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1243 the occurrence of cases which have been notified forward, and which would be regarded by some as having penetrated our first line of defence," are in no sense a breakdown of the English system, which involves preparation against cholera, not only in port districts, but also in every inland sanitary district in England. The Bristol port sanitary inspector, whose report is appended to the one just referred to, states that there is a steady improvement in the habitable condition of crew spaces, and that during 1893 no instance of non-ventilation was discovered. The inspector again calls attention to the desirability of lining the crew spaces of iron ships, a condition which, he points out, is usually found in the officers’ but not in the men’s quarters. He thinks that the best way of remedying the evil is for the Board of Trade to insist on all living-spaces being wood-lined. Poplar Urban Sanitary IJistrict.-Mr. Russell Talbot, the medical officer of health of the Bow parish, estimates its population at 41 143, and its number of inhabitants per house at 7’3. The general death-rate of the parish for 1893 was 23 per 1000. In dealing with the prevalence of diphtheria in his district Mr. Talbot remarks that "medical men may be divided into two bodies-the one never notifies diph- theria’ without the case is typical and complete ; and the other does not wait for development." Having regard to the fact that the object of notification ia to obtain the earliest information of the presence of infectious disease, Mr. Talbot thinks that it is to the latter class of medical men "that the best thanks of the community are due," and he suggests that the addition of "infectious sore-throat," or even sore-throat," to the list of notifiable diseases would remove the conscientious scruples of some medical men as to notifying " diphtheria." The Board schools in the Bow district were all inspected during 1893 and Alr. Talbot reports that they are now in a satisfactory sanitary condition. He states, however, that in various instances the filters used in the schools were in a decidedly dangerous condition, and he advises that no filters should be used. The southern district of Poplar comprises the parishes of All Saints, Poplar (56 634), and Bromley St. Leonard (71,336). Mr. Frederick W. Alexander, the recently appointed medical officer of health for this part of the district, reports that he has taken the disinfecting department under his immediate supervision, and it appears that he has succeeded in providing a modern disinfecting apparatus. In dealing with the subject of cowhouses Mr. Alexander expresses a hope that in the near future the county councils throughout the country will appoint veterinary surgeons to periodically examine the cows of milk-sellers, and that proper precautions may be taken as regards any animals affected with tuberculosis, and, we would add, any eruptive disease of teats or udders. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN thirty-three of the largest English towns 6261 births and 3427 deaths were registered during the week ending Nov. 17th. The annual rate of mortality in these towns, which had declined in the preceding three weeks from 18-5 to 16 per 1000, rose again last week to 17-1. In London the rate was 15’3 per 1000, while it averaged 18 4 in the thirty-two provincial towns. The lowest rates in these towns were 10-7 in Croydon, 11-0 in Leicester, 11-6 in Hudders- field, 11-8 in Halifax, and 13-3 in Birkenhead ; the highest were 22 7 in Burnley, 23-8 in Sunderland, 24-6 in Swansea and in Gateshead, and 26’3 in Newcastle-on-Tyne. The 3427 deaths included 375 which were referred to the principal zymotic diseases, against 385 and 365 in the preceding two weeks; of these, 108 resulted from measles, 73 from diphtheria, 67 from diarrhoea, 51 from fever" (principally enteric), 37 from whooping-cough, 35 from scarlet fever, and 4 from small- pox. The lowest death-rates from these diseases were recorded in Burnley, Halifax, Leicester, and Norwich, and the highest rates in Portsmouth, Leeds, Newcastle-on-Tyne, Gateshead, and Derby. The greatest mortality from measles occurred in Sunderland, Bradford, Leeds, Portsmouth, Gateshead, and Derby ; from scarlet fever in Birkenhead and Nottingham ; from whooping-cough in Gateshead ; and from "fever " in Plymouth. The 73 deaths from diphtheria included 44 in London, 5 in West Ham, 3 in Birmingham, and 3 in I Manchester. Two fatal cases of small-pox were registered in Birmingham and 2 in Liverpool, but not one in London I or in any other of the thirty-three towns. There were- 42 cases of small-pox under treatment in the Metro- politan Asylum Hospitals and in the Highgate Small- pox Hospital on Saturday last, the 17th inst., against’ 50, 48, and 51 at the end of the preceding three-- weeks ; 3 new cases were admitted during the week, against 8 and 12 in the preceding two weeks. The number of scarlet fever patients in the Metropolitan.’ Asylum Hospitals and in the London Fever Hospital at the end of the week was 2254, against 2285, 2245, and 2258 on the preceding three Saturdays ; 215 new cases were admitted during the week, against 223 in each of the preceding two weeks. The deaths referred to diseases of the respiratory organs in London, which had been 329 and 245 in the preceding two weeks, were again 245 last week, and were 192 below the average. The causes of 67, or 2 0 per cent., of the deaths in the thirty-three towns were- not certified either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in Portsmouth, Cardiff, Nottingham, Oldham, and in ten other- smaller towns ; the largest proportions of uncertified deaths were registered in Bristol, Norwich, Leicester, and Hudders- field. ____ HEALTH OF SCOTCH TOWNS. The annual rate of mortality in the eight Scotch towns,. which had been 22’2 and 20-3 per 1000 in the preceding* two weeks, was again 20-3 last week, and was 3’2per 1000’ below the mean rate during the same period in the thirty-three large English towns. The rates in the eight Scotch towns‘ ranged from 14’0 in Paisley and 16 in Leith, to 22’6 in Glasgow and 24-2 in Greenock. The 579 deaths in these towns included 12 which were referred to measles, 12 to diphtheria, 11 to whooping-cough, 11 to diarrhoea, 10 to scarlet fever, 3 ta " fever," and 1 to small-pox. In all, 60 deaths resulted from these principal zymotic diseases, against 54 and 84 in the pre- ceding two weeks. These 60 deaths were equal to an annual rate ot 2’1 per 1000, which was slightly above the mean rate last week from the same diseases in the thirty-three large English towns. The fatal cases of diphtheria, which had been 14 and 13 in the preceding two weeks, further declined to 12 last week, of which 6 occurred in Glasgow. The deaths referred to measles, which had increased from 3 to 16 in the preceding four weeks, declined to 12 last week, and included 10 in Glasgow. The 11 fatal cases of whooping-cough were within’ 2 of the number in the preceding week, and included 6 in Glasgow and 2 in Edinburgh. The deaths from scarlet, fever, which had been 7 and 8 in the preceding two weeks, further rose to 10 last week, of which 5 occurred in Glasgow and 3 in Edinburgh. The 3 fatal cases of "fever" were all’ recorded in Glasgow, and the death from small-pox occurred’. in Edinburgh. The deaths referred to diseases of the respira- tory organs in these towns, which had been 144 and 166 in, the preceding two weeks, declined to 155 last week, and were 57 below the number in the corresponding week of last year. The causes of 37, or more than 6 per cent., of the> deaths in these eight towns last week were not certified. HEALTH OF DUBLIN. The death-rate in Dublin, which had been 23 9 and 22’8 per 1000 in the preceding two weeks, rose again to 23 v’ during the week ending Nov. 17th. During the past seven- weeks of the current quarter the death-rate in the city has averaged 22-2 per 1000, against 15-9 in London and 19’3 in Edinburgh. The 156 deaths registered in Dublin. during the week under notice showed an increase of 3 uporr the number in the previous week, and included 10 which were referred to the principal zymotic diseases, against 11 and 12 in the preceding two weeks ; of these, 3 resulted from small-pox, 3 from "fever," 2 from diarrho3a, 11 from diphtheria, 1 from whooping-cough, and not one either from measles or scarlet fever. These 10 deaths were equal to an annual rate of 1’5 per 1000, the zymotic. death-rate during the same period being 1’5 in London. and 1-7 in Edinburgh. The fatal cases of small-pox, which had been 1 and 4 in the preceding two weeks, were- 3 last week, making 20 deaths from this disease recordecs within the city since the beginning of the current quarter.. The deaths referred to different forms of "fever," which had been 3 and 2 in the preceding two weeks, rose again to 3 last week. The 2 fatal cases of diarrhoea corresponded with the number in the preceding week. The 156 deaths ire, Dublin last week included 22 of infants under one year of’
