718

inebriates. Among those who took part in the discussionwere Messrs. Jabez Hogg, H. W. Williams, G. K. Poole,Hazell, Paramore, and Parsons (West Worthing).

EXTENSION OF MARISCHAL COLLEGE.

WITH a view to extending the University Buildings inNew Aberdeen, the university authorities some time agoacquired several of the old houses adjoining the College,and, to make way for the present extensions, seven housesare to be cleared away. The new buildings are to be erected

parallel to, and between, the south wing of Marischal

College and Longacre, and will measure 168 fit. in length,27 ft. in width, and 57 ft. in height, and will consist of fourstoreys. Amongst other conveniences, there will be twolarge animal observation rooms, a hygienic museum, a

bacteriological laboratory, a materia medica practical class-room, a physiological practical class-room, a medical juris-prudence practical class-room, and numerous other depart-ments connected with medical study, all designed on themost modern and approved principles. The new buildings,which have been designed by the Government architect forScotland, Mr. W. W. Robertson, are to be ready for

occupancy by March, 1891, and the total cost of the presentextensions will be between JE5000 and .S6000.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Birmingham, OitÝ.-Last year, according to Dr. AlfredHill, Birmingham attained the lowest death-rate it has eveibeen able to record-namely, one of 17’5 per 1000,-andconsiderable improvement existed as regards the more

preventable diseases, such as fever and diphtheria. The

authority are, however, very properly warned that some atleast of this satisfactory state of affairs was due to excep-tionally favourable climatic conditions; and we may nowadd that scarlet fever, which last year was just rising fromits lowest ebb, has since then given evidence of how suchdiseases run in cycles ; indeed, in 1888 that disease was stilllying all but dormant. The infantile death-rate was alsolow in Birmingham last year in comparison with previousyears. As usually, it was to an important extent made upof infantile diarrhoea, and to this disease Dr. Hill devotessome attention, quoting, among other things, the whole ofDr. Ballard’s general report to the Local GovernmentBoard on the subject. The abolition of the filthy form ofmidden privy, heretofore almost general, is steadily pro-ceeding ; the need for a proper abattoir is becoming moreand more pressing; the dairies, milkshops, and cowhousesare looked after, and are especially reported on ; as are

also the canal boats and the bakehouses. The infectioushospital received 528 cases of scarlet fever and 18 of small-pox, and resort to the hospital for the purposes of isolationis stated to be becoming more and more popular. Anexcellent disease chart, which, however, includes neitherdiarrhoea nor small-pox, appears in the report, in additionto other matter both tabulated and in the form of diagrams.

Bollington Urban District.-With a population estimatedat 3900, Bollington had last year a death-rate of 18 -2 per 1000.Mr. Allen’s report is a brief one in so far as the sanitarycircumstances of the district are concerned, but it is statedthat back yards and streets are still in a very defectivestate as regards paving, that some improvement has takenplace as to dwelling accommodation, that drainage andother nuisances have been attended to, and that the dairies,cow sheds, and milk shops have been inspected as heretofore.

Kingston-upon-Thames.—This district had in 1888 thelowest general and zymotic death-rates on record-namely,14-2 and 0-68 per 1000 living, the population being 23,490.Diphtheria, formerly somewhat prevalent, almost dis-appeared last year, and Dr. Shirtliff desires to point outthat this result has occurred concurrently with a system ofdisconnexion of house drains, although he declines to tie

himself to the view that the two events are necessarilyrelated to each other as cause and effect. A constantwater-supply remains to be provided. The question of thedisposal of the sewage is reported to have been most satis-factorily dealt with, and the dual system of notification isreferred to as working in a harmonious way.EaZing Urban District.-Assuming the population of this

West-end suburb to be 22,800, Dr. Patten finds the death-rate to have been 10’9 per 1000 for last year. The zymoticmortality was also small; but Ealing is well prepared tomeet any emergency by having an excellent isolation hos-pital, which continues to be resorted to by all classes, andespecially by so-called private patients, who have a smallisolation room to themselves. Private roads have beenimproved during the year, and there has been a con-tinuation of good current sanitary work.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5501 birthsand 3285 deaths were registered during the week endingSept. 28th. The annual rate of mortality in thesetowns, which had been 16’2, 16’9, and 17’0 per 1000 inthe preceding three weeks, further rose last week to 17’9.During the thirteen weeks ending on Saturday last thedeath-rate in these towns averaged 18’6 per 1000, andwas 1’6 below the mean rate in the correspondingperiods of the ten years 1879-88. The lowest rates inthese towns last week were 7’9 in Huddersfield, 12’5 inNottingham, 14’7 in Oldham, and 14-9 in Norwich. Therates in the other towns ranged upwards to 27’6 in Sunder-land, 28’0 in Blackburn, 31’0 in Preston, and 32-7 in Ply-mouth. The deaths referred to the principal zymoticdiseases, which had been 529 and 537 in the preceding twoweeks, declined again last week to 529; they included 258from diarrhoea, 67 trom scarlet fever, 60 from diphtheria, 60from whooping-cough, 56 from " fever

" (principally enteric),28 from measles, and not one from small-pox. These zymoticdiseases caused no death last week in Derby, and thehighest death-rates in Blackburn, Preston, and Plymouth.The greatest mortality from diarrhoea occurred in Sunder-land, Newcastle - upon - Tyne, Bolton, Wolverhampton,Blackburn, and Preston; from scarlet fever in Blackburnand Plymouth; from whooping-cough in Plymouth andWolverhampton ; from "fever" in Salford, Portsmouth,and Halifax ; and from measles in Newcastle-upon-Tyneand Norwich. The deaths from diphtheria included 44in London, 4 in Portsmouth, 3 in Manchester, 3 inSalford, and 2 in Plymouth. Small-pox caused no deathin any of the tweny-eight great towns; and no small-pox patient was under treatment at the end of theweek either in the Metropolitan Asylum Hospitals or

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 was1247, against numbers increasing in the precedingthirteen weeks from 559 to 1171 ; 166 cases were ad-mitted to these hospitals during the week, against 196 and128 in the two previous weeks. The deaths referred todiseases of the respiratory organs in London, which hadbeen 152 and 142 in the preceding two weeks, rose last weekto 189, but were 34 below the corrected average. Thecauses of 69, or 2’1 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 causesof death were duly certified in Salford, Oldham, Ports-mouth, and in six other smaller towns ; the largest propor-tions of uncertified deaths were registered in Liverpool,Cardiff, and Hull.

-

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 19’1 and 16’4 per 1000 in the preceding twoweeks, rose again to 18’8 in the week ending Sept. 28th; thisrate exceeded by 0 ’9 the mean rate that prevailed during thesame week in the twenty-eight large English towns. Therates in the Scotch towns ranged from 9-5 in Perth, and16’6 in Edinburgh and in Dundee, to 20’7 in Glasgow, and25’2 in Leith. The 481 deaths in the eight towns showedan increase of 62 upon the number in the previous week,and included 30 which were referred to diarrhoea, 14 to

719

whooping-cough, 11 to "fever" (typhus, enteric, or ill-defined), 9 to diphtheria, 6 to measles, 4 to scarlet fever,and not one to small-pox; in all, 74 deaths resulted fromthese principal zymotic diseases, against 79 and 74 inthe preceding two weeks. These 74 deaths were equalto an annual rate of 2’9 per 1000, which corresponded withthe mean rate last week from the same diseases inthe twenty-eight English towns. The fatal cases ofdiarrhcea, which had been 38 and 36 in the preceding twoweeks, further declined last week to 30, of which 13occurred in Glasgow, 7 in Dundee, and 5 in Edinburgh.The 14 deaths from whooping-cough were within one of thenumber in the preceding weeks, and included 9 in Glasgowand 2 in Edinburgh. The 9 fatal cases of diphtheriaexceeded the numbers in recent weeks; 3 were returned inLeith and 2 in Dundee. The deaths referred to "fever,"which had been 11 and 6 in the preceding two weeks, roseagain last week to 11, and included 6 in Glasgow and 2 inEdinburgh. Five of the 6 fatal cases of measles werereturned in Glasgow, and 2 of the 4 deaths from scarletfever in Leith. The deaths referred to acute diseases ofthe respiratory organs in the eight towns, which had been61 and 66 in the preceding two weeks, further rose lastweek to 89, and exceeded by 10 the number returned in thecorresponding week of last year. The causes of 58, or morethan 12 per cent., of the deaths registered in the eighttowns during the week were not certified.

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 18.6, 24’5, and28’5 per 1000 in the preceding two weeks, further rose to 31 ’5in the week ending Sept. 28th. During the thirteen weeksending last Saturday the death-rate in the city averaged24’0 per 1000, the mean rate during the same period being16-5 in London and 15-9 in Edinburgh. The 213 deathsin Dublin last week showed a further increase of 10 uponthe numbers returned in the previous three weeks; theyincluded 23 which were referred to diarrhoea, 6 to "fever"(typhus, enteric, or ill defined), 1 to measles, and not oneeither to small-pox, scarlet fever, diphtheria, or whooping-cough. Thus the deaths from these principal zymoticdiseases, which had been 20 and 31 in the preceding twoweeks, were last week 30 ; they were equal to an annualrate of 4’4 per 1000, the rate from the same diseases being2’4 in London and 2’0 in Edinburgh. The deaths attri-buted to diarrhcea, which had been 11, 15, and 18 in theprevious three weeks, further rose last week to 23;the 6 deaths from "fever" showed a decline of 2 from thenumber in the previous week. The deaths of infantsshowed a considerable increase, while those of elderlypersons had declined. Five inquest cases and 7 deaths fromviolence were registered; and 55, or more than a quarter,of the deaths occurred in public institutions. The causesof 43, or more than 20 per cent., of the deaths in the citywere not certified.

THE SERVICES.

ARMY MEDICAL STAFF. - Surgeon David MiddletonGreig, M.B., resigns his commission (dated Oct. 2nd, 1889).ARMY MEDICAL RESERVE OF OFFICERS. - Surgeon

Charles Arrol, M.D., 3rd Volunteer Kent Brigade, CinquePorts Division, Royal Artillery, to be Surgeon-Major, rank-ing as Major (dated Oct. 2nd, 1889); Surgeon RichardJoseph Bryden, 3rd Volunteer Brigade, Cinque PortsDivision, Royal Artillery, to be Surgeon, ranking as

Captain (dated Oct. 2nd, 1889).ADMIRALTY.-In accordance with the provisions of Her

Majesty’s Order in Council of April 1st, 1881, Surgeon JohnCashin has been placed on the Retired List of his rank ;Surgeon Matthew Digan has been allowed to withdrawfrom Her Majesty’s Naval Service, with a gratuity.The following appointments have been made :-Surgeon

John J. A. Costello to be Surgeon and Agent at Carnsoreand Rosslare (dated Sept. 26th, 1889); Staff Surgeon Thos.M. Sibbald to the Canada (undated); Staff Surgeon GeorgeD. Twigg to the Royalist, Staff Surgeon Archibald M’Kinlayto the Egeria, Staff Surgeon John B. B. Triggs, M.B., to thePyla des, Staff Surgeon George W. Bell to the Tozcrmalirze,and Staff Surgeon Henry J. Madders, M.D., to the Hecla(all dated Oct. 6th, 1889); Surgeon Bowen S. Meuds to theCanada (dated Oct. 6th, 1889); Surgeons George Wilson,

M.B., and Harold F. D. Stephens, M.B., to the Pembroke(both dated Sept. 27th, 1889); Staff Surgeon Michael J.M’Carthy, M.D., to the Cruiser, and Staff Surgeon JamesPorter, M.A., M.B., to the Scout (both dated Oct. 3rd,1889); Surgeon Charles W. Sharples to the illelita, SurgeonOctavious W. Andrews, M.B., to the Duke of Wellington,and Surgeon Francis M. Puddicombe to the Royal Adetaidt(all dated Oct. 3rd, 1889).VOLUNTEf1;R Coprs.—1st Volunteer Battalion, the King’s

(Shropshire Light Infantry): Acting Surgeon F. K. P. Pigottto be Surgeon (dated Sept. 28th, 1889).—MemorandumInfantry Volunteer Brigade-Eastern Counties Brigade:Surgeon and Surgeon-Major S. M. Hopson, 3rd VolunteelBattalion, the Norfolk Regiment, to be Brigade Surgeon,ranking as Lieutenant-Colonel (dated Sept. 28th, 1889).PROFICIENCY EXAMINATION FOR VOLUNTEER MEDICAL

OFFICERS.--An order has been recently issued from theHome District Office notifying, for the information ojOfficers commanding Volunteer Corps, that the examinationof Volunteer Medical Officers for certificates of proficiencyon Army Form E 564 will in future be held quarterly orthe first Tuesday in each quarter, commencing October 1st,1889. Names of medical officers desirous of attending theseexaminations should reach the Home District Office at leasta week before the date of examination. In order to preparemedical officers for the examination to be held next January,a course of six lectures will be given by Surgeon WalterPearce, M.D., B.Sc., 20th Middlesex (Anists) Rifle Volunteers, on Thursday, Nov. 7th, 1889, and following fiv(Thursdays, at the Headquarters of the Queen’s Westminster Rifle Volunteers, Buckingham-gate, St. James’spark, S.W. For further particulars application should btmade to the Hon. Secretary, R. R. Sleman, 7, St. Benetplace, Gracechurch-street, E.G.

Correspondence.THE USE OF THE ELECTRO-MAGNET IN

OPHTHALMIC SURGERY.

" Audi alteram partem."

To the Editors oj THE LANCET.SIRs,—The efficacy of the electro-magnet in the remova’

of fragments of steel or iron from the interior of the eythas been attested by too many to permit of any question alto its value; moreover, it rightly finds a place in all th,text-books on ophthalmic surgery. I confess, then, it issomewhat disappointing to find a clinical lecture byDr. Jeaffreson advocating, without allusion to the magnetmethods for removal of splinters of steel or iron from thiiris, which were all very well some years ago, but are, t.

say the least, crude with the knowledge we now possess ato the capabilities of magnets and electro-magnets. Therecan be no question that numbers of eyes have been savedby the timely use of the electro-magnet which would otherwise have been lost; and it is the sense of this fact, foundeton large experience of the employment of the electro-magneand of accidents previously to its introduction, that impelme to write these few lines. From different regions of theye I have removed seventy-three fragments of steel or ironmany of these I have recorded from time to time, and thwhole have been incidentally alluded to in my address1 aPresident of the Yorkshire Branch of the British MedicaAssociation. Of this number, eight have been frorthe iris and anterior chamber. In such a case of foreignbody in the iris as Dr. Jeaffreson mentions, the electromagnet would have been valuable in two ways: 1. 01approaching the electro-magnet to the cornea the presencand nature of the foreign body would have been immfdiately evident by its springing forward to the back of th,cornea, or, if entangled much in the iris, by its dragging thamembrane towards the magnet. In some cases it is possiblto guide the foreign body in the anterior chamber to a corvenient locality for removal, and then to drop it on the iris athe selected point. 2. After making a small corneal incisioand advancing the point of the electro-magnet to or insidthe wound, the fragment would have been extracted adherinto it, and very probably, as generally happens, without an;necessity for removing a segment of iris. Such cases havnot only occurred in my own practice, but in that of other;

1 Brit. Med. Jour., July 13th, 1889