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upon. In some cases the report is issued on the same daythat the specimen arrives ; but in the majority of cases theexamination necessitates as much as twenty-four hours’work. An accurate record has been kept of the examina-tion of each case, including the various organisms found.Daring the first seven weeks the director with two assistantsexamined all the cases, but since the third week in FebruaryMr. Card has relieved the director of the superintendence ofthe microscopic examination of some of the specimens. Thework goes on very smoothly, and is now being accomplishedmore rapidly than at first. The director has undertaken to

report fully to the Metropolitan Asylums Board on every 500cases examined. (b) The preparation of antitoxin serum.After some unavoidable delay the Metropolitan AsylumsBoard placed at the director’s disposal stabling for fifteenhorses at Tooting ; four horses are being prepared, all of themsre in good health, and in three cases the treatment is welladvanced. As soon as these horses are ready the supply ofserum will be ample, and it is intended that one or tworeserve horses shall be prepared. It is probable that theserum will be ready for use at an early date.

2. The Goldsmiths’ Company’s grant for researches on theantitoxin treatment of diphtheria, &c -The Committee, seeingtheir way to placing a certain quantity of antitoxic serumat the disposal of investigators, have for the purposes ofexperiment determined to make a grant of 100 to Dr.Sidney Martin for the purpose of working out the action ofthe antitoxic serum when used to counteract the effects ofYarious poisons separated by him from the membrane and from the spleen in cases of diphtheria. This appears to the ’,Committee to be a most important question, and one thatmust be settled before the mode of action of antitoxic serumcan be understood, and they feel that no one can betterundertake this work than Dr. Martin. The Committee havesome other lines of research under consideration, on whichthey will fully report to the Colleges in due course.A letter was read-signed by the President, Vice President,

and Secretary of the Royal College of Surgeons in Ireland-expressing the regret of that College at the death of thePresident of the Royal College of Surgeons of England. Itwas moved and carried unanimously that the thanks of theCouncil be conveyed to the Royal College of Surgeons inbelaud for the kind words of sympathy contained io theirletter.A letter was read from the Registrar of the General

Medical Council stating that Mr. Charles Tomes has beenappointed by that Council as Visitor of the D antal Egamina-tions of the College, and that he will visit and inspect theseexaminations during the present year.

Mr. Hutchinson moved : "That steps be taken to obtainbusts of the late Sir William Savory, B.1rt , F.R S., and thelate Mr. J. W. Hulke, F.R.S." The matter was referred to acommittee consisting of the President, Vice-Presidents, andPast Presidents to consider and report.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN thirty-three of the largest English towns 6611 birtts aand 4280 deaths were registered during the week endingApril 6th. The annual rate of mortality in these towns,which had declined in the four preceding weeks from 35’0to 23.4 per 1000, further fell last week to 21’1. In Londonthe rate was equal to 19-0 per 1000, while it averaged 22’6 inthe thirty-two provincial towns. The lowest rates in thesetowns were 10’9 in Croydon, 13’1 in Haddersfield. 15-2 inPlymouth, 15-4 in Nottingham, and 15-7 in West Ham ; thehighest rates were 26-9 in Birmingham, 27-0 in Blackburn,235 in Oldham, 31’9 in Preston, and 33-0 in Burnley. The4280 deaths included 274 which were referred to theprincipal zymotic diseases, against 314 in each of the twopreceding weeks; of these, 93 resulted from whooping-cough,53 from measles, 51 from diphtheria, 38 from diarrhoea,21 from scarlet fever, 17 from 1-1 fever (principally enteric),and one from small-pox. No fatal case of any of these diseasesoccurred last week either in Bristol, Bradford, or Birkenhead ;in the other towns they caused the lowest death-rates inNeweastte-upon-Tyne, Gateshead, and HuddeIsfield j andthe highest rates in Manchester, Cardiff, Salford, andBnmley. The greatest mortality from measles occurredin Cardiff, Sheffield, and Bolton ; and from whooping-cougb

in Norwich, Salford, 1’reston, Burnley, and Portsmouth.The mortality from scarlet fever and from "fever" showedno marked excess in any of the thirty-three large towns.The 51 deaths from diphtheria included 23 in London,5 in Birmingham, 4 in Manchester, and 3 in West Ham. Onefatal case of small-pox was registered in Derby, but not onein London or any other of the large towns. There were 53cases of small-pox under treatment in the MetropolitanAsylum Hospitals and in the Highgate Small-pox Hospital onSaturday last, April 6th, against 57, 58, and 55 at the endof the three preceding weeks ; 7 new cases were admittedduring the week, against 12, 14, and 10 in the three precedingweeks. The number of scarlet fever patients in the Metro-politan Asylum Hospitals and in the London Fever Hospitalat the end of the week was 1519, against 1615, 1587, and 1555on the three preceding Saturdays; 143 new cases wereadmitted during the week, against 184 and 161 in thetwo preceding weeks. The deaths referred to diseases ofthe respiratory organs in London, which had declined from1448 to 497 in the five preceding weeks, further fell to427 last week, but were 17 above the corrected average.The causes of 69, or 1-6 per cent., of the deaths in thethirty-three towns were not certified either by a registeredmedical practitioner or by a coroner. All the causes of deathwere duly certified in Bristol, Salford, Leeds, Newcastle-

upon-Tyne, and in eight other smaller towns ; the largestproportions of uncertified deaths were registered in

Birmingham, Liverpool, Sheffield, and Hull.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had declined in the five preceding weeks from 42’8to 25-4 per 1000, further fell to 24-7 during the week endingApril 6th, but exceeded by 36 per 1000 the meanrate during the same period in the thirty-three largeEnglish towns. The rates in the eight Scotch townsranged from 18’9 in Perth and 20-0 in Edinburgh, to26 6 in Dundee and 30-3 in Aberdeen. The 713 deaths inthese towns included 25 which were referred to whooping-cough, 22 to measles, 17 to diarrhoea, 3 to small-pox, 3 to"fever, "2 to diphtheria, and 2 to scarlet fever. In all, 74deaths resulted from these principal zymotic diseases, against115 and 90 in the two preceding weeks. These 74 deathswere equal to an annual rate of 2’6 per 1000, which was 1 3above the mean rate last week from the same diseases inthe thirty-three large English towns. The fatal cases ofwhooping-cough, which had been 27 and 26 in the twopreceding weeks, were 25 last week, of which 13 occurred inGlasgow, 5 in Dundee, and 4 in Leith. The deaths referredto measles, which bad been 48, 56, and 35 in the threepreceding weeks, further declined to 22 last week. andincluded 7 in Edinburgh and 7 in Aberdeen. The 17 fatalcases of diarrhoea exceeded by 3 the number in the precedingweek, and included 9 in Glasgow. The 3 deaths referredto different forms of " fever " corresponded with thenumber in the preceding week, and included 2 inDundee. The fatal cases of diphtheria, which had been9 and 5 in the two preceding weeks, further declined to 2 lastweek. Of the 3 deaths from small-pox, 2 were recorded inGlasgow and 1 in Edinburgh. The deaths referred to diseasesof the respiratory organs in these towns, which had been313 and 199 in the two preceding weeks, further declined to189 last week, but were 74 above the number in the

corresponding week of last year. The causes of 62, or

nearly 6 per cent., of the deaths in the eight towns

last week were not certified.

HEALTH OF DUBLIN.

The death-rate in Dublin, which had increased from 42 4to 48-6 per 1000 in the three preceding weeks, declined againto 43’3 during the week ending April 6th. During the thirteenweeks of last quarter the death-rate in the city averaged37’1 per 1000, the rate during the same period being 26’0in London and 30 5 in Edinburgh. The 290 deathsregistered in Dublin during the week under notice showeda decline of 36 from the number in the previousweek, and included 11 which were referred to the prin-cipal zymotic diseases, against 7 and 12 in the two

preceding weeks; of these, 4 resulted from whooping-cough, 3 from small - pox, 3 from diarrhoea, 1 from"fever," and not one either from measles, scarlet fever,or diphtheria. These 11 deaths were equal to an annualrate of 16 per 1000, the zymotic death-rate during

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the same period being 1’4 in London and 23 in Edin-

burgh. The 4 fatal cases of whooping-cough exceededthe number recorded in recent weeks. The deathsreferred to small-pox, which had been 4, 5, and 1 in the

three preceding weeks, rose again to 3 last week. The threefataleases of diarrhoea corresponded with the number in theprevious week, while the mortality from "fever"

" showed amarked decline. The 290 deaths registered in Dublin lastweek included 44 of infants under one year of age and 111 of

persons aged upwards of sixty years ; the deaths both ofinfants and of elderly persons almost corresponded with thenumbers in the previous week. Three inquest cases and 3deaths from violence were registered ; and 96, or nearly athird, of the deaths occurred in public institutions. Thecauses of 17, or nearly 6 per cent., of the deaths in the citylast week were not certified.

VITAL STATISTICS OF LONDON DURING MARCH, 1895.IN the accompanying table will be found summarised

complete statistics relating to sickness and mortality duringMarch in each of the forty-three sanitary areas of London.With regard to the notified cases of infectious diseases inthe metropolis during last month, it appears that the numberof persons reported to be suffering from one or other of thenine diseases specified in the table was equal to 5’8 per 1000 ofthe population, estimated at 4,392,346 persons in the middleof this year. In the three preceding months the rates had been84, 70, and 5’9 per 1000 respectively. Among the varioussanitary areas the rates were considerably below the averagein Paddington, St. Giles, City of London, St. Saviour South-wark, St. Olave Southwark, and Woolwich ; while they showedthe largest excess in Fulham, Strand, Limehouse, Poplar,Rotherhithe, Camberwell, and Greenwich. The prevalence ofsmall-pox in London showed a slight decline during March,41 cases being notified during the month, including 10 inRotherhithe, 9 in Marylebone. 7 in Greenwich, and 4 inHolborn sanitary areas. The Metropolitan Asylum Hospitalscontained 54 small-pox patients at the end of March,against 16, 51, and 66 at the end of the three precedingmonths; the weekly admissions averaged 11, against 3,10, and 15 in the three preceding months. The prevalenceof scarlet fever in London during March showed a slightdecline from that recorded in the preceding month ; this ,,

disease was proportionally most prevalent in Fulham, Strand, Limehouse, Poplar, Rotherhithe, Wandswortb, Camberwell,and Plumstead sanitary areas. The Metropolitan Asylum Hos-pitals contained 1485 scarlet fever patients at the end ofMarch, against 1865, 1633, and 1569 at the end of thethree preceding months; the weekly admissions averaged 145,against 171,148, and 141 in the three preceding months. The

prevalence of diphtheria in London showed a slight increaseduring March; among the various sanitary areas this diseaseshowed the highest proportional prevalence in Fulham,Limehouse, Mile End Old Town, Poplar, Rotherhithe,Battersea, Camberwell, and Greenwich. There were 435cases of diphtheria under treatment in the MetropolitanAsylum hospitals at the end of March, against 521, 515, and461 at the end of the three preceding months ; the weeklyadmissions averaged 62, against 93, 71, and 50 in the threepreceding months. The prevalence of enteric fever inLondon showed a slight decline during the month undernotice; among the various sanitary areas this disease showedthe highest proportional prevalence in Poplar and Camber-well. Erysipelas was proportionally most prevalent inSt. Pancras, Holborn, and Rotherhithe sanitary areas. The13 cases of puerperal fever notified during March included3 in Islington, 3 in Lambeth, and 2 in Battersea sanitaryareas.The mortality statistics in the accompanying table relate

to the deaths of persons actually belonging to the variousmetropolitan sanitary areas, the deaths occurring in the in-stitutions of London having been distributed among thedifferent sanitary areas in which the patients had previouslyresided. During the four weeks ending Saturday, March 30th,the deaths of 10,107 persons belonging to London wereregistered, equal to an annual rate of 30.0 per 1000,against 177, 183, and 30’3 in the three precedingmonths. This high rate was principally due to the epidemicprevalence of influenza. The lowest death-rates duringMarch in the various sanitary areas were 20-8 in Hampstead,22’9 in Stoke Newington, 23.3 in Plumstead, 23-5 in Lee,23.8 in Woolwich, and 25’2 in Wandsworth ; the highest rateswere 35-0 in Westminster and St. Giles, 35’1 in Shoreditch,

38-6 in Newington, 39-3 in Holborn, 40-3 in St. George South-wark, and 40.5 in Strand. During the four weeks of March 508deaths were referred to the principal zymotic diseases inLondon ; of these, 203 resulted from whooping-cough, 114from diphtheria, 77 from measles, 55 from diarrbcea, 38 from.scarlet fever, 20 from different forms of " fever," (including,1 from typhus fever, 18 from enteric fever, and 1 from an ill-defined form of fever), and 1 from small-pox. These 508 deaths.were equal to an annual rate of 1 5 per 1000, against 1 6 and1.5 in the two preceding months. No fatal case of any ofthese diseases was recorded last month in Stoke Newingtonor in Woolwich ; in the other sanitary areas they caused thelowest death-rates in Paddington, Hampstead, City ofLondon, St.. Saviour, Southwark, Wandsworth, and Plum-.stead ; and the highest rates in St. Martin-in-the-Fields,Limehouse, St. Olave Southwark, Rotherhithe, and Green-wich. Only 1 fatal case of small - pox was registeredin London during the month under notice, the cor-

rected average in the corresponding periods of theten preceding years being 13 ; this fatal case belonged to-Marylebone sanitary area. The 77 deaths referred to measles.were little more than a third of the corrected average-number ; among the various eanitary areas this disease.showed the highest proportional fatality in Hackney, Holborn,Shoreditch, Limehouse, Poplar, and Battersea. The 38 fatal’cases of scarlet fever were 23 below the corrected averagenumber ; the mortality from this disease showed no.

marked excess last month in any of the sanitary areas.

The 114 deaths from diphtheria almost correspondedwith the corrected average number ; this disease showedthe highest proportional fatality in Westminster, Stro-Martin -in - the-Field s, Mile End Old Town. Camberwell,and Greenwich sanitary areas. The 203 fatal cases

of whooping-cough were 84 below the corrected average-number ; among the various sanitary areas this disease showedthe highest proportional fatality in St. James Westmin-ster, St. Luke, Srioredith. Limehouse, Newiington, Lambeth,and Lewisham. The 18 deaths referred to enteric feverwere little more than half the corrected average number ;.there was no marked excess of " fever " mortality last monthin any of the sanitary areas. The 55 deaths from diarrhoea,were within one of the corrected average number. In con-clusion, it may be stated that the mortality in London duringthe month under notice from these principal zymotic diseases-was as much as 36 per cent. below the average.

Infant mortality in London during March, measured bythe proportion of deaths under one year of age to registeredbirths, was equal to 193 per 1000, and considerably exceededthe average. Among the various sanitary areas the lowest.rates of infant mortality were recorded in St. Giles, St. Lake,City of London, Whitechapel, Mile End Old Town, andWandsworth ; and the highest rates in Fulham. Westminster,St. James Westminster, St. Martin-in-the-Fields, Strand..and Newington.

THE SERVICES.

ARMY MEDICAL STAFF.SURGEON - MAJOR SIR JAMES R. A. CLARK, Bart.,

F.R C.S. Edin., retires from the service, receiving a gratuity.Surgeon-Captain Vere E. Hunter to be Surgeon-Major.Surgeon-Captain Frederick T. Skerrett, F.R.C. S. I., from half-pay, to be Surgeon-Captain, vice A. Wright, seconded.

INDIA AND THE INDIAN MEDICAL SERVICES.

The following appointments are announced :-lOth BombayInfantry: Surgeon-Major Adey to the Medical Charge, viceSurgeon-Captain Arinini, transferred permanently to the CivilDepartment, and Surgeon Lieutenant B. H. F. Leumann,M.B., Officiating Medical Officer, to act as Civil Surgeon.29th Bombay Infantry : Surgeon - Captain Heath to the-Medical Charge, vice Surgeon - Major Adey, transferred.Surgeon- Captain T. W. Shaw, M.B., (Bombay), is con-

firmed in the appointment of Medical Officer 1s’; Regi-ment Central India Horse, and of the Gocna PoliticalAgency. Surgeon-Majors H. McCalman and D. C. Davidsonhave respectively delivered over and received charge of theDharwar Prison, and Surgeon-Captain S. E Prall, M.B.,. y.

B.S., and Brigade-Surgeon-Lieutenant-Colonel C T. Peters,M.B., have delivered over and received charge of the BijapurPrison. Surgeon-Major A. Milne (Bombay Establishment),Deputy Assay Master, Calcutta, is transferred to Bombay as