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the scholars and congratulated the Head Master on the successthe school had achieved.The large company shortly afterwards adjourned to the

lawn, where light refreshments were served.

MEDICO - PSYCHOLOGICAL ASSOCIATIONOF GREAT BRITAIN AND IRELAND.

THE fifty-first annual meeting of the above Association twas held on July 21st at The Retreat, York, in honour of thecentenary of the foundation of that institution. The pro-

ceedings commenced at eleven o’clock by a general meetingof members for the receipt of reports, the election of officersand the transaction of other business. Dr. Yellowlees moved rthe following resolution: "That the Medico-PsychologicalAssociation of Great Britain and Ireland, assembled in its zannual meeting at the York Retreat, desires to place on recordits admiration of the spirit which animated William Tuke and (his fellow workers a hundred years ago, its appreciation of the imighty revolution which they inaugurated, and its thank-fulness for the beneficent result which their example hassecured in the humane and enlightened treatment of theinsane throughout the world." Various matters were dis- 1cussed and committees were appointed to revise the rules iand the question of proxy voting, to consider and report (on the subject of public asylum dietaries, and to com-pile and reissue a handbook of instruction to attendantsand nurses on the insane. It was resolved-"that acopy of the report of the Care and Treatment Committee -be sent to each County Councillor and to each member ofCommittees of Asylums not managed by County Councilswithin the United Kingdom" ; that application should bemade to the Home Office for the prefix of the word Royal"to the name of the Association ; and that a board of educa-tion be appointed to consider all questions affecting medico-psychological teaching. Suggestions were also presentedfrom a committee for the improvement of the rules for thetraining, examination and certification of attendants andnurses on the insane ; these were discussed and for the mostpaxt agreed to. Dr. Needham and Dr. Fere were electedhonorary members. After luncheon, provided by the RetreatCommittee, Dr. Baker, the President, delivered his address.Hetook for his subject Hospitals for the Insane, theirpower andinfluence in the treatment of mental ill-health. He consideredthat such hospitals were factors for good in two distinct ways :(1) They possess, or ought to possess, every possible powerand appliance for the care, treatment and cure of the insane,and everything that brains and money can obtain ; (2) all themoney obtained from the remunerative patients being spentliberally and impartially in promoting the welfare, com-fort and cure of the patients who are not remunerative,whether they pay anything or nothing. As a means towardsthe first object special accommodation for special cases ofmental illness had been made and numerous villas had beenbuilt in the grounds of the hospital; an increased numberof resident medical officers had also been appointed. Inthe evening the members and a number of invited guests,among whom were Dr. Morel (Belgium), Dr. Semelaigne(great-grand-nephew of the illustrious Pinel) and the CitySheriff dined at the Station Hotel. Numerous letters ofregret for non-attendance and congratulations to the Asso-ciation and the Committee of the Retreat on the com-

pletion of the centenary of its foundation from official bodiesat home and abroad were read by the honorary secretary,Dr. Fletcher Beach.

ROYAL BRITISH NURSES’ ASSOCIATION.

THE fourth annual meeting of this Association was held inthe Pavilion at Brighton on July 21st. Dr. Hollis, F.R.C.P.,took the chair and a considerable number of members were

present. The annual report of the General Council, presentedby Dr. Bezly Thorne, showed that there were 2818 membersnow on the roll and more than 1800 on the register of trainednurses, the second volume of which was published in January.Reference was made to the petition presented by PrincessChristian, the President, for a Royal Charter of incorporation

or the Association, and Her Royal Highncss’s constant interest.nd support were warmly acknowledged. It was pointed out,hat the select committee of the House of Lords in theireport had expressed their opinion that no woman should beent out as a private nurse unless she had received three-ears’ hospital training, thus corroborating the standardvhich the Association had from the first adopted and forvhich it had been so very strenuously opposed. Asdl hospitals will probably now adopt this standard it wasconfidently hoped that the opposition to the Association.vould soon disappear. The good work done by the Associa-tion in giving pensions and pecuniary grants to its members.vho were in indigence or temporary difficulties, and the

steadily increasing support accorded to its registrationscheme by medical men all over the country, were commentedipon. Dr. Bedford Fenwick presented the audited accounts,showing that the Association had in four years made invest-nents amounting to £1340, that the balance in hand was.255 and that all the schemes of the Association except the-egister were now more than self supporting. Variousalterations were made in the by-laws which, amongst)ther things, provided that the General Council, which.s the governing body and which consists of 100’’nedical men, 100 hospital matrons and 100 sisters and.curses, should be elected by voting papers sent toall the members in May of each year. Votes of thanks to;he Mayor and corporation, the committees of the Sussex

County Hospital and of the Home of Rest for Nurses, to .

others who had offered hospitality to the Association and to .the chairman concluded the meeting. Luncheon was thenserved in the Banqueting Hall of the Pavilion, at which the-Mayor (Dr. J. Ewart, F.R.C.P.) took the chair. After pro-posing the healths of the Queen and of the President ofthe Association the chairman gave the toast of "The-

Nursing Profession." He welcomed the Association to.

Brighton and warmly congratulated it upon the importantpublic work in which it was engaged, and noted the opposi-..tion with which it had been met as a further proof of thevalue and necessity of its work. He thought that it was mostfortunate that its opponents had prevented it from becomingregistered under the auspices of the Board of Trade, as theimportance of its work and of the nursing profession as anintegral part of the medical profession demanded that the’Association should be considered as something higherthan a mere limited liability company. He felt con-

fident that all medical men who learnt what the Associa-tion was doing in attempting to afford them and the-

public some means of distinguishing trained nurses fromignorant and incompetent women who called themselves.such and to bring the whole nursing profession under pro-fessional control would give the Association their cordial

support and assistance. Whether the Association obtained a

Royal Charter this time or not he thought would matter very-little, for if it persevered in its valuable work it would un-doubtedly succeed, as truth always succeeded in the endand it would obtain all the more support and sympathy the’more it was opposed. The toast of *’ The Chairman " havingbeen duly honoured the proceedings terminated. The mem-bers spent the rest of the day in various sea and inland’excursions which had been planned for them on the invita-tion of the committee of the Sussex County Hospital, theninspected that institution and had afternoon tea in the-

garden, and later in the day enjoyed the hospitality of the.Nurses’ Home of Rest in Sussex-square.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN thirty-three of the largest English towns 6303 births and,3467 deaths were registered during the week ending July 23rd.The annual rate of mortality in these towns, which had been.17 ’1 and 17 ’9 per 1000 in the preceding two weeks, declinedlast week to 17 ’7. In London the rate was 19 .0 per 1000,while it averaged 168 in the thirty-two provincial towns.The lowest rates in these towns were 11’1 in Cardiff,11-5 in Portsmouth, 12’1 in Brighton, and 12-8 in Brad-ford ; the highest rates were 19 ’9 in Hull, 20 ’1 in Birken-head, 21-3 in Blackburn, and 21-5 in Bolton. The 3467’deaths included 625 which were referred to the principalzymotic diseases, against numbers increasing from 477 to 598 inthe preceding four weeks ; of these, 282 resulted from diarrhæa

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135 from measles, 81 from whooping-cough, 53 from diph-theria, 41 from scarlet fever, 27 from fever " (principallyenteric), and 6 from small-pox. No fatal case of anyof these diseases occurred last week in Burnley ; in theother towns they caused the lowest death-rates in Newcastle-upon-Tyne, Swansea and Wolverhampton, and the highestrates in Croydon, Leicester, London, Preston and West Ham.The greatest mortality from measles occurred in Huddersfield,Sunderland, West Ham and Halifax ; from whooping-coughin Portsmouth, Salford, Croydon, Hull and Preston ; andfrom diarrhoea in Blackburn, Croydon, Norwich, London, WestHam, and Leicester. The mortality from scarlet fever and from" fever " showed no marked excess in any of the large towns.The 53 deaths from diphtheria included 37 in London,4 in Birmingham, 4 in Manchester and 2 in Liverpool.Four cases of small-pox were registered in London, 1 inHalifax, and 1 in Sheffield, but not one in any other ofthe thirty-three large towns ; 11 cases of this diseasewere under treatment in the Metropolitan Asylum Hos-pitals and 4 in the Highgate Small-pox Hospital onSaturday last. The number of scarlet fever patientsin the Metropolitan Asylum Hospitals and in theLondon Fever Hospital at, the end of the week was2671, against numbers increasing from 1226 to 2488 onthe preceding seventeen Saturdays; 382 new cases were

admitted during the week, against 301 and 323 in theprevious two weeks. The deaths referred to diseases of the

respiratory organs in London, which had declined from 185to 168 in the preceding three weeks, further fell to 158 lastweek, and were 24 below the corrected average. The causesof 69, or 2 ’0 per cent., of the deaths in the thirty-three townswere not certified, either by a registered medical practitioneror by a coroner. All the causes of death were duly certifiedin Brighton, Nottingham, Oldham, Sunderland, Newcastle-upon-Tyne and in nine other smaller towns ; the largestproportions of uncertified deaths were registered in Ports-mouth, Bristol, Birmingham and Liverpool.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had declined from 19’3 to 17’2 per 1000 in the pre-ceding four weeks, rose again to 18 ’4 during the week endingJuly 23rd, and was 0 ’7 per 1000 above the mean rate duringthe same period in the thirty-three large English towns.The rates in the eight Scotch towns ranged from 6 ’9 in Perthand 10-4 in Leith to 20-0 in Edinburgh and 21-8 in Dundee.The 512 deaths in these towns included 28 which werereferred to measles, 13 to whooping-cough, 10 to diarrhoea,5 to scarlet fever, 5 to diphtheria, 5 to "fever " andnot one to small-pox. In all, 66 deaths resulted fromthese principal zymotic diseases, against 62 in each of thepreceding two weeks. These 66 deaths were equal to anannual rate of 2’4 per 1000, which was 0’8 below themean rate last week from the same diseases in the thirty-three large English towns. The fatal cases of measles,which had declined in the preceding four weeks from 35to 13, rose again to 28 last week, of which 25 occurred inGlasgow. The deaths referred to whooping-cough, whichhad declined from 27 to 18 in the previous four weeks,further fell to 13 last week and included 6 in Glasgow and4 in Edinburgh. The 10 fatal cases of diarrhcea showed adecline of 6 from the number in the preceding week andincluded 6 in Glasgow and 3 in Edinburgh. The deathsfrom diphtheria, which had been 3 and 7 in the previoustwo weeks, declined to 5 last week, of which 3 occurred inGlasgow. The 5 fatal cases of scarlet fever were within 1 ofthe number in the preceding week and included 2 in

Glasgow and 2 in Edinburgh. The deaths referred to diseasesof the respiratory organs in these towns, which had been71 and 65 in the preceding two weeks, further declined lastweek to 59, and were 21 below the number in the correspond-ing week of last year. The causes of 69, or more than 13per cent., of the deaths in the eight towns last week werenot certified.

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HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 21’8 and 24’!per 1000 in the preceding two weeks, declined again to 19 vduring the week ending July 23rd. During the first three week,of the current quarter the death-rate in the city averaged 21per 1000, against 18-4 in London and 16-4 in Edinburgh. Th(133 deaths in Dublin during the week under notice showec

a decline of 29 from the number in the preceding week,and included 7 which were referred to measles, 4 to diarrhœa,2 to whooping-cough, and not one either to small-pox, scarletfever, diphtheria, or "fever." " In all, 13 deaths resultedfrom these principal zymotic diseases, equal to an annualrate of 1-9 per 1000, the zymotic death-rate during thesame period being 4’4 in London and 2 4 in Edinburgh. Thefatal cases of measles, which had declined in the precedingfive weeks from 27 to 9, further fell to 7 last week. The 4deaths referred to diarrhoea exceeded the number in anyrecent week. The fatal cases of whooping-cough, whichhad been 2 and 0 in the preceding two weeks, rose

again to 2 last week. The 133 deaths registered inDublin last week included 24 of infants under one year ofage and 36 of persons aged upwards of sixty years; thedeaths of infants showed a decline from those recordedin recent weeks ; while those of elderly persons showed anincrease. Three inquest cases and one death from violencewere registered; and 36, or more than one-fourth, of thedeaths occurred in public institutions. The causes of 17, or13 per cent., of the deaths in the city last week were notcertified.

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THE SERVICES.

THE CHAIR OF PATHOLOGY AT NETLEY.To the Editors of THE LANCET.

SIRS,—Not holding a medical commission in Her Majesty’sImperial or Indian Army I am privileged, with your per-mission, to draw attention to the passing over of the medicalofficers of the Services in the election of a Professor to theChair of Pathology at Netley. It is to be borne in mind thatthe probationers who enter here are qualified and havealready gone through a very sound course of ordinary patho-logy ; now, as I understand, this chair was instituted especi-ally with reference to the instruction in and elucidation ofthe pathology of those diseases incidental to armies andthose living in tropical and sub-tropical regions. There arein the Army Medical and Indian Medical Departments gentla-men of very considerable renown, distinguished graduatesand diplomates of their universities and colleges, men whohave had greater experience of the pathology of the kind ofdiseases just indicated than any others on the face of theglobe. What inducement is there, Sirs, for young men of

professional distinction, with the potentiality of and desirefor original research, to enter a service which entails long-continued residence in dangerous climates when posts such asthese, to which they would be legitimately entitled to aspirein the lapse of years, are handed over to civilians? Takingall these circumstances into consideration and not wishing inany way to be personal, I think all those who view the matterimpartially will admit that the present appointment is notonly an anomaly per se but an injustice de facto, and willagree with me in saying: Palmam qui nierititferat.

I am, Sirs, yours faithfully, - - - - - --

E. KENNETH CAMPBELL, M.B., F.R.C.S.Lincoln’s-inn.fields, July 25th, 1892.

THE LATE MR. THOMAS COOK.

The late Mr. Thomas Cook, to whose death we referredlast week, was buried the other day at Leicester. Hewas the enterprising originator of the famous tourists’ticket system and his name was probably better knownthan that of any man of his time. It is not, however,in this connexion that we here allude to his loss, but theenergy and good work which the firm of Cook and Son dis-played in Egypt on behalf of the sick and wounded soldier

, deserve a word of grateful recognition from medical officers

: in particular. After the campaign of 1882 the firm placed a, number of their Nile steamers at the disposal of the military

authorities in Egypt. They were equipped and fitted outwith everything necessary for the sick soldier in a remark-ably short space of time and rendered most excellent service.Nor was this the only occasion on which Cook and Sonrendered effective aid to the army in Egypt.

PRESIDENCY OF THE INDIA OFFICE MEDICAL BOARD.

) Surgeon-General Sir Joseph Fayrer, K. C.S.I., M.D., F.R.S.,’ retains his appointment at the India Office until January,l 1895.