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majority of instances in households of several children. Aninstructive example is given of an epidemic following non-closure, the disease being unrecognised during schoolattendance and 16 children out of 40 being attacked. Thecases occurred in 15 houses, of which 12 had more than onemember attacked, and in one house of 13 occupants 9 hadsome symptoms of the disease.

l3oroult of l2icltntond (811rrey).-Dr. J. H. Crocker hasdevised an ingenious system of coloured enamel signals tohelp in the arrangement of the medical inspection cards,and classify the children into defectives, non-defectives,home visitation, and a number of other categories. Ten

qualifications for the ideal school nurse are given, beginningwith "strong constitution" and ending with "tact."1437 children were inspected, and 500 notices forwarded toparents concerning 623 defects. But out of 737 cases ofcarious teeth only 84 notices were sent, presumably becauseof the absence of facilities for treatment. An inspectionclinic has been set up at the public health offices, and 391inspections were made. Treatment, with the possible ex-ception of the dental cases noted, is said to be satisfactory,Richmond being a small borough-a point of great import-

..’E.nce—and fortunate in its charitable institutions.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN the 95 largest English towns, having an estimated population of 17,639,816 persons in the middle of this year,8334 births and 3648 deaths were registered during the week.ending July 6th. The annual rate of mortality in thesetowns, which had steadily decreased from 13-0 0 to 11 1 per1000 in the six preceding weeks, further declined to 10’8 8per 1000 in the week under notice. During the 13 weeks of’the second quarter of this year the mean annual death-ratein these 95 towns averaged 131 per 1000, while in London.during the same period the average death-rate did not exceed- 124 per 1000. The annual death-rates in the several towns3.astweek ranged from 2 - 9 in Eastbourne, 3-7 7 in Wimbledon,’4’6 in Northampton, 5’4 in Hornsey, and 5’5 in Newport.(Mon.), to 15-6 in Blackburn, 16-9 in Stockport and inBootle, 18’0 0 in Liverpool, and 20’5 5 in Rotherham.

The db4o deaths from all causes were lib fewer than the’number in the previous week, and included 342 which werereferred to the principal epidemic diseases, against 390 and376 in the two preceding weeks. Of these 342 deaths, 139resulted from measles, 72 from infantile diarrhceal diseases,’69 from whooping-cough, 37 from diphtheria, 15 from scarletfever, and 10 from enteric fever, but not one from small-pox.’The mean annual death-rate from these epidemic diseases’was equal to l’ per 1000, against 1’2 and 1’1 1 in’the two preceding weeks. The deaths attributed to

rmeasles, which had been 201, 172, and 173 in the’three preceding weeks, declined to 139 last week, and,caused the highest annual death-rates of 2’ 0 in Black-,burn, 2’3 in Liverpool, 3-4 in Middlesbrough, and 4’1 inRotherham. The deaths of infants under two years of age’’referred to diarrhoea and enteritis, which had been 61, 55,: and 75 in the three preceding weeks, were 72 last week,.and included 30 in London and its suburban districts, 6 inLiverpool, and 5 in Stoke-upon-Trent. The fatal cases of

whooping-cough, which had been 86, 96, and 61 in the threepreceding weeks, slightly rose to 69 last week ; 26 deathswere registered in London and its suburban districts, 8in Liverpool, 5 in Grimsby, 4 in Bristol, and 4 in

Birmingham. The deaths attributed to diphtheria lastweek numbered 37, and were 4 in excess of the average inthe five preceding weeks; 6 deaths occurred in London,3 in Birmingham, and 2 each in Portsmouth, Manchester,’Gateshead, and Cardiff. The deaths referred to scarlet fever,which had been 26, 22, and 21 in the three preceding weeks,further declined to 15 last week, and included 3 in London,.3 in Liverpool, and 2 in Birmingham. The fatal cases of- enteric fever, which had been 17, 9, and 15 in the three pre-

. -ceding weeks, fell to 10 last week, of which number 5 were- registered in London.

The number of scarlet fever patients under treatmentin the Metropolitan Asylums and the London FeverHospital, which had steadily increased from 1213 to

;; 1398 in the seven preceding weeks, had further risen to

1417 on Saturday last ; 201 new cases of this diseasewere admitted to these institutions during the week,against 179, 188, and 195 in the three preceding weeks.These hospitals also contained on Saturday last 873 cases ofdiphtheria, 615 of measles, 445 of whooping-cough, and 32of enteric fever, but not one of small-pox. The 891 deathsfrom all causes in London were 42 fewer than the number inthe previous week, and were equal to an annual deatli-rate of10’ 3 per 1000. The deaths referred to diseases of the

respiratory organs, which had been 153, 112, and 126 in thethree preceding weeks, slightly rose to 131 last week, andwere 29 in excess of the number registered in the correspond-ing week of last year.Of the 3648 deaths from all causes in the 95 towns last

week, 152 resulted from different forms of violence, and 327were the subject of coroners’ inquest. The causes of 39, or1 1 per cent., of the deaths registered were not certifiedeither by a registered medical practitioner or by a coronerafter inquest. All the causes of death were duly certifiedlast week in London and its 14 suburban districts, in Leeds,Bristol, Bradford, Newcastle-on-Tyne, Nottingham, Ports-

mouth, and in 56 other smaller towns. The 39 uncertifiedcauses of death last week included 9 in Birmingham, 7 inLiverpool, 3 in Manchester, and 2 each in Blackburn,Sheffield, Hull, South Shields, and Gateshead.

HEALTH OF SCOTCH TOWNS.

In the 18 largest Scotch towns, with an aggregate popula-tion estimated at 2,182,400 persons in the middle of thisyear, 1101 births and 609 deaths were registered during theweek ending July 6th. The annual rate of mortality inthese towns, which had declined from 15 5 to 14-0 0 per 1000in the four preceding weeks, rose to 14’6 per 1000 inthe week under notice. During the 13 weeks of the secondquarter of this year the mean annual death-rate in theseScotch towns averaged 15-5 5 per 1000, against 13 per 1000in the 95 large English towns during the same period.Among the several towns the death-rates last week rangedfrom 4-3 in Perth, 5-0 in Motherwell, and 5-3 in Partickto 22-4 4 in Dundee, 24-9 9 in Ayr, and 27-5 5 in Falkirk.The 609 deaths from all causes were 23 in excess of the

number in the previous week, and included 60 which werereferred to the principal epidemic diseases, against 74 and57 in the two preceding weeks. Of these 60 deaths. 18resulted from measles, 15 from wbooping-congh, 13 frominfantile diarrhoea,! diseases, 9 from diphtheria, 4 from scarletfever, and 1 from enteric fever, but not one from small-pox.These 60 deaths from the principal epidemic diseases wereequal to an annual death-rate of 1-4 per 1000, against 1-0 0per 1000 in the 95 large English towns. The deathsattributed to measles, which had increased from 27 to32 in the three preceding weeks, fell to 18 last week,and included 7 in Dundee and 2 each in Glasgow,Edinburgh, Coatbridge, and Hamilton. The deaths referredto whooping-cough, which had been 14, 21, and 8 inthe three preceding weeks, rose to 15 last week ; 6 deathswere registered in Edinburgh, 3 in Glasgow, and 2 inDundee. The fatal cases of diarrhoea and enteritis

among infants under two years of age, which had declinedfrom 15 to 9 in the four preceding weeks, rose to 13 lastweek, and included 3 deaths in Glasgow and 3 in Dundee.The 9 deaths attributed to diphtheria last week were 5 inexcess of the average in the four preceding weeks ; 5 deathsoccurred in Glasgow and 2 in Aberdeen. The 4 deathsreferred to scarlet fever showed but slight variation from theaverage number in recent weeks, and comprised 2 in

Glasgow and 2 in Greenock. The fatal case of entericfever was registered in Glasgow.The deaths referred to diseases of the respiratory system in

the 18 Scotch towns, which had decreased from 107 to 69 inthe four preceding weeks, were again 69 last week, and 25deaths were attributed to different forms of violence, against22 and 18 in the two preceding weeks. -

HEALTH OF IRISH TOWNS.

In the 22 town districts of Ireland, having an estimatedpopulation of 1,157,014 persons in the middle of this year,603 births and 306 deaths were registered during the weekending July 6th. The annual rate of mortality in thesetowns, which had been 15-7 and 16-0 per 1000 in thetwo preceaiuj weeks, declinedto 13’ per 1000 in the week

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under notice. During the 13 weeks of the second quarterof this year the mean annual death-rate in these Irishtowns averaged 19-0 0 per 1000 ; in the 95 large Englishtowns the corresponding death-rate did not exceed 13’1 1

per 1000, while in the 18 Scotch towns it was equalto 15-5 per 1000. The annual death-rates in theseveral Irish towns last week were equal to 16’0 0 inDublin (against 10’ 3 in London), 12’ 1 in Belfast,12- 2 in Cork, 10- 2 in Londonderry, 12’2 2 in Limerick, and11-4 in Waterford, while in the remaining 16 towns themean death-rate was equal to 14’ 5 per 1000.The 306 deaths from all causes in the 22 Irish towns were

48 fewer than the number in the previous week, and included27 which were referred to the principal epidemic diseases,against numbers decreasing from 37 to 29 in the three

preceding weeks ; of these 27 deaths, 9 resulted frommeasles, 8 from whooping-cough, 6 from diarrhoeal diseases,3 from scarlet fever, and 1 from diphtheria, but not onefrom enteric fever or from small-pox. These 27 deaths fromthe principal epidemic diseases were equal to an annualdeath-rate of 1-2 per 1000 ; the death-rate from thesediseases last week did not exceed 1’ 0 per 1000 inthe 95 large English towns, and was equal to 1-4 in the18 Scotch towns. The deaths attributed to measles, whichhad declined from 17 to 5 in the three preceding weeks, roseto 9 last week, and comprised 7 in Dublin and 2 in Belfast.The deaths referred to whooping-cough, which had increasedfrom 5 to 10 in the three preceding weeks, fell to 8 last

week, and included 4 in Belfast, 3 in Newry, and 1 in Dublin.The fatal cases of diarrhoea and enteritis, which had risenfrom 3 to 10 in the four preceding weeks, declined to6 last week, all of which related to infants under2 years of age; 4 of the 6 deaths were recordedin Dublin. The deaths attributed to scarlet fever lastweek numbered 3, against 2 in each of the three precedingweeks, and were all registered in Dublin. The fatal caseof diphtheria also occurred in Dublin.The deaths referred to diseases of the respiratory system

in the 22 Irish towns, which had steadily decreased from 84to 63 in the four preceding weeks, further declined to 47 inthe week under notice. Of the 306 deaths from all causes,92, or 30 per cent., occurred in public institutions, and 6resulted from different forms of violence. The causes of13, or 4’2 per cent., of the total deaths were not certifiedeither by a registered medical practitioner or by a coronerafter inquest ; in the 95 large English towns the proportionof uncertified causes of death last week did not exceed1-1 per cent.

_______________

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointment has been notified :-Staff-

Surgeon : G. L. Buckeridge to the Haulbowline Hospital andYard.

ROYAL ARMY MEDICAL CORPS.

Colonel T. J. R. Lucas, principal medical officer of theJubbulpore and Jliansi Brigades, has arrived home on leaveof absence from India. Colonel S. Westcott, C.M.G., hasbeen transferred from the Scottish Command to the SouthernCommand, for appointment as Assistant Director of MedicalServices at Portsmouth.

Lieutenant-Colonel J. H. Daly, at present holding chargeof the Military Hospital at Limerick, has been selected forthe higher rate of pay under Article 317 of the RoyalWarrant. Lieutenant-Colonel C. A. Lane, on arrival inIndia for a tour of duty, has been appointed to commandthe Station Hospital at Madras. Lieutenant-Colonel A. P.

Blenkinsop has taken up duty at Army Heaclquarters, Simla,as Assistant Director, Medical Services in India, vice Brevet-Colonel R. S. F. Henderson, honorary physician to His

Majesty the King, appointed to command the Station Hos-pital at Quetta. Lieutenant-Colonel E. G. Browne, com-manding the Station Hospital at Delhi, has arrived home onfour months’ leave of absence from India.Major A. H. 0. Young has been transferred from the

Military Hospital at Halifax to Strensall for duty. MajorF. Harvey has been transferred from the Southern Commandto the Northern. An exchange on the roster for serviceabroad has been sanctioned by the Director-General between

Major F. W. Cotton, in charge of the Military Hospital atFleetwood, and Major L. W. Harrison, clinical pathologist,Military Hospital, Rochester-row. Major J. E. Brogden hasarrived home on leave of absence from Gibraltar. Major0. W. A. Elsner has been transferred from the Military Hospitalat Pretoria to Fort Napier, Pietermaritzburg. Major E. P.Hewitt, lately holding charge of the Military Hospital at Poona-mallee, has been transferred from the Ninth (Secunderabad)Division to the Fifth (Mhow) Division. Major H. Swabeyhas been appointed to command the Section Hospital at St.Thomas’s Mount, Madras Presidency. Major J. F. M.Kelly, in charge of the Military Hospital at Potchefstroom,has arrived home on leave of absence. Major H. E. Staddon,at present serving at Dover, has been placed under orders forservice abroad during the coming trooping season.

Captain M. W Falkner has been appointed Specialist inOperative Surgery at Bermuda. Captain R. W. D. Lesliehas arrived home for duty from Malta. Captain D.Coutts has been transferred from the Station Hospital atAllahabad to the Seventh (Meerut) Division for duty atRanikhet. Captain A. C. Elliott has taken up duty at theStation Hospital, Sialkot. Captain J. H. Duguid, on arrivalin India, has been appointed to the Presidency Brigade forduty at the Station Hospital, Calcutta. Captain C. Ryleyhas been transferred from Chatham to Shoeburyness.Captain E. V. Aylen, specialist in dermatology to the Second(Rawal Pindi) Division, has arrived home on leave of absencefrom India. Captain A. N. Fraser has been placed underorders for service abroad during the coming trooping season.Captain A. S. Littlejohns has been appointed CompanyOfficer to No. 22 Company, Royal Army Medical Corps, atWynberg. Cape Colony. Captain V. G. Johnson has takenup duty in charge of the Cantonment Hospital at Nowshera.Captain M. J. Cromie has been transferred from KilbrideCamp to Dublin. Captain R. B. Hole has taken up dutyas Adjutant of the Royal Army Medical Corps School of,Instruction at Edinburgh.The following officers have been selected to attend the

next promotion courses at the Royal Army Medical College,Grosvenor-road :-Captains R. P. Lewis, J. H. Graham,W. Benson, G. E. Ferguson, C. E. W. S. Fawcett, T.

Scatchard, V. H. Symons, R. A. Bryden, E. L. Moss, and;E. T. Potts.

Lieutenant H. R. Edwards has been transferred from the

Royal Herbert Hospital at Woolwich to the South African,Command for duty at the Military Hospital, Pretoria. Lieu-tenant E. L. Fyffe has been transferred from the MilitaryHospital at Fermoy to Cork. Lieutenant W. A. Frost has.taken over charge of the Military Hospital at Alderney.Lieutenant G. H. Dive has been appointed Clinical Assistantat Queen Alexandra’s Military Hospital, Grosvenor-road.Lieutenant C. Robb has joined the Public Health Depart-ment in Egypt. Lieutenant J. R. Yourrell has joined theMilitary Hospital at Rangoon for duty. Lieutenant A. G..Jones has been appointed to hold charge of the MilitaryHospital at Oxford. Lieutenant P. C. Field has joined for’duty in Egypt. Lieutenant J. M. Elliott has been appointedto the Military Hospital at Cosham. Lieutenant J. K. Gaunthas been placed under orders for service abroad during thecoming trooping season.

INDIAN MEDICAL SERVICE.

Lieutenant-Colonel C. A. Johnston has arrived home on.leave of absence from India. Lieutenant-Colonel W. H. B.Robinson, first-class agency surgeon in Bengal Presidency,has been appointed to hold charge of the duties of the

Residency Surgeon, Western Rajputana States. Lieutenant-Colonel F. P. Maynard, professor of ophthalmic surgery atthe Medical College, Calcutta, has been granted nine months’leave of absence home from India. Lieutenant-ColonelB. H. Deare, civil surgeon at Darjeeling, has been appointedProfessor of Materia Medica at the Medical College, Calcutta,and Second Physician to the College Hospital in succession -to Lieutenant-Colonel J. T. Calvert, appointed to be Principal’and Professor of Medicine, Medical College, Calcutta, andFirst Physician to the College Hospital. Lieutenant-ColonelB. J. Singh has been appointed Inspector-General of Prisonsin the Province of Bihar and Orissa. Lieutenant-ColonelW. Robertson Clark has been granted six months’ combinedleave of absence.

Major F. F. Elwes, recently surgeon to H.E. the

Governor of Madras, has been appointed Surgeon of the-