1104

IT has come to the knowledge of the Council of the PooLaw Medical Officers Association that very defective arrangements exist in our large urban workhouses, and possible,provincial ones, as regards the supply to women of line]for periodical use. The insanitary consequences probablresulting from this neglect is of so much importancethat the Council venture to suggest to workhouse medicaofficers the advisability of inquiring into this matter.

THE terrific storm which raged on the night of the 14t]inst. at Tunis is stated to have completely destroyed thetemporary wooden hospital at Manouba. The sick rescuecfrom the dbris were conveyed to the adjoining palace, busix of them died on the following morning. The Golett

Hospital contains over 600 patients, mostly suffering frontyphoid, which appears to be on the increase among the

troops. ____

DR. YELLOWLEES, physician superintendent of the Roya.Asylum, Gartnavel, Glasgow, in a lecture delivered last

week, stated that all the sorrow and misery caused in thewest of Scotland by the failure of the City of Glasgow Bankhad contributed only two patients to the asylum over whielhe presides.

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Two ships, the Braidwood and the Dragon, have arrivedat Falmouth with scurvy on board. One man had died onthe former vessel, which sailed from Rangoon, and theDragon put in with nine men, out of a crew of seven-

teen, ill with the disease. Dr. Harris, by direction of theBoard of Trade, has been holding an inquiry into the matter.

DR. W. ACLAND and Dr. G. W. CHILD are included

amongst the delegates appointed by Convocation, under thestatute lately passed, for the supervision of lodging-houses inOxford.

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THE President of the Royal College of Physicians ofLondon has appointed George Johnson, Esq., M.D., F.R.S.,Harveian Orator for 1882.

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ON Saturday last at the Westminster Hospital Mr. PearceGould stretched the spinal accessory nerve in a case of

spasmodic torticollis, recently under Dr. Murrell’s care.

IN the clandestine removal of Lord Crawford’s body, theItalian papers find a fresh argument in favour of cremation.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

St. Martin-in-the-Fields (Westminster). - Mr. Skegg’sreport for the year 1880 appears, with other reports of theVestry, in the later days of 1881, although these reportsprofess to be for the year ending March 25th, 1881. It is noi

easy to understand why the appearance of this report shouldhave been delayed until nearly a year after the periodwhen it was due, for it is of the simplest and briefest, andthrows little light upon the sanitary condition of the parish.The births and deaths were less in number than in theprevious year, but of the deaths it is said : " I attribute thisdecrease in the mortality to the displacement of inhabitantsby the demolition of houses in Bedfordbury and other partsof the parish." The death rate of the parish is given at 16’8per 1000 of population. The population of St. Martin’s was21,238 at the Census of 1871, but it had fallen to 17,447 at the

r Census of 18S1 ; the decline being due, Mr. Skeg states, to_ the " migration of the people, from demolition of houses andother causes." Of the zymotic diseases the parish suffered

most from whooping-cough during the year, but it appearsto have had an entire immunity from small-pox, notwith.

stranding the prevalence of that disease in the metropolis.Bradford.—Mr. Harris Batterfield’s report for the third

1 quarter of the year shows births equal to an annual birth-rate of 3233 per 1000 of the population, and deaths equal toan annual death-rate of 16’0 per 1000 population, as com.

pared with 18’3 and 239 in the autumn quarters of 1879 andand 1880 respectively. Mr. Butterfield reports very favour-ably of the results obtained from the provision for the com-

’ pulsory notification of certain infectious diseases in theL Bradford Improvement Act, although the Act has only, been a short time in operation. Mr. Butterfield writes: "It, has already, however, been of great service to the community;

for without its aid, and the services of the Fever Hospital,there can be but little doubt that the outbreak (scarlet fever)of September would have developed into an epidemic of likeproportions to that which is raging in Hull, where for sometime the deaths from scarlet fever have averaged thirty perweek. It is yet early to speak of the operation of the Act ;

, but, so far as can be judged from a limited experience, it hasworked remarkably well, and with but little friction. OnJuly 23rd, forms of certificates were sent to sixty-six medicalmen, including some not in active practice, and others resid-

ing without the borough. Up to the present date, fifty-oneof these gentlemen have sent notifications, which is a muchlarger proportion than could have been reasonably expected.To the end of the quarter under consideration, 209 caseswere reported by forty-two medical men. The cases includedone of small-pox, 170 of scarlet fever, 39 of enteric fever, 8 ofdiphtheria, and 2 of English cholera. Besides these, 11 caseswere reported without certificates from medical men, some.of them by parents who wished their children to be at onceremoved to the hospital." ____

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TYPHUS IN MARYLEBONE.

Mr. Wynter Blyth in the last published number of his"Sanitary Chronicles’’ lets us into the secret of the in-

efficiency of action of the Vestry in the last outbreak oftyphus in the parish. He tells us that the cases of typhusofficially reported have, with two exceptions, "occurredamong the poorest class of the community, and have been veryproperly dealt with as pauper cases. He states thatwhen the cases were not pauper cases, the sanitary authoritydealt with them efficientlv, without delay, removing themat once to a proper hospital ; but that if they werepauper cases, a complex process had to be gone through ofreference to a relieving officer and to a district medicalofficer before the patient could be isolated and removed frombeing a danger to others. In other words, the Vestry ofMarylebone, according to Mr. Winter Blyth, instead ofexercising their sanitary functions on behalf and for theadvantage of the healthy portion of its parishioners, in viewof an excessively infectious and dangerous malady, preferredto exercise them in consideration of Poor-law economics-economics which have incidentally only in view the safetyof the healthy from an infectious disease, and in so far arequite inconsistent with the functions imposed upon the sani-tary authority. It is not surprising that, adopting so con.tracted a view of its duties, the sanitary administrationof the Vestry permitted the outbreak of typhus to makeheadway. The wonder is that a more serious outbreak oftyphus was not fostered. When will the London Vestrieslearn that neither sanitary administration nor disease pre-vention in London is a function of the Poor-law authorities ?

THE LONDON WATER-SUPPLY.

Reporting upon the quality of the water supplied toLondon in November, Messrs. Crookes, Odling, and MeymottTidy say :-" These results show that the quality of thewater supplied by the London companies continues to beexcellent, notwithstanding the unfavourable condition ofthe rivers consequent on the heavy rainfall of the month.The aeration of the water is abundant, and its freedom fromorganic matter but little less complete than during thesummer months." The waters of the West Middlesex Com-pany, the Lambeth Company, the Grand Junction Company,and the Southwark Company were found each once only"

very slightly turbid," at other times " well filtered, clear,and bright."

1105

SMALL-POX IN BELFAST.

During the week ending 10th inst., sixty-three cases ofsmall-pox were under treatment in the Belfast workhouse,of which number ten were admitted during the week. Threedeaths took place from the disease in the workhouse duringthe same period.

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Dr Hamilton, a medical member of the Health Committeeof the Liverpool Corporation, misreading certain figures of areport of the medical officer of health, stated at a recentmeeting of the committee that in the epidemic of small-poxto which they referred, cases of small-pox treated in hospitalhad died at the rate of 50’0 per cent., while cases treated intheir homes during the same epidemic had died at the rateof only 8 per cent. In an explanatory letter addressed tothe public press since the statement, Dr. Hamilton showshow the blunder happened, but at the same time arguesas if the blunder were an actual fact. Dr. EdwardW. Hope, resident medical officer to the Netherfieldinfectious disease hospital in Liverpool, and Dr. RobertS. Archer, a physician to that hospital, presently correctedDr. Hamilton’s astonishing statement, and showed that themortality from small-pox in that hospital had not exceeded16’0 per cent., but Dr. Hamilton notwithstanding thinks itadvisable to explain that " the greater mortality " in hisopinion arose from "the dread, the dislike, the horror,which the majority of people suffering under an infectiousdisease had at the thought of being taken to a hospital. Theshock to the nervous system at a critical period of thedisease often gave it a fatal turn," and so forth. Hence Dr.Hamilton objects to compulsory removal of the sick, andwould leave it optional. Obviously the law as to theremoval of infectious sick to hospital differs in Liverpoolfrom the rest of the kingdom, or Dr. Hamilton has over-looked sec. 124 of the Public Health Act, 1875.Mr. W. W. Yates of Dewsbury has issued an example oi

what he terms a "Zymotic Disease Chart." He desires tcimprove the present system of reporting cases by medicalofficers of health, and suggests that sanitary authorities inthe kingdom should provide themselves with some sanitaryoutline charts of their own districts, and supply copies to themedical officer. The suggestion is excellent, and if actedupon would give the sanitary authority definite informationof the distribution of disease in its district, and, if the mapswere filed regularly, would presently enable it to ascertairthe persisting habitats of sickness and death therein.A person was recently find in the Swansea Police Courl

for refusing to allow the public vaccinator to take lymptfrom a child after successful vaccination.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

In twenty of the largest English towns, with an aggregatepopulation estimated at more than seven and a half millions inthe middle of this ear, 4960 births and 3476 deaths were re-gistered in the week ending Saturday, l7th inst. The annualdeath-rate in these towns, which had been but 19’9 and 20’7per 1000 in the two preceding weeks, further rose last weekto 22’3. The lowest rates in these towns last week were15’6 in Bristol, 16’0 in Plymouth, 19’0 in Norwich, and 19’5in Portsmouth ; the rates in the other towns ranged upwardsto 29’1 in Salford, 30’9 in Hull, 32’1 in Liverpool, and 34-6in Manchester. The deaths referred to the principal zymoticdiseases in these towns further rose last week to 564, from475 and 536 in the two previous weeks ; 142 resulted fromwhooping-cough, 141 from measles, 131 from scarlet fever,74 from "fever" (principally enteric), 27 from diarrhoea,26 from small-pox, and 23 from diphtheria. The highestzymotic death-rates last week occurred in Liverpool andHull. Whooping-cough showed the largest proportionalfatality in Manchester, Leicester, and Salford; measlesin Plymouth and Liverpool; and scarlet fever in Hull, Not-tingham, and Sunderland. The highest death-rates from"fever" were recorded in Portsmouth and Leeds. Twenty-six :more fatal cases of scarlet fever were returnedin Hull, raising the number registered in this boroughsince the beginning of July to 587. The 23 deathsfrom diphtheria in the twenty towns included 12 in London,5 in Portsmouth, and 3 in Birmingham. Small-pox caused25 more deaths in London and 1 in Hull. The number ofsmall-pox cases in the metropolitan asylum hospitals, which

had been 477 and 460 on the two preceding Saturdays,had risen again to 471 at the end of last week; these in.cluded 105 in the Convalescent Hospital at Darenth. Thenew cases of small-pox admitted to these hospitals were 93,showing an increase of 27 upon the number in the previousweek. The deaths referred to diseases of the respiratoryorgans in London, which had been but 336 and 329 in thetwo previous weeks, rose to 434 last week ; these were, how-ever, 109 below the corrected weekly average. The causesof 82, or 2 -1 percent., of the deaths in the twenty townslast week were not certified either by a registered medicalpractitioner or by a coroner. The proportion of uncertifieddeaths did not exceed 1’5 per cent. in London, whereasit averaged 3’1 per cent. in the nineteen provincial towns.All the causes of death were duly certified in Portsmouth,Plymouth, Wolverhampton, and Bradford; while the pro-portions of uncertified deaths were largest in Oldham,Hull, and Leicester.

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HEALTH OF SCOTCH TOWNS.

The annual death-rate in the eight Scotch towns, whichhad been 19’8 and 21’6 per 1000 in the two precedingweeks, was again 21’6 in the week ending the 17th inst., andwas 2’2 below the average rate in the twenty Englishtowns. The deaths referred to the principal zymotic diseasesin these Scotch towns, which had been 67 and 81 in thetwo previous weeks, rose again to 81 in the week endinglast Saturday; of these, 19 resulted from scarlet fever, 17from measles, 17 from whooping-cough, 12 from diphtheria,13 from diarrhoea, 3 from fever, and not one from small-pox.The annual death-rate from these zymotic diseases was equalto 3’5 per 1000 in the eight towns, and was 0’4 belowthe average rate from the same diseases in the twentyEnglish towns. The highest zymotic death-rates in theScotch towns were 4’5 in Greenock and 5’2 in Glasgow.The 19 fatal cases of scarlet fever exceeded those in theprevious week by 3, and included 9 in Glasgow, 5 in Edin-burgh, 2 in Dundee, and 2 in Greenock. No fewer than15 of the 17 deaths from measles, 10 of the 17 from whooping-cough, and 8 of the 12 from diphtheria, occurred in Glasgow.Three fatal cases of diphtheria were returned in Greenockand 3 of whooping-cough in Dundee. The 3 deaths referredto fever included 2 in Glasgow and 1 in Edinburgh; thedeath-rate from this cause was considerably lower in theScotch than in the English towns. The deaths attributedto acute diseases of the lungs (bronchitis, pneumonia, andpleurisy), which had been 92, 103, and 112 in the three

,

preceding weeks, further rose to 122 last week, and wereequal to an annual rate of 5’3 per 1000, corresponding withthe rate from the same diseases in London.

HEALTH OF DUBLIN.

The rate of mortality in Dublin, which had been equal to24’5 and 28’8 per 1000 in the two preceding weeks, furtherrose to 339 in the week ending the 17th inst. The deaths

. in the city showed a further increase of 34 upon the numbersreturned in the two previous weeks; 24 were referred to

: measles, 2 to scarlet fever, 2 to diphtheria, 2 to "fever," 2 to. diarrhoea, and not one either to small-pox or whooping-. cough. The annual death-rate from these principal zymotic

diseases averaged 4-8 per 1000 in the city; the rate from’ the same diseases being equal to 3’8 in London and 2’1‘ in Edinburgh. The fatal cases of measles, which had been’

18 in the three preceding weeks, rose to 24 last week ; therecorded deaths from this disease, which were but 2 and 9‘ in the second and third quarters of this year, rose to 61 in the

eleven weeks ending on Saturday last. The death-rate fromthe other zymotic diseases was below the average. The

.

deaths of infants and of elderly persons differed but slightlyfrom the numbers returned in the previous week.

HEALTH MATTERS GENERALLY AT HOMEAND ABROAD.

CHOLERA IX INDIA.

A correspondent writes :-" The appearance of choleraat this time of year in the North-West Provinces iscausing great anxiety, especially with regard to the hugefestival of the Magh Mela, at Allahabad, to be heldin January, 1882. A great fair occurs every twelfth year;and the approaching one is the last of the series, since,