1474 PUBLIC HEALTH AND POOR LAW.-VITAL STATISTICS.

diphtheria we are glad to see that in Brighton "threeconsecutive failures to find the diphtheria bacillus are

required before any importance can be attached to negativeresults." There were 42 cases of enteric fever in Brightonduring 1902 and Dr. Newsholme states definitely that of thisnumber 1 11 were caused by oysters, six and three secondaryto these were caused by mussels, and one was caused bywhelks, with one case secondary (by personal infection).

"

With regard to the evidence as to the connexion betweenshell-fish and diseases the statement is made that "it is purelycircumstantial and can only be regarded as conclusive bythose who, like myself, have felt the steadily increasingweight of conviction produced by the steady flow of casesfor which no cause can, after diligent search, be detectedother than the previous consumption of shell-fish." The words"of shell- fish known to have been derived from sources liableto specific pollution are perhaps necessary to complete thissentence, as if the oysters were derived from mid-oceanand had no opportunities of becoming polluted the merefact of the consumption of oysters would be of little

greater value than the fact of the consumption’of any otherarticle of food theoretically capable of conveying entericfever. But apparently Dr. Newsholme could, at least insome of the cases, have quite well added the words whichwe suggest, although we fear that the statements of someoyster merchan s as regards the source of their shell-fishare not always to be relied upon. But in any circumstancesthere can be no question whatever that the sale of shell fishfrom polluted sources should be prohibited, and we are gladto see that Brighton has recently drafted a by-law whichaims at, " prohibiting the sale or exposure for sale in

Brighton fish market of oysters or other shell-fish known tohave come from a sewage-contaminated source." The wordsused in the by-law of ’’ polluted or contaminated with

sewage " might perhaps be held by some bacteriologists toapply to almost every estuary in England as well as to muchof the littoral, but Dr. Newsholme may be trusted to takea reasonable view of the situation and to content himselfwith excluding shell-fish concerning which there can

be no reasonable doubts. We much hope that Brightonwill obtain, either in the shape of a modified by-lawor otherwise, the protection which it seeks against theconsumption of specifically polluted shell-fish. The volun-

tary notification of pulmonary tuberculosis has now beenin operation in Brighton since 1899 and there appearsto be a steady increase in the number of cases notified

year by year. Certain cases seem to have been notifiedseveral times. In case of death or in the event of changeof address disinfection and cleansing of the invaded housesare undertaken by the town council. As the result of four

years’ experience of the notification of pulmonary tuber-culosis in Brighton Dr. Newsholme is of opinion that themeasure is necessary in the interests of the public health.He is more convinced than ever that the effective preven-tion of the spread of infection can only be secured whenthe family practitioner and the medical officer of health

cooperate." Arrangements have now been made for theadmis.’-ion of cases of pulmonary tuberculosis into the isolationpavilion of the borough sanatorium, one of the main objectsof this step being to educate the patients in precautionarymeasures.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8911 births and 4441deaths were registered during the week ending May 16th.The annual rate of mortality in these towns, which hadbeen 17 4, 17 5, and 15 9 per 1000 in the three precedingweeks, further declined to 15-4 per 1000 last week. InLondon the death-rate was 14’4 per 1000, while it

averaged 15’ 8 in the 75 other large towns. The lowestdeath-rates in these towns were 3’3 in Hornsey, 7’1 inEa.st Ham and in Hastings, 7’ 9 in Warrington, 8’ 6 inWillesden, 9 1 in Ipswich and in Handsworth, 9’8 in KingsNorton, and 10 6 in Devonport ; while the highest rates were21-2 in West Bromwich, 21-4 in Oldham, 21-8 in MerthyrTydfil, 22. in Coventry, 22 9 in Stockport, 23-1 in Hanley,24-0 in Rochdale, and 24-1 in Middlesbrough. The 4441deaths in these towns last week included 428 which were re-ferred to the principal infectious diseases, against 504,518, and 457 in the three preceding weeks; of these 428

deaths 125 were referred to measles, 110 to whooping-cough,57 to diarrhoea, 52 to diphtheria, 41 to scarlet fever,26 to "fever" (principally enteric), and 17 to small-

pox. In Hornsey, Brighton, Norwich, Stockport, Hudders-field, Halifax, York, South Shields, and in eight other smallertowns, no death from any of the principal infectious diseaseswas registered last week, while they caused the highestdeath-rates in Tottenham, Wolverhampton, Nottingham,Bootle, Wigan, Oldham, Merthyr Tydfil, and Swansea. The

greatest proportional mortality from measles occurred in

Croydon, Tottenham, Coventry, Nottingham, Wigan, Bolton,Manchester, and Swansea; from diphtheria in Hanley,Oldham, and Merthyr Tydfil ; from whooping-cough in

Salford, Oldham, Barrow-in-Furness, Sheffield, and MerthyrTydfil; from 11 fever " in Wolverhampton ; and fromdiarrhoea in Wolverhampton and West Bromwich. Sixfatal cases of small-pox were registered in Liverpool,two in Leeds, and one each in Aston Manor, Bootle, Man-chester, Oldham, Rochdale, Burnley, Bradford, Hull, andGateshead, but not one in any other of the 76 large towns.The number of small-pox patients under treatment in theMetropolitan Asylums hospitals, which had risen from sevento 60 on the eight preceding Saturdays, were again 60 onSaturday, May 16th ; seven new cases were admitted duringthe week, against nine, 12, and 17 in the three precedingweeks. The number of scarlet fever patients in these hos-pitals and in the London Fever Hospital at the end of theweek was 1756, against 1700, 1717, and 1730 at the end ofthe three preceding weeks ; 236 new cases were admittedduring the week, against 243, 235, and 229 in the three

preceding weeks. The deaths referred to diseases of therespiratory organs in London, which had been 280, 284, and260 in the three preceding weeks, declined again last weekto 226 and were five belowifthe number in the correspond-ing period of last year. The causes of 67, or 1’5 percent., of the deaths in the 76 towns were not certifiedeither by a registered medical practitioner or by a coroner.All the causes of death were duly certified in Portsmouth,Plymouth, Bristol, Bolton, Salford, Oldham, Newcastle-on-Tyne, and in 36 other smaller towns ; the largest pro-portions of uncertified deaths were registered in Leyton,Liverpool, Bootle, St. Helens, Preston, Sheffield, Rotherham,and South Shields.

____

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in eight of the principalScotch towns, which had been 18-5, 19-2, and 17-9 9 per 1000in the three preceding weeks, rose again to 18 0 per 1000during the week ending May 16th, and was 2’ 6 per 1000 inexcess of the mean rate during the same period in the 76large English towns. The rates in the eight Scotch townsranged from 7’ 7 in Perth and 12-9 in Aberdeen to 19 3 inGlasgow and 22’5 in Greenock The 590 deaths in thesetowns included 25 which were referred to whooping-cough,16 to measles, 12 to diarrhoea, six to diphtheria, five toI fever," and four to scarlet fever, but not one to small-pox.In all, 68 deaths resulted from these principal infectiousdiseases last week, against 57 in each of the two pre-ceding weeks. These 68 deaths were equal to an annualrate of 2-1 per 1000, which was 0-6 above the meanrate last week from the same diseases in the 76 largeEnglish towns. The fatal cases of whooping-cough, whichhad been 30, 32, and 26 in the three preceding weeks,f mther declined last week to 25, of which 12 occurred inGlasgow, seven in Edinburgh, and four in Greenock. Thedeaths from measles, which had been four, seven, andeight in the three preceding weeks, further rose to 16last week, and included nine in Glasgow, and five in

Edinburgh. The fatal cases of diarrhoea, which hadbeen 11 in each of the two preceding weeks, in-creased last week to 12, of which seven were registeredin Glasgow, two in Dundee, and two in Aberdeen.The deaths from diphtheria, which had been two. one, andfive in the three preceding weeks, further rose to sixlast week and included four in Glasgow, where also two ofthe five deaths from " fever " were recorded. The fatal casesof scarlet fever, which had been four in each of the twopreceding weeks, were again four last week, and includedtwo in Edinburgh and two in Paisley. The deaths referredto diseases of the respiratory organs in these towns, whichhad been 129, 125 and 104 in the three preceding weeks,further declined last week to 101, and were 13 belowthe number in the corresponding period of last year. The

1475VITAL STATISTICS.-THE SERVICES.

causes of 24, or more than 4 per cent., of the deaths inthese eight towns last week were not certified.

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 24’ 8, 25.7, and25 ’ 3 per 1000 in the three preceding weeks, further declinedto 22 -3 per 1000 during the week ending May 16th. Duringthe past four weeks the death-rate has averaged 24’ 5 per1000, the rates during the same period being 16 ’ 1 in Londonand 1’7’2 2 in Edinburgh. The 162 deaths of persons belong-ing to Dublin registered during the week under notice showed- a decline of 22 from the number in the preceding weekand included 15 which were referred to the principalinfectious diseases, against eight, nine, and 15 inthe three preceding weeks ; of these, five resulted frommeasles, four from small-pox, three from whooping-cough,and one each from scarlet fever, from "fever," andfrom diarrhoea, but not one from diphtheria. These 15deaths were equal to an annual rate of 2.1 1 per 1000, thedeath-rates last week from the same diseases being 1’5in London and 2’ 5 in Edinburgh. The deaths frommeasles, which had been one, one, and 0 in the three pre-ceding weeks, increased last week to five. The fatal cases of

small-pox, which had been one, three, and four in the three’preceding weeks, were again four last week. The deathsfrom whooping-cough, which had been one, one, and fourin the three preceding weeks, declined again last week to’three. The 162 deaths in Dublin last week included 34of children under one year of age and 48 of personsaged 60 years and upwards ; the deaths among bothinfants and elderly persons slightly exceeded the respectivenumbers recorded in the preceding week. Two inquest caseswere registered, and 71, or nearly 44 per cent., of thedeaths occurred in public institutions. The causes of five,or more than 3 per cent., of the deaths in Dublin last weekwere not certified.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments are notified : Surgeons:

F. F. Lobb to Royal Marines Division, Plymouth, and E. F. .jMortimer to Plymouth Hospital.Civil Practitioner : T. Foley to be Surgeon and Agent at

Ardmore, Ballymacart, and Whiting Bay.1ST LIFE GUARDS.

Surgeon-Major B. W. C. Deeble to be Surgeon-Lieutenant-Colonel. Dated Feb. 3rd, 1903.

ROYAL ARMY MEDICAL CORPS.

Major J. Paterson, from half-pay, to be Major, viceV. E. Hunter, deceased, with precedence next below A. P.Blenkinson. Dated April 26th, 1903. Lieutenant G. W. G.

Hughes, from the seconded list, to be Lieutenant. Dated

May 2nd, 1903. Lieutenant-Colonel William BirkmyreMiller, retires on retired pay. Dated May 16th, 1903.The undermentioned Lieutenants to be Captains (dated

April 25th, 1903) :-T. Biggam, W. L. Baker, F. W. Cotton,F. M. Parry, B. R. Dinnis, W. J. P. Adye-Curran, J. Powell,B. L. Argles, J. G. Foster, E. G. Ford, F. S. Walker, L. M.Purser, W. Bennett, P. G. Stock, H. B. Fawcus, T. E.

Fielding, E. P. Sewell, C. H. Straton, B. S. Bartlett, R. T.Brown, G. Carroll, D. 0. Hyde, A. E. Hamerton, G. J.Houghton, J. G. Churton, A. D. Waring, T. H. Stevenson,J. M. Cuthbert, F. McLennan, A. F. Weston, J. Dorgan,.c. H. Furnivall, J. H. Robinson, and Fitz G. FitzGerald.

THE ROYAL MILITARY TOURNAMENT.

Important as are the many aspects from which the RoyalMilitary Tournament at the Agricultural Hall may beviewed there is one which should be placed before all

others—namely, the point of view of charity. The entireprofits derived from the performances-an aggregate of47,000 for the past seven years-are devoted by the com-mander-in-chief to naval and military charities, and for thisreason alone the tournament should receive the widestsupport. But the tournament has an important bearingon the education of the general public in military mattersand forms a means of healthy amusement for the people, to

say nothing of its use as an aid to recruiting. For the pre-sent we must confine ourselves to a brief reference to thedisplays and competitions, reserving for another occasion, ifspace permits, a more critical review of the tournament.From a spectacular point of view the pageant, which is aminiature representation of the Delhi durbar, is enthusiasti-cally appreciated, as is also the military tattoo by massedbands ; the latter item, however, is only to be seen and heardthree times in the fortnight during which the tournamentis in process. It is worth a visit to the Agricultural Hall tosee either of these items alone, but there are other " turns

"

-if we may borrow a word from music-hall parlance-whichare equally attractive, and amongst them we may mentionthe musical double ride by the 2nd Life Guards, the finestperformance of this description which has ever been seen atthe tournament. Next week the Life Guards will giveplace to the 5th Royal Irish Lancers. The displays by theseamen of the Excellent and by the Royal Marines arereferred to in another part of our present issue (p. 1457).Then there are the competition of the Army Service Corps, awonderful exhibition of smartness ; the musical drive bythe Royal Artillery ; bareback riding, furnished by a teamfrom the Cavalry Depot at Canterbury ; the.’ display bythe A Battery of the Royal Field Artillery ; wrestling onhorseback and the usual competitions, which include tent-pegging, lemon-cutting, heads and posts, and the combatsbetween men using the various arms of the service.Altogether the twenty-fourth Royal Military Tournamentis the best which has ever been held at Islington and Major-General Oliphant and his committee deserve the best thanksof the public for providing such an excellent, instructive,and entertaining programme. The medical and sanitaryarrangements, though perhaps not all that could be desired,are undoubtedly the best that can be obtained in a buildingwhich does not belong to the military authorities and whichis certainly not adapted to military performances. Surgeon-Lieutenant-Colonel W. R. Crooke-Lawless of the ColdstreamGuards is the principal medical officer and he is assisted byCaptain F. A. Symons, R. A. M. C. Lieutenant-Colonel A. R.Rowe is in charge of the veterinary arrangements. Thetournament will close on May 30th.

THE WOUNDED IN NAVAL WARFARE.

The disposal of the wounded in naval warfare is con-

fessedly a very difficult problem. In a lecture deliveredrecently at the Royal United Service Institution and pub-lished in our present issue (p. 1431) Dr. Philip N. Randall,late R.N., advocated the plan which has seemed to bethe most plausible to those who have given the matterconsideration, namely, the provision of vessels flying theGeneva Cross and specially fitted out for the purpose. Theseshould be attached to a fleet and utilised for the receptionand treatment of the wounded during or immediately afteran engagement. There seemed to be a consensus of opinionamong those who took part in the discussion that it wouldprove unsafe and impracticable to attempt any removal of thewounded during an action and that beyond having firstaid rendered to them the wounded must remain wherethey were until the action was over and their safe removalcould be assured.

THE ARMY CORPS.

Whether an army corps scheme borrowed from the con-tinent or an organisation by divisions be best suited to thiscountry from a strategical point of view is a matter intowhich we need not enter. It must be admitted, however,that the War Office return just issued giving the actualnumbers and peace establishment of the units in the First,Second, Third, and Fourth Army Corps goes a long way inshowing that such corps are not a mere paper organisation,and that they are not, as has been alleged, only phantomcorps, but that they have a fairly real existence and thatMr. Brodrick’s contentions regarding his new scheme havebeen so far justified.The King has granted to Captain Henry Nason Dunn,

R.A.M.O., His Majesty’s Royal licence and authority thathe may accept and wear the Insignia of the Fourth Classof the Imperial Ottoman Order of the Osmanieh, conferredupon him by His Highness the Khedive of Egypt in recognitionof valuable services rendered to the Egyptian Government.The report of the committee appointed to consider the

existing conditions under which canteens and regimentalinstitutes are conducted, together with a minority report andappendices, has been issued as a Parliamentary Blue-book.