1091

be in no way implicated, but in the area specially affecteda defective and blocked sewer had recently been cpeaed,and to th;s the outbreak h provisionally attributed. Furtherreports as to both these epidemics are promised.

AN alarm of fire was raised in Glasgow Royal Infirmaryan Monday evening. A chimney formed of iron tubing,which pa-sed through the rout of a small outshot budding,took fire, and burned so fiercely that for a short time thestructure seemed in some danger. Through the exertionsmainly of the s,ipaririteudetit and the resident assistans thefire was prevented from spreading further. In view of theterrible results which would certainly ensue from the occur-rence of a fire in such an institution, it is to be hoped thatthe Royal Infirmary authorities have their fire extinguishingapparatus in proper ordtr, and judiciously placed about thelauildiugs. The new part of the Infirmary is well suppliedwith hose, &c.; but what of the "old house" ?

AN order was lately made by a Justice of the Peace forSuffolk for the vaccination of a child whose father had beenfined nine years before for refusing to have it vaccinated.Disputing the power of the Magistrate to make the order,counsel on behalf of the father made an application to theQueen’s Bench Division to raise the issue before the Court,but permission to do this was refused, Mr. Justice Hawkinsholding that to do what was a-ked would only be to raisedoubts about what was perfectly clear.

THE French doctors in Nice are, it appears, up in arms

against their English and other foreign brethren establishedin that favoured health resort. A general meeting of theformer body has be°n held, at which protests were enteredagainst the manner in which alien practitioners monopolisethe most lucrative practice. Amongst other points urged itwas stated that many of the intruders are not qualifiedFrench physicians, and consequently have no right to prac-tise anywhere in France. -

MR. PRIDGIN TEALE, in a letter to the Leeds llfercury,calls attention to a rough-and-ready method of filch disposaladopted in the town. " Within the last few month"," saysMr. Teale, " hundreds of c cartloads of ashpit refuse and "nightsoil’ have been tipp-d into an old qnarry by our corporationcarts," with what effect upan the health and comfort of theimmediate residents may be safety left to the imagination todepict. -

LiSTERiSM grows in favour in Italy, if we are to judgefrom an article "On the Foundations of Modern Surgery,"just published by Professor Andrea Ceccherelli in the

Gazzetta degli Ospitali (Milan, Dec. 13th). The author is afirm believer iu the clinical potency of micro-organisms, andextols antiseptic dressings as amongst the greatest of modernsurgical conquests. -

IT was decided at a meeting held at Liverpool on the15th inat., the Ma3 or presiding, to erect at a cost of £100,000a new and more c tfmnodious infirmary, the present onebeing quite unsuited to the present requirement., and thesanitary arrangements also being defective. Subscriptionsto the amount of f50,000 are already promised.

THE expedient of pouring oil upon the broken waves of I’the ocean to produce a comparative calm is, cnrioui-ly’enough, spoken of by some of the scientific journals as anew thing. Tne fact is that this action of oil in stillingbreakers is as old at least as Aristotle.

DR. MEREDITH, in the Birmingham llledicaL Review, re-commends o,l of peppermint a an exteroal application forallaying the neuralgic pain so often complained of in cases ofherpes zoster (shingles).

DR. D. G. F. MACDONALD has in the press a work on"Grouse Diseaie, its Causes and Remedies," with illustra-tious by Etwes. It will be published by Messrs. W. H. Allenand Cu. early next month.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

St. George’s, Hanover square.-According to Dr. Corfield’sannual rrport the death-rate for this parish is still main-tained at a low ehb, it being 16.9 per 1000, as opposed to anaverage, during the ten precediug yt’ars, of 17’9. The popu-latiou is all but stationary ; for although there has been anincrease in the neighbourhood of Mayfair, there has been astill greater decrease about Hanover-square, the re"ult beingthat in 1881 there were 185 les inhabitants than iu 1871.The mortality under one year of age is 13’4 for every 100births. This rate is low, but the circumstancts of the districtare exceptionally favonrable to the maj ’rit.y of the childrenborn. The mean duration of life in trre parish is also high.During the past seven ea’s it has been 50 years ; last, yearit ws 50’2 years ; whereas it is but little over 35 years forLondon generally. Apart from deaths of non-parishioners inSt. George’s Hospital, no special prevalence of infectiousdisease is indicated ; but having regard to the amount ofsanitary work done, uch a re-ult must in part be atniburedto the careful action taken against the spread of infectionand agdin-t the contiuuauce of conditions unfavourable tohealth. Amongst olh.r items we notice that infection of236 houses in which infectious disease had prevailed hadben carriei out, nd that over 3000 large articles, in addi-tion to many sm,til:;r oue". hdd been dealt with in the hot-air disiutect ng stove. The stove is that dtsign-d by Dr.Ransom, F.R.S., and it is reported to work satisfactorily inevery respect.Bethnal-green; Sewer Ventilation. - According to Dr.

Bate’s annual report for the parish of St. Matthew, Bethnal-green, the dlstr ct had in the middle of 1881 a population of127,180, the number of hours bring at the rate of one toevery 7’2 idhabitatits. The death-rate amounted to 24’0 per1000, this rate exhibitiog a slight increase on t,he average forthe ten preceding Bears. The birth-rate was high, amount-in to 41 1 per 1000, but the infantile mortality was alsohigh ; the rate of death amongst, infants under one yearreachillg 15.3 per cent. of the birh-< registered. Srnall-poxattacked 737 p ons, of whom 680 were remo. ed to hospital.Owing to the rapid of the Asylums Board Ho spitalsthe vrstry provided additio nal hospital accommodation atPlaistow, and Dr. Bate remarks that in no sing’e ins!aocewas it ne4-es4aiy to resort to compulsory measu es III order toget the cases removed. Measles was very faral during theyear, and ir. is to be regretted that eauitary interference cana" yet do but little to prevent its spread and f ,t.tliIY, forowing to the fact that it is so highly contagious brfore 1t canbe diagnosed, even isolation is rarely of anyavdil. Unfor-tunately, however, Betbnat-gi-eeri is Dot yet provided withall the IIIeall8 which are proved to be of nse in prevrnriug thei-pread of infe tious diseases. In 18SO Dr. B.i,te ) repared anexhaustive report on the value of the different disinft-ct:ngcham her., and concluded by recommending the erection of aWashington Lyou’s stt-am apparatus. Nothing has. how-ever, beeu doine in the matter; and hence when clea. sing anddisinfection of 1)ren)i-et4, as also the burning of beds, &c.,have heen cartird out in houses where infectious di-ease hasprevailed, the disease breaks out again by reason of the useof infected cluthing.A separate report is issued by Dr. Bate on the question of

the ventilation "f the seivrrs in his di-trict. He wuld, as ageneral rule, advocate a y-tem by which ventilation g shaftsshould be carried from the sewers to a height above the levelof bouse chimneys, sme of the openings being fitted withcowls so as to ensu.’e a down current of fre:h air. The

1092

system at present adopted in the metropolis is to place anumber of shafts in the course of the sewer, these shaftsopening by means of gratiogs down the centre of the road-ways ; and it was with a view of ascertaining the eflicieucyor the reverse of this plan that Dr. Bute undertook a seriesof experiments. Nearly all ttre shafts in the district wereexamined in detail: 11 per cent. were found to be entirely,and 28 per ceut. patrtially, choked with road detritus, leavingonly some 6L per cellt. in working order. By the aid ofLind’s anemometer it was found that out of 162 shaftsthere was an up-current in 135, the velocity varying from onewhich was only just perceptible, to as much as 800 linealfeet per minute. In 41 cases the current varied during thecourse of the experiment, a down-current alternating with anup-current. In nearly 54 per cent. no offensive odour wasgiven off; in the remainder the effluvium varied from onethat was slightly offensive, to that which is described ashorrible. The distribution of the ventilating shafts was, how-ever, most unequal, long lengths of sewer being without anyopening; some of the sewers are admitted to be old andleaky, and others not having sufficient fall have becomelittle better than tlongated cesspools. The admission, also,into the sewers of hot refuse from steam engines and factoriesraised the emanating air at times to as much as 70&deg; Fahr.,a temperature necessarily tending to produce rapid putre-factive changes. Uuder these conditions it is impossible tojudge as to the respective value of the two systems of venti-lation from the circumstances of Bethnal-green ; indeed, Dr.Bate admits that with a system of sewers " well deignedand constructed, freely ventilated, and periodically andcopiously flushed, the danger to health from the escape ofsewer gas in the centre of wide road3 is not great." Underthe system of vi-ntilation at the road level, it is laid downby the Local Government Bdard that there should be a shaftat every hundred feet, at every change of gradient, at everyjunction, and at every blind end ; and further it is held desir-able th it each shaft, including its aperture in the road level,should ill point of sizeequal the sectional area of thesewerwhichit ventilates. By such regulations alone can a sufficientvolume of fresh air be expected to pass into the sewer, bythose shafts admitting of a down-current, as will ensure areasonable dilution of the foul air before it makes its escape.Under the system of ventilating the sewers at a level abovethe houses, it would, owing to the length of the Lecessaryshafts and to the one or more angles which would oc<’ur m

their course, be even more diilicult to secure tne desireddown-current of fresh air, and hence the number of shaft-would have to be considerable. Indeed, it would probablybe desirab!e that samtary authorities should have the powerof placing such shafts agdiost every house, should they sosee fit; and then, if a certain proportion of them were fittedwith vanes so arranged as to keep the mouths of the cowlsalways facing the direction from which the wind is blowing, inthe mannersuggested by Dr. Bate, a stiffi ient ditutionuf sewerair would doubtless be i-ecur; d aud the escape of the sewereffluvium into the lower parts of streets between rows ofdwellings would be avoided.Belfast..During the fiY’1 weeks ending the 25th ult., the

average death-rate was i6 77 per 10HO of the p pulntion.The death rate from lnug affections averaged ten, and fromzymotic affections live, of wolic’1 m’a-les showed it death-rate of 14, and scarlatina 2-4. C of f,-tver hive decreased,but scarlatina has prevailed to a considerable extent.

BIRTHS AND DEATHS AT BIRKENHEAD.

To the Editor of THE LANCET.SIR,&mdash;In your notice of my Annual Export (THE LANCET,

page 999) you qnole the birth-rate of B ikenhead at 36 9,and the death-rate at 19.7 p 1000. The:<e were the ratesfor 1880 ; the rates for 1881 were 36’2 and 17’3 re’pectively.I do not think that the latler iate falls much short of that’which sanitary administration may reasonably expect toreach in a large borough. I regret I did not send the correc-tion last week. I am, Sir, yours trulv,

FRANCIS VACHER.Medical Officer’s Department, Birkenbead, Dec. 20th, 1882.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

In twenty-eight of the largest English townh 5719 birthsand 4’70 deaths were re,,,istert-.d durina the week endingthe 16th inst. The annual death-rate in these towns, which

had not exceeded 22-3 and 23’4 per 1000 in the two pre-ceding weeks, rose last week to 26’9, a higher rate thanin any week since the middle of February last. During thefirst eleven weeks of the current quarter the death-rate inthese towns averaged 21’2 per 1000, against 21’6 and 2l’0 inthe corresponding periods of 1880 and 1881. The lowestdeath-rates in these towns last week were 18’9 in Bristoland 20’5 in Birkenhead. The rates in the other townsranged upwards to 31’4 in Blackurn, 34’0 in Liverpool, 34’5in L(eds, 35’3 in Preston, and 37’7 in Halifax. The deathsreferred to the principal zymotic diseases in the twenty-eight towns were 468, and 4 fewer than those in the previousweek; 134 resulted from measles, 95 from scarlet fever, 85 fromwhooping-cough, 79 from "fever" (principally enteric), 46 fromdiarrhoea. 23 from diphtheria, and 6 from small-pox. Thesezymotic diseases caused the lowest aggregate death-rates lastweekin Huddersfield,Plymouth, and Wolverhampton; andthehighest in Hull and Sunderland. Measles caused the highestdeath-rates in Birkenhead, Cardiff, and Sunderland; scarletfever in Derby, Sheffield, and Birkenhead ; whooping-coughin Cardiff and Norwich, and "fever" in Leeds, Liverpool,and Portsmouth. The 23 deaths from diphtheria in thetwenty-eight towns included 13 in London, and 2 both inBirmingham and Hull. Small pox cdused 3 deaths inNeweast,le-upon-Tyne, and 1 each in Birmingham, Oldham,and Sheffield. The number of small-pox patients ia themetropolrtan asylum hospitals, which had been 70 and 62on the two preceding Saturdays, had risen to 75 at the endof last week, 22 new cases having been admitted duringthe week, against 15 and 5 in the two previous weeks.Thf deaths referred to diseases of the respiratory organsin London, which had steadily increased in the five pre-ceding weeks from 330 to 447, further rose last week, underthe combined influence of fog and low temperature, to 637,which exceeded the corrected weekly average for the twoprevious corresponding weeks by 108. Ttre causes of 140,or 3’2 per cent., of the deaths in the twenty-eight townslast week were not certified either by a registered medicalpractitioner or by a coroner. All the causes of death wereduly certified in Brighton, Portsmouth, Nottingbam, andin f"ur other smaller towns. The proportions of uncertifieddeaths were largest in Oldham, Halifax, Sunderland, andHull. ---

HEALTH OF SCOTCH TOWNS.

The annual death-rate in the eight Scotch towns, whichhad been equal to 24’8 and 28’0 per 1000 in the two pre-ceding week-, further rose under the influence of excep.tionally severe weather, to 32.1 in the week ending 16thiu st., aud exceeded by no le:s than 5’2 the mean rate lastweek in the twenty-eight English towns. The deaths referredto the principal zymotic diseases in thee Scotch towns,which had been 88 and 128 in the two previous weeks, were116 last week, and equal to an annual rate of 4’9 per 1000,which was 2’0 above the rate from the sime diseases in theEnglish towns. This zymotic rate showed the largest excesslat week in Glasgow, where it was equal to 7’3 per 1000.The 37 fatal cases of whooping-cough were within 2 of thehigh number ia the previous week, and included no fewerthan 27 in Glasgow. The deaths from scarlet fever,which had been 12 and 18 in the two previous weeks,further ro-’e to 23 last week; 15 occurred in Glasgow,6 in Edinburgh and 2 in Leith. The 19 deaths at-tributed to diphtheria showed a decline of 5 from thenumber in the previous week, and included 7 in Glasgowand 5 in Dundee. The 14 deaths from measles were fewerby 2 than the number in the previous wtek, and all werereturned in Glcisgow. The deaths referred to "fever,"which had been 12 and 19 in the two previous weeks,declined to 11 last week, of which 5 occmred in Glasgowaud 3 in Edinburgh. The 12 deaths attributed to diarrhceacorresponded with the number in the previous week. Thedeaths referred to acute diseases of the lungs in the eighttowns, which had been 139 and 185 in the two precedingweeks, further rose, in consequence of the severe weather,to 231 ltst week, and exceeded by 109 the number from thesediseases in the corresponding week of lat year. The causesof 124, or nearly 17 per cent., of the deaths registered inthe eight towns last week were not certified.

HEALTH OF DUBLIN.

The annual rate of mortality in Dublin, which had beenequal to 29’2, 25’6, and 24’9 per 1000 in the three precedingweeks, rose last week to 33’6, and exceeded the rate in any