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and disease, and the resulting official inquiry. The premisesare described by Mr. Spear, and it is perfectly evident thatthey are not such as should be used for a slaughterhouse.They violate a number of the conditions laid down andexplained in the Annotated Edition of the Model Bye-lawsof the Local Government Board ; and it is altogether in-credible how the sanitary authority should have acted inthe inconsistent way they did. The inability of the medicalofficer of health to prove that nuisance and injury to healthhad actually been brought about can hardly be raised as anexcuse, since he had distinctly condemned the premises.The Wallesey Local Board should erect an abattoir in asuitable place, a step which they unwisely decided againstbefore their unfortunate action in granting the licencereferred to.On the Sanitary Adrninistration of the Bridgend hegistra-

tion District, by Mr. SPEAR.-This report enters at veryconsiderable length into all the physical and sanitary cir-cumstances of this district as a whole, and of its severalconstituent sanitary districts; but it is evident that it hasbeen compiled rather with a view to purposes of sanitaryadministration than because of any points of generalsanitary interest. For an area of this rural and semi-ruralsort, an average death-rate from all causes reaching 20 per1000 living must be regarded as excessive ; as also must adeath-rate from the continued fevers of 7 per 10,000. Inone sanitary district Mr. Spear points out that the health-officering is so contrived as to obliterate the most importantfunction-namely, that of an adviser to the sanitaryauthority; and he gives a number of details in support ofthis contention. In another, much the same arrangementsexist, the result being that even pressing and importantsanitary needs hardly ever receive serious consideration.Perhaps the little town of Cowbridge is most typical offaulty sanitary administration. Formerly, when under therural sanitary authority, nothing whatever, it is alleged,appears to have been done to ameliorate the sanitary condi-tion of the town. And even since it has been made an urbandistrict, the value set by the local authority on the services ofa medical officer of health were locally estimated at the rateof JE5 per annum; and, on the protests of the Local Govern-ment Board, the question of salary seems to have beenadjourned, the officer now serving without knowing whathis remuneration is to be. In the meantime he has neverbeen consulted by his authority; grave sanitary faults arebeing committed without reference to him; and the attitudeof the authority as to sanitary affairs may perhaps best beappraised by Mr. Spear’s statement that " much of thewretched house property in the town belongs, directly orindirectly, to town councillors." Throughout the registra-tion district sanitary work is greatly needed, and conditionsfavouring high mortality from such diseases as enteric feverare rife. Mr. Spear evidently feels that, since the majorityof these districts cannot remedy such prevailing evils asrelate, for example, to faulty sewerage without co-operation,as also for other reasons, there would be great advantage ifthe authorities of the several sanitary areas within theregistration district were to combine and appoint one

medical officer of health at a salary which would securethem reasonable and skilled services.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5627 birthsand 3647 deaths were registered during the week endingApril 13th. The annual rate of mortality in these towns,which had been 19-9 and 20-3 per 1000 in the precedingtwo weeks, declined again last week to z9. During lastquarter the death-rate in these towns averaged 20-9 per1000, and was 2-8 below the mean rate in the correspondingperiods of the ten years 1879-88. The lowest rates inthese towns last week were 13-7 in Birkenhead, 13-9’inWolverhampton, 14-8 in Derby, and 15-6 in Hull. Therates in the other towns ranged upwards to 28-1 inManchester, 28’2 in Newcastle-upon-Tyne, 30-1 in Black-burn, and 31’0 in Preston. The deaths referred to theprincipal zymotic diseases in these towns, which had been421 and 464 in the preceding two weeks, declined again lastweek to 436; they included 174 from measles, 104 fromwhooping-cough, 45 from scarlet fever, 43 from diphtheria,38 from "fever" (principally enteric), 32 from diarrhcea,and not one from small-pox. These zymotic diseases t

s caused no death in Wolverhampton, whereas they causedt the highest death-rates in Manchester, Preston, and Black-’. burn. The greatest mortality from measles was recorded1 in Preston, Oldham, Bolton, Birkenhead, and Manchester;.s from whooping-cough in Blackburn, Newcastle-upon-Tyne,- Cardiff, and Preston; from scarlet fever in Birkenhead1 and Blackburn; and from "fever" in Preston and Ports-1 mouth. The 43 deaths from diphtheria in the twenty-i eight towns included 36 in London and 3 in Birmingham.a No death from small-pox was registered in any of the. twenty-eight great ;towns; and no small-pox patient was.J. under treatment at the end of the week in the Metro-t politan Asylum Hospitals. The number of scarlet-feverB patients in the Metropolitan Asylum and London Fever

Hospitals at the end of last week was 572, against 579 and;- 580 in the preceding two Saturdays; 56 cases were admitted, to these hospitals during the week, against 41 and 47 in the- previous two weeks. The deaths referred to diseases of1 the respiratory organs in London, which had been 332 ands 364 in the preceding two weeks, declined last week to 294;r they were 161 below the corrected weekly average and were1 fewer than in any previous week of this year. The causesI of 83, or 2’3 per cent., of the deaths in the twenty-eightr towns last week were not certified either by a registeredi medical practitioner or by a coroner. All the causes of’i death were duly certified in Newcastle-upon-Tyne, Salford,- Cardiff, Norwich, Plymouth, Derby, and Birkenhead. Theb largest proportions of uncertified deaths were registered inT Halifax, Hull, Preston, Leicester, and Brighton.E

, HEALTH OF SCOTCH TOWNS.

, The annual rate of mortality in the eight Scotch towns,f which had declined in the preceding four weeks from 25’4 to’; 21’8, rose again to 23’0 in the week ending April 13th;., this rate exceeded by 3-1 per 1000 the mean rate during the, same period in the twenty-eight large English towns. Thel rates in these Scotch towns ranged last week from 14’8 and’f 18-8 per 1000 in Edinburgh and Dundee to 26-6 in Paisley

and 28’9 in Glasgow. The 588 deaths in the eight towns.. showed an increase of 30 upon the number in the previous.l week, and included 44 which were referred to whooping-j cough, 27 to measles, 7 to diphtheria, 6 to diarrhcea, 2 to-. scarlet fever, 1 to "fever," and not one to small-pox; in all,

87 deaths resulted from these principal zymotic diseases,against 92 and 90 in the preceding two weeks. These 87deaths were equal to an annual rate of 3’4 per 1000,

: which exceeded by 1’1 the mean rate from the same. diseases in the twenty-eight English towns. The fatal. cases of whooping-cough, which had been 31, 37, and 41

in the preceding three weeks, further rose to 44, and in-eluded 30 in Glasgow and 9 in Dundee. The 27 deaths from

measles showed a further decline of 4 from recent weeklynumbers ; 23 occurred in Glasgow, 2 in Dundee, and 2 inGreenock. The 7 deaths referred to diphtheria were withinone of the number in the previous week, and included 3 inGlasgow. The deaths from the principal diseases of the re--

: spiratory organs, which had steadily declined in the pre--: ceding four weeks from 173 to 124, further fell last week.

to 122, and were 7 below the number in the corresponding:week of last year. The causes of 65, or more than 11per cent., of the deaths registered during the week werenot certified.

____

HEALTH OF DUBLIN.

The rate of mortality in Dublin, which had been 27.6-and 25’7 in the preceding two weeks, was again 25’7 inthe week ending April 13th. During last quarter, the-death-rate in the city averaged 28’6 per 1000, the meanrate during the same period being 19.5 in London and’19’0 in Edinburgh. The 174 deaths in Dublin corre-

sponded with the number in the preceding week; theyincluded 10 which were referred to measles, 7 to whooping-cough, 2 to "fever," 2 to diarrhoea, and not one either-to small-pox, scarlet fever, or diphtheria. Thus the deathsfrom these principal zymotic diseases, which had beenbut 8, 9, and 7 in the preceding three weeks, rose lastweek to 21, and exceeded the number in any previous weekof this year; they were equal to an annual rate of 3’1per 1000, the rates from the same diseases being 2’2 inLondon and 0-6 in Edinburgh. The fatal cases of measlesand of whooping-cough, which had in each case been but 2in the previous week, rose last week to 10 and 7 respectively.The deaths from 11 fever corresponded with the number in

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the previous wee . The deaths of infants showed anincrease, while those of elderly persons were fewer thanthose in the previous week. Eleven inquest cases and3 deaths from violence were registered; and 51, or nearlya third, of the deaths occurred in public institutions. Thecauses of 26, or more than 13 per cent., of the deaths inthe city were not certified.

THE SERVICES.

The Queen has given orders for the appointment o

Surgeon-Major Richard Hugh Carew, Medical Staff, to thDistinguished Service Order and for promotion in the Armby Brevet, in recognition of his services during the operationat Sikkim, bearing date Nov. 2nd, 1888.ARMY MEDICAL STAFF. - Brigade Surgeon Benjami]

Cowan Kerr, M.D., has been granted retired pay (date<April 2nd, 1889); Surgeon-Major John Ross Murray, M.D.F.R.C.S. Edin., to be Brigade Surgeon, ranking as LieutenantColonel, to complete establishment (dated April 1st, 1889)The undermentioned Surgeons-Major are granted retire(

pay (dated April 17th, 1889) :-Francis Alfred Turton, M.D.F.R.C.S. Edin., Thos. Babington, and John Nugent StockYEOMANRY CAVALRY. -Royal lst Devon : Fredericl

Morgan, Gent., to be Surgeon (dated April 17th, 1889).ADMIRALTY.&mdash;In accordance with the provisions of He:

Majesty’s Order in Council of April 1st, 1881, Fleet SurgeoiAstley Cooper has been placed on the Retired List, at hi!own request, with permission to assume the rank of DeputyInspector-General of Hospitals and Fleets (dated April 12th1889)..The following appointments have been made:&mdash;Doyle

M. Shaw, C.B., Inspector-General of Fleets and Hospitalsto Haslar Hospital (dated April 25th, 1889) ; S. J. Hunter,M.B., surgeon, to the Research, and E. St. M. Nepean,surgeon, tc Haulbowline Hospital (both dated April 24th,1889); Richard J. Barry, Staff Surgeon, to the Ritpert,additional, temporarily (dated April 1st, 1889).VOLUNTEER CORPS. -Artillery: lst Northumberland:

John Victor Walton Rutherford, Gent., to be Acting Sur-

geon (dated April 13th, 1889).-lst Newcastle-on-Tyne:Acting Surgeon M. J. Wakefield, M.B., resigns his appoint-ment (dated April 13th, 1889).-9th Lancashire: The follow-ing Officers are transferred from the 3rd Lancashire Artil-lery Volunteer Corps on its division into two Corps-viz. : Acting Surgeons R. Patrick, M.D., and J. J. Neville, tobe Acting Surgeons (dated April 1st, 1889). The above-namedOfficers will be considered to have received commissions ofthe same rank and date as those previously held by them.in the 3rd Lancashire Artillery Volunteer Corps.-3rd Volun-teer (Kent) Brigade, Cinque Ports Division, Royal Artillery:Surgeon R. Gooding to be Surgeon-Major, ranking as Major(dated Feb. 25th, 1889).&mdash;1st Volunteer (Hampshire) Brigade,Southern Division, Royal Artillery: Acting Surgeon G. G.Sparrow to be Surgeon, ranking as Captain (dated April 13th,1889).-Rifle : 2nd Volunteer Battalion, the King’s (Liver-pool Regiment): Charles Thurstan Holland, Gent., to beActing Surgeon (dated April 17th, 1889).&mdash;1st VolunteerBattalion, the Buffs (East Kent Regiment): Sidney Waclier,Gent., to be Acting Surgeon (dated April 13th, 1889).-3rd Volunteer Battalion, the Norfolk Regiment: ActingSurgeon A. W. Thomas to be Second Lieutenant, Super-numerary(dated April 13th, 1889).&mdash;2nd Volunteer Battalion,the East Surrey Regiment : Surgeon E. Pocklington to beSurgeon-Major, ranking as Major (dated March 18th, 1889).3rd Volunteer Battalion, the Queen’s Own (Royal WestKent Regiment): Surgeon William Robert Smith, M.D.,to be Surgeon-Major, ranking as Major (dated Feb. 4th,1889).-3rd (the Blythswood) Volunteer Battalion, the High-land Light Infantry : Alexander Dryden Moffat, Gent., to beActing Surgeon (dated April 13th, 1889).&mdash;1st Dumbarton-shire : James McLachlan, M.B., to be Acting Surgeon(dated April 13th, 1889).VOLUNTEER MEDICAL STAFF CORPS. -The Aberdeen

Division : Alexander McGregor, M.D., to be Acting Surgeon(dated April 17th, 1889).

DONATIONS.&mdash;Mr. Gervas Taylor and Messrs. JohnJameson and Son have each given X50 towards the funds ofthe Adelaide Hospital, Dublin.

Correspondence.THE COLLEGE OF SURGEONS AND ITS

MEMBERS.

"Audi alteram partem. ’

To the Editors of THE LANCET.SIRS,&mdash;Will you allow me to point out why neither Mr.

Marsh’s letter nor Mr. Trimmer’s reply to Mr. Marsh’sinquiry in the least affects my argument ? In answer to thedemand of the Members to have some share in the manage-ment of the affairs of the College, it is said that any Membermay, if he will, become a Fellow. I say this is true only ofthose having convenient access to a large hospital and amedical school; but to those not so situated, and having todepend for their living on their day’s work, the Fellowshipis practically impossible. Mr. Marsh puts into my mouthwords in quotation commas which I never used at themeeting on the 3rd inst. Quoting the College Calendar ofthe current year, I said that six years must be spent instudy (p. 72, par. d), and that Mr. Trimmer assures us thatthe extra two years of the curriculum may be spent in avillage surgery (!) does not affect the fact that in a villageit is impossible to get the course of operative surgery on thecadaver (Section 3, Clause 2), which is an extra necessity;nor does country practice afford the opportunities for gettingthe special information-say in abdominal surgery--whichwould enable the candidate who had successfully passed theexamination for the Membership to have any chance at thepass examination for the Fellowship.The new conditions of admission to the examination indi-

cated by Mr. Trimmer, as compared with those in force in1871, afford merely another grievance against the presentsystem of government of the College. In those days aharassing number of extra certificates and signatures wererequired which are apparently now not insisted on. Manyapplicants at that time were refused admission altogetherfor want of them; very many had their admission deferredfor periods of six and twelve months, till they could beearned by attending new courses. These frequent altera-tions make the value of the Fellowship a variable and un-known quantity, and yet it is evident that the apparentrelaxation of the technical conditions is a mere sham. TheCouncil appear to have made of their own bye-law a condi-tion so elastic that the "six years" clause may mean any-thing ; yet it does mean what it really was-two extra yearsof hard hospital and school work, ivhich few men in practicewould face, and which they could avail themselves of onlyin a town large enough to have a clinical hospital and amedical school. Therefore, to say that any Member can,after he has settled in practice, become a Fellow is merenonsense.. I am, Sirs, yours obediently,

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April 18th, 1889. LAWSON TAIT.

"IS SYPHILIS CURABLE?"To the Editors oj THE LANCET.

SIRS,&mdash;The question which has been raised by Dr. Gowers.is so important that it behoves all who have had practicalexperience in the treatment of syphilis to throw whateverlight they can upon the subject, however little that lightmay be.The reoccurrence of syphilis in the same individual has.

been already adduced as a proof that syphilis may be con-sidered curable; and the belief, formerly general, that asecond attack of syphilis was unknown, may now be con-sidered as quite exploded. The exceptions are much toonumerous to prove the rule. If syphilis were incurable,ought we not to see many more deaths from it? That it isthe cause of many abortions, many stillbirths, and manydeaths in early childhood is clear, but how seldom compara-tively do we see or hear of the death of an adult fromsyphilis pure and simple. Even the cases in which it plays.a more remote part in causing death are few, considering thegeneral prevalence of syphilis in this country for many yearspast.

I would also ask another question. If syphilis were notcurable, should we not see much more of it among the wivesand children of those who have formerly suffered from it?Every practitioner of middle or advanced age must be able-to recall scores, if not hundreds, of cases of male patientsm