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THE DRAINAGE OF WORKHOUSES.

The Local Government Board has issued a circular toBoards of Guardians relative to the drainage of workhouses.Nothing could well be better than the advice given in it,and altogether it forms an excellent summary of the primaryrequirements of the drainage of buildings. But the puzzleof the matter is this, that advice of this sort should at thislate date be required in institutions so long and so rigidly(as it is presumed) supervised. So it is, however, and thecircular states that the Local Government Board have hadunder their consideration the reports made from time totime by their inspectors regarding the system of drainage inoperation at various workhouses and other poor-law institu-tions, and it is evident to them that in many instances thearrangements in this respect are not as satisfactory as couldbe desired. If guardians go wrong now as to drainagearrangements, in view of this circular, it must be from pureparochial perversity, and we may be permitted to hope that,in future, workhouses, and particularly the new ones, willfurnish examples of such drainage as domestic dwellingsshould possess.

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Dr. Griffin, medical officer of Louisburgh Dispensary dis-trict of the Westport Union, in a late report to the LocalGovernment Board, states that a permanent fever hospitalat Louisburgh is absolutely indispensable. The attentionof the Westport guardians has been recently directed to thismatter by the Board, but the former appear to doubt thenecessity, and have requested Dr. Griffin to produce thenames of the thirty-one fever patients stated to have beenunder his care.

A broker in the Borough has been heavily fined forhaving, under a distress warrant, removed articles offurniture and bedding from a room in which a patient suf-fering from small-pox was lying, and offered them for salewithout previous disinfection.

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VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

The highrate of urban mortality last week was again causecby the fatality of summer diarrhoea. In twenty of the largestEnglish towns, estimated to contain in the middle of thi;year seven and a half millions of persons, or nearly one-thircof the entire population of England and Wales, 5191 birthsand 3490 deaths were registered last week. The births ex.ceeded by 6, and the deaths by 215, the average weeklynumbers during 1879. The deaths showed, however, a de-cline of 77 from those returned in the previous week. Theannual death-rate per 1000, which had risen steadily from18’9 to 24’8 in the seven preceding weeks, fell last week to24’3. During the past seven weeks of the current quarterthe death-rate in these twenty towns has averaged 22-3 per1000, against 25’5 and 17’8 in the corresponding periods of1878 and 1879. The lowest death-rates in the twenty townslast week were 16’0 in Brighton, 16’4 in Bristol, 19’9 in

Wolverhampton, and 21’3 in London. The rates in theother towns ranged upwards to 31’5 in Manchester, 33’1 inSalford, 34’5 in Leicester, 34’8 in Plymouth, and 39’7 in theborough of Hull. The high death-rates in these last-men-.tioned towns were mainly due to excessive diarrhoea fatality.

The deaths referred to the seven principal zymotic diseasesin the twenty towns, which had steadily increased from 406to 1100 in the ten preceding weeks, further rose to 1136 lastweek. These included 864 from diarrhoea, 105 from scarletfever, GO from whooping-cough, 48 from measles, and 40from different forms of fever. The annual death-rate fromthese seven diseases averaged 7’9 per 1000 in the twentytowns ; and while it was but 2 9 and 3’9 in Bristol andBrighton, it ranged upwards to 15 0 and 24’1 in Hull andLeicester. Scarlet fever showed the largest proportionalfatality in Oldham and Leicester. Three deaths from diph-theria were returned in Birmingham. Small-pox caused 4more deaths in London, but not one in any of the nineteenlarge provincial towns. The number of small-pox patientsin the Metropolitan Asylum Hospitals, which had steadilydeclined in the four preceding weeks from 200 to 134, were135 on Saturday last ; 30 new cases of small-pox were, how-ever, admitted to these hospitals during the week, against15 and 20 in the two previous weeks. The Highgate Small-pox Hospital contained seven patients on Saturday last.The fatal cases of diarrhoea in the twenty towns, which

in the nine preceding weeks had steadily increased from 51to 807, further rose last week to 864. The annual death-rate from diarrhoea averaged 6’0 per 1000 in the twentytowns; it was equal to 3’8 in London, and to 8’1 in thenineteen large provincial towns. The death-rate fromdiarrhoea among the twenty towns ranged last week from1’7 in Bristol, to 12’9 in Hull, and 20’1 in Leicester. In thelast-mentioned town the diarrhoea rate has risen from 3’6to 20’1 during the past four weeks.The deaths referred to diseases of the respiratory organs

in London, which had been 175 and 152 in the two pre-ceding weeks, were 167 last week, and exceeded the cor-rected weekly average by 26. Of these 167 deaths 93 wereattributed to bronchitis, and 48 to pneumonia. The annualdeath-rate from diseases of this class was equal to 24 per1000 in London, and 3’7 in Liverpool.

HEALTH OF SCOTCH TOWNS.

In eight of the largest Scotch towns, having an estimatedpopulation of rather more than a million and a quarterpersons, the annual death-rate last week averaged 18 6 per1000, and was below the mean of the six preceding weeks ;this rate was 5’7 below the average rate in the twenty largeEnglish towns. The rates in the eight Scotch towns rangedfrom 9’7 and 14’6 in Perth and Aberdeen, to 20’4 and 27’6in Leith and Paisley. The deaths from the seven principalzymotic diseases in the eight towns were 127, against 125and 122 in the two preceding weeks; they included 65 fromdiarrhoea, 22 from whooping-cough, 17 from scarlet fever, 8from measles, 8 from diphtheria, 7 from fever, and not onefrom small-pox. The annual death-rate from these sevendiseases averaged 5’1 per 1000 in the eight towns, against7’9 in the large English towns. The excess of the zymoticdeath-rate in the English towns was almost entirely due tothe greater fatality of infantile diarrhoea. There were nodeaths from the seven zymotic diseases in Perth, and thezymotic rate was but 1 ’5 in Aberdeen, whereas it rangedupwards to 8’0 and 8’5 in Leith and Paisley ; the excess inthe zymotic death-rate in Leith was due to scarlet fever,and in Paisley to diarrhoea and whooping-cough. The fatalcases of diarrhoea in the eight towns, which had declined inthe week before last to 51, rose again last week to 65, ahigher number than has been returned in any week of thecurrent quarter. The annual death-rate from this diseasedid not average more than 2’6 per 1000, while in the Englishtowns the rate was equal to 6’0. The highest proportion offatality of diarrhoea in the Scotch towns occurred in Greenockand Paisley. The 22 deaths from whooping-cough included9 in Glasgow, and 7 in Edinburgh. Seven of the fatal casesof scarlet fever occurred in Glasgow and 6 in Leith. Fourof the deaths from measles were returned in Glasgow ; anddiphtheria caused 3 deaths in Edinburgh, 2 in Glasgow.and 2 in Dundee. The deaths referred to fever, whichhad been 13 and 17 in the two previous weeks, declined lastweek to 7, of which 6 were recorded in Glasgow. The deathsattributed to acute diseases of the lungs (bronchitis, pleurisy,and pneumonia) were 39 in the eight Scotch towns last week,against 67 and 70 in the two preceding weeks ; the annualdeath-rate from these diseases was equal to 1’6 per 1000,against 2’4 in London. The causes of 81, or 17 per cent., ofthe 463 deaths registered in the Scotch towns last weekwere uncertified ; in the English towns the proportion ofuncertified causes of death was scarcely two per cent.

HEALTH OF DUBLIN.

The rate of mortality again showed a marked excess inDublin last week, and was equal to 37’8 per 1000, against35’3 in each of the two preceding weeks. During the pastseven weeks of the present quarter the death-rate in thecity has averaged 32’6 per 1000, against 22’1 in London, and17-9 in Edinburgh. The 228 deaths in Dublin included 56,or no less than 25 per cent., which were referred to theseven principal zymotic diseases, showing but a slight de-cline from the high number returned in the preceding week;5 resulted from small-pox, 3 from measles, 15 from scarletfever, 3 from whooping-cough, 5 from different forms offever, and no less than 25 from diarrhoea. The annualdeath-rate from these seven diseases was equal to 9’3 per1000 in Dublin last week, against 5’6 in London, and 4Sin Edinburgh. The fatal cases of small-pox and measlesshowed a decline from recent weekly numbers. The deathsfrom scarlet fever corresponded with the number returned inthe previous week. The fatal cases of diarrhœa, which had

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averaged but 4 weekly during July, rose successively to 9,23, and 25 in the first three weeks of August, and wereequal to an annual rate of 4’1 per 1000 ; this rate, however,was considerably below the average rate in the twenty largeEnglish towns. --

INFANTILE DIARRHŒA IN LEICESTER.

Infantile mortality has begun during the past few weeksto show the marked increase in Leicester which usuallytakes place in that time during the season of summerdiarrhœa prevalence. The weekly number of deaths re-

gistered under one year of age in that town, which averagedbut 13 during June, steadily and rapidly increased during July,and were successively 30, 42, and 48 in the first three weeksof August. This increase is almost entirely due to diarrhoeafatality, which caused but 2 deaths in June, 25 in July, and19, 26, and 50 respectively in the three weeks ending lastSaturday. The excessive fatality of diarrhoea in Leicesterhas been the subject of much investigation and manytheories, but it cannot be separated from the fact that therate of infant mortality from all causes is excessive inLeicester, and that the excess in the rate is only partiallyaccounted for by the fatality from diarrheea. During lastyear the proportion of deaths under one year to births inLeicester was 185 per 1000, although the year was remark-able for the small recorded fatality of diarrhoea. Thenearest approach to so high a rate of infant mortalityin the twenty large towns dealt with in the Registrar-General’s weekly return occurred in Salford, where, how-ever, the rate did not exceed 170 per 1000. Dr. WilliamJohnson, the Medical Officer of Health for the borough,freely admits in his last report-what he was previouslyinnlinarl to dispute—that the axcessive death-rate nf

infants in Leicester is not confined to diarrhoea. During theten years 1870-79 infant mortality in those twenty townsaveraged 171 per 1000, and ranged from 141 and 158 inPortsmouth aud London, to 216 both in Leicester and Liver-pool ; the nearest approach in the other towns was 192 inLeeds. Dr. Johnson in his last report gives some valuableand interesting tables conclusively proving what we havefrequently noticed in these columns in connexion with thehigh rate of infant mortality in Leicester-namely, that thedeath-rate in the borough at all ages above one year notonly compares favourably with the rates in other large towns,but is below the standard English life table rates at thoseages. His suggestion that creches or nursing-homes shouldbe established under medical inspection, and visited byLadies’ Committees, is a useful one, but somethingmore must be done before Leicester will lose thestigma which now attaches to it as the town in whichinfant life is least successfully cared for among our

largest towns. Dr. Johnson wisely exposes the fallacy ofattribntiog the high rate of infant mortality to the highbirth-rate; we cannot, however, agree with him in regard-ing the high birth-rate in Leicester as a natural consequenceof the excessive infant mortality. For the cause of the highbirth-rate in Leicester it is unnecessary to look muchbeyond the fact that the town population includes an ab-normally large proportion of young adults.

HEALTH MATTERS GENERALLY AT HOMEAND ABROAD.

THE SANITARY COMMISSIONERSHIP OF INDIA.

A correspondent of the Pioneer, evidently well informed,questions the wisdom of doing away, at the present time,with the post of Sanitary Commissioner with the Govern-ment of India. Dr. Cunningham’s reports, it is observed,have done this signal service, that they have shown clearlythat very nearly half of the total deaths of the troops aredue to three of the most easily preventable of all diseases-namely, cholera, typhoid fever, and dysentery. Of the totalof 1212 deaths in the European army in India in 18i8,cholera caused 226, typhoid 258, and dysentery 98, or alto-gether 582 out of 1212. Thus by abolishing the causes oithee three diseases, the death-rate of the troops would bereduce 1 nearly one-half. Dr. Cunningham has not had timeapparently to make an exhaustive inquiry into the causation of disease at different stations. His reports are limitedto mere expositions of numerical results without refer-ence to the causes. But the time has now come to]tuking up systematically the investigation of the causes oj

sickness in each station on the plan which has been pursuedfor many years with remarkable success in England by themedical inspectors of the Local Government Board. Onesingle example will show how important it is that such aninvestigation should be made. In olden days Jullundur wasone of the healthiest stations in India, and for the last yearit has been one of the most unhealthy, and this change inits condition has coincided with the erection of barracks onwhich a vast outlay was incurred. These barracks werefirst occupied in 1872, and between that year and 1878 theoccupants of them have suffered from three severe epi-demics-viz., in 1872 cholera and typhoid, 1875 typhoid, 1878dysentery and typhoid. It is very singular, too, that whilethe occupants of the new barracks have been unhealthy, theartillery, who continue to occupy the old style of barracks,remain in the enjoyment of the good health of former times.The death-rate per 1000 of the two bodies is shown in juxta-position as follows :-

11 I feel satisfied," says the writer, " that if this remarkablecase were studied with the same exhaustive thoroughness ashas been brought to bear for some years on the study ofepidemic outbreaks in England, a flood of light would bethrown on the causes of disease, not in this particular in-stance only, but in all other stations where dysentery,cholera,, and typhoid fever prevail. But the very momentwhen problems of this kind were pressing on for solution,has been chosen for abolishing the appointment of SanitaryCommissioner altogether."

THE INTERNATIONAL RED-CROSS HOSPITAL, BADEN.

The Russian journal, the B6reg, states that after theFranco-German war the central committee of the RussianRed Cross Society established a hospital at Baden for sickand wounded soldiers. These were provided with medicaland surgical treatment and food at the expense of the society,and 338 patients were received into the hospital, of whom183 were discharged cured, 183 improved, and 16 withouthaving received benefit from their residence there. Afterthe Russo-Turkish war the Red Cross Society re-establisheda hospital at Baden, but to the time of the Béreg giving thisnotice, only one Russian soldier had been sent there. Dr.Heidenreich, the principal medical officer, believes thatthis must have arisen from the existence of the hospital nothaving been made sufficiently known by those likely to profitby it, and he appears to have asked the intervention of theRussian press in publishing information concerning thehospital. ____

SCAVENGING IN DUBLIN.

The Dublin Corporation had last Monday under considera-tion a report of the Committee appointed in February lastto deal with the question of public and domestic scavenging.The Committee, after receiving the report of a deputationwhich visited Glasgow, Manchester, Liverpool, and othertowns in December last, and obtaining from the CityEngineer and the executive officer of the Public HealthCommittee reports embodying their opinions as to the bestmeans to be adopted, have recommended that the Corpora-tion should take entire charge of the scavenging, and havethe same carried out by their own staff under a competentmanager. The expense of the department is estimated at£28,700 per annum, or a trifle over one shilling in the poundon the city rates. The report has been adjourned for afuture meeting of the Council.

THE RUSSIAN RED-CROSS SOCIETY.

- A Te Deum, was announced to be celebrated in St. Peters-

burg on the 14th instant on the despatch of certain sisters ofcharity of the Community of the Exaltation of the HolyCross to the assistance of the sick and wounded of the expe-

’ dition to Akhal-Teké. Countess Elizabeth Milintine, one[ of the sisters, accompanies the detachment, and Dr. Stcher-

hak is attached to it as delegate of the Red-Cross Society.The assistance despatched by the Red-Cross Society to theexpedition, in nurses, medical men and material, did not reachthe scene of action until the operations of the troops had

’ terminated. The efforts of the Society were thereforedirected to the amelioration of the state of the sick andwounded they found in hospital on both coasts of the