1345THE PLAGUE IN INDIA.-VITAL STATISTICS.

’" may" in the clause ought to be changed to "shall." The

anacy outbreaks of scarlet fever and diphtheria whichoccurred in his district after the hop-picking season was.over would lead him to believe that disease was imported bythese casual workers.

Dr. TEw (Tonbridge), Mr. ADAMS (Maidstone), Dr.THRESH, Dr. PORTER (Stockport), the Rev. EMBLETON’THOMAS, and Major L. FLOWER took part in the discussion.

THE PLAGUE IN INDIA.

ALTOGETHER apart from the frontier war the Government.of India and the authorities of the India Office at home arEconfronted with a very grave and anxious duty in having t(,deal with the plague the spread and progress of which ir

India is a really serious matter. As was confidently expecte&oacute;there has been a recrudescence of bubonic plague in WesternIndia with the advent of the cold weather, and thedisease has, moreover, manifested itself in other anddistant provinces and districts, cases having occurred in theMadras Presidency, in the North-West Provinces, in thePunjab, and in Central India and Rajputana. At Poonaand in the towns and villages thereabout there has been analarming increase in the number of cases during the pastmonth; the number of patients admitted to hospital and<under treatment is double what it was and the mortality isvery large. According to the latest telegram (Nov. 15th)the epidemic in the city and cantonments shows no abate-ment. There were 630 plague patients in the Poona hos-

pitals, and there had been 134 cases and 94 deaths during thepreceding forty-eight hours. The city is completely desertedand several of the principal streets are closed. At Sholapore,Nasik, and other towns and villages there have beennumerous attacks. Nasik is not very far from Deolalie, themilitary dep6t through which our troops have to pass in’their railway journey on arriving at, and leaving, India.

It will be remembered that an outbreak of plague occurredsome time ago at Hurdwar, but owing to the prompt andenergetic action of the local authorities the disease did notspread. Still, it is believed that it was carried into theJullundur district of the Punjab where some cases of plaguehave recently occurred. The Punjab Government have takenstringent measures in regard to this outbreak. The Standardof the 15th inst. contains an interesting communication fromits own correspondent on the plague in India and the spreadof the infection in which it is stated among other things thatat Hurdwar the disease was communicated to the monkeyswhich always congregate in large numbers on such occasions.The Government of India and the local governments are, itis needless to say, using all vigilance in their efforts to limitthe spread of the disease.Lord Sandhurst, the Governor of Bombay, visited Poona

on the 29th ult., inspected the plague hospitals and camp,and expressed himself satisfied at the way in whicheverything was being conducted. Lord Sandhurst alsovisited Sholapore on Oct. 21st and inspected the hospitalsand segregation sheds at that station. The exodus of peoplefrom these places has, as might be expected, been very greatand much inconvenience has resulted from the want ofnative labour. Surgeon-General Cleghorn, C.S.I., was

expected at Bombay with the view of making specialenquiries into the plague.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN thirty-three of the largest English towns 6324 birthsand 4009 deaths were registered during the week endingNov. 13th. The annual rate of mortality in thesetowns, which had increased in the three preceding weeksfrom 16-9 to 18’1 per 1000, further rose last week to 19-0.In London the rate was 19-4 per 1000, while it averaged18’8 in the thirty-two provincial towns. The lowest death-ratec in these towns were 10-7 in Cardiff, 11-7 in Plymouth,13’3 in West Ham, and 13’9 in Gateshead ; the highest rateswere 23’1 in Liverpool, 24-7 in Sheffield, 25’4 in Preston, and26 in Burnley. The 4009 deaths in these towns included461 which were referred to the principal zymotic diseases,

against 463 and 412 in the two preceding weeks ; of these,157 resulted from measles, 70 from diphtheria, 68 fromdiarrhoea 61 from whooping. cough, 59 from "fever" (princi-pally enteric), and 46 from scarlet fever. No fatal case ofany of these diseases was recorded last week in Birkenhead;in the other towns they caused the lowest death-rates inBrighton, Newcastle-upon-Tyne, Portsmouth, and Hull, andthe highest rates in Bolton, Bristol, Gateshead, and Black-burn. The greatest mortality from measles occurred inHuddersfield, Sunderland, Gateshead, Swansea, Croydon,Oldham and Blackburn ; from scarlet fever in Gateshead ;from "fever" in Bristol; and from diarrhoea in Wolver-hampton and in Bolton. The mortality from whooping-coughshowed no marked excess in any of the large towns. The70 deaths from diphtheria included 46 in London, 5 inBirmingham, 4 Liverpool, 3 in Cardiff, and 3 in Leicester.No fatal case of small-pox was registered last week inany of the thirty-three large towns; and no small-poxpatients were under treatment in any of the Metro-politan Asylum Hospitals. The number of scarlet feverpatients in these hospitals and in the London FeverHospitals at the end of the week was 3777, against3685, 3682, and 3680 on the three preceding Saturdays;460 new cases were admitted during the week, against342, 416, and 339 in the three preceding weeks. Thedeaths referred to diseases of the respiratory organs inLondon, which had been 326 and 363 in the two pre-ceding weeks, further rose to 420 last week, and were14 above the corrected average. The causes of 50, or 1-2per cent., of the deaths in the thirty-three towns werenot certified either by a registered medical practitioneror by a coroner. All the causes of death were duly certifiedin Bristol, Nottingham, Bradford, Leeds, and in fourteenother smaller towns; the largest proportions of uncertifieddeaths were registered in Swansea, Leicester, Liverpool,and Sheffield.

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HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had declined in the three preceding weeks from 20’3to 18 8 per 1000, rose again to 20’1 during the week endingNov. 13th, and exceeded by 1’1 per 1000 the mean rateduring the same period in the thirty-three large Englishbowns. The rates in the eight Scotch towns ranged from16’1 in Paisley and 16’6 in Aberdeen to 21’4 in Glasgow and3-7 in Greenock. The 599 deaths in these towns included23 which were referred to diarrhoea, 12 to whooping-cough,Ll to scarlet fever, 7 to measles, 6 to diphtheria, 4 to’ fever," and 1 to small-pox. In all, 64 deaths resulted fromihese principal zymotic diseases, against 79 and 70 inihe two preceding weeks. These 64 deaths were equal tom annual rate of 2’1 per 1000, which was slightly belowihe mean rate last week from the same diseases in the;hirty-three large English towns. The fatal cases of whoop-ng-cough, which had been 15 and 16 in the two precedingveeks, declined to 12 last week, and included 8 in Glasgowmd 3 in Greenock. The deaths referred to scarlet fever,vhich had increased from 4 to 18 in the three precedingveeks, fell to 11 last week, of which 6 occurred in Glasgow,nd 4 in Dundee. The 7 fatal cases of measles alsohowed a decline from those recorded in recent weeks, andQcluded 5 in Greenock. The deaths from diphtheria,rhich had been 3 and 5 in the two preceding weeks, furtherDse to 6 last week, of which 2 occurred in Glasgow andin Edinburgh. The 4 fatal cases of " fever" included 2

i Glasgow and 2 in Edinburgh. The deaths referred toiseases of the respiratory organs in these towns, whichad been 137 and 142 in the two preceding weeks, furtheruse to 161 last week, but were slightly below the numberi the corresponding period of last year. The causes of5, or nearly 6 per cent., of the deaths in these eight townstst week were not certifi4d’

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 28’2 and 21-5;r 1000 in the two preceding weeks, further declined to)-8 during the week ending Nov. 13th. During the pastx weeks of the current quarter the death-rate in the cityts averaged 22-8 per 1000, the rate during the same perioddng 17-3 in London and 18-7 in Edinburgh. The 133iatha registered in Dublin during the week under noticelowed a decline of 11 from the number in the precedingaek, and included 24 which were referred to the principal

1346 THE SERVICES.

zymotic diseases, against 8 and 12 in the two precedingweeks ; of these, 10 resulted from " fever " (principallyenteric), 8 from scarlet fever, 3 from diarrhoea, 2 from diph-theria, and 1 from scarlet fever. These 24 deaths were equal toan annual rate of 3 6 per 1000, the zymotic death-rate duringthe same period being 2’5 in London and 14 in Edin-burgh. The deaths referred to different forms of "fever,"which had been 6, 0, and 8 in the three preceding weeks,rose to 10 last week, a higher number than in anyweek during the past four years. The fatal cases of scarletfever, which had been 2 and 0 in the two preceding weeks,rose to 8 last week, and exceeded the number recorded inany week during the current year. The 133 deaths regis-tered in Dublin last week included 17 of infants under oneyear of age and 38 of persons aged upwards of sixty years ; ;the deaths of infants showed a further decline, while thoseof elderly persons exceeded the numbers recorded in the pre-ceding week. No deatbs from violence, and only 1 inquestcase were regi tered ; and 50, or more than a third, of thedeaths occurred in public institutions. The causes of 7, ormore than 5 per cent., of the deaths in the city last weekwere not certified.

_____________

THE SERVICES.

ARMY MEDICAL STAFF.SURGEON-MAJOR Mun’ANY has embarked for Bombay.

Sargeon-Captam Robinson proceeds to the Coik District fordutv. Surgeon-Major A. F. Russell is posted to Fort George

’’

as Medical Officer in Charge of the Station Hospital.Sapernumerary Surgeon-Colonel Robert C. Eaton to be

Surgeon-Colonel, rice C. A. Atkins, retired.

Her Majesty the Qaeen has been graciously pleased toconfer the Jubilee Commemoration Medal on Surgeon-Major-General A. F. Preston, M.B.Dub., Principal Medical Officerin Ireland.Her Majesty has also been graciously pleased to confer the

Jubilee Commemoration Medal on Surgeon-Major-GeneralThomas Maunsell, A M.S., Principal Medical Officer, Malta.

INDIA AND THE INDIAN MEDICAL SERVICES.The services of the under-mentioned officers (Bengal)

are replaced temporarily at the disposal of the MilitaryDepartment :-Sargeon-Major Cunningham, Surgeon-Lieu-tenant Milne, and Surgeon-Captain Smith. The under-mentioned officers to be Magistrates of the Second Classin the District of S&agrave;tara :-Surl’ eon- Captain Smith, medicalofficer in charge of Plague Flying Column No. 2, Karad.and Surgeon-Lieutenant Robertson, on plague duty, Karadvillages. Surgeon-Major T. H. Sweeney, Civil Surgeon,Benares, is appointed to cfficiate as Superintendent, CentralPrison, Benares. Surgeon-Captain L. G. Fischer is appointedto the civil medical charge of the Almora district. Sur-geon-Major Tuohy, Civil Surgeon, Agra, is appointed to thevisiting medical charge of the Etawah district. Surgeon-Major Smith, Civil Surgeon, Shahjahanpur, is appointed tothe visiting medical charge of the Hardoi district. Surgeon-Major Hawkins, Civil Surgeon, Moradabad, is appointedto the visiting medical charge of the Budaun and Bijnordistricts.

Brigade-Surgeon-Lieutenant-Colonel Caldecott vacates hisappointment in Central India on promotion to the adminit3-trative grade in the Indian Medical Service, Surgeon-Lieu-tenant-Colonel Dane succeeds him as civil administrativemedical officer in the Central India Agency, and has hisheadquarters at Bhopal, Surgeon-Major Gimlette, of Rewah, 1

going to Indore as Residency Surgeon. 1

MILITIA MEDICAL STAFF CORPS. (

Surgeon - Lieutenant Stuart Oliver, from the London 1

Companies Volunteer Medical Staff Corps, to be Surgeon- tLieutenant. r

VOLUNTEER CORPS. fRifle: 2nod Volunteer Battalion the Sherwood Foresters r

(Derbyshire Regiment): Surgeon-Major J. Knox to be rSurgeon-Lieutenant-Colonel ; burgtoa-Captain W. S. Symes ito be Surgeon-Major. 1st Volunteer Battalion the Royal nScots Fusiliers : Surgeon-Captain W. Sneddon, M.D , to beSurgeon - Major. 4th (fatirlingshire) Volunteer Battalion

Princess Louise’s (Argyll and Sutherland Highlanders) :James Hay Murray, M.B , to be Surgeon-Lieutenant.

VOLUNTEER MEDICAL STAFF CORPS.The London Companies: Surgeon - Captain H. W. G.

Macleod, M.D., resigns his commission.VOLUNTEER AMBULANCE SCHOOL OF INSTRUCTION.

The following officers who have been under instructionfrom the staff of the school have recently passed the pro-ficiency examination conducted by the Army Medical Staff.thereby earning the higher grant for their corps and becomingentitled to promotion after completing the’necessary periodof service :-Colonial Forces: Brigade-Sargeon-Lientenant-Colonel H. A. de Lautour, V.D., New Zealand DefenceForces ; and Surgeon-Captain F. A. Foy. M.B., 1st BombayRifles. Volunteers: Surgeon-Major R. Grant, M.A., MD.,2nd Volunteer Battalion the Black Watch ; Surgeon CaptainT. C. Bailey, 2nd Cheshire Royal Engineer Volunteers;Surgeon-Captain F. C. R)gers, 4th Volunteer BattalionCheshire Regiment ; Surgeon Lieutenant M. A. Cooke,2nd Volunteer Battalion Gloucester Regiment; Surgpon-Lieutenant J. Robinson, lst Volunteer Battalion Wor-cester Regiment : Surgeon - Lieutenant M. Richards,North London Volunteer Brigade Bearer Company TSurgeon-Lieutenant W. H. Forsbrooke, M D., lst VolunteerBattalion Royal Fusiliers ; S argeon- Lieutenant H. Allport,lst City of London Volunteer Artillery ; Surgeon-LieutenantR. A. Johnston, lst Volunteer Battalion Derbyshire Regi-ment ; Surgeon-Lieutenant C. Rigby, 1st Volunteer Battalionthe Loyal North Lancashire Regiment ; Surgeon-LieutenantJ. W. Jessop, 1st Volunteer Battalion Lincolnshire Regi-ment ; Surgeon-Lieutenant A. Whitton, M B., 6th VolunteerBattalion the Gordon Highlanders ; Surgeon -LieutenantR. B. Sidebottom. 4th Volunteer Battalion Cheshire Regi-ment ; Surgeon-Lieutenant F. H. Thompson, 1st VolunteerBattalion Shropshire Light Infantry ; Surgeon-LieutenantT. A. Sellar, M.D., 6th Volunteer Battalion the GordonHighlanders ; Surgeon-Lieutenant J. Kyffin, lst Hants Royal,Engineer Volunteers ; Surgeon-Lieutenant F. A. Brooks,M D , 1st Essex Volunteer Artillery ; Surgeon-LieutenantT. C. Ticehurst, 3rd D.C.O. Volunteer Battalion Hamp-shire Regiment ; Surgeon - Lieutenant A. H. Vernon,F.R C.S , 4th Volunteer Battalion Hampshire Regiment;Surgeon-Lieutenant V. J. Blake, M.B., 5th Volunteer Bat-talion Hampshire Regiment ; Surgeon Lieutenant D. Smart,M.B., 2nd Volunteer Battalion The King’s Liverpool Regi-ment ; Surgeon-Lieutenant H. Dickie. M.D., lst VolunteerBattalion Northumberland Fusiliers ; Surgeon-Lieutenant H.Legh de Legh, lst Volunteer Battalion Prince of Wales’s Ownlorkshire Regiment; Surgeon-Lieutenant W. P. Peake, lstVolunteer Battalion Leicestershire Regiment.Surgeon-Captain R. R. Sleman, "Artists" Rifle Volun-

teers, has obtained a certificate of proficiency with specialmention at an examination conducted by a Board of ArmyMedical Officers at Aldershot.

TROOPSHIPS AND HIRED TRANSPORTS.Last May Mr. Labouchere alluded in Truth to the over-

crowding of the hired transport Britannia. stating that shehad arrived in England carrying about 1200 persons, whereasaccording to the Board of Trade certificate she had onlyaccommodation for 692 ; and recently a correspondent of theDaily Ma&Ucirc; instanced the case of the IJuncra, which sailedfor India with 1395 officers, men, women, and children onboard in addition to the ship’s company, in spite of the factjhat if she were engaged in private trade her certificatewould not permit her to carry more than about 680 pas-:engers. No doubt when a private vessel is taken up for theJonveyance of troops the alterations effected in her internalarrangements enable her to carry a larger number of soldiers,vho do not require separate cabins, than would be possiblemder Board of Trade rules, but it is, nevertheless, difficult tomderstand how her carrying capacity could be more thanloubled without entailing overcrowding. According to aiote which we published last week 1 Dr. Bannafy, of thefrench colonial service, found that for a period of ten yearshe proportion of deaths among invalids on board Goverr-ment troopships and hired transports during the voyagerom Saigon to Toulon, was eighteen and twenty-sixespectively per thousand embarked, and yet there waso more overcrowding in one class of vessel than1 the other, and the conditions of life in both were asearly as poscibie alike. It would be interesting if similar

1 THE LANCET, Nov. 13th, 1897, p. 1276.