Parents have been shown willingly to consent to the removal of their children to proper hospitals, situated within a reasonable distance from their homes, and ’, this sort of provision should everywhere be available. A good deal of excellent sanitary work is in progress in the district : nuisances are abated, removal of refuse is well carried out, and the sanitary arrangements in newly built houses are subject to efficient bye-laws. The local streams, however, remain much polluted, and there is every reason to believe that they constitute a distinct danger to health. SANITARY PROGRESS AT CHRISTCHURCH, NEW ZEALAND. Dr. Courtney Ned will, the medical officer of health for this district, points in his annual report for 1882 to a rapidly diminishing mortality. In 1875 the death-rate in Christ- church amounted to 30’4 per 1000 of the population ; in 1879 it had fallen to 20’1, and during the past three years the rates have been 17’9, 15’2, and 13’7 respectively. The deaths from zymotic diseases have also undergone a corresponding diminution, and this has corresponded with the enforcement of a provision in the local Public Health Act, throwing upon medical practitioners the responsibility of notifying such cases. A similar lowering of infant mortality has also taken place. Typhoid fever, formerly a scourge in the district, is now abating, the cases being in the main isolated ones, occurring with special incidence in localities just outside Christchurch, where the ground is sodden with slop refuse, and where there is either an absence of closet accommodation or where closets are leaky and defective. Diphtheria has been somewhat seriously prevalent, it having become practi. cally endemic in the quarter of St. Albans, where it is main- tained by the influence of the public school attendance. This quarter also presents those physical conditions which are now recognised as favourable to diphtheria; it is low- lying, damp, and badly drained, and it suffers besides from the effects of years of soil pollution from house slops and human excreta. An outbreak in another quarter is alleged to have been at once stamped out, because, owing to the system of notification in force, school closing could be resorted to at the onset. The works of sewer- age which have been carried out have, amongst other things, led to a lowering of the subsoil water by as much as from three to five feet, and a corresponding effect in the diminution from death by pulmonary consumption is already in progress. As in England, infantile diarrhoea is a cause of death which occasions much local concern, and, according to Dr. Nedwill, it is in the main due to improper food, to impurity of air about dwellings, to filth in and around houses, and to the want of breast-milk. It is, however, impossible to read this report without seeing that in num- berless ways sanitary progress is in steady operation, and this at a rate which might well put some towns in the mother country to shame. Cesspools are stated to have been practically abolished in the Christchurch division of the district, an organised system of scavenging is in progress, the sewage is being pumped to a series of sand hills, the various details of house construction and domestic sanitation are evidently under systematic supervision, infectious disease: are notified, and week by week the death returns are care fully examined. The cost of all this has evidently beer somewhat considerable ; but both in the saving of life and in the maintenance of the population in such a state of health as enables them to follow remunerative occupations, much gain is steadily being secured. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. In twenty-eight of the largest English towns, 5595 births and 3580 deaths were registered during the week ending the 5th inst. The annual death-rate in these towns, which had steadily declined from 29’2 to 22’7 per 1000 in the five pre. ceding weeks, further fell last week to 21’7. During the past five weeks of the current quarter, the death-rate in these towns averaged 23 ’6 per 1000, against 21.7 and 22’6 in the corresponding periods of 1881 and 1882. The lowest rates in these towns last week were 15 ’3 in Bradford, 15.5 in Brighton, and 15’9 both in Portsmouth and Derby. The rates ranged upwards in the other towns to 26’0 in Liverpool, 29-1 both in Manchester and Sheffield, and 31’1 in Hull. The deaths referred to the principal zymotic diseases in the twenty-eight towns, which had been but 351 and 344 in the two previous weeks, were 362 last week; they included 81 from measles, 76 from scarlet fever, 74 from whooping-cough, 54 from "fever" (principally enteric), 50 from diarrhœa, 21 from diphtheria, and 6 from small-pox. No death was referred to any of these zymotic diseases in Wolverhamp- ton, Derby, or Halifax ; whereas they caused the highest death-rates in Liverpool and Sheffield. Measles was most fatal in Liverpool and Sheffield ; scarlet fever in Leeds and Sheffield ; whooping-cough in Hull and Cardiff; and " fever " in Portsmouth and Sundetland. The 21 deaths from diphtheria in the twenty-eight towns included 16 in London and 2 in Liverpool. Small-pox caused 2 deaths in London, 2 in Birmingham, and 1 both in Liverpool and in Cardiff. The number of small-pox patients in the metro. politan asylum hospitals, which had been 82 and 73 on the two preceding Saturdays, rose again to 78 at the end of last week ; 14 new cases of small-pox were admitted to these hospitals during the week, against 15 and 7 in the two previous weeks. The deaths referred to diseases of the respiratory organs in London, which had declined from 672 to 445 in the five preceding weeks, further fell to 371 last week, but exceeded the corrected average by 26. The causes of 104, or 2’9 per cent., of the deaths in the twenty. eight towns last week were not certified either by a regis. tered medical practitioner or by a coroner. All the causes of death were duly certified in Brighton, Portsmouth, Bolton, and Cardiff. The proportions of uncertiiied deaths were largest in Wolverhampton, Derby, Preston, Halifax, and Hull. - HEALTH OF SCOTCH TOWNS. The annual rate of mortality in the eight Scotch towns, which had been equal to 27’5 and 27’6 per 1000 in the two preceding weeks, declined to 25 0 in the week ending the 5th inst. ; this rate, however, exceeded by 3’3 the mean rate last week in the twenty-eight English towns. The rates in the Scotch towns ranged from 15’3 in Perth to 31-3 and 35’3 respectively in Glasgow and Paisley. The deaths in the eight towns included 90 which were referred to the principal zymotic diseases, showing a further considerable decline from recent weekly numbers ; these deaths were equal to an annual rate of 3’8 per 1000, which was no less than 1 -6 above the mean rate last week from the same diseases in the large English towns. The fatal cases of whooping-cougb, which had ranged from 57 to 38 in the seven previous weeks, further declined to 25 last week, of which 12 occurred in Glasgow, 8 in Dundee, and 3 in Leith. The 38 deaths from measles, however, exceeded the number returned in any recent week ; no fewer than 31 occurred in Glasgow, against 27 in each of the two previous weeks. The fatal cases of "fever," scarlet fever, and diphtheria were unusually few ; the 4 deaths from "fever," and 3 of the
