770

op[Jo...it’oll against the mftropotitan asytuos dtstnct hospi’atsis curried out, sccsstulty. A suggnt-ton made to theDistrict Board to provide its own ho:aotal a’c()mll1odat.íon helooks upon as visionary. If infectious disease hospitals willnot he tolerated in comparatively sparsely hopula ed suburbs,wht likelihood is tiiere that they would be tole;ateed in

dens’)y pouiafed districts such as the St. Giles’ district?Greenock.-Dr. BV<llJi1ce reports, for tne Hve weeks (’n,jing

Septern"er 3rd, a mortality at the rate of 18’9 per 1000

population. Nfl case of death from typhus in the town was

reported ; but an increased prevalence of enteric fever andscarlet. fever ivus rise to some anxiety.

Dublin.&mdash;During September the deaths within the muni-cipal art*a were 509, beins; in the annual ratio of 21’24 per1000 of the population. The deaths from zymotic diseasesamounted to 66, the mortality from this class of diseasesduring last month, and the month of Junn, being the lowestrecorded, alowamce being made for the increased accuracyin regi-tration which recent legislation has effected. Withthe corresponding September of 1880, last mouth com-pares very satisfactorily. The death-tate from all causesin September, 1880, was 38 50 per 1000, as comparedwith 21’24; and the rate from the seven principal con-

tagmus diseases 11 87, against 1’96. Dr. Cameron, thesuperintendent medii’al officer of health, justly considersthat, this improvement in the state of plitilic health inDublin is iu some iueisure due to the important sanitarywork-; carried out in the city during the last few years. It,is, however, as he observes, necessary that the improvedcleansing and paving of the city, the shutting up of hundredsof old tenemental aldwellings, and the moregeneral use of wat-r-closes if the te,)etiiezital dwellings, should be fnllowed upby the erecrion of a large number of dwellings for the mosthurnhle and the most dependent classes of the population.There ts a great flearth of house accommodation for theseclasses, owing to the clus’ng of 841 houses and hundreds ofsingte rooms and cellar dwellings since August, 1879.

SANITARY HOSPITALS AND HONORARY MEDICAL STAFFS.

Recent occurrences in Sheffield have raised the question(not f r the firsr, time) whether it is proper or ju-t t themedtcat profession to appoint an honorary medi,-al staff toa sanitary, otherwise a rate-paid, hospital. What cldimupon the services of a medical man a hospital can havewhich is in no sense a charity, and nut intended toreceive patients as objects of charity, is not explained,and, indeed, not attempted to be explained. The question,as it has come before us, does not in reality involve anyrecondite matter of ethics, professional or otherwise, or

of m..rality. It simply relates to the cheapening oflocal sanitary administration at the expense of the medicalprofession. If the medical profe-sion be induced to lookup..n rate-paid hospitals in the same sense as hospitals sup-ported by voluntary contributions, it might be possible toinduce them to undertake the charge of these hospitals freeof co’t. We trust that the profession is sufficiently cantiousto escape falling iuto this very obvious trap. We arenot called upon to assist local authoridies in performing adutv for which they are paid, for which they are anthoiisedto pay, and into which no element of charity enters.

THE METROPOLITAN LOCAL AUTHORITIES AND THEWATER-SUPPLY.

A meeting of delegates from the District Boards andVestries of Is!ington, Kensington, Limehouse, Waudsworth,M le end, Clerke..well, Fulham, &c , tuok p)ace in tbevestry-hall of St. Martin’s, on the 26ch inst., to consider thequestion of the water-supply of the metropolis. Mr. E. J.Wather-.tonn occupied the chair, and explained that themeeting had been called to urge the Government totake stepsto deal with the water question next session. He describedthe way in which deiay in settling this matter was tellingto the large advantage of the Water Companies and to thedisadvantage of the consumers, and generally complicatingthe whole question. lu the end the meeting determined toaddress a memorial to the Prime Minister, represeuting theincreasing charges which the ratepayers of the metropolishad to pay to the Water Companies without obtaining anyequivalent in the shclpe of purer or more copious supply,and urging the Government to legislate on the subject nextsession on the lines of the report of the Select Committee oflast year.

INQUIRY AS TO VACCINATION.

The Epidemiological Society of London has appointed aspecial committee, consisting of Dr. Robert Cory, Dr. JohnM’Combie, and Mr. Shirley Murphy, to ascertain theevidence which the present state of medical knowledgesupplies as to the conditions affecting the protection againstsmall-pox afforded by vaccination. To etfect this purposethe committee have issued a circular of questions for dis-tribution among men calculated to elicit the information thesociety seeks fur. A report of an inquiry by a committee ofthis society, made and published in 1853, and which waspresented to and ordered to be printed by Parliament,exercised an important influence on subsequent legislationas to vaccination in this country. The late Dr. E. C. Seatonacted as the honorary secretary to this committee. Renewedactivity of the society in this direction will be welcomed byall who take an interest in the subject. The circular issigned by Sir Joseph Fayrer, and it must be regarded as oneof his last official acts before vacating the presidential chair.

The Llandovery Board of Guardians has recently come toa decision which may well form a precedent for other boardsunder similar circumstances. Mr. Lewis, medical officer ofthe union, presented an account for extra services in anurgent case, where an order for medical relief could not beobtained at the moment when such relief required to beadministered. In this case the guardians were not, ofcourse, legally bound to admit the medical officer’s claim,but to obviate the hardship which would s,)metirnes be in-flicted on the poor by a rigid adherence to the rule, the board,after allowing the bill, resolved that the medical officer should,as soon as possible after atteuding auy case on his ownresponsibility, inform the relieving officer, who should thenat once institute inquiries, and be able to report at the nextmeeting.The nervous system of residents in Fulham must have

undergone a more serious shock from the contiguity of theFulham Small-pox Hospital thanhad at first been antici-pated. It has been suggested that the disinfecting cart ofthe district should not be allowed to move through thestreets except between the hours of 7 P.M. and 8 A.M. Thissuggestion should surely have been supplemented byanother suggestion forbidding medical men moving about.the streets except within the same hours.

VITAL STATISTICS.

I HEALTH OF ENGLISH TOWNS.

Under the influence of the recent unseasonably low tem-perature the rate of mortality showed a further increase lastweek. During the week ending last Saturday 5518 birthsand 3097 deaths were registered in the twenty large Englishtowns dealt with in the Registrar-General’s weekly return.The annual death-rate in these towns, which had beenequal to 17-9, 18’8, and 20.5 in the three preceding weeks,further rose to 21’2 last week. The lowest rates in thesetowns were 15’6 in Bristol, 16’0 in Norwich, and 16’2 inBirmingham ; the rates in the other towns ranged up-wards to 25-1 in Oldham, 28-2 in Salford, 28-9 in Liver-pool, and 29’9 in Hull. The deaths referred to the prin-cipal zymotic diseases in these twenty towns were 477,and 24 less than the number returned in the previous week;they included 138 from scarlet fever, 102 from "fever"(principally enteric), 74 from measles, 61 from whooping-cough, 57 from diarrhoea, 31 from diphtheria, and 14 fromsmall-pox. The annual death-rate from these zymoticdiseases averaged 3 3 per 1000 in the twenty towns, andranged from 0’3 and 0 6 in Leeds and Norwich, to 6’3 and12.8 in Liverpool and Hull. Scarlet fever is still themost fatal zymo’ic disease in these towns, and showed thelargest proportional fatality last week in Hull, Nottingham,Sunderland, and Leicester ; 32 more fatal cases were

recorded in Hull, no fewer than 318 having been recordedwithin that borough since the end of June last. The 31deaths from diphtheria in the twenty towns included21 in London, 5 in Liverpool, and 4 in Portsmouth. Thedeaths referred to "fever" showed a furr.her generalincrease, and were proportionally most numerous inBrighton, Hull, London, and Salford. Small-pox caused16 more deaths in London and its suburban districts,whereas no fatal case was recorded in any of thelarge provincial towns. The number of small-pox

771

patients in the metropolitan asylum hospitals, which hadbeen 422 and 443 on the two previous Saturdays, further roseto 455 at the end of last week, including 140 in the Atlashospital ship, and 63 in the Convalescent Hospital atDarenth. The new cases of small-pox admitted to the8ehospitals, which had been but 51 and 62 in the two pre-ceding weeks, rose again to 106 last week. The deathsreferred to diseases of the respiratory organs in London,which had steadily increased in the seven preceding weeksfrom 115 to 279, further rose last week to 319, and exceededthe corrected weekly average by 17 ; 182 resulted frombronchititi and 77 from pneumonia. The causes of 82, or2’6 per cent., of the deaths in the twenty towns last weekwere not certified either by a registered medical practi.tioner or by a coroner. The proportion of uncertified deaths,which did not exceed 1’4 per cent. in London, averaged 4’0

per cent. in the nineteen provincial towns. All thecauses of death were duty certified in Plymouth, Leicester,and Sunderland, whereas the proportions of uncertified deathswere largest in Salford, Bradford, and Leeds.

HEALTH OF SCOTCH TOWNS.

The annual death-rate in eight of the largest Scotchtowns, which had been equal to 18’4 and 21’4 in thetwo preceding weeks, was again 21-4 last week, andwas almost identical with the average rate in the twentylarge English towns. The deaths referred to the priu-cipal zymotic diseases in these Scotch towns, which hadbeen 71 aud 108 in the two previous weeks, declined againto 79 last week; of these, 25 resulted from diarrhoea, 15from scarlet fever, 13 from diphtheria, 12 from whooping-cough, 8 from measles, 6 from "fever," and not one fromsmall-pox. The fatal cases of diarrhoea, although showinga decline from the number in the previous weeks, were pro-portionally more numerous than those returned in the Englishtowns. The death-rate from "fever," on the other hand,was little more than half that which prevailed in theEnglish towns. Both diphtheria and measles showed thegreatest fatality in Glasgow, while the deaths from scarletfever were most numerous in Edinburgh. The deaths attri-buted to acute diseases of the lungs (bronchitis, paeumouia,and pleurisy), vhich had been 96 and 108 in the two previousweeks, were 103 last week, and equal to an annu d rate of4’5 per 1000, against 3’9 from the same causes in London.

HEALTH OF DUBLIN.

The r,J,te of mortality in Dublin, which had been 18’7 and18’2 per 1000 in the two preceding weeks, rose to 21 lastweek. During the first three weeks of the current quarterthe death-rate in the city has averaged 19’6, against 20 0in Lon Inn and 20’6 in Edinburgh. The 147 deaths in thecity shuwed an increase of 25 from the low number in theprevious week, and included 12 whic were referred to theprincip-rl zymbic diseases, of which 4 resulted from scarletfever, 3 from measles, 2 from diphtheria, 2 from diarrh&oelig;a,and one from "fever"; no fatal case of whooping.coughor small-pox was registered. The annual death-rate fromthese zymotic diseases was equal to 18 per 1000, whilethe rtte from the same causes was 3’2 in London and 2’5in Edingburgh. The fatal cases of scarlet fever, mea61es, anddiphtheria, exceeded the numbers in recent weeks ; whilethose of diarrhcea and " fever" showed a marked decline.The deaths, b dh of infants and e’derly persons, consider-ably exceeded those recently returned.

HEALTH MATTERS GENERALLY AT HOMEAND ABROAD.

THE SANITARY ASSURANCE ASSOCIATION.

At the ordinary meeting of the Conncil of this Association,held at the offices, 5, Argyll-place, Regent-street (Oct. 26th),Professor Hayter Lewis, F.S.A., in the chair, certificateswere issued to those subscribers who had carried out the re-commendatiuns of the association with regard to the sanitaryarrangements of their houses. The certificates are signed bythe ctuef sanitary officer of the association, Professor Cor-field, M.D., and the surveyor, Mr. Mack H. Judge, audthey guarantee the satisfactory condition of the houses towhich they refer, the inspection, report, and supervision ofthe work where altcrations are necessary being made per-sonally by both officers. The certificates are issued subject

to an aunual inspection of the property, for which themembers are charged a small fee, according to the rateablevalue of the houses ; for instance, for a house rated at ;S80the fee is half a guinea for each annual inspection, while fora house rated at i200 the fee is two guineas. The work ofthe association is very simple m plan. Application is madefor the inspection of a house, and the inspection is conductedpersonally by both the chiet sanitary officer and the sutveyor,who supply a detailed report on the sanitary condition ofthe property, together with a specification of the worknecessary to put it into a condition satisfactory to the associ-ation. While this work is in progress it is supervised bythese officers, and on its completion the council graut acertificate.

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THE LONDON WATER-SUPPLY.

Messrs. Crookes, Odling, and Meymott Tidy, in theirreport on the water supplied to London during the month ofSeptember, say that : "Altogether the water supplied bythe companies continues of excellent quality, though nohuger presenting that exceptional freedom from other thanblue colour by which it was characterised during the summerin,inth4." Dr. Frankland’s report, attached to ColonelBulton’s (the water examiner’s) report, may be read prettymuch in the same sense, although we would not venture tosay so absolutely, having regard to the very different con-ditions under which the examinations of the water are pur-sued. Colonel Bolton states that the water in the Thamesat Hampton, Mo dsey, and Sunbury (where the intakes othe West Middlesex, Grand Junction, Southwark andVauxhall, Lambeth, Chelsea, and East London Companiesare situated) was good in quality during the whole monthof September with the exception of two days, the 271h and28th, when it became iudifferent. The water in the riverLea was good during the month.

" LEICESTER PIES."From time to time the metropolitan and general public

have been painfully, not to say revoltingly, enlihtened asto the subject of "Leicester Pies." But it wou!d appearfrom a CtH-e receutly heard in the Leicester Borough Police-court, that there is still a demand for theae savoury articlesof diet, notwithstanding the light which has occasionallybeen thrown upon their too fragrant composition. Theme-).t inspector for the borongh had seized no less than2 tons 5 cwt. of pork, and 6001b of beef unfit for humanfood upon the premises of one of the wholesale pie manu-facturers, part of the seizure having been already minced,spiced, and seasoned preparatory to being converted intopies and sansages. The medical officer of health gave evidenceas to the unfitnes for food of the mattrial in question, and theproprietor of the premises upon which the meat was seizedwas sentenced to two months’ imprisonment without thealternative of a fine. He, however, intends to appeal againstthe sentence.

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The Governor of Bombay has telegraphed to Lord Dnfferinthat cholera hds ceased in Sur,tt. rhe removal of the tendays’ quarantine at Bussorah is requested. At Aden alsothe epidemic appears to have subsided.Dr. Iliff recently directed the attention of the Newington

Vestry to a series of cases in which the Lamheth WaterCompany had cut off the water-supply of families in themo,t inconsiderate and cruel mauner. The vestry havetaken up the question, and the Company, through itssecretary, have promised to act less aibitrartly in thequestion of cutting off a water-suppty.

COLLEGE OF PHYSICIANS IN IRELAND.-On St.Luke’a Day, the 18th inst.,the following otfi,’ers were electedfor the eusung year :-President : George Johnston. Vice-President : John W. Moore. Censors: R. J. Harvey,Arthur V. Macan, John W. Moore, C. J. Nixon. AdditionalExaminers : A. Foot (Forensic Medicine), Fteer.woodChmch 11 (iVIidwifer,v), J. H. Ben-"on (Medicine), W. G.Smith (Chemistry), G, F. Duffey (Materia Medica), J. Purser(Physiology), C. J. Nixon (Anatomy). Registrar : J. MageFinny. Treasurer: AquilIa Smith. Examiners m Mid-witery: Fleetwood Churchill, John R. Kirkpatrick. Pro.fessor of MedICal Jurisprudence : Robert Travers. Repre-sentative on the General Medical Council : Aquilla Smith.