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1184 ,Lavender-hill, Clapham Junction, to consider a scheme for establishing in the district of Battersea an institution on lines similar to those adopted by the Wandsworth Medical Aid Society. It has been felt for some time past that an organi- sation which has so admirably answered its purpose in Wandsworth in meeting the requirements of a large class of ’patients who cannot be regarded as parish cases, and yet are unable to pay the usual fees of the general practitioner in that district, might with advantage be established in this one, and thus many not affected by existing organisations would be benefited. The chair was occupied by Dr. Barkwell, who explained the object of the proposed society, to be called I The Battersea and Clapham Medical Service," and as two- thirds of the gentlemen present expressed approval of the scheme the society was forthwith inaugurated and duly established, a committee of management of six medical men being chosen-viz., Dr. Terry, Dr. Macrory, Dr. Richards, and Dr. Wallace, together with the treasurer and secretary. The next meeting is fixed for Tuesday, the 27th inst., at 4 P.M., at 299, Lavender-hill, S.W. Public Health and Poor Law. LOCAL GOVERNMENT DEPARTMENT. REPORTS OF MEDICAL OFFICERS OF HEALTH. Liverpool Urban Sanitary .District.-The extension of the boundaries of Liverpool which took place in November, 1895, has had the effect of very materially increasing the size of the city both in acreage and population. The former is now 13,236 in place of 5210 and the population 638,291 in place of 503,967. Another important effect of the extension has been to render the population of Liverpool a far more repre- sentative one than was formerly the case, and, as Dr. E. M. Hope observes, it will probably lead to an apparent fall in the death-rate of the city taken as a whole. The population of greater Liverpool is now estimated at 48 per acre, that of the old city being 97 and of the added area 16. The birth-rate of Liverpool during 1895 was 34’5 per 1000, a rate which was only exceeded by five other towns, the rates in the several wards varying from 44’8 to 21’7. The general death-rate was 25’4 per 1000, as against an average in the former city of 25’6 per 1000, the rates ranging from as much as 41’2 per 1000 in Exchange district to 10’4 in Toxteth. Typhus fever, Dr. Hope reports, still lingers in Liverpool, and during 1895 there were 162 cases with 24 deaths. The Liverpool figures as regards the importation of foreign meat are as usual interesting and extremely suggestive. Over 2000 fewer cattle were slaughtered in the city slaughter-houses during 1895 than was the case during 1894, but 1500 more carcases were imported than in the previous year. Similarly in respect of sheep, there was a decrease in the number slaughtered of about 62,000, while the imported carcases were increased by 51,000. Under the heading of smothered and injured cattle it was reported that such beasts are found chiefly among cattle imported from Ireland, the cross channel traffic being more disastrous than the transatlantic voyage. Birkenhead Urban Sanitary .District.-There were 3 cases of typhus fever notified in Birkenhead in 1895 and 1 death resulted. Dr. Sydney Marsden has devised a means for dealing with books from the public library which may be present in houses invaded by infectious disease. A copy of all notifications is sent to the librarian, and he in turn notifies to the medical officer of health such of the invaded houses as contain library books. The books are handed over to the sanitary authority and disposed of by them as they think desirable. In no case are the books returned to the public library, but some of them find their way to the fever hospital. Dr. Marsden gives in his report a short summary of the general conclusions arrived at by the Royal Com- mission on Tuberculosis, and he points out that in Birken- head the practice is not to condemn a carcase if the offal alone be affected, but to do so at once if there are any indi- cations that the disease is generalised. Reference is also made by Dr. Marsden to the use for food of the flesh of cows killed in an advanced state of pregnancy. He tells us that many cows are imported into Birkenhead in a stage far advanced towards calving, and that such cows are at once killed, the calves cut out, and the carcases of the cows sold in the usual way. Dr. Marsden thinks it most undesirable that the flesh of these pregnant cows should be used for human food. In discussing the adverse influences affecting the health of the people Dr. Marsden strongly expresses the opinion that female sanitary inspectors would be of the greatest value to the more ignorant classes in giving advice as to the feeding and management and nursing in sickness, to explain the use of disinfectants, &c., when necessary, and generally to impress upon the people the risks attending such diseases as measles, whooping-cough, and diarrhoea. Blacltpool Urban 8anitary District.-This borough still maintains its high infantile mortality, and last year it amounted to 206’3 per 1000 births, the quarterly rates vary- ing from 120 per 1000 in the first quarter to 254 in the third. Dr. Jasper Anderson states that six of the deaths were uncertified, and in one in which an inquest was held the verdict was " Found dead in her bedroom." The notification of 11 puerperal fever" does not seem to be a success in Blackpool, and Dr. Anderson reports that but one case-a fatal one-was notified during 1895. It is somewhat rare ta hear of small-pox being introduced into England from America, but during 1$95 a woman from Philadelphia, where the disease was rife, developed small-pox shortly after her arrival in this country, and by the fact of having con- sulted a druggist, who naturally did not recognise the disease, she was instrumental in conveying it to several other people. In respect of enteric fever Dr. Anderson thinks that much harm is done by insisting that the disease is infectious only through the excreta, and he points out however infection i& carried the disease is a great danger to those brought in contact with it. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN thirty-three of the largest English towns 6583 births and 3381 deaths were registered during the week ending Oct. 17th. The annual rate of mortality in these towns, which had increased in the four preceding weeks from 15’), to 16’7 per 1000, declined again last week to 16’3. In London the rate was 15’7 per 1000, while it averaged 16’6 in the thirty-two provincial towns. The lowest rates in these towns were 9’4 in Leicester, 9’7 in Croydon, 114 in Wolverhampton, and 11’9 in Huddersfield ; the highest rates were 19 8 in Hull. 20’1 in Liverpool, 21-8 in Sheffield, and 23-8 in Bolton. The 3381 deaths included 351 which were referred to the principal zymotic diseases, against 386 and 361 in the two preceding weeks; of these, 92 resulted from diphtheria, 67 from diarrhoea, 55 from "fever" (principally enteric), 48 from scarlet fever, 46 from measles, 43 from whooping-cough, and not one from small-pox. The lowest death-rates from these diseases were recorded in Bristol, Derby, Burnley, and Huddersfield ; and the highest rates in Sheffield, Plymouth, Gateshead, and Hull. The greatest mortality from measles’ occurred in Hull, Gateshead, and Plymouth; from scarlet fever in Birkenhead ; from whooping-cough in Swansea; y from "fever " in Sunderland; and from diarrhoea in Oldham, Blackburn, and Preston. The 92 deaths from diphtheria included 66 in London, 6 in West Ham, and 3 in Birmingham. No fatal case of small-pox was registered in any of the thirty - three towns. There were 2 cases of small - pox under treatment in the Metropolitan Asylum Hospitals on Saturday last, the 17th inst., against numbers declining from 16 to 4 at the end of the six preceding weeks ; no- new cases were admitted during the week. The number of scarlet fever patients in the Metropolitan Asylum Hos- pitals and in the London Fever Hospital at the end of the week was 4073, against 3951, 4020, and 4105 at the end of the three preceding weeks; 372 new cases were admitted during the week, against 466, 454, and 424 in the three preceding weeks. The deaths referred to diseases of the respiratory organs in London, which had increased in the five preceding weeks from 118 to 218, further rose last week to 238, but were 76 below the corrected average. The causes of 48, or 1-4 per cent., of the deaths in the thirty-three towns were not certified either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in Bristol, Nottingham, Bradford, Leeds, Newcastle-upon-Tyne, and in fourteen other smaller towns ; the largest proportions of uncertified deaths. were registered in Birmingham, Liverpool, Salford, and Hull.
