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of officer of health, Dr. Davidson does not fail faithfully to showthe authority the direction in which its future work shouldlie; and we trust that both for the sake of the inhabitantswhom they represent, and for their own sakes, the TownCouncil will during the present year set themselves earnestlyto work.

Stroud Urban District.-The town has a death-rate ofIT’2 per 1000, and a birth-rate of 21-3. The number ofuncertified deaths amongst infants is high, and Mr. Partridgeattributes it to an important extent to the practice whichprevails amongst ignorant mothers of dosing their childrenwith soothing syrups and other nostrums instead of securingthat medical aid which is open to the poorest in the country.Some enteric fever and diphtheria have occurred in con-nexion with the use of polluted well water, and, as a result,some extension of the town mains has been made. Inspec-tion of bakeries, slaughter-houses, &c., continues, and a goodlist of sanitary work is recorded.

Stroud Rural District.-In this rural district certainworks of drainage are in progress; the water-supply issubject to frequent and careful inspection, all suspicioussources being examined and dealt with. Horsley is spokenof as being much in need of a proper supply in place of thepresent one, which is subject to the risk of pollution.Stonehouse, which has more than once been to the front asa place needing sanitary measures, is again referred to in;connexion with the prevalence of enteric fever. The placeis, however, now being drained.Huntingdon Rural District. -- In the Alconbury and

Sawtry division of this district steady work is in progressas to the prevention of disease and nuisance. Alconburybrook has been cleansed in so far as the duty devolved onprivate owners, and so a large improvement has beeneffected ; but further action in the same direction is requiredby the authority. Sawtry is also in urgent need of a goodwater-supply. The death-rate for the district was 13’3 per1000 during 1884. There was one death from scarlatinaand two from non-spasmodic croup.

St. George, Hanover-square.----During the year endingMarch 25th, 1884, this parish exhibited a lower death-ratethan for years past-namely, one of 15’7 per 1000.

Apart from diphtheria, infectious diseases caused but fewdeaths, and a majority of the diphtheria deaths occurred inSt. George’s Hospital. The report is in the main statistical;but the inspector of nuisances compiles a goodly table,showing the current sanitary work of the year; and Dr.Corfield shows also that a large amount of disinfection iscarried out in the hot-air chamber with which the parishis provided. In view of the possibility of cholera appearing,arrangements were made for the isolation of the sick. Dr.Corfield communicated with the Duke of Westminster as tothe site he regarded as the one most applicable, and theDuke gave his assent, and went so far as to issue notices tothe then occupiers to quit. Fortunately, no use had to bemade of the permission thus acquired.

Woodford Urban -District.-Dr. Groves attributes someoccurrences of diphtheria to emanations from sewer

ventilators which open on the road level, and he quotesTHE LANCET as endorsing his views on the subject. Onthis matter being brought before the authority they deter-mined to make inquiry of the sanitary authority of Surbiton,where, according to Dr. Groves, a system of ventilating thesewers at a high level is in existence. The death-rate inWoodford was 14-2 per 1000 during 1884 and 12-1 in 1883,and so far as the medical officer of health can ascertain therewas not last year even a single case of enteric fever.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5937 birth,and 3660 deaths were registered during the week endingthe 28th ult. The births exceeded by 123 and the deaths b:33 the average weekly numbers during 1884. The annuadeath-rate in these towns, which had steadily declined iithe preceding four weeks from 24’5 to 20’5 per 1000, roseagain last week to 21’4. During the first eight weeks othe current quarter the death-rate in these towns average(22-8 per 1000, against 24-6, the mean rate in the corresponding periods of the nine years 1876-84. The lowest death-rates in these towns last week were 13-9 in Portsmouth14-3 in Huddersfield, 16-7 in Hull, and 16-9 in Halifax. Thirates in the other towns ranged upwards to 29’6 in Sunder

land, 30’3 in Newcastle-upon-Tyne, 31’7 in Cardiff, and32’2 in Preston. The deaths referred to the principalzymotic diseases in the twenty-eight towns, which hadbeen 398 and 384 in the previous two weeks, further declinedlast week to 377; they included 113 from whooping-cough, 102from measles, 44 from scarlet fever, 32 from "fever" (prin-cipally enteric), 31 from diphtheria, 31 from diarrhoea, and24 from small-pox. No death from any of these zymoticdiseases was recorded last week either in Derby or inHalifax, whereas they caused the highest death-rates inPreston, Norwich, Cardiff, and Sunderland. The highestdeath-rates from whooping-cough occurred in Preston,Bristol, Wolverhampton, and Norwich ; from measles inCardiff and Sunderland; from scarlet fever in Preston; andfrom "fever" in Norwich. The 31 deaths from diphtheriain the twenty-eight towns included 16 in London, 3 inNottingham, 3 in Liverpool, and 2 in Leeds. Small-poxcaused 38 deaths in London and its outer ring of suburbandistricts, 2 in Birmingham, 2 in Sunderland, 1 in Brighton,and 1 in Liverpool. The number of small-pox patients inthe metropolitan asylum hospitals situated in and aroundLondon, which had been 1223 and 1141 on the precedingtwo Saturdays, further declined to 1103 at the end of lastweek; the admissions, which had been 255 and 163 in theprevious two weeks, were 170 last week. The HighgateSmall-pox Hospital contained 98 patients on Saturdaylast, 19 cases having been admitted during the week.The deaths referred to diseases of the respiratory organsin London, which had steadily declined in the precedingfour weeks, from 556 to 343, rose again last week to 384,but were 105 below the corrected weekly average. Thecauses of 79, or 2’2 per cent., of the deaths in the twenty-eight towns last week were not certified either by aregistered medical practitioner or by a coroner. All thecauses of death were duly certified in Leeds, Bristol,Leicester, Portsmouth, and in six other smaller towns. Thelargest proportions of uncertified deaths were registered inSheffield, Preston, and Newcastle-upon-Tyne.

HEALTH OF SCOTCH TOWNS.

The annual death-rate in the eight Scotch towns, whichhad steadily declined from 30’2 to 23-1 per 1000 in the pre-ceding four weeks, rose again to 24’6 in the week ending the28th of February, and exceeded by 3’2 the mean rate duringthe same week in the twenty-eight large English towns.The rates in the Scotch towns last week ranged from 13’3in Perth and 16-0 in Edinburgh, to 26-2 in Dundee, 29-0 inGlasgow, and 35’2 in Paisley. The 600 deaths in the eighttowns included 31 which were referred to whooping-cough,17 to scarlet fever, 15 to measles, 11 to diarrhoea, 6 to " fever"(typhus, enteric, or simple), 2 to diphtheria, and not one tosmall-pox; in all, 82 deaths resulted from these principalzymotic diseases, against 95 and 81 in the preceding twoweeks. These 82 deaths were equal to an annual rate of3’4 per 1000, which was 1’2 above the mean rate from thesame diseases in the twenty-eight English towns. The 31deaths from whooping-cough showed a slight further in-crease upon the numbers in the previous two weeks. Thefatal cases of measles, which had been 25 and 21 in the pre-vious two weeks, further declined to 15 last week, of which12 occurred in Glasgow and 2 in Dundee. The 17 deathsfrom scarlet fever, however, showed a considerable increaseupon the numbers in recent weeks, and included 14 inGlasgow and 2 in Paisley. Of the I deaths attributed todiarrhoea 5 occurred in Dundee. The 6 deaths referred to"fever" were considerably below the average. Both thefatal cases of diphtheria (a lower number than has beenreturned in any recent week) occurred in Glasgow. Thedeaths referred to acute diseases of the respiratory organsin the eight towns, which had declined in the precedingfour weeks from 214 to 139, further fell last week to 125,but exceeded the number returned in the correspondingweek of last year by 17. The causes of 17, or nearly 12 percent., of the deaths registered last week in the eight Scotchtowns were not certified.

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HEALTH OF DUBLIN.

The rate of mortality in Dublin, which had been equal to36’2, 34-9, and 30’4 per 1000 in the preceding three weeks,further declined to 30’3 in the week ending the 28th ult.During the first eight weeks of the current quarter the death-rate in the city averaged no less than 32-7 per 1000, the meanrate during the same period not exceeding 21’9 in London

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and 20-6 in Edinburgh. ’. The 205 deaths in Dublin lastweek showed a further decline of 1 from the numbers inrecent weeks, and included 18 which were referred to theprincipal zymotic diseases, against 20 in each of the pre-vious two weeks. Of these 18 deaths, 8 resulted frommeasles, 6 from scarlet fever, 2 from whooping-cough, 1from "fever" (typhus, enteric, or simple), 1 from diarrhoea,and not one either from small-pox or diphtheria. These18 deaths were equal to an annual rate of 2-7 per 1000, therate from the same diseases being equal to 1-8 in Londonand 1-9 in Edinburgh. The fatal cases of measles in Dublin,which had been 10 and 11 in the preceeding two weeks,declined to 8 last week; the deaths from scarlet fever, onthe other hand, rose to 6 last week, from 3 in each of theprevious two weeks. Only 2 deaths from "fever" havebeen recorded in the city in the past fortnight, whereasthey averaged 4 per week in the first seven weeks of thisyear. Seven inquest cases and 2 deaths from violence wereregistered within the city; and 61, or nearly a third, ofthe deaths were recorded in public institutions. The 39deaths of infants showed an increase upon the number inthe previous week, while the deaths of elderly persons werefewer than in any previous week of this year. The causesof 34, or more than 16 per cent., of the deaths registered inthe city last week were not certified.

CLASS MORTALITY IN DUBLIN.

The death-rate in Dublin last year was equal to 27’9 per1000 of the estimated population in the middle of the year.This high rate of mortality, although showing a decline of1’3 per 1000 fromthe mean rate in the preceding ten years,bears most unfavourable comparison with the rates prevailingin the capitals of the other portions of the United Kingdom.In London the rate last year did not exceed 20’3, and inEdinburgh it was only 20’0. In the Registrar-General’s yearlysummary for Dublin and other large Irish towns furtherstatistics are published with a view to elucidate that in-teresting but difficult problem of class mortality. Therecorded death-rates during 1884 in the families of eighteendifferent occupational subdivisions grouped in five socialclasses are given in this report. Class mortality, as distinctfrom occupational mortality, is a branch of vital statisticsthat has not yet secured its due share of attention, in greatmeasure owing to the inherent difficulties which the sub-ject presents. The figures published by the Registrar-General of Ireland bearing upon class mortality in Dublin,crude as they are at present, form a welcome additionto our slender knowledge on the subject. Some time since,when we noticed these class death-rates in Dublin, wepointed out that such rates of mortality were practicallyuseless for comparative purposes unless due allowance wasmade for the wide differences of age distribution in thevarious social classes. In order to estimate the true importof a death-rate, it is absolutely necessary to know the ageconstitution of the population upon which it is calculated.We have been pleased to notice that the Registrar-Generalof Ireland now affords the means for correcting hisclass death-rates for differences in the age constitution ofthe population in the several classes. A table is publishedin the yearly summary, recently issued, giving the agesof the Dublin population in each social class, and ineach group of occupations for which the deaths are

given. This information affords the necessary assistancefor calculating the disturbing influence of age distribu-tion upon this recorded class mortality. By applyingstandard life table rates of mortality to the varying pro-portions of persons living at five groups of. ages in thefour social classes adopted by the Registrar-General ofIreland, we find that the normal death-rate ranged from19’5 per 1000 in the Middle class, to 25’2 in the Professionaland Independent class. Bearing in mind that this differenceof 6-3 per 1000 is entirely due to difference of age distribu-tion in the living population of each class, it is impossibleto doubt that the recorded death-rate in these two classesis useless for comparative purposes, unless due correctionbe made for this disturbing influence. The explanation ofthis important effect of age distribution upon recorded classdeath-rates is patent. It will be found from the Registrar-General’s table to which we refer that in the Professionaland Independent class population 15’8 per cent. are personsaged upwards of sixty years, whereas in the Middle clas,,only 4-8 per cent. are returned at the same group of agesThis remarkable difference in the age distribution of twc

classes, between which the barrier must be ill-defined andmore or less artificial, points to difficulties of classificationof the social class and occupation of living and deceasedpersons, to which we shall probably hereafter refer.

THE SERVICES.

THE EGYPTIAN EXPEDITION.

We learn from our Indian contemporaries that the follow-ing Indian medical officers proceed on active service withtheir respective regiments forming the Indian contingentfor the Soudan:-Surgeon-Major G. Hutcheson, M.D., 9thBengal Cavalry, to which is attached for duty Surgeon G.Jameson; Surgeon-Major Kelly, M.D., 15th Sikhs; Surgeon-Major R. T. Lyons, M.D., 17th Bengal Infantry; Surgeon F.Burness, M.B., 28th Bombay Infantry; and Surgeon-MajorR. V. Power, M.D., 12th Madras Infantry.At Aldershot a further draft of the Medical Staff Corps,

the officers and men for which have been drawn togetherfrom various outlying stations, is being prepared, and willprobably embark at the end of the week for Suakim.

L The Indian troopship Crocodile left Portsmouth on the4th inst. for Bombay, having embarked, amongst otherofficers, on the previous day, Surgeon-Major Macphersonand Surgeons Dodd and Hunston, medical staff.The Greenwich Hospital pension of 50 per annum, vacant

: by the death of Deputy Inspector-General of Hospitals and: Fleets Alexander Crawford Macleory, has been awarded by-

the Lords Commissioners of the Admiralty to Deputy’ Inspector-General of Hospitals and Fleets William Hoggan.

WAR OFFICE.-Army Medical Staff : The following. officers are granted the local and temporary rank of Deputyl Surgeon-General whilst serving with the Expeditionaryr Force, Suakim: Brigade Surgeon George Langford Hinde;r Brigade Surgeon Samuel Black Roe, M.B., C.B. Surgeon-’

Major John Candy, M.D., has retired upon temporary half-pay.1 ADMIRALTY.-Staff Surgeon Richard William Coppinger,I M.D., has been promoted to the rank of Fleet Surgeon in

t Her Majesty’s Fleet.s RIFLE VOLUNTEERS.-3rd Lancashire: Andrew Alexandert Watson, Gent., to be Acting Surgeon.-2nd Battalion, the’

Queen’s Own (Royal West Kent Regiment): Henry William.- Roberts fp-nt-- to be Ap.t.inp’ HnT’o’eon.

Correspondence.

SLOW PULSE, WITH EPILEPTIFORM SEIZURES.To the Editor of THE LANCET.

" Audi alteram partem."

SiB,—The interesting case narrated by Dr. Gibbings inyour issue of Feb. 14th reminds me of one, the notes ofwhich I have long had by me with the object of publishing

whenever a suitable occasion should present itself. I wasmuch interested in it because it seemed to me to show con-

clusively the effect of cerebral anaemia in the causation of’

epileptic or epileptiform attacks.The following is a copy, with only a few verbal altera-

tions, of the case as I wrote it out at the time.W. P-, aged thirty-one, was admitted under the careof the late Dr. Goolden on May 4th, 1869. He had been a.

soldier, and was in India for four years, during which timehe contracted syphilis and suffered from " fever and ague."’Was discharged after twelve years’ service on account of"weakness of constitution." He has never had rheumatism,and never suffered from shortness of breath or palpitationpreviously to his present illness. This came on two weeksbefore admission. At that time, under some mental excite-

, ment, he jumped over some palings in order to prevent a.

s fight. He was immediately attacked with faintness, but’ recovered from it very shortly. The next morning in bedL he woke up with "heavy" breathing, which also soon sub-s sided. In the evening it returned, and he had a fit in whichs he lost consciousness. From that time he has had to give.. up work, and attacks of dyspnoea, followed by losses of3 ) consciousness, have recurred frequently night and day up