sir henry acland on the army medical school

1
1030 SUMMER MORTALITY, 1887. of young dogs and cats produces the green diarrhoea. The same result ensues if the stomach is the way of entrance, for the gastric juice of a fasting animal only retards the growth, but does not’kill the bacillus. The transmission of the bacillus by the atmosphere has been demonstrated by various experiments, according to M. LESAGE. In discussing the treatment of this form of diarrhoea, the reaction of the alimentary canal is first considered. It is not, he maintains, true that the reaction is acid throughout the intestine, even when the mouth and the colon give an acid reaction; the rest of the intestine is neutral. Lactic acid is the best medicament. (See THE LANCET, vol. i. 1887, p. 1149.) Annotations. " Ne quid nimis." SUMMER MORTALITY, 1887. NOTWITHSTANDING the high temperature that prevailed during July and the greater part of August, it appears from the Registrar-General’s last quarterly return that the public health, judged by the recorded death-rate, was below the average during the third or summer quarter of this year. The English annual death-rate during the three months ending September last was 17-6 per 1000, a rate slightly below both the mean rate in the corresponding quarters of the ten years 1877-83 and the rate in the third quarter of last year. The summer death-rate is to a large extent governed by the mortality from infantile diarrhoea, which, in its turn, is mainly dependent upon temperature. The rate of mortality from diarrhoea in the whole of England and Wales during last quarter was equal to 2’1 per 1000, against 1’8, the mean rate in the ten preceding cor- responding quarters. As diarrhoea, however, is specially fatal in large urban populations, it will be well to note the mortality from this disease in the twenty-eight large towns dealt with in the Registrar-General’s Weekly Return. In these towns the delth-rate from diarrhoea. last quarter was 3’3 per 1000, against 2 8 in the ten preceding summer quarters, in which the rate ranged from 1’2 in 1879, to 4-2 in 1878 and 4 5 in 1880. The annual death-rate from diarrhoea in the twenty-eight towns, under the influence of the ex- ceptionally high temperature during July, rose steadily from 1’5 in the first week of that month to 5’5 in the first week of August, which was the maximum weekly rate in the quarter. The highest rate in any week of 1886 was 5 7 in the second week of September. The diarrhoea rate last quarter was maintained at 5’3 and 5’0 in the following two weeks of August, after which it rapidly and steadily declined week by week, influenced by the low temperature in September, to 0 9 in the week ending Oct. lst. The un- seasonably cold weather in September undoubtedly spared the lives of several thousands of infants in England and Wales, who would have succumbed to diarrhoea if the average temperature of the month had prevailed. The diarrhoea death-rate in the last four weeks of the quarter, however, averaged but 16 per 1000 in the twenty-eight great towns, whereas in the corresponding period of 1886 the rate was as high as 4,6. The diarrhoea rate last quarter, which, as we have seen, was 2-1 in the whole of England and Wales and 3 in the twenty-eight largest towna, was 2 2 in fifty other large town districts, and 1’4 in the remainder of England and Wales, exclusive of the seventy-eight great towns. The variations between the diarrhoea rates in different towns were as unaccountably wide as in previous summers; they ranged last quarter in the twenty-eight towns from 0’8 in Halifax, 1’1 in Huddersfield, and 1’6 in Bristol, to 4’7 in Salford, 6’4 in Leicester, and 7’6 in Preston; and in the smaller towns from 0’4 in Southport, 06 in Rochdale, and 0’7 in Gloucester, to 55 in Chatham and 63 3 in Wigan. The Lancashire towns, as in former summer8, showed generally high death-rates from diarrhoea, but some satisfactory elucidation of the causes which produce such variations as 0 G and 1’7 in Rochdale and Oldham, and 6’3 and 76 in Wigan and Preston, is still urgently needed in the best interests of sanitary progress. SIR HENRY ACLAND ON THE ARMY MEDICAL SCHOOL. SIR HENRY AcLAND has done well to allow his Address to the Army Medical School, delivered in July at the distri- bution of prizes, to be published. It might be thought that one of less eloquence and authority than Sir Henry Acland might have sufficed to vindicate the claims to continued existence and increased support of the Netley School. But it is not so. The scandalous calamities of the Crimea are now far enough off to be forgotten by eager.politicians who think they can make a little party capital out of any pro- posal of paltry economy, which may not bear disastrous fruit till their petty purposes are served. But they are not forgotten by the nation, and will not he suffered to recur for want of the few thousands a year that the Netley School costs. This is not the time when we can afford to relax the cultivation of military hygiene and medicine. Our army and navy are too small, and the duties and the distances to which they are called are too great, to allow any such experiment. If anyone is in doubt on this subject, let him read the stirring words of Sir Henry Acland, in which he relates the origin of Netley School in the sufferings of our Crimean troops—"sufferings...... in which sickness destroyed far more than were slain by the sword or the projectile, and which were such as to shock the most thoughtless." The very triumphs of medicine and hygiene tend to make nations forget what will happen if they fail to cultivate these science?, especially as affecting the services on which our safety depends. But Sir Henry spoke not only to public men who on superficial financial grounds would starve or abolish such a school as Netley, but to the students and candidates of the school, and gave them much good advice. Few men were more fitted or entitled to give it, or to commend to them the great lessons and the great teachers of recent years in respect of army medical organisation, and to inspire them with lofty thoughts in repairing to the distant dependencies of the Empire on their beneficent mission. HUMAN LOCOMOTION. M. MABEY, whose brilliant researches into the kinema!ics of animal movements are so well known, has, in collaboration with M. Demeny, been making a series of observations upon human locomotion, of which a highly interesting account appears in a recent numbpr of the Coinptes Rendus of the Academic des Sciences. The method employed has been that of " photo-chronography," and the experiment is de- scribed as follows :" In order to obtain a representation of the movements of torsion about a vertical axis, we covered a floor with black velvet, and caused the subject of the experiment, attired in white, to pass beneath a photo- chronograph placed vertically at a height of about 40ft." In this way the investigators obtained a series of suc- cessive images, from which they publish a selection, displaying movements complementary to those movements in the vertical plane which have been photographically registered some time ago. In order to obtain more exact materials for measurement, they clothed their subject in black, and fitted to his shoulders and hips white wands, marking the transverse horizontal axes at these points. Of the index lines so depicted they obtained a series of photo-

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1030 SUMMER MORTALITY, 1887.

of young dogs and cats produces the green diarrhoea. The

same result ensues if the stomach is the way of entrance, forthe gastric juice of a fasting animal only retards the growth,but does not’kill the bacillus. The transmission of the bacillus

by the atmosphere has been demonstrated by variousexperiments, according to M. LESAGE. In discussing thetreatment of this form of diarrhoea, the reaction of the

alimentary canal is first considered. It is not, he maintains,true that the reaction is acid throughout the intestine,even when the mouth and the colon give an acid reaction;the rest of the intestine is neutral. Lactic acid is the best

medicament. (See THE LANCET, vol. i. 1887, p. 1149.)

Annotations." Ne quid nimis."

SUMMER MORTALITY, 1887.

NOTWITHSTANDING the high temperature that prevailedduring July and the greater part of August, it appears fromthe Registrar-General’s last quarterly return that the publichealth, judged by the recorded death-rate, was below theaverage during the third or summer quarter of this year.The English annual death-rate during the three monthsending September last was 17-6 per 1000, a rate slightlybelow both the mean rate in the corresponding quarters ofthe ten years 1877-83 and the rate in the third quarter oflast year. The summer death-rate is to a large extentgoverned by the mortality from infantile diarrhoea, which,in its turn, is mainly dependent upon temperature. Therate of mortality from diarrhoea in the whole of Englandand Wales during last quarter was equal to 2’1 per 1000,against 1’8, the mean rate in the ten preceding cor-

responding quarters. As diarrhoea, however, is speciallyfatal in large urban populations, it will be well to notethe mortality from this disease in the twenty-eight largetowns dealt with in the Registrar-General’s Weekly Return.In these towns the delth-rate from diarrhoea. last quarterwas 3’3 per 1000, against 2 8 in the ten preceding summerquarters, in which the rate ranged from 1’2 in 1879, to 4-2 in1878 and 4 5 in 1880. The annual death-rate from diarrhoeain the twenty-eight towns, under the influence of the ex-ceptionally high temperature during July, rose steadily from1’5 in the first week of that month to 5’5 in the first weekof August, which was the maximum weekly rate in thequarter. The highest rate in any week of 1886 was 5 7 inthe second week of September. The diarrhoea rate last

quarter was maintained at 5’3 and 5’0 in the following twoweeks of August, after which it rapidly and steadilydeclined week by week, influenced by the low temperaturein September, to 0 9 in the week ending Oct. lst. The un-

seasonably cold weather in September undoubtedly spared thelives of several thousands of infants in England andWales, who would have succumbed to diarrhoea if the

average temperature of the month had prevailed. Thediarrhoea death-rate in the last four weeks of the quarter,however, averaged but 16 per 1000 in the twenty-eightgreat towns, whereas in the corresponding period of 1886the rate was as high as 4,6. The diarrhoea rate last quarter,which, as we have seen, was 2-1 in the whole of Englandand Wales and 3 in the twenty-eight largest towna, was 2 2in fifty other large town districts, and 1’4 in the remainderof England and Wales, exclusive of the seventy-eightgreat towns. The variations between the diarrhoea rates indifferent towns were as unaccountably wide as in previoussummers; they ranged last quarter in the twenty-eighttowns from 0’8 in Halifax, 1’1 in Huddersfield, and 1’6 inBristol, to 4’7 in Salford, 6’4 in Leicester, and 7’6 in Preston;

and in the smaller towns from 0’4 in Southport, 06 inRochdale, and 0’7 in Gloucester, to 55 in Chatham and 63 3in Wigan. The Lancashire towns, as in former summer8,showed generally high death-rates from diarrhoea, but somesatisfactory elucidation of the causes which produce suchvariations as 0 G and 1’7 in Rochdale and Oldham, and6’3 and 76 in Wigan and Preston, is still urgently needed inthe best interests of sanitary progress.

SIR HENRY ACLAND ON THE ARMY MEDICALSCHOOL.

SIR HENRY AcLAND has done well to allow his Addressto the Army Medical School, delivered in July at the distri-bution of prizes, to be published. It might be thought thatone of less eloquence and authority than Sir Henry Aclandmight have sufficed to vindicate the claims to continuedexistence and increased support of the Netley School. Butit is not so. The scandalous calamities of the Crimea arenow far enough off to be forgotten by eager.politicians whothink they can make a little party capital out of any pro-posal of paltry economy, which may not bear disastrousfruit till their petty purposes are served. But they are notforgotten by the nation, and will not he suffered to

recur for want of the few thousands a year that the NetleySchool costs. This is not the time when we can affordto relax the cultivation of military hygiene and medicine.Our army and navy are too small, and the duties and thedistances to which they are called are too great, to allow anysuch experiment. If anyone is in doubt on this subject, lethim read the stirring words of Sir Henry Acland, in whichhe relates the origin of Netley School in the sufferings of ourCrimean troops—"sufferings...... in which sickness destroyedfar more than were slain by the sword or the projectile, andwhich were such as to shock the most thoughtless." The

very triumphs of medicine and hygiene tend to make nationsforget what will happen if they fail to cultivate these

science?, especially as affecting the services on which oursafety depends. But Sir Henry spoke not only to public menwho on superficial financial grounds would starve or abolishsuch a school as Netley, but to the students and candidates ofthe school, and gave them much good advice. Few men weremore fitted or entitled to give it, or to commend to them thegreat lessons and the great teachers of recent years in

respect of army medical organisation, and to inspire themwith lofty thoughts in repairing to the distant dependenciesof the Empire on their beneficent mission.

HUMAN LOCOMOTION.

M. MABEY, whose brilliant researches into the kinema!icsof animal movements are so well known, has, in collaborationwith M. Demeny, been making a series of observations uponhuman locomotion, of which a highly interesting accountappears in a recent numbpr of the Coinptes Rendus of theAcademic des Sciences. The method employed has beenthat of " photo-chronography," and the experiment is de-scribed as follows :" In order to obtain a representation ofthe movements of torsion about a vertical axis, we covereda floor with black velvet, and caused the subject of the

experiment, attired in white, to pass beneath a photo-chronograph placed vertically at a height of about 40ft."In this way the investigators obtained a series of suc-cessive images, from which they publish a selection,displaying movements complementary to those movementsin the vertical plane which have been photographicallyregistered some time ago. In order to obtain more exactmaterials for measurement, they clothed their subject inblack, and fitted to his shoulders and hips white wands,marking the transverse horizontal axes at these points. Ofthe index lines so depicted they obtained a series of photo-