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of the profession of a locality to confer with the sanitaryauthority on questions of a medical nature particularly affect-ing them strikes us as admirable, and must largely con-tribute to the willing co-operation of the profession in thework of the authoritv and of its medical officer of health,to the great advantage of the local population.

Brownhills, Urban (Staffordshire).—Dr. Flinn reports adeath-rate for 1880 of 19’7 per 1000 living (estimated popula-tion, 1871, over 10,000). The health of the district, he de-scribes as on the whole satisfactory during the year. The

mortality under one year of age constituted one-third of thetotal mortality, and under ten years more than one-half. Dr.Flinn attributes the large mortality among infants andyoung children to the want of proper feeding and attentionduring infancy. Mothers of the poorer classes, he states,commonly give their young infants solid or otherwise im-proper food, and this improper food is a most frequent causeof diarrhoea and other wasting diseases. The water-supplyof the district, derived from wells, appears to be unsat.ifac-tory ; but a hope is expressed that it may be brought, at nodistant time, within the range of the South StaffordshireWater-Companv’s service.

Hartlepool, West (Urban).—Dr. Gourley, in his report ofthis district for the month of May, gives the impression thatthe general sanitary administration of this district is by nomeans what it ought to be. He describes the insanitaryconditions under which he found a series of cases of infec-tious diseases he was called upon to visit. One case reportedis curious. A death from scarlet fever had occurred in a houseused as both dwelling-house and pawn-office. The articlespawned consisted chiefly of wearing apparel and bedding,parcels of which were packed in every room, even in oneoccupied by another child lying ill from scarlet fever. Theliability of dIssemination of the disease by the pawnedarticles among their owners was obvious. The premises,moreover, were in a filthy state. Dr. Gourley advised theclosure of the pawn-shop, and the disinfection of the severalparcels of pawned goods by dry heat.

At a meeting of the Metropolitan Asylums Board on the25th ult., it transpired that the vessels lent to the Boardby the Admiralty for small-pox purposes were, after all, tobe moored, not off Greenhnbe, as we have previously re-

ported, but off Deptford. The difficulties which the Boardhave experienced in obtaining a wharf on the Thames suit-able for the embarkation of patients have at length beenovercome. Sir Edward Currie moved the following reso-lution, which has been referred to the General PurposesCommittee for consideration :-" That application be madeto the Local Government Board to authorise the managersto purchase two sites in the north and south of the metro-polis respectively, whereon to erect administrative blocksto form the nucleus of hospitals for the accommodation, inhuts; tents, or otherwise, of convalescent patients in timesof epidemics. That, upon the consent of the Local Govern- Iment Board being obtained to this proposal, the GeneralPurposes Committee he empowered to take such measuresas may be necessary for giving effect thereto."A reported death of a young child from vaccination at

Plymouth has been going the round of the general pre8s,apparently confirmed by the verdict of a coroner’s jury. Itwould appear, however, from a statement made by thePresident of the Local Government Board in the House ofCommons, that vaccination was not the cause of death, andthat the jury returned a verdict of "Death from naturalcauses. "

Mr. Wynter Blvth, in the number of his "SanitaryChronicles" for St. Marylebone during the month of May,reports that the meteorology of the month was favourable toanimal and vegetable life, that the mortality from variouszymotic diseases in the parish was at the same rate asoccurred in the corresponding month of the previous tenyears, and that small-pox was distinctly on the decline.Under the direction of the Port Sanitary Authority of the

port of London, vaccination and revaccination of sailors andothers employed within the limits of their jurisdidion havebeen actively pushed, free of cost, by their medical officer ofhealth, Dr. William Cotlingridge.Our contemporary the Metropolitan pertinently asks, " Is

the Patent Destructor to become a recognised parochialinstitution ? "A female aged ninety-one years has been admitted into the

Fulham Small-pox Hospital suffering from the disease.

It is reported that the Admiralty have issued an order,directing a special examination by the medical officers intothe state of vaccination and revaccination of the officers andcrews of the ships in the Royal Navy.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

English urban mortality showed a further decline lastweek, and was lower than in any previous week of thisyear. In twenty of the largest towns, estimated by theRegistrar-General to contain in the middle of this year apopulation somewhat exceeding seven and a half millions,5252 births and 2700 deaths were registered last week. Thebirths exceeded by 66, whereas the deaths were no less than557 below, the average weekly numbers during 1880. Theannual rate of mortality in the twenty towns, which hadbeen equal to 18 7 and 19’5 in the two preceding weeks,declined last week to 18 5. The lowest rates in the twentytowns last week were 9’7 in Plymouth, 11’7 in Wolver.hampton, 13’6 in Nottingham, and 14’3 in Sunderland.The rates in the other towns ranged upwards to 20’6 inSheffield, 20’7 in Bradford, 21’3 in Norwich, and 23’0 inLiverpool. During the first twelve weeks of the currentquarter the death-rates in the twenty towns averaged 20’6per 1000, against 22’5, the average rate in the correspond-ing periods of the five years 1876-80.The deaths referred to the principal zymotic diseases in the

twenty towns, which had been 401 and 461 in the two pre-ceding weeks, were 441 last week; these included 93 fromsmall-pox, 91 from measles, 88 from whooping-cough, 73from diarrhœa, 50 from scarlet fever, 23 from fever (prin-cipally enteric), and 23 from diphtheria. The annual death-rate from these zymotic diseases averaged 3’0 per 1000 inthe twenty towns, and ranged from 0 0 in Plymouth and0’5 in Brighton and Oldham, to 3’9 and 4’5 in London andLiverpool. The fatality of measles, scarlet fever, andwhoopiiig-cough has recently showed a general decline,and was last week considerably below the average forthe season. The 23 deaths from diphtheria in the twentytowns corresponded with the number in the previousweek, and included 14 in London nnd 6 in Portsmouth,The 73 fatal cases of diarrhoea showed but a slightfurther increase upon recent weekly numbers ; theywere proportionally more numerous in London than inthe provincial towns. Small-pox caused 93 more deaths inLondon and its outer ring of suburban districts, 4 in Liver-pool, and 1 in Bradford ; no fatal case of this disease wasrecorded in any of the seventeen other large provincialtowns. The number of small-pox patients ill the Metropo-litan Asylum Hospitals, which had deflined from 1644 to1612 in the two preceding weeks, further felt to 1578 onSaturday lat, of whom 53l were inmates of the Convales-cent Camp Hospital at Darenth. The new cases of small-pox admitted to these hospitals, which had been 293 and358 in the two previous weeks, were 321 last week. TheSt. Pancras Sanatorium at Finchley contained 42 small-poxpatients on Saturday last. The number of patients in theHighgate Small-pox Hospital was 87 at the end of last week,27 new cases having been admitted during the week.

, The deaths referred to diseases of the respiratory organsin London, which had been 216 and 225 in the two preced-ing weeks, declined to 210 last week, but exceeded by 6the corrected average number in the corresponding week ofthe last ten years; they included 108 from bronchitis and75 from pneumonia. The annual death-rate from lungdiseases, exclusive of phthisis, did not exceed 2’9 per 1000in London last week; the rate from the same disease wasequal to 6’4 in Liverpool, and did not exceed 2’1 in Salford.The causes of 64, or 2-4 per cent., of the deaths in the

twenty towns last week were not certified either by a regis-tered medical practitioner or by a coroner. The proportionof uncertified deaths in London did not exceed 1-4 per cent.,whereas it averaged 3’4 in the nineteen provincial towns.No uncertified deaths were registered list week in Brighton,Plymouth, Wolverhampton, or Leicester ; the proportionsof such deaths were largest in Bristol, Newcastle-upou-Tyneand Liverpool.

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HEALTH OF SCOTCH TOWNS.

The Registrar-General of Scotland has now revised hisestimate of the present population of the eight largeScotch towns, dealt with in his Weekly Return, on the

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basis of the numbers enumerated in April last. Thesenumbers, although still subject to final revision, are suffi-ciently trustworthy for all practical purposes. This new

sestimate makes the aggregate population of the eight towns i1,206,023, and 111,Oi4 less than the estimate hitherto 1used, which was based on the rate of increase that prevailed between 1861 and 1871. It appears that the festimates now discarded for more trustworthy ones veryconsiderably overstated the population of Glasgow and rGreenock, and to a smaller extent overstated that of Dundee and of Edinburgh ; whereas the population both of

(

Paisley and Perth was under-estimated. The estimates now adopted give greatly increased value to the mortality statistics of these towns. The annual death-rate in the eight towns, which had been equal to 20’5 and 23’6 per1000 of the present population of the eight towns,

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declined last week to 19’6, but exceeded by 1.1 the ]average rate in the aggregate of the twenty large English towns. The rates in the eight Scotch townsranged from 11 ’8 and 12 0 in Aberdeen and Greenock, ]to 26’2 and 30’7 in Leith and Paisley. The deaths referred tothe principal zymotic diseases in the eight towns, which hadbeen 65 and 84 in the two previous weeks, declined to 63 lastweek; they included 18 from diarrhoea, 11 from whooping-cough, 10 from measles, 10 from diphtheria, 9 from scarletfever, 5 from "fever," and not one from small-pox. Theannual death-rate from these zymotic diseases averaged2’7 per 1000 in the eight towns, and was 0-3 below theaverage rate from the same diseases in the twentyEnglish towns. This zymotic death.rate ranged in theeight Scotch towns from 0’0 and 0 5 in Greenock and Aber-deen, to 3’5 and 3’8 in Perth and Glasgow. The 18 fatalcases of diarrhoea in the eight towns showed a decline of9 from the number in the previous week, but showed a pro-portional fatality very considerably in excess of that whichprevailed in the twenty English towns. The 11 deaths fromwhooping-cough also showed a decline from recent weeklynumbers, and included 5 in Edinburgh and 3 in Glasgow.Nine of the 10 deaths from measles, and 8 of the 10 fromdiphtheria, were returned in Glasgow. Of the 9 fatal casesof scarlet fever 5 occurred in Edinburgh and 4 in Glasgow.The deaths referred to "fever" (including typhus, enteric,and simple), which had been 11 and 13 in the two precedingweeks, declined to 5 last week, and included 4 in Glasgow and1 in Edinburgh ; they were equal to an average annual rate of0’22 per 1000, against 0’16, the average rate from the samecauses in the twenty English towns. The deaths attributedto acute diseases of the lungs (bronchitis, pneumonia, andpleurisy) in the eight towns, which had been 95 and 110in the two preceding weeks, further rose to 114 last week,and were equal to an annual rate of 4’9 per 1000, whereasthe rate from the same diseases in London did not ex-ceed 2’5.

HEALTH OF DUBLIN.

The rate of mortality in Dublin showed a slight furtherincrease last week. The annual rate of mortality, calculatedupon the population enumerated in April last, which hadbeen equal to 21’0 and 24’3 in the two previous weeks,further rose last week to 24’5. During the past twelve weeksof the current quarter the death-rate in the city averagedno less than 26’2 per 1000, against 20’2 in London and 20 8in Edinburgh. The 164 deaths in Dublin last week showeda further increase of 2 upon the number returned in thetwo previous weeks, and included 19, or nearly 12 per cent.,that were referred to the principal zymotic diseases, against11 and 13 in the two preceding weeks. These 19 deathsfrom zymotic diseases included 8 from fever (typhus, enteric,or simple), 6 from diarrhoea, 3 from whooping-cough, 1 eachfrom measles and scarlet fever, and not one either fromsmall-pox or diphtheria. The annual death-rate from thesezymotic diseases was equal to 2-8 per 1000 in Dublin, whilethe rate from the same diseases was 3’9 in London and32 in Edinburgh. The deaths referred to fever cor-

responded with the number in the previous week, and wereequal to an annual rate more than seven times as high asthe average rate from the same cause in the twenty largeEnglish towns. The 6 deaths from diarrhoea considerablyexceeded the numbers in recent weeks, and showed a fatalitylargely in excess of that prevailing in the English towns.The deaths from whooping-cough were also more numerousthan in recent weeks, while those from the other zymoticdiseases were again but few. Infant mortality showed amarked further increase upon that recorded in recent weeks,

FATAL DIPHTHERIA IN PORTSMOUTH.

The epidemic of diphtheria in Portsmouth shows littlesign of abatement, as no fewer than 43 fatal. cases have ebeen registered within the borough since the end of Marchlast, against 6, 15, and 17 in the three preceding quarters.Thus during the past nine months 75 deaths have resultedfrom this disease, whereas the highest number returned inany year since 1870 was 24 in 1874. Bearing in mind thenear approach of the holiday season at Southsea, it isdifficult to suppress surprise at the apparent apathy withwhich this continuance of the epidemic is locally regarded.There would appear to have been no serious attempt to checkthe spread of infection or to trace its origin. We believethe local sanitary authority is supposed to possess hospitalaccommodation for the isolation and treatment of infectiousdiseases, but we have not heard of a single case of diphtheriahaving been treated in this hospital. If the new MedicalOfficer of Health for the borough has made any specialreport to the Town Council on this epidemic, such report, asfar as we have been able to ascertain, has never yet beenpublished. The severity of the present epidemic may bejudged from the following figures. During the past twelveweeks the annual death-rate from diphtheria within theborough of Portsmouth has averaged 1’46 per 1000, exceeding

, by more than thirteen times the average rate from this diseasein twenty of the largest English towns during the ten years1871-80. The greatest fatality of diphtheria in Portsmouth has

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recently occurred in Kingston sub-district, where the death-rate has been equal to 243 per 1000; in Landport sub-

’ district, however, which contains Southsea, the rate has’

averaged 1’28 per 1000. Six fatal cases were registeredwithin the borough during each of the last two weeks.

HEALTH MATTERS GENERALLY AT HOMEAND ABROAD.

THE METHOD OF DEALING WITH TRADE REFUSE, HOUSEREFUSE, ETC., IN THE METRUPOLIS.

The meeting of the Society of Medical Officers of Healthon the 24th ult., Dr. Bristowe, the President, in the chair,was occupied with the consideration of a report by a com-mittee of its members on the best method of dealing withthe trade refuse, house refuse, and other waste matters ofthe metropolis. The committee entrusted with the pre-paration of the report consisted of Dr. Orme Dudfield,Mr. Wynter Blyth, Dr. Alfred Carpenter, Mr. ShirleyF. Murphy, and Dr. Sedgwick Saunders. The subjectssubmitted for consideration to the committee were

arranged under three heads. 1. The best and most con-venient method of dealing with animal and vegetable traderefuse (e.g., from slaughter-houses, fishmongers’, poulterers’,greengrocers’ shops, &c.), with a view to its collection,removal, and ultimate disposal, whether by utilisation orotherwise. 2. The collection and disposal of house refuse.3. The collection and disposal of stable and cowshedrefuse. With regard to the first subject the committeeconclude that " in any case the refuse should be collecteddaily in the early morning hours, and conveyed in pro-perly constructed covered receptacles or in vehicles ex-

pressly adapted for the prevention of effluvium nuisance.Failing an arrangement for utilisation, each district shouldprovide the means of destroying animal refuse. It appearsdoubtful whether vegetable refuse could be profitably uti-lised in London by the process of ’ carbonisation.’ The meredestruction of such retuse by fire could be effected withoutdifficulty or nuisance." With regard to the second subject,the committee observe "that the removal of houserefuse ought not to depend upon its pecuniary value, butshould be regarded from the sanitary rather than the com-mercial point of view, and they are of opinion that the timeis at hand when the nuisance authority will have to

adopt the process of refuse-destruction by fire, in speciallyconstructed apparatus, such, for instance, as is in opera-tion at many great provincial centres of population, asBirmingham, Leeds, Manchester, Warrington," &c. We areglad to note here that the meeting was wholly in favour ofhouseholders accumulating their house refuse in movable re-ceptacles, and of a daily collection by the metropolitan nuisanceauthorities, after the fashion adopted in several towns in

England. With regard to the third subject, the committee, were of opinion that the nuisance authority " should have

the same right everywhere as in the City of London to col-