51 to the many disadvantages under which the officers of the service have for so many years laboured. They hope that the subject of Poor-law reform may engage at the earliest possible moment the earnest attention of our legislature. It is beyond all doubt or contention that the Irish Poor-law medical service is insufficiently paid ; that the pittance, varying between £ 33 and £80 per annum, still given to medical officers in many unions bears no relationship to the areas of the dispensary districts, nor to the popula- tion contained therein, nor to the number of persons entitled to gratuitous attendance. The Association now approaches you, not alone with the view of enlisting your sympathy and interest in the welfare of its members, many of whom in the past have rendered up their lives in the same heroic manner as Dr. Smyth has done, but with the object of directing your attention to the following- facts of great and vital importance to the health and, it may be added, the prosperity of the people of Ireland:- (a) The prevention and control of epidemics in Ireland are duties for the due performance of which the public are almost wholly dependent upon the Poor-law medical officer. The rate at which this official is paid (in most cases about £5 per annum) for this all-important office connected with the public health is wholly inadequate to ensure its efficient discharge, and is almost ludicrous when compared with similar salaries paid to English medical officers for less difficult duties of a similar character. (b) The great cost of advanced medical education and its consequent increase in value, with little or no prospect of an adequate return, is one of the causes of the yearly emigration of the best, ablest, and more healthily ambitious of our young Irish doctors, who carry with them to our colonies, or to foreign lands, those abilities which might be of such service to their fellow-countrymen at home. This is a serious matter affecting the health and welfare of the pubhc and may become more acute if redress of these grievances is longer withheld. It cannot be expected that able medical men will continue in the future to enter a service where there is no hope of advancement and where no facilities are given for the study of those new subjects in connexion with medical science which are yearly becoming of more and more interest and utility in the alleviation of the sufferings of mankind, especially when they are offered as an inducement a less wage than is given to a tradesman or a skilled mechanic. The Irish Medical Association could mention, if necessary, many dis- abilities and hardships under which its members have at all times struggled to discharge their duty to the poor. Suffice it to say that no thinking person can approach the subject of Poor-law reform in Ireland without being driven to the conclusion that our grievances are real and that their redress must mean an enormous advantage to the sick poor. With these facts before you we venture to solicit your cooperation by either yourself introducing a measure of necessary reform or in furthering legislation to that end. We call upon you to provide for your own poor, sick, and dying fellow-countrymen a physician of the very best skill and ability, not one rendered incompetent by age or bodily infirmity-not one whose declining years are soured and embittered by the thought that he must leave those dependent on him unprovided for when death overtakes him in this service of danger, hardship, and distress to which the Poor- law medical officer has devoted his life. He must at all times be pre- pared to face disease and death, and it is not unreasonable to ask that those who are responsible should insure that he be physically able to meet it as nobly as Dr. Smyth has done. The yearly stream of emigration from our shores, the yearly increase of our insane population, are subjects that must alarm our social reformers and all interested in the welfare of Ireland. Tbe housing of the very poor, the sanitary education of the bulk of our people, are also matters which should be dealt with by the Legislature in its responsi- bilities for the betterment of our country. These weighty matters should, in the opinion of the Irish Medical Association, find a place in any measure dealing with the reform of ths Poor-law system of Ireland. RICHARD R. LEEPER, F.R.C.S. Irel., Honorary Secretary. ASYLUM REPORTS. Saint Andrew’s Hospital for Mental Diseases, Northampton (Annual Report for 1900).-The average number of patients resident during the year was 378 and comprised 184 males and 194 females. During the year 98 patients were admitted, of whom 41 were males and 57 females. Of these three males and 13 females were re-admissions. The hospital is intended for the reception of insane patients of the middle and upper classes. Mr. Joseph Bayley, the medical super- intendent, states in his report that the female wing of the hospital has been constantly full throughout the year, but that on the male side there has been room in the wards recently altered. During the year 50 patients were discharged as recovered, or 13-2 per cent. of the average number resident. Of the deaths during the year, which amounted to 24, or 6’5 per cent. of the average number resident, two were due to cancer, two to mania, two to phthisis, three to melancholia, three to general paralysis, six to senile decay, and the rest to other causes. There has been no case of infectious fever and the sanitary condition of the hospital has been satisfactory during the year. The seaside house at Deudraeth Castle has been occupied for the greater part of the year. "115 patients have gone there. I hope, writes Mr. Bayley, "still further to increase the number of patients who will have the benefit of a change to the seaside now that the governors have purchased Bryn-y-Neuadd Hall, Llanfairfechan, which is much nearer and more easily reached than Castle Deudraeth was. " Every endeavour has been made to get the patients to occupy themselves on the-- farm and gardens and in the shops, and with satisfactory results. The average numbers employed daily comprise- 73 males and 57 females. The Commissioners in Lunacy state in their report that the highest praise can be given. with respect to the state in which they found the institution everywhere, and that the entries in the medical case-books. are made fully and up to date. At a later visit the Com- missioners record that the hospital is in excellent order, that, the wards on the male side are all that can be desired, and that when the projected improvements of the wards in the- female division are effected this division will fully equal the- male. The Committee of Management state in their report that. the payments for patients are 42s. and 25s. a week per head respectively, according to the class in which the patients are to be placed. fhey have recently purchased Bryn-y-Neuadd Hall, a mansion situated in a park of 180 acres, close to the- sea, and affording accommodation for at least 40 patients. Various improvements have been made with regard to electric lighting and the arrangements for boilers, heating, and stores. There has been no change in the staff of- officers. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN 33 of the largest English towns 6549 births and 4233. deaths were registered during the week ending Dec. Hist, 1901. The annual rate of mortality in these towns, which had declined from 21’3 to 18’5 per 1000 in the four pre-- ceding weeks, rose again to 19’3. In London the death-- rate was 18’7 per 1000, while it averaged 19’6 in the 32 large provincial towns. The lowest death-rates in these- towns were 14’3 in Portsmouth, 15’1 in Croydon, 15’9 in, Halifax, 16’3 in Norwich, and 16’4 in Hull; the highest rates were 22’1 in Liverpool, in Manchester, and in Salford, 22-2 in Gateshead, and 32-6 in Oldham. The 4233 deaths in these towns included 441 which were referred to the prin- cipal zymotic diseases, against 433, 418, and 414 in the three preceding weeks; of these 441 deaths 138 resulted from measles, 78 from whooping-cough, 76 from diph-- theria, 49 from diarrhoea, 39 from scarlet fever, 37’ from "fever" (principally enteric), and 24 from small-pox. The lowest death-rates from these diseases were recorded in Portsmouth, Bristol, Nottingham, Bradford, Hull, Gates-- head, and Newcastle ; and the highest rates in Bolton, Salford, Oldham, Blackburn, and Preston. The greatest mortality from measles occurred in Plymouth, Norwich, Manchester, Oldham Blackburn, Preston, and Halifax;, ;. from whooping-cough in Bolton, Salford, Burnley, and Sunderland ; from "fever" in Salford ; and from diarrhoea in Burnley. The mortality from scarlet fever showed no- marked excess in any of the large towns. The 76 deaths from diphtheria included 34 in London, eight in Liverpool, three in Croydon, three in Cardiff, three in Leicester, three in Manchester, and three in Salford. 24 fatal cases of small-pox were registered in London, but not one in any other of the 33 large towns. There- were 538 cases of small-pox under treatment in the Metropolitan Asylums hospitals on Saturday, Dec. 21st, against 427, 474, and 506 on the three preceding Saturdays ;. 161 new cases were admitted during the week, against 123, 170, and 134 in the three preceding weeks. The number of scarlet fever patients in these hospitals and in the London Fever Hospital, which had declined from 3353 to 3241 at the end of the four preceding weeks, had further declined to 3033 on Saturday, Dec. 21st ; 247 new cases were admitted during the week, against 320, 376, and 327 in the three preceding weeks. The causes of 53, or 1-3 per cent., of the deaths in the 33 towns were not certi-- fied either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in. West Ham, Bristol, Leicester, Salford, Leeds, and other smaller towns ; the largest proportions of uncertified deaths were registered in Birmingham, Liverpool, Blackburn, Sheffield, and Gateshead. In 33 of the largest English towns 4565- births and 4628. deaths were registered during the week ending Dec. 28th. 1900. The annual rate of mortality in these towns, which had’ been 18-5 and 19-3 per 1000 in the two preceding weeks,.
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to the many disadvantages under which the officers of the service havefor so many years laboured. They hope that the subject of Poor-lawreform may engage at the earliest possible moment the earnestattention of our legislature.
It is beyond all doubt or contention that the Irish Poor-law medicalservice is insufficiently paid ; that the pittance, varying between £ 33 and£80 per annum, still given to medical officers in many unions bears norelationship to the areas of the dispensary districts, nor to the popula-tion contained therein, nor to the number of persons entitled to
gratuitous attendance.The Association now approaches you, not alone with the view of
enlisting your sympathy and interest in the welfare of its members,many of whom in the past have rendered up their lives in the sameheroic manner as Dr. Smyth has done, but with the object of directingyour attention to the following- facts of great and vital importanceto the health and, it may be added, the prosperity of the people ofIreland:-
(a) The prevention and control of epidemics in Ireland are duties forthe due performance of which the public are almost wholly dependentupon the Poor-law medical officer. The rate at which this official is
paid (in most cases about £5 per annum) for this all-important officeconnected with the public health is wholly inadequate to ensure itsefficient discharge, and is almost ludicrous when compared with similarsalaries paid to English medical officers for less difficult duties of asimilar character.
(b) The great cost of advanced medical education and its consequentincrease in value, with little or no prospect of an adequate return, isone of the causes of the yearly emigration of the best, ablest, and morehealthily ambitious of our young Irish doctors, who carry with themto our colonies, or to foreign lands, those abilities which might be ofsuch service to their fellow-countrymen at home.This is a serious matter affecting the health and welfare of the
pubhc and may become more acute if redress of these grievances islonger withheld.
It cannot be expected that able medical men will continue in thefuture to enter a service where there is no hope of advancement andwhere no facilities are given for the study of those new subjects inconnexion with medical science which are yearly becoming of more andmore interest and utility in the alleviation of the sufferings of mankind,especially when they are offered as an inducement a less wage than isgiven to a tradesman or a skilled mechanic.The Irish Medical Association could mention, if necessary, many dis-
abilities and hardships under which its members have at all timesstruggled to discharge their duty to the poor. Suffice it to say that nothinking person can approach the subject of Poor-law reform in Irelandwithout being driven to the conclusion that our grievances are real andthat their redress must mean an enormous advantage to the sick poor.With these facts before you we venture to solicit your cooperation
by either yourself introducing a measure of necessary reform or infurthering legislation to that end.We call upon you to provide for your own poor, sick, and dying
fellow-countrymen a physician of the very best skill and ability, notone rendered incompetent by age or bodily infirmity-not one whosedeclining years are soured and embittered by the thought that he mustleave those dependent on him unprovided for when death overtakeshim in this service of danger, hardship, and distress to which the Poor-law medical officer has devoted his life. He must at all times be pre-pared to face disease and death, and it is not unreasonable to ask that
those who are responsible should insure that he be physically able tomeet it as nobly as Dr. Smyth has done.The yearly stream of emigration from our shores, the yearly increase
of our insane population, are subjects that must alarm our socialreformers and all interested in the welfare of Ireland. Tbe housing ofthe very poor, the sanitary education of the bulk of our people, are alsomatters which should be dealt with by the Legislature in its responsi-bilities for the betterment of our country.These weighty matters should, in the opinion of the Irish Medical
Association, find a place in any measure dealing with the reform ofths Poor-law system of Ireland.
RICHARD R. LEEPER, F.R.C.S. Irel., Honorary Secretary.
ASYLUM REPORTS.
Saint Andrew’s Hospital for Mental Diseases, Northampton(Annual Report for 1900).-The average number of patientsresident during the year was 378 and comprised 184 malesand 194 females. During the year 98 patients were admitted,of whom 41 were males and 57 females. Of these threemales and 13 females were re-admissions. The hospital isintended for the reception of insane patients of the middleand upper classes. Mr. Joseph Bayley, the medical super-intendent, states in his report that the female wing of thehospital has been constantly full throughout the year, butthat on the male side there has been room in the wardsrecently altered. During the year 50 patients were dischargedas recovered, or 13-2 per cent. of the average number resident.Of the deaths during the year, which amounted to 24, or
6’5 per cent. of the average number resident, two weredue to cancer, two to mania, two to phthisis, three to
melancholia, three to general paralysis, six to senile decay,and the rest to other causes. There has been no case ofinfectious fever and the sanitary condition of the hospitalhas been satisfactory during the year. The seaside houseat Deudraeth Castle has been occupied for the greater partof the year. "115 patients have gone there. I hope, writesMr. Bayley, "still further to increase the number of patientswho will have the benefit of a change to the seaside nowthat the governors have purchased Bryn-y-Neuadd Hall,
Llanfairfechan, which is much nearer and more easilyreached than Castle Deudraeth was. " Every endeavour hasbeen made to get the patients to occupy themselves on the--farm and gardens and in the shops, and with satisfactoryresults. The average numbers employed daily comprise-73 males and 57 females. The Commissioners in Lunacystate in their report that the highest praise can be given.with respect to the state in which they found the institutioneverywhere, and that the entries in the medical case-books.are made fully and up to date. At a later visit the Com-missioners record that the hospital is in excellent order, that,the wards on the male side are all that can be desired, andthat when the projected improvements of the wards in the-female division are effected this division will fully equal the-male. The Committee of Management state in their report that.the payments for patients are 42s. and 25s. a week per headrespectively, according to the class in which the patients areto be placed. fhey have recently purchased Bryn-y-NeuaddHall, a mansion situated in a park of 180 acres, close to the-sea, and affording accommodation for at least 40 patients.Various improvements have been made with regard toelectric lighting and the arrangements for boilers, heating,and stores. There has been no change in the staff of-officers.
VITAL STATISTICS.
HEALTH OF ENGLISH TOWNS.
IN 33 of the largest English towns 6549 births and 4233.deaths were registered during the week ending Dec. Hist,1901. The annual rate of mortality in these towns, whichhad declined from 21’3 to 18’5 per 1000 in the four pre--ceding weeks, rose again to 19’3. In London the death--rate was 18’7 per 1000, while it averaged 19’6 in the32 large provincial towns. The lowest death-rates in these-towns were 14’3 in Portsmouth, 15’1 in Croydon, 15’9 in,Halifax, 16’3 in Norwich, and 16’4 in Hull; the highestrates were 22’1 in Liverpool, in Manchester, and in Salford,22-2 in Gateshead, and 32-6 in Oldham. The 4233 deathsin these towns included 441 which were referred to the prin-cipal zymotic diseases, against 433, 418, and 414 in thethree preceding weeks; of these 441 deaths 138 resultedfrom measles, 78 from whooping-cough, 76 from diph--theria, 49 from diarrhoea, 39 from scarlet fever, 37’from "fever" (principally enteric), and 24 from small-pox.The lowest death-rates from these diseases were recordedin Portsmouth, Bristol, Nottingham, Bradford, Hull, Gates--head, and Newcastle ; and the highest rates in Bolton,Salford, Oldham, Blackburn, and Preston. The greatestmortality from measles occurred in Plymouth, Norwich,Manchester, Oldham Blackburn, Preston, and Halifax;, ;.from whooping-cough in Bolton, Salford, Burnley, andSunderland ; from "fever" in Salford ; and from diarrhoeain Burnley. The mortality from scarlet fever showed no-
marked excess in any of the large towns. The 76deaths from diphtheria included 34 in London, eight inLiverpool, three in Croydon, three in Cardiff, threein Leicester, three in Manchester, and three in Salford.24 fatal cases of small-pox were registered in London,but not one in any other of the 33 large towns. There-were 538 cases of small-pox under treatment in the
Metropolitan Asylums hospitals on Saturday, Dec. 21st,against 427, 474, and 506 on the three preceding Saturdays ;.161 new cases were admitted during the week, against 123,170, and 134 in the three preceding weeks. The numberof scarlet fever patients in these hospitals and in theLondon Fever Hospital, which had declined from 3353 to3241 at the end of the four preceding weeks, hadfurther declined to 3033 on Saturday, Dec. 21st ; 247 newcases were admitted during the week, against 320, 376, and327 in the three preceding weeks. The causes of 53, or
1-3 per cent., of the deaths in the 33 towns were not certi--fied either by a registered medical practitioner or by acoroner. All the causes of death were duly certified in.West Ham, Bristol, Leicester, Salford, Leeds, and othersmaller towns ; the largest proportions of uncertified deathswere registered in Birmingham, Liverpool, Blackburn,Sheffield, and Gateshead.
In 33 of the largest English towns 4565- births and 4628.deaths were registered during the week ending Dec. 28th.1900. The annual rate of mortality in these towns, which had’been 18-5 and 19-3 per 1000 in the two preceding weeks,.
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further rose last week to 21’1. In London the death-ratewas equal to 20’6 per 1000, while it averaged 214 in the32 large provincial towns. The lowest death-rates in thesetowns were 14 3 in Derby, 17.2 in Norwich, 17’4 in Halifax,18’1 in Bradford, and 18’3 in Birkenhead; the highest rateswere 23-5 in Birmingham, 24’2 in Salford, 25’2 in Hudders-field, 26-3 in Burnley, and 29-3 in Manchester. The 4628deaths in these towns last week included 485 whichwere referred to the principal zymotic diseases, against418, 414, and 441 in the three preceding weeks; ofthese 485 deaths 198 resulted from measles, 84 fromwhooping-cough, 71 from diphtheria, 45 from scarletfever, 37 from diarrhoea, 27 from small-pox, and 23from "fever" (principally enteric). The lowest death-rates from these diseases last week were recordedin Plymouth, Portsmouth, Derby, and Bradford ; andthe highest rates in Norwich, Burnley, Preston, andLeeds. The greatest mortality from measles occurred inNorwich, Manchester, Salford, Oldham, Preston, andHuddersfield; and from whooping-cough in Liverpool,Burnley, and Leeds. The mortality from scarlet fever,from I fever," and from diarrhoea showed no marked excessin any of the 33 towns. The 71 deaths from diphtheria inthese towns included 28 in London, seven in Burnley,five in Birmingham, four in Birkenhead, four in Liverpool,and four in Sheffield. 25 fatal cases of small-pox occurredin London and two in West Ham, but not one in anyother of the 33 large towns. There were 665 small-poxcases under treatment on Saturday last in the MetropolitanAsylums hospitals, against 474, 506, and 538 on the three
preceding Saturdays ; 225 new cases were admitted duringthe week, against 170, 134, and 161 in the three precedingweeks. The number of scarlet fever patients in these hos-pitals and in the London Fever Hospital, which had been3241, 3188, and 3033, at the end of the three pre-ceding weeks, had risen again to 3137 on Saturday,Dec. 28th ; 263 new cases were admitted during the
weeks, against 377, 331, and 320 in the three precedingweeks. The deaths referred to diseases of the respiratory.organs in London, which had been 470, 427, and 393 inthe three preceding weeks, rose again to 425 last week, butwere 176 below the corrected average weekly number. The.causes of 86, or 1 -9 per cent., of the deaths in the 33 townslast week were not certified either by a registered medicalpractitioner or by a coroner. All the causes of death were duly certified in West Ham, Bristol, Salford, Leeds, and in 11 other smaller towns ; the largest proportions ofuncertified deaths were registered in Swansea, Birmingham,Liverpool. Blackburn, Preston, Sheffield, and Sunderland.
HEALTH OF SCOTCH TOWNS.
The annual rate of mortality in the eight Scotch towns,which had been 20’5 and 20’7 per 1000 in the two pre-.ceding weeks, further rose to 21’5 during the week endingDec. 21st, 1901, and was 2’2 per 1000 in excess of themean rate during the same period in the 33 large Englishtowns. The rates in the eight Scotch towns rangedfrom 13-4 in Leith and 17-0 in Paisley to 27-7 inDundee and 31-5 in Perth. The 684 deaths in thesetowns included 30 which were referred to measles, 17 todiarrhoea, 10 to whooping-cough, seven to 11 fever," three4o diphtheria, and two to scarlet fever. In all, 69 deathsresulted from these principal zymotic diseases in theweek, against 72 and 70 in the two preceding weeks.These 69 deaths were equal to an annual rate of 2-2 per1000, which was 0’2 above the mean rate from the samediseases in the 33 large English towns. The fatal cases
of measles, which had been 23 and 28 in the two
preceding weeks, further rose to 30, of which 22 occurredin Glasgow and seven in Dundee. The deaths fromdiarrhœa, which had declined from 30 to 15 in the four
preceding weeks, rose again to 17, and included seven
in Glasgow, five in Dundee, two in Aberdeen, and two inGreenock. The fatal cases of whooping-cough, which hadbeen four and nine in the two preceding weeks, furtherrose to 10, of which seven were registered in Glasgow.The deaths referred to different forms of "fever," whichhad been nine, 10, and 11 in the three preceding weeks,- declined again to seven and included six in Glasgow.’The three fatal cases of diphtheria corresponded with thenumber in the preceding week, and included two in Dundee.the deaths referred to diseases of the respiratory organs inthese towns, which had been 186, 180, and 165 in the three
preceding weeks, rose again to 188, and were 77 in excessof the number in the corresponding period of last year.The causes of 28, or more than 4 per cent., of the deathsin these eight towns were not certified.The annual rate of mortality in the eight Scotch towns,’
which had been 20’5, 20’7, and 215 per 1000 in the threepreceding weeks, further rose to 22-6 per 1000 during theweek ending Dec. 28th, 1901, and showed an excess of 1’5over the mean-rate during the same period in the 33 largeEnglish towns. The rates in the eight Scotch towns rangedfrom 14’1 in Leith and 17’4 in Perth to 24’2 in Dundeeand 24’8 in Glasgow. The 720 deaths in these townsincluded 36 which were referred to measles, 23 to diarrhoea,eight to diphtheria, seven to scarlet fever, seven to
whooping-cough, and five to "fever." In all 86 deathsresulted from these principal zymotic diseases last week,against 72, 70, and 69 in the three preceding weeks. These86 deaths were equal to an annual rate of 2 -7 per 1000, whichwas 0’5 above the mean rate last week from the samediseases in the 33 large English towns. The fatal cases
of measles, which had been 23, 28, and 30 in the threepreceding weeks, further rose last week to 36, of which22 occurred in Glasgow, 10 in Dundee, and four in Greenock.The deaths from diarrhoea, which had been 15 and 17 inthe two preceding weeks, further increased to 23 last week,and included 15 in Glasgow, four in Dundee, two in Edin-burgh, and two in Aberdeen. The fatal cases of diphtheriawhich had been three in each of the two preceding weeks,increased last week to eight, of which three were registeredin Dundee and three in Aberdeen, The deaths from scarletfever, which had been nine, four, and two in the three pre.ceding weeks, rose again to seven last week, and includedfour in Glasgow and two in Greenock. The fatal cases ofwhooping cough, which had been four, nine, and 10 in thethree preceding weeks, declined again last week to seven, ofwhich six occurred in Glasgow. The deaths referred to differentforms of ’’ fever," which had been 10, 11, and seven in thethree preceding weeks, further declined to five last week, andincluded three in Glasgow. The deaths from diseases of therespiratory organs in these towns, which had been 165 and188 in the two preceding weeks, declined again last weekto 166, but showed an excess of 45 over the number in thecorresponding period of last year. The causes of 27, or
nearly 4 per cent., of the deaths in these eight towns lastweek were not certified.
____
HEALTH OF DUBLIN.
The death-rate in Dublin, which had been 18 8, 20’2, and17’9 per 1000 in the three preceding weeks, rose againto 25’9 during the week ending Dec. 21st, 1901. Duringthe previous four weeks the death-rate had averaged 20’7 per1000, the rates during the same period being 19’3 in Londonand 19’9 in Edinburgh. The 186 deaths belonging to Dublinregistered during the week under notice were 57 in excessof the number in the preceding week, and included 15 whichwere referred to the principal zymotic diseases, againt-t seven,six, and one in the three preceding weeks ; of these, fourresulted from whooping-cough, four from fever," threefrom diphtheria, two from scarlet fever, and two fromdiarrhoea. These 15 deaths were equal to an annual rateof 2’1 per 1000, the zymotic death-rates during the same
period being 2’1 in London and 0’2 in Edinburgh. The
mortality during the week from fever, from whooping-cough,from diphtheria, and from scarlet fever was considerably inexcess of that recorded from each of these diseases in anyof the three preceding weeks. The deaths from diarrhoea,which had been four, two, and none in the three precedingweeks, rose again to two. The 186 deaths in Dublinincluded 28 of children under one year of age and 42of persons aged upwards of 60 years ; the deaths bothof infants and of elderly persons showed a marked excessover the numbers recorded in the preceding week. Eleven
inquest cases and 10 deaths from violence were registered,and 63, or more than a third, of the deaths occurred in
public institutions. The causes of 10, or more than 5 percent., of the deaths in Dublin were not certifiedThe death-rate in Dublin, which had been 17’9 and 25. 9
per 1000 in the two preceding weeks, further ro-e to 26’8 per1000 during the week ending Dec. 28th, 1901. During the13 weeks ending on that date the death-rate averaged 21’7 per1000, the rates during the same period being 18’4 in Londonand 18’0 in Edinburgh. The 193 deaths of persons belongingto Dublin registered during the week under notice -howedan excess of seven over the number in the preceding week,
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and included 10 which were referred to the principalzymotic diseases, against six, one, and 15 in the three pre-ceding weeks ; of these five resulted from "fever," three fromdiarrhoea, and two from diphtheria. These 10 deaths wereequal to an annual rate of 14 per 1000, the zymotic death-rateduring the same period being 2’1 in London and 0’8 inEdinburgh. The mortality both from "fever" and fromdiarrhoea slightly exceeded that recorded in the pre-ceding week, while the deaths from diphtheria showed aslight decline. The 193 deaths in Dublin last weekincluded 26 of children under one year of age and 63 ofpersons aged upwards of 60 years ; compared with thenumbers in the preceding week, the deaths of infantsshowed a decline of two, while those of elderly persons were21 in excess Three inquest cases and seven deaths fromviolence were registered ; and 71, or nearly three-eighths,of the deaths occurred in public institutions. The causesof 13, or nearly 7 per cent., of the deaths in Dublin lastweek were not certified.
THE SERVICES.
ROYAL ARMY MEDICAL CORPS.
SURGEON-GENERAL A. F. PRESTON, who has been acting asDirector-General of the Army Medical Service, has resumedthe post of Principal Medical Officer in Ireland on beingrelieved at the War Office by Surgeon-General W. Taylor.Major J. R. Stuart is transferred from the Deesa district
to the Bombay district, and Major A. P. H. Griffiths fromthe Mhow district to the Deesa district and appointed to themedical charge of the Station Hospital, Ahmedabad. MajorF. S. Le Quesne, V.C., is appointed for duty with the3rd Battalion York and Lancaster Regiment.
VOLUNTEER CORPS.
Artillery: : 1st Dorsetshire (Southern Division, RoyalGarrison Artillery) : Surgeon-Captain A. Kinsey-Morgan tobe Surgeon-Major. Rifle : lst Volunteer Battalion theLincolnshire Regiment: Arthur Stanley Green to be Sur-geon-Lieutenant.
DEATHS IN THE SERVICE:::.
Henry James Penny, F. R. C. S. Eng., I.M.S. (retired), athis residence at Taunton on Dec. 22nd, 1901, in his eighty-sixth year. The deceased belonged to an old Taunton
family and qualified M. R. C. S. Eng. in 1841, being admittedF.R.C.S. Eng. in 1856. Shortly after qualifying he enteredthe Indian Medical Service, retiring about 30 years ago withthe rank of deputy inspector-general of hospitals. Mr.
Penny then returned to Taunton.
ROYAL NAVAL HOSPITAL, HASLAR.The session of special instruction at the Royal Naval
Hospital, Haslar, terminated on Dec. 21st, 1901, when thefollowing surgeons received appointments to H.M. ships.Prizes were awarded to Surgeon A. T. Gailleton (silvermedal and books) and Surgeon T. B. Shaw (microscope).Surgeons in order of seniority :-
Name. Marks. Name. Marks.T. B. Shaw ...... 6014 G. S. Davidge ......... 5121A. T. Gailleton ...... 5731 P. T. Nicholls ......... 4997
P. L. Crosbie (entered under special Admiralty regula-tions).
SOUTH AFRICAN WAR NOTES.
Civil Surgeon Reid is reported severely wounded andCivil Surgeon Wright slightly wounded at Tweefontein
(Dec. 25th).Lieutenant J. S. Twigg, R.A.M.C., is reported killed on
Dec. 22nd between Clanwilliam and Calvina. He joinedthe service in 1900.
Civil Surgeon (attached R.A.M.C.) W. E. Jones is reportedseriously ill.
VITAL STATISTICS OF THE INDO-DUTCH ARMY.
The information set forth in the following table is interest-ing, but its value is considerably lessened for the purposes ofcomparison because the system upon which the statistics are
arranged is somewhat at variance with that adopted in Indiaand in our tropical colonies.
Indo-Duteh Army.
Among the European deaths 36 took place out of hospita -
in 1898 and 30 in 1899, the causes alleged being as fol-lows : fever, three ; beri-beri, one ; apoplexy, two ; deliriumtremens, two ; paralysis of the heart, two ; enteritis, one ; peri-tonitis, one ; hæmorrhage, one ; gunshot wound (murderor accident), four ; killed in action, four ; died from
wounds, six ; exhaustion, two ; drowning, 16 ; hanging, one ;crushing, four ; fear, one ; burning, six ; suicide, 10 ; causeunknown, two. Of the deaths in hospital among Europeans,147 are ascribed to paludism, 13 to typhoid fever, threeto cholera, eight to beri-beri, one to tetanus, three to
pyæmia, three to syphilis, five to debility, seven to affectionsof the nervous system, seven to affections of the lungs, fourto pulmonary phthisis, four to heart disease, five to palpita-tion, four to liver affections, 54 to other digestive diseases,five to venereal complaints, two to skin diseases, and 36 toother affections, the total for the biennium being 311.
SOUTH AFRICAN AFFAIRS.
Although we are not, of course, directly concerned withthe progress of any purely military occurrences at theseat of war in South Africa otherwise than as thesemust affect the medical services by tending to prolongthe war, it is impossible to pass over unnoticed the lossessustained by the British force at Tweefontein, owing toDe Wet’s fierce and determined attack. The recent disasterat Tweefontein closely resembled that which happened atMajuba Hill in 1881 ; essentially the same plan and tacticswere successfully adopted by the Boers with very similarresults on both occasions. In addition to the long list ofcasualties at Tweefontein, which may happily be regardedas an exceptional occurrence, there have been several minorengagements in which the British troops have successfullysurprised and attacked laagers and made more or less im-portant captures with relatively small loss to themselves. Thelatest sick returns are satisfactory on the whole. They showmuch the same amount and nature and causes of disease asheretofore. The management of the concentration campshas been taken over bv Lord Milner and his civil staff. The
camps are gradually being broken up with good results asfar as the prevalence and amount of sickness are concerned.
THE INDIAN MEDICAL SERVICE AND THE REPORT OFMR. BRODRICK’S COMMITTEE.
As might be expected much interest and curiosity havearisen as to how the changes foreshadowed in the report ofMr. Brodrick’s Committee on the Royal Army Medical Corpswill be received and carried out by the Indian Governmentand what effect the new scheme will have upon the IndianMedical Service. Any changes and improvements in theBritish Medical Service will have to be adapted and madeapplicable to the Indian Medical Service which, it must beborne in mind, has to meet numerous civil as well as militaryrequirements in that country. It is pretty well known thatthe subject has been occupyng the attention of the officialsat Simla and it is believed that the Indian Government hasbeen drawing up some scheme of proposals for submissionto the Secretary of State.
THE POST OF DIRECTOR-GENERAL OF THE INDIANMEDICAL SERVICE,
The recent death of Surgeon-General R. Harvey at Simlacauses a vacancy in the appointment of Director-General ofthe Indian Medical Service, and the Government of India,in addition to other more or less urgent matters of a military
