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VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN the 96 English and Welsh towns with populationsexceeding 50,000 persons at the last Census, and whoseaggregate population at the middle of this year is estimatedat 17,852,766 persons, 8293 births and 5195 deaths wereregistered during the week ended Saturday, April 12th.The annual rate of mortality in these towns, which hadbeen 16-5, 16-9, and 15-6 6 per 1000 in the three precedingweeks, further declined to 15° 2 per 1000 in the week undernotice. During the 13 weeks of the quarter just ended themean annual death-rate in these towns averaged 16’ 9

per 1000, against a corresponding rate of 17-5 in London.The death-rates last week in the several towns ranged from7’5 in Tottenham and in Edmonton, 7’7 in Coventry, 7-9 inCarlisle, 8-2 in Croydon, and 8-3 in Willesden and in

Hornsey, to 22 7 in Gloucester and in Stoke-on-Trent, 24’3in Halifax, 26’7 7 in St. Helens, and 27.9 9 in Stockton-on-Tees.The 5195 deaths from all causes in the 96 towns were 142

fewer than the number in the previous week, and included394 which were referred to the principal epidemic diseases,against numbers declining from 464 to 402 in the fourpreceding weeks. Of these 394 deaths, 213 resulted frommeasles, 63 from infantile diarrhoeal diseases, 50 fromwhooping-cough, 36 from diphtheria, 19 from scarlet fever,and 13 from enteric fever, but not one from small-pox. Themean annual death-rate from these diseases last week wasequal to 1-2 per 1000, and coincided with the rate in eachof the two preceding weeks. The deaths attributed to

measles, which had been 220, 208, and 215 in thethree preceding weeks, were 213 last week, andcaused the highest annual death-rates of 2-0 in Boltonand in Stockton-on-Tees, 2-1 1 in Smethwick, 2-2 in

Wolverhampton, 2-3 in West Bromwich and in Wigan,2-4 in Newport (Mon.), 3-1 in St. Helens, and 5-2 in

Gloucester. The deaths of infants (under 2 years of

-age) referred to diarrhoea and enteritis, which had been67, 71, and 53 in the three preceding weeks, rose to 63 lastweek, and included 16 in London, 7 in Liverpool, 4 in Stoke-.on-Trent, 4 in Walsall, 3 in Birmingham, and 3 in Notting-ham. The fatal cases of whooping cough, which haddeclined from 83 to 60 in the four preceding weeks, furtherfell to 50 last week; 15 deaths were registered in London,5 in Liverpool, 3 in Stoke-on-Trent, and 2 each in Birming-ham, in Oldham, in Leeds, and in Aberdare. The deathsattributed to diphtheria, which had declined from 54 to 35 inthe five preceding weeks, were 36 last week, and included 11in London, 4 in Stoke-on-Trent, 4 in Manchester, 3 in Leeds,2 in Cambridge, and 2 in Leicester. The deaths referred toscarlet fever, which had been 28, 19, and 23 in the threepreceding weeks, were 19 last week, of which number 4were recorded in London, 3 in Birmingham, and 2 in WestHam. The fatal cases of enteric fever, which had been 13,.8, and 16 in the three preceding weeks, slightly fell to 13.last week, and included 3 in Manchester and 2 in Liverpool.

The number of scarlet fever patients under treatment inthe Metropolitan Asylums and the London Fever Hospitals,which had steadily declined from 2112 to .1410 in the 15 pre-*ceding weeks, had further fallen to 1357 on Saturday last;148 new cases were admitted during the week, against156, 168, and 167 in the three preceding weeks. These

hospitals also contained on Saturday last 872 cases of

diphtheria, 811 of measles, 264 of whooping-cough, and38 of enteric fever, but not one of small-pox. The 1287deaths from all causes in London were 129 fewer than thenumber in the preceding week, and were equal to an annualdeath-rate of 14 - 9 per 1000. The deaths referred to diseasesof the respiratory system, which had steadily declined from453 to 346 in the six preceding weeks, further fell to 285last week, but were 59 above the number recorded in thecorresponding week of last year. The deaths attributed- to influenza numbered 45, against 65, 47, and 45 in thethree preceding weeks.Of the 5195 deaths from all causes in the 96 towns, 177

resulted from different forms of violence, and 384 were the-subject of coroners’ inquests. The causes of 42, or 0-8 per- cent., of the total deaths were not certified either by a.registered medical practitioner or by a coroner after inquest..All the causes of death were duly certified in Leeds, Bristol,’*West Ham, Portsmouth, Salford, Cardiff, Bolton, and in 59

other smaller towns. Of the 42 uncertified causes of death,4 were registered in Birmingham, 3 in Stoke-on-Trent, 3 inLiverpool, 3 in Gateshead, 2 in Gloucester, 2 in Bury, and2 in Newcastle-on-Tyne. _

HEALTH OF SCOTCH TOWNS.

In the 16 largest Scotch towns with an aggregate popula-tion estimated at 2,259,600 persons at the middle of thisyear, 1196 births and 746 deaths were registered during theweek ended Saturday, April 12th. The annual rate of

mortality in these towns, which had steadily declined from20’7 7 to 17’2 per 1000 in the six preceding weeks, was again17’2 per 1000 in the week under notice. During the 13weeks of the quarter just ended the mean annual death-rate in these Scotch towns averaged 19’1, against a

corresponding rate of 16’ 9 per 1000 in the 96 large Englishtowns. Among the sevaral towns the death-rates last weekranged from 10-7 in Ayr, 11-9 in Perth, and 12’0 inKilmarnock, to 20’ 8 in Greenock, 21-6 6 in Coatbridge, and22- 0 in Dundee.The 746 deaths from all causes were 2 in excess of the

number in the previous week, and included 83 which werereferred to the principal epidemic diseases, againstnumbers declining from 88 to 75 in the three precedingweeks. Of these 83 deaths, 44 resulted from whooping-cough, 13 from measles, 11 from infantile diarrhoeal diseases,9 from diphtheria, 3 from enteric fever, and 3 from scarletfever, but not one from small-pox. These 83 deaths fromthe principal epidemic diseases were equal to an annualdeath-rate of 1’9, against 1-2 2 per 1000 in the 96 largeEnglish towns. The deaths attributed to whooping-cough,which had been 55, 44, and 43 in the three precedingweeks, were 44 last week, and included 25 in Glasgow,8 in Edinburgh, 4 in Greenock, and 2 each in Leith, inMotherwell, and in Hamilton. The deaths referred to measles,which had been 5, 9, and 8 in the three preceding weeks, rose to13 last week of which number 5 occurred in Glasgow and 4in Aberdeen. The fatal cases of diarrhoea and enteritis

(among infants under 2 years of age), which had been 18,17, and 13 in the three preceding weeks, further declinedto 11 last week, and included 5 in Glasgow and 2 inDundee. The deaths attributed to diphtheria, which hadbeen 3, 7, and 6 in the three preceding weeks, rose to 9last week and comprised 5 in Glasgow, 3 in Aberdeen, and1 in Greenock. The 3 deaths referred to enteric feverwere equal to the number registered in each of the two

preceding weeks, and were recorded in Aberdeen, Paisley,and Coatbridge respectively.; the 3 fatal cases of scarlet

fever, which coincided with the average in the three pre-ceding weeks, were registered in Glasgow, Aberdeen, andLeith respectively.

’, The deaths referred to diseases of the respiratory system,which had been 166, 154, and 127 in the three precedingweeks, further declined to 117 last week ; 31 deaths wereattributed to different forms of violence, against 17 and 27 inthe two preceding weeks. _

HEALTH OF IRISH TOWNS.

In the 27 town districts of Ireland, with an aggregatepopulation estimated at 1,199,180 persons at the middle ofthis year, 716 births and 517 deaths were registered duringthe week ended Saturday, April 12th. The annual rate ofmortality in these towns, which had been 21-7, 23’8, and23 3 per 1000 in the three preceding weeks, further declinedto 22-5 per 1000 in the week under notice. During the 13weeks of the quarter just ended the mean annual death-ratein these towns .averaged 22-2 per 1000 ; in the 96 largeEnglish towns the corresponding death-rate did not exceed16’9, while in the 16 Scotch towns it was equal to 19’1 1 per1000. The annual death-rate last week was equal to 27’2 inDublin (against 14-9 in London and 18’0 in Glasgow),19 6 in Belfast, 24-5 in Cork, 14 - 0 in Londonderry, 19’0 0 inLimerick, and 20-9 in Waterford, while in the remaining21 smaller towns the mean death-rate did not exceed 20-7per 1000.The 517 deaths from all causes in the 27 Irish towns

were 18 fewer than the number in the previous week, andincluded 37 which were referred to the principal epidemicdiseases, against 46 and 39 in the two preceding weeks. Ofthese 37 deaths, 14 resulted from measles, 10 from infantilediarrhoeal diseases, 5 from scarlet fever, 5 from diphtheria,and 3 irom whooping-cough, but not one from small-pox

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or from enteric fever. These 37 deaths from the principalepidemic diseases were equal to an annual death-rate of 1- 7 7per 1000; the death-rate from these diseases last week didnot exceed 1-2 2 in the 96 large English towns, while in the16 Scotch towns it rose to 1’9 per 1000. The deaths attri-buted to measles, which had been 14, 17, and 14 in the threepreceding weeks, were again 14 last week, and comprised8 in Wexford, 3 in Newry, 2 in Belfast, and 1 in Cork.The deaths of infants (under 2 years of age) referred todiarrhoea and enteritis, which had been 7, 8, and 11 inthe three preceding weeks, were 10 last week, and included5 in Dublin and 3 in Belfast. The 5 fatal cases of scarletfever, of which 3 occurred in Dublin and 2 in Belfast, were3 above the average in the three preceding weeks. The5 deaths attributed to diphtheria were equal to the averagein the three preceding weeks, and comprised 4 in Dublinand 1 in Belfast. The 3 deaths referred to whooping-coughwere registered in Dublin.The deaths in the 27 Irish towns referred to diseases of the

respiratory system, which had been 138, 122, and 142 in thethree preceding weeks, declined to 109 in the week undernotice. Of the 517 deaths from all causes, 158, or 31 percent., occurred in public institutions, and 10 resulted fromdifferent forms of violence. The causes of 17, or 3’3 percent., of the total deaths were not certified either by aregistered medical practitioner or by a coroner after inquest ;in the 96 large English towns the proportion of uncertifiedcauses of death last week did not exceed 0’ 8 per cent.

VITAL STATISTICS OF LONDON DURING 1912.

IN the accompanying table statistics of sickness andmortality in the City of London and in each of the

metropolitan boroughs are summarised for the year 1912.With regard to the notified cases of infectious disease it

appears that the number of persons reported to be sufferingfrom one or other of the ten diseases specified in the tablewas equal to a rate of 5-3 per 1000 of the populationestimated at 4,519,754 persons in the middle of the year ; inthe three preceding years the rates had been 6-6, 4’5, and5’4 per 1000 respectively. Among the various boroughs therates last year ranged from 3’4 in the City of West-minster, 3’6 in the City of London, 3-7 in Kensington,and 3-8 in Hampstead and in Stoke Newington, to 6’5 5in St. Pancras, 6’9 in Bermondsey, 7-2 in Deptford,8’4 in Woolwich, and 8’5 in Greenwich. The cases of

small-pox notified during the year numbered 4, against21, 7, and 63 in the three preceding years; ofthese 4 cases, 3 belonged to Woolwich and 1 to Poplar.The prevalence of scarlet fever showed a slight increase,11,312 cases being notified in 1912, against 10,489 in 1911.Among the several metropolitan boroughs the greatest pro-portional prevalence of this disease was recorded in Fulham,Stepney, Bermondsey, Deptford, Greenwich, and Woolwich.The number of scarlet fever patients admitted into the

Metropolitan Asylums Hospitals was 10,488 last year,against 16,183, 9889, and 9631 in the three preceding years ;2088 cases remained under treatment at the end of the year,against 2329, 1574, and 1878 at the end of the three

preceding years. Diphtheria was somewhat less prevalentlast year, 7101 cases being notified, against 7389 in the pre-ceding year ; this disease was proportionally most prevalentin Hampstead, St. Pancras, Holborn, Greenwich, Lewisham,and Woolwich. There were 6184 diphtheria patients admittedinto the Metropolitan Asylums Hospitals last year, against5799, 4882, and 6336 in the three preceding years; 959 patientsremained under treatment at the end of the year, against904, 827, and 1294 at the end of the three preceding years.The prevalence of enteric fever showed a marked decreaselast year ; 704 cases were notified, against 1284 and 1025 inthe two preceding years. Among the several boroughs thisdisease was proportionally most prevalent in Holborn,Bethnal Green, Stepney, Poplar, Southwark, Bermondsey,Lambeth, and Wandsworth. The number of enteric feverpatients admitted into the Metropolitan Asylums Hospitalswas 381, against 539, 745, and 552 in the three precedingyears ; 37 cases remained under treatment at the end of the

year; 62, 88, and 76 at the end of the three precedingyears. The greatest proportional prevalence of erysipelasoccurred in Finsbury, Shoreditch, Bethnal Green, Stepney,Poplar, Southwark, Bermondsey, and Deptford. The 380 casesof puerperal fever notified during the year included 31 in

Stepney, 30 in Fulham, 29 in Wandsworth, 27 in Hackney,24 in Lambeth, and 20 in St. Pancras and in Poplar. Of the105 cases of cerebro-spinal meningitis, 13 belonged to

Islington, 11 to Stepney, 8 to Southwark, and 7 each toPaddington, Hackney, and Lambeth ; and of the 132 casesnotified as poliomyelitis 12 belonged to Stepney, 11 to

Islington, 11 to Camberwell, 9 to Lambeth, and 8 to

Hackney.The mortality figures in the table relate to the deaths of

persons actually belonging to the several boroughs and areobtained by distributing the deaths in institutions among theboroughs in which the deceased persons had previouslyresided ; the death-rates from all causes are further correctedfor variations in the sex and age constitution of the popula-tions. During last year the deaths of 61,101 personsbelonging to London were registered, equal to a death-rateof 14 - 3 per 1000, the rates in the three preceding years being14-6, 13-3, and 15’8 8 per 1000. Among the several boroughsthe lowest death-rates last year were 10’ 8 in Wandsworth andin Lewisham, 11.1 in Hampstead, 12’4 in Woolwich, and12.6 6 in Stoke Newington and in Hackney ; the highest rateswere 16-9 in Poplar, 17’2 in Bermondsey, 17’5 in South-wark, 19-0 in Shoreditch, and 19-4 in Finsbury. The 61,101deaths from all causes included 4869, which were referred tothe principal infectious diseases ; of these, 1 resulted fromsmall-pox, 1799 from measles, 159 from scarlet fever, 452from diphtheria, 970 from whooping-cough, 117 from entericfever, and 1371 from diarrhoea and enteritis among childrenunder 2 years of age. The death-rates from these diseasesin the aggregate ranged from 0 - 2 in Stoke Newington, 0 - 4 inHampstead, and 0’6 in Kensington, in Hackney, and in

Lewisham, to 1 - 5 in Bethnal Green, 1 ’7 in Stepney, in Poplar,and in Southwark, and 2-6 6 in Finsbury and in Shoreditch.The death from small-pox belonged to Woolwich. The1799 fatal cases of measles were 223 below the correctedaverage number for the five preceding years; the greatestproportional mortality from this disease occurred in Finsbury,Shoreditch, Bethnal Green, Stepney, Poplar, Southwark, andBermondsey. The 159 deaths from scarlet fever were 229 fewerthan the corrected average number ; this disease was propor-tionally most fatal in St. Marylebone, Finsbury, Bermondsey,Deptford, and Greenwich. The 452 fatal cases of diph-theria were 187 below the corrected average number ; thehighest death-rates from this disease were recorded in

Hampstead, Holborn, Finsbury. Shoreditch, Greenwich,Lewisham, and Woolwich. The 970 deaths from whooping-cough were 318 less than the corrected average number;this disease was proportionally most fatal in Fulham,Finsbury, Shoreditch, Stepney, Poplar, Bermondsey, andGreenwich. The 117 fatal cases of enteric fewer showed adecline of 63 from the corrected average number ; the

greatest proportional mortality from this disease was

recorded in Fulham, St. Marylebone, Shoreditch, Poplar,Bermondsey, Lambeth, and Lewisham. Diarrhoea andenteritis among childien under two years of age were pro-portionally most fatal in Finsbury, Shoreditch, Stepney,Southwark, and Bermondsey. In conclusion, it may bestated that the aggregate mortality in London last year fromthe principal infectious diseases, excluding diarrhoea, was22 per cent. below the average.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE undermentioned Acting Surgeons have been confirmed

in the rank of Surgeon in His Majesty’s Fleet :-AlbertEdward Malone, Hamlet Mark Whelan, Robert FrancisPreston Cory, Henry St. Clair Colson, George Albert

Finegan, John Timothy Donal Sullivan Higgins, JacksonGraham Boal, Frederick St. Barbe Wickham, and SidneyPunch (dated Oct. 4th, 1912).The following appointments have been notified :-Surgeons-

General : A. J. J. Johnston to the Pembroke, additional, forChatham Hospital, and to the Chatham Hospital; and A. W.May to the President, additional, for service at the AdmiraltyMedical Department.

ROYAL ARMY MEDICAL. CORPS.Frederick Edward Bissell, late Captain, Royal Army

Medical Corps Special Reserve, to be Captain (datedApril 16th, 1913).