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the notification of erysipelas, Dr. Yarrow calls attention to thelarge number of certificates received and the expenditure in fees,,occasioned thereby. His experience in connexion with thissubject is worth quoting. "I may add," he says, "thatsince the disease has been notified to sanitary authorities-viz., October, 1889-235 certificates have been received,with the result that only six have been removed, two to’hospitals and four to workhouse infirmaries ; yet in no

single case has a second case occurred in the same house,although neither disinfection nor other means have beentaken to prevent its spreading." Dr. Yarrow further remarks :" I can only suppose that the disease has assumed a milder- type after it was decided to include it amongst the notifiablediseases, otherwise I feel certain that neither measles nor

whooping-cough would have been passed over in its favour."It would have been of interest had Dr. Yarrow told us some-thing of the sanitary condition of the houses in which the.disease occurred.

Batley Urban Sanitary District. -Dr. Swann remarks in hisannual report that during 1892 there were 453 cases of small-pox notified. Of these 234 were removed to hospital and theremainder were treated at their own homes. As Dr. SidneyCoupland was especially commissioned to inquire into andreport upon the epidemic, Dr. Swann, beyond prophesying’that the value of vaccination will receive abundant illustra-tion, refrains from dealing further with the subject. Theisolation accommodation of the district is said to be utterlyunsuitable for the reception of patients, and it was foundimpossible to maintain an equable temperature in the Dekkerportion of the buildings. Under the circumstances we are gladto learn from a postscript to the report that a suitable sitefor the erection of permanent accommodation has been secured.and that plans for a new building are being prepared. Batley,situated as it is in the heavy woollen district, is naturallyinterested in the subject of the importation of rags from

foreign countries, and Dr. Swann, whilst discussing choleraprecautions, refers to the serious consequences which wouldresult if the importation of rags were prohibited, and he evengoes so far as to speak of a "rag famine." We thinkhe may rest content on this score, since, if an industry- cannot adapt itself to the very lenient rag orders at

present in force, it cannot be of a very substantial character,and it is certainly improbable that orders of any greaterstringency will be enforced. Lead poisoning is still presentdn the district, and the samples of water analysed during theyear contained lead in quantities varying from 0 ’014 to 0 ’378

Iper gallon.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN thirty-three of the largest English towns 6053 births and.3751 deaths were registered during the week ending May 20th.The annual rate of mortality in these towns, which hadbeen 19’8 and 18’6 per 1000 in the preceding two weeks,cose again last week to 189. In London the ratewas 182 per 1000, whilst it averaged 19 in the thirty-two provincial towns. The lowest rates in these towns were.’13 4 in Portsmouth, 13.9 in Croydon, 14 -0 in West Ham and14’7 in Nottingham ; the highest rates were 21’8 inOldham, 21’9 in Huddersfield, 22-0 in Manchester and in.Salford, 24-0 in Bolton and 27-1 in Liverpool. The 3751 deathsincluded 487 which were referred to the principal zymoticdiseases, against 442 and 435 in the preceding two weeks ;of these, 150 resulted from measles, 91 from whooping-cough, 75 from diphtheria, 70 from diarrhoea, 49 from scarletfever, 33 from" fever" (principally enteric), and 19 fromsmall-pox. The lowest death-rates from these diseases wererecorded in Brighton, Huddersfield, Burnley, Bristol and

Nottingham, whilst they caused the highest rates in Bolton,Newcastle-upon-Tyne, Cardiff, Gateshead and Preston. The

greatest mortality from measles occurred in Leeds, Bolton,Plymouth, Cardiff, Newcastle-upon-Tyne, Gateshead andPreston ; from scarlet fever in Cardiff ; from whooping-coughin Birkenhead, Leicester and Salford ; from 11 fever " in

’Wolverhampton and Birkenhead ; and from diarrhoea inLeicester and Sunderland. The 75 deaths from diphtheriaincluded 51 in London, 4 in Manchester and 3 inCroydon. Six fatal cases of small-pox were registeredin Oldham, 4 in London, 2 in Manchester, 2 in Halifax,:2 in Bradford and 1 each in West Ham, Leicesterand Birmingham ; 566 cases of this disease were undertreatment in the .Metropolitan Asylum Hospitals and in

the Highgate Small-pox Hospital on Saturday last, against474, 531 and 569 at the end of the preceding three

weeks ; 113 new cases were admitted during the week,against 110, 161 and 126 in the preceding three weeks. Thenumber of scarlet fever patients in the Metropolitan AsylumHospitals and in the London Fever Hospitals at the end ofthe week was 2345, against 2037, 2103 and 2161 on the

preceding three Saturdays ; 370 new cases were admittedduring the week, against 280 and 346 in the previous twoweeks. The deaths referred to diseases of the respiratoryorgans in London, which had declined from 416 to 304 inthe preceding five weeks, were again 304 last week andwere 31 below the corrected average. The causes of 65, or1-7 per cent., of the deaths in the thirty-three towns werenot certified either by a registered medical practitioner orby a coroner. All the causes of death were duly certifiedin Croydon, Bolton, Oldham, Blackburn and in four othersmaller towns ; the largest proportions of uncertified deathswere registered in Leicester, Derby, Preston and Sheffield.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 21’5 and 20-7 per 1000 in the precedingtwo weeks, rose again to 21’9 during the week endingMay 20th, and exceeded by 30 per 1000 the mean rateduring the same period in the thirty-three large Englishtowns. The rates in the eight Scotch towns ranged from15’4 in Perth and 16’9 in Aberdeen to 21’1 in Paisley and26’8 in Glasgow. The 618 deaths in these towns included51 which were referred to measles, 23 to whooping-congh,15 to diarrhoea, 8 to scarlet fever, 5 to diphtheria, 4 to"fever," and 1 to small-pox ; in all, 107 deaths resultedfrom these principal zymotic diseases, against 101 and 108in the preceding two weeks. These 107 deaths were equalto an annual rate of 3’8 per 1000, which exceeded by 1’3the mean rate last week from the same diseases in thethirty-three large English towns. The fatal cases of measles,which had been 48 and 47 in the preceding two weeks, roseagain to 51 last week, of which 38 occurred in Glasgow and6 in Greenock. The deaths referred to whooping-cough, whichhad been 29 and 28 in the preceding two weeks, further declinedto 23 last week and included 18 in Glasgow and 4 in Edin-burgh. The 8 fatal cases of scarlet fever exceeded by 3 thenumber recorded in the preceding week and included 7 inGlasgow. The deaths from diphtheria, which had been 1 and7 in the preceding two weeks, declined to 5 last week, ofwhich 2 occurred in Glasgow, where 3 of the 4 fatal casesof I fever’’ and the death from small-pox were also recorded.The deaths referred to diseases of the respiratory organsin these towns, which had declined from 149 to 105 in thepreceding three weeks, rose again last week to 122, andwere within 4 of the number in the corresponding weekof last year. The causes of 51, or more than 8 percent., of the deaths in these eight towns last week were notcertified.

___

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 22’2 and 26’1per 1000 in the preceding two weeks, further rose to 26’7during the week ending May 20th. During the past sevenweeks of the current quarter the death-rate in the city hasaveraged 25’7 per 1000, against 19 4 in London and 16 2 inEdinburgh. The 179 deaths registered in Dublin during theweek under notice showed an increase of 4 upon the numberin the previous week and included 15 which were referredto the principal zymotic diseases, against 16 and 22 in thepreceding two weeks. Of these 8 resulted from "fever" "

(principally enteric), 3 from whooping-cough, 2 frommeasles, 1 from scarlet fever, 1 from diphtheria, andnot one either from small-pox or diarrhoea. These 15deaths were equal to an annual rate of 2’2 per 1000,the zymotic death-rate during the same period being 2’3in London and 1’2 in Edinburgh. The deaths referredto different forms of "fever," which had increased from2 to 6 in the preceding three weeks, further rose to 8last week, a higher number than in any week since Marchlast. The fatal cases of whooping-cough, which had risenfrom 1 to 8 in the preceding three weeks, declined again to3 last week. The 2 deaths referred to measles showed adecline from those recorded in recent weeks. The 179deaths registered in Dublin last week included 36 of infantsunder one year of age and 53 of persons aged upwards ofsixty years ; the deaths both of infants and of elderly persons

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showed a further increase upon those recorded in recentweeks. Four inquest cases and 4 deaths from violence wereregistered; and 51, or more than a fourth, of the deathsoccurred in public institutions. The causes of 21, or nearly12 per cent., of the deaths in the city last week wera notcertified.

THE SERVICES.

MOVEMENTS IN THE MEDICAL STAFF.

SURGEON-MAJOR THOMAS HEAZLE PARKE has been placed IIin Charge of the Infectious Diseases Hospital at the RoyalVictoria Hospital, Netley. Surgeon-Lieutenant L. P. More,doing duty in the Medical Division of the Royal VictoriaHospital, has received orders to proceed to York, for tem-

porary duty in the North-Eastern District. The followingofficers have arrived in England on leave : Surgeon-CaptainSawyer from Gibraltar ; Surgeon-Major Carey from SouthAfrica ; Surgeon-Captains Hore and Dillon from Malta andSurgeon-Major Webb from India. Surgeon-Captain Dormanhas re-embarked for Halifax on return from leave of absence.

Surgeon-Lieutenant Martin has been transferred from New-castle to York. Surgeon-Captains Kearney and Hamilton havebeen placed in charge of Militia Battalions out for trainingat Stoneleigh and Brockenden Moor, respectively, and Sur-geon-Lieutenant Hughes has been posted to similar duty atChipping. Surgeon-Captain Wilson has been posted to Wool-wich on return from trooping duty. Surgeon - CaptainBaylor has been transferred from Cork to Ennis ; Surgeon-Lieutenant Moore from Cork to Kilkenny and Surgeon-Lieutenant Walker to Wexford.

INDIA AND THE INDIAN MEDICAL SERVICES.

The following appointments are announced :-8th BengalCavalry : Surgeon-Captain J. T. Daly to the Medical Chargeof the Regiment. 10th Bengal Lancers : Surgeon-Captain

, W. H. E. Woodwright to the Officiating Medical Chargeof the Regiment. 17th Bengal Infantry : Surgeon-MajorG. Money-Shewan, from the Medical Charge of theL3rd Bengal Infantry, to the Officiating Medical Charge of the Regiment; Surgeon-Captain B. C. Oldham to the IOfficiating Medical Charge of the Regiment; Surgeon-Captain D. T. Lane to the Medical Charge of the Regi-ment. Surgeon-Captain C. M. Moore, M.D., Indian MedicalService (Bombay), Medical Officer, 3rd Bombay Cavalry,to Officiate as Medical Officer of the Deoli Irregular Forceand of the Harowtee and Tonk Pol Agency. Brigade-Surgeon-Lieutenant-Colonel J. B. Gaffney, Officiating Civil

Surgeon of Jubbulpore, to the Medical Charge of the Jubbul-pore Central Gaol. Surgeon-Major H. E. W. Barrington,A.M.S., to the Medical Charge of the Cantonment GeneralHospital, Dalhousie. Surgeon-Captain J. S. Edye, A.M.S.,to the Medical Charge of the Cantonment General Hospital,Ranikhet. Surgeon-Lieutenant-Colonel B. O’Brien, Civil

Surgeon, 2nd class, Kheri, to Officiate as Civil Surgeon,1st class, Benares. The following are transferred : Surgeon-Major C. J. Bamber, Civil Surgeon, from Gujrat to Jullundur.Surgeon-Major B. Doyle, Civil Surgeon, from Ferozepore toPeshawar. Surgeon-Major W. Deane, Civil Surgeon, fromBahraich to Moradabad and Surgeon-Captain F. D. C. Haw-kins, Civil Surgeon, from Pilibhit to Etawah. The servicesof Surgeon-Captain A. G. Hendley, of the Bengal Establish-ment, are placed at the disposal of the Chief Commissionerof the Central Provinces. Surgeon-Lieutenant G. Bidie isbrought on the strength of the Madras Establishment.Brigade-Surgeon-Lieutenant-Colonel Griffith Griffith, DeputySanitary Commissioner, North-West Provinces and Oudh, andBrigade- Surgeon -Lieutenant -Colonel W. Gray retire fromthe service. Surgeon-Major A. W. F. Street, D.S 0., andSurgeon-Captain A. V. Anderson, M.B., have respectivelydelivered over and received charge of the office of the DeputySanitary Commissioner, Central Registration District. Thefollowing promotions are made :-To be Surgeon-Majors :Surgeon-Captain A. G. E. Newland, Surgeon-Captain A. T. L.Patch, M.B., Surgeon-Captain R. Ross, Surgeon-Captain C.Adams, M.B., and Surgeon-Captain A. J. O’Hara.

NAVAL MEDICAL SERVICE.The following appointments are announced :-Fleet Sur-

geons : George Maclean, M.A., M.B., has been promoted to

the rank of Deputy-Inspector-General of Hospitals and Fleetsin Her Majesty’s Fleet ; Richard G. Brown, M.B., to the -Castor and William D. Wodsworth to the Royal Sovereign.Staff-Surgeons : William H. Patterson to the Hood and Chas.A. Macaulay, M.D., to the Narcissus. Surgeons: Alfred W.Sturdee and Charles S. Woodwright to the Eloud.

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Captain Robert T. A. O’Callaghan, F.R.C.S.I., tobe Surgeon-Major.

MILITIA MEDICAL STAFF.

Surgeon-Major D. McFadyen, 2nd Battalion, the Queen’sOwn Cameron Highlanders, to be Surgeon-Lieutenant-Colonel.

VOLUNTEER CORPS.

Royal Engineers (Submarine Miners) The Mersey Division:J. Edwd. Gemmell, M.B., late Surgeon, Royal Naval ArtilleryVolunteers, to be Surgeon-Lieutenant.-Rifle: lst VolunteerBattalion, the Duke of Cornwall’s Light Infantry : Surgeon-Lieutenant E. Rundle resigns his commission.-lst VolunteerBattalion, the Prince of Wales’s Volunteers (South LancashireRegiment) : Surgeon-Captain and Honorary Surgeon-Major E.Lister resigns his commission ; also is permitted to retain hisrank and to continue to wear the uniform of the Battalion onhis retirement.-5th (Glasgow Highland) Volunteer Battalion,the Highland Light Infantry : Surgeon-Captain D. Cowie,M.B., to be Surgeon-Major.

VOLUNTEER AMBULANCE SERVICE INSPECTION.

Surgeon-Colonel Hamilton, Principal Medical Officer of theHome District, on Saturday last (May 20th) inspected thesixth regimental Ambulance Class of the 4th VolunteerBattalion, East Surrey Regiment, at the headquarters of theBattalion, 71, Upper Kennington-lane. The class is con-

ducted by Surgeon-Captain E. J. Lawless, M.D., and is the

strongest regimental class in the home district. A fullbearer company, consisting of eight fully-equipped stretchersquads, with horsed ambulance waggon of the 3rd Queen’sRoyal West Surrey Regiment Volunteer Battalion, sent byColonel Bevington, paraded before Surgeon-Colonel Hamilton.He was accompanied by his staff officers, Surgeon-MajorLamprey, A.M.S., and Surgeon-Captain Raw, V.M.S.C.Other officers in attendance were Mr. John Farley, Order ofSt. John of Jerusalem ; Major MacLure, late London Scot-tish Rifle Volunteers, President, Volunteer AmbulanceSchool; Lieutenant-Colonel Tully and Officers, 4th VolunteerBattalion, East Surrey Regiment; and Surgeon-CaptainMaitland Coffin, 3rd Volunteer Battalion, West SurreyRegiment. After the usual salutes and marches the Com-

pany was put through stretcher drill, with stretchers bothclosed and prepared. They were also drilled in bandaging,lifting and carrying the wounded, and in hand-seat drill.The new Medical Staff Corps drill, 1893, was followedthroughout the inspection, and as the new regulations haveonly been issued for three weeks this inspection probablyafforded to Londoners the first opportunity of witnessing thenew exercises. In order to make up the Company, Surgeon-Captain Maitland Coffin had eight of his men present fromthe 3rd West Surrey Regiment. At the conclusion of theinspection Surgeon-Colonel Hamilton expressed himself asgratified by the careful way in which the work had been carriedout. It might appear a small thing, he said, to learn a drillof this kind, but the knowledge was easily carried about andthey could never tell the moment when it might be drawnupon. As an illustration of this he noted that the Director-General only that day had forwarded to him an order regard-ing the conduct of Private Phillips, who had succeeded inrestoring a drowning man after fifty minutes’ artificial respira-tion. Of course they had their military duties to perform aswell and it was very important in the battlefield that thefighting men should feel that behind them there were thosewho would assist them in the time of injury. He had seenin the Soudan a wounded man in the hands of the ArmyService Corps five seconds after being shot. He complimentedSurgeon-Captain Lawless upon the efficiency, steadiness andmilitary bearing of the company and with the knowledgewhich had been displayed by the class. An inspection ofall the Volunteer Ambulance Classes in the Home Districtswould, if it were possible to arrange such a review, be ofmuch service in enabling the Principal Medical Officer toascertain how the various Volunteer Ambulance Corps wouldact on an occasion which required their mobilisation.

’, THE LATE SIR JAMES DORMER.The late Commander-in-Chief of Madras was well known

to a large number of medical officers, who will regret his