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320 the facts given for different periods of the epidemic which show that all through the 13 months the same dispropor- tionate incidence was observed. Dr. Buchanan has also applied a very searching test by comparing the intensity of’ small-pox prevalence within the half-mile area with that in 12 wards of Gateshead and Felling each of which is more than half a mile from the hospital and con- tains somewhat about the same number of dwellings as the half-mile area. He finds that the incidence on the half-mile area exceeded that in any one of these wards and that this is shown not only when the epidemic is taken as a whole but also when it is divided into three-monthly periods. We reproduce here the diagram in the report which illustrates this. Dr. Buchanan also gives reasons for believing that the influence of ’the hospital was exerted on certain localities near, but more than half a mile from, Sheriff Hill Hospital. His conclusions on the facts obtained are that there is no evidence that maladministration or absence of proper precautions in connexion with the traffic to and from the hospital was responsible for the exceptional and sustained incidence on the half-mile area and that the probable explanation is that here, as in other well-known cases, aerial transmission of infection has occurred. Dr. Buchanan agrees also with the observations of Dr. Hill that the direction of prevalent gentle winds at Sheriff Hill accords with this explanation. It is in any case evident that the use of this hospital has been responsible directly or indirectly for a material portion of the epidemic which has occurred during 1903-04 in these two administrative districts and Dr. Buchanan concludes by stating that he has no hesitation in recommending that it should no longer be used for the isolation of small-pox. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN 76 of the largest English towns 8914 births and 5520 deaths were registered during the week ending Jan. 28th. The annual rate of mortality in these towns, which had been 19’ 9, 17’ 5, and 18 1 per 1000 in the three preceding weeks, further rose to 18’4 per 1000 last week. In London the death-rate was 18 - 9 per 1000, while it averaged 18 - 1 per 1000 in the 75 other large towns. The lowest death-rates in these towns were 9’0 in Walthamstow, 9 3 in Handsworth (Staffs), 10’ 5 in Homsey, 12’ 0 in King’s Norton, 12’3 in Southampton, 13’ 2 in Willesden, and 13’ 7 in Leyton and Portsmouth; the highest rates were 23’ 3 in Bootle, 24 ’ 1 in West Hartlepool, 24-2 in Nottingham, 24’9 9 in Stockton-on-Tees, 25’4 in Rochdale, 27 1 in Rbondda, 28 - 9 in Merthyr Tydfil, and 29’ 7 in Middlesbrough. The 5520 deaths in these towns included 376 which were referred to the principal infectious diseases, against 399, 378, and 358 in the three preceding weeks ; of these 376 deaths, 124 resulted from measles, 107 from whooping-cough, 61 from diphtheria, 37 from diarrhoea, 28 from scarlet fever, 15 from "fever" " (principally enteric), and four from small-pox. In Croydon, Hornsey, Brighton, Southampton, Rochdale, York, and seven other smaller towns no death from any of the principal infectious diseases was registered, while they caused the highest death-rates in East Ham, Leyton, Plymouth, Grimsby, Nottingham, Bootle, Stockton-on-Tees, Sunderland, and Merthyr Tydfil. The greatest proportional mortality from measles occurred in East Ham, Leyton, Bristol, Nottingham, Burnley, Stockton-on-Tees, South Shields, and Merthyr Tydfil ; from diphtheria in Grimbsby and Bootle ; from whooping-cough in Hastings, Hanley, Aston Manor, Grimsby, Preston, Barrow-in-Furness, Hull, and Sunderland ; from "fever" " in Bootle ; and from diarrhoea in Ipswich and Ply- mouth. Of the four fatal cases of small-pox re- gistered in the 76 towns last week one belonged to London, one to Leeds, one to Gateshead, and one to Newcastle-on-Tyne. The Metropolitan Asylums Hospitals contained 15 small-pox patients at the end of last week, against 18, 19, and 18 at the end of the three pre- ceding weeks ; no new case was admitted during the week, against one in each of the three preceding weeks. The number of scarlet fever cases remaining under treatment in these hospitals and in the London Fever Hospital, which had been 2309, 2192, and 2174 on the three preceding Saturdays, had further declined to 2096 on Saturday, Jan. 28th; 251 new cases were admitted during_the week, against 1$7,-194;-- and 225 in the three preceding weeke. The deaths in London referred to pneumonia and diseases of the respiratory system, which had been 443, 301, and 377 in the three preceding weeks, further rose last week to 478 and were 47 above the number in the corresponding period of last year. The causes of 72, or 1 1 3 per cent., of the deaths in the 76 towns were not certified either by a registered me(1iJl rractitioner or by a coroner. All the causes oi death were (iuly certified in West Ham, Leicester, Leeds, Newcastle-on-Tyne, Cardiff, and 46 other smaller towns ; while the largest proportions of uncertified deaths were registered in Portsmouth, Birming- ham, Aston Manor, Liverpool, St. Helens, Roclidale, Sheffield, and Gateshead. ___ HEALTH OF SCOTCH TOWNS. The annual rate of mortality in eight of the prin- cipal Scotch towns, which had been 20’6, 21’6, and 20’1 1 per 1000 in the three preceding weeks, rose again to 20’3 per 1000 during the week ending Jan. 28th and was 1 9 per 1000 above the mean rate during the same period in the 76 large English towns. The rates in the eight Scotch towns ranged from 15’ 8 in Paisley and 16’ 5 in Dundee to 23’ 8 in Greenock and 26’ in Aberdeen. The 681 deaths in these towns incluced 44 which were referred to whooping cough, nine to diphtheria, nine to diarrhoea, six to measles, six to "fever," and five to scarlet fever. In all, 79 deaths resulted from these principal infectious diseases last week, against 79, 85, and 72 in the three preceding weeks. These 79 deaths were equal to an annual rate of 2’ 4 per 1000, which was 1’ 3 per 1000 above the mean rate last week from the same diseases in the 76 large English towns. The fatal cases of whooping-cough, which had been 37, 45, and 33 in the three preceding weeks, rose again last week to 44, of which 25 occurred in Glasgow, seven in Greenock, three in Edinburgh, three in Aberdeen, three in Paisley, and three in Perth. The deaths from diphtheria, which had been four, five, and three in the three preceding weeks, increased to nine last week, and included four in Glasgow and three in Edinburgh. The fatal cases of diarrhoea, which had been 13, 16, and 17 in the three preceding weeks, declined again last week to nine, of which five were registered in Glasgow and three in Edinburgh. The deaths from measles, which had been 14, 12, and 15 in the three preceding weeks, decreased to six last week and included three in Aberdeen. The fatal cases of "fever," which had been eight, four, and three in the three preceding weeks, rose again last week to six and included two in Glasgow, two in Aberdeen, and two in Greenock. The deaths from scarlet fever, which had been three, three, and none in the three preceding weeks, rose last week to five, of which two occurred in Edinburgh and two in Aberdeen. The deaths referred to diseases of the respiratory organs in these towns, which had been 182, 183, and 156 in the three preceding weeks, rose again to 163 last week and were 35 in excess of the number in the corresponding period of last year. The causes of 25, or nearly 4 per cent., of the deaths registered in these eight towns last week were not certified. HEALTH OF DUBLIN. The death-rate in Dublin, which had been 25’6, 22 ’ 6, and 21’ 2 per 1000 in the three preceding weeks, rose again to 25’5 5 per 1000 during the week ending Jan. 28th. During the past four weeks the death-rate has averaged 23’ 7 per 1000, the rates during the same period being 17’5 5 in London and 8’9 9 in Edinburgh. The 185 deaths of persons belonging to Dublin were 31 in excess of the number in the preceding week, and included 18 which were referred to the principal infectious diseases, against five, 21, and 10 in the three preceding weeks; of these 13 resulted from measles and two from scarlet fever, two from whooping cough, and one from diarrhsea, but not any from small-pox, from diphtheria, or from "fever." These 18 deaths were equal to an annual rate of 2’5 per 1000, the death-rates last week from the principal infectious diseases being l- 2 in London and 1 ’ 9 in Edinburgh. The fatal cases of measles, which had been three, 12, and five in the three preceding week, rose again last week to 13. The two deaths from scarlet fever corresponded with the number in the preced- ing week. The 185 deaths in Dublin last week included 26 of children under one year of age and 54 of persons aged 60 years and upwards ; the deaths both of infants and of - elderly persons were- in excess of the respective numbers recorded in the preceding week. Four inquest cases and
