the services
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deaths referred to diseases of the respiratory organs in thesetowns, which had been 113, 114, and 156 in the three preced-ing weeks, declined again last week to 129, but were 22 abovethe number in the corresponding period of last year. Thecauses of 22, or nearly 4 per cent., of the deaths registeredin these eight towns last week were not certified.
HEALTH OF DUBLIN.
The death-rate in Dublin, which had been 24’8 and19’1 per 1000 in the two preceding weeks, rose again to22’3 per 1000 during the week ending May 31st. Duringthe past four weeks the death-rate has averaged 22’2per 1000, the rates during the same period being 16’5 inLondon and 17’5 in Edinburgh. The 162 deaths of personsbelonging to Dublin registered during the week undernotice exceeded by 23 the number in the precedingweek and included eight which were referred to the prin-cipal zymotic diseases, against 12, 13, and six in thethree preceding weeks ; of these, two resulted frommeasles, two from diphtheria, one from scarlet fever,one from whooping-cough, one from " fever," and one
from diarrhcea. These eight deaths were equal to an
annual rate of 1-1 per 1000, the zymotic death-rates during the same period being 2-3 in London and1-5 in Edinburgh. The deaths from measles, which hadbeen six, three, and two in the three preceding weeks,were again two last week. The mortality from ’’ fever " andfrom diarrhoea also corresponded with that recorded in thepreceding week, while that from scarlet fever showed a
slight decline. The 162 deaths in Dublin last week included33 of children under one year of age and 35 of persons agedupwards of 60 years ; the deaths of infants were consider-ably in excess of the number recorded in the precedingweek, while those of elderly persons showed a slight decline.S’even inquest cases and four deaths from violence wereregistered ; and 63, or more than a third, of the deathsoccurred in public institutions. The causes of seven, or morethan 4 per cent., of the deaths registered in Dublin lastweek were not certified.
THE SERVICES.
ROYAL ARMY MEDICAL UORPS.MAJOR C. G. WOODS retires from the service, receiving a
gratuity. Dated June 4th, 1902.INDIAN MEDICAL SERVICE.
Colonel A. Scott Reid, succeeds Surgeon-General Spencer,C.B., as Principal Medical Officer of the Punjab Commandand Colonel W. McConaghey, Lucknow, takes Colonel A.Scott Reid’s place as Inspector-General of Civil Hospitalsin the Punjab.
IMPERIAL YEOMANRY (IN SOUTH AFRICA).32nd Battalion : Robert John McClelland to be Medical
Officer, with the temporary rank of Captain.38th Battalion : Richard Murphy to be Medical Officer,
with the temporary rank of Captain in the Army.IMPERIAL YEOMANRY.
The undermentioned officers resign their commissions andreceive new commissions subject to the provisions of theMilitia and Yeomanry Act, 1901, each retaining his presentrank and seniority, viz. :-Duke of Lancaster’s Own : Surgeon-Lieutenant-Colonel
W. W. Wingate-Saul and Surgeon-Lieutenant L. G. S.Molloy.
ARMY MEDICAL RESERVE OF OFFICERS.
Surgeon-Captain W. A. Dingle to be Surgeon-Major.Dated June 4th, 1902.
VOLUNTEER CORPS.
Royal Garrison Artillery (Volunteers) : lst Cinque PortsSurgeon-Captain J. W. T. Gilbert to be Surgeon-Major.2nd Devonshire : Malcolm Bell Hay to be Surgeon-Lieutenant.
Rifle: 8th Volunteer Battalion the Royal Scots (LothianRegiment) : Surgeon-Captain John Anderson resigns hiscommission and is appointed Captain. lst VolunteerBattalion the Northumberland Fusiliers : Surgeon-CaptainD. Stewart to be Surgeon-Major. 3rd (Morayshire) Volun-teer Battalion, Seaforth Highlanders (Ross-shire Buffs, theDuke of Albany’s) : Surgeon-Lieutenant D. G. Campbell to
be Surgeon-Captain. lst Dumbartonshire: Surgeon-Lieu-tenant T. J. Burton to be Surgeon-Captain.
VOLUNTEER INFANTRY BRIGADE BEARER COMPANY.lst London : Surgeon-Captain W. N. Evans, from the
lst Volunteer Battalion the Duke of Cambridge’s Own(Middlesex Regiment), to be Surgeon-Captain and to com-mand under paragraph 55A Volunteer Regulations.
NOTES FROM SOUTH AFRICA.Civil Surgeon Abraham Ellenbogen was reported dan.
gerously ill from typhlitis at Cape Town on June lst, butafter an operation on the following day he showed signs of
recovery and is now progressing satisfactorily.Civil Surgeon White is reported distinctly better."THE FUTURE EDUCATION AND TRAINING OF ARMY
OFFICERS.
Among the recommendations and suggestions contained inthe report of the Committee on Military Education there isone which will commend itself, if only on hygienic grounds,to the medical profession as highly desirable-namely, that amilitary cadet’s studies would be, as far as possible, bettercarried out in the open air than in class-rooms. As far astheir health and physical efficiency are concerned-and thesecount for even more in the army and navy than they do inother walks of life-we should say that army cadets cannotbe too much in the open air and too little in lecture-roomsand class-rooms or engaged in sedentary occupations. It isdifficult, no doubt, to discover some method of selecting can.didates for our public services other than that of competitiveexaminations, but so far as these are written examinations
they give a very inadequate idea of the capacity and fitnessof a young fellow for an army life and campaigning work.They necessarily leave out of consideration altogether qualitiesof character, judgment, temper, and common-sense. Providedthat a candidate comes up to the physical standard requiredby the regulations he may, if only properly crammed, succeedin taking a high place at a competitive examination and insupplanting other and much more desirable candidates. Itcannot be said that the Boers are an intellectual or a culturedrace, but as far as military tactics are concerned they havetaught us and every other nation a great practical lesson. A
competitive examination for our future officers should,as we have always held, be competitive all round,and superior physical qualifications and efficiency inschool sports and games should count for something.It goes without saying that the possession of brains as wellas bodies is a necessary qualification and that everybody isthe better for being well educated generally and for beingspecially taught and trained for any and every walk in life.In the case of the more scientific branches of the armyservice-such as the Royal Engineers, the Royal Artillery, andthe Royal Army Medical Corps-such special training is
essential ; and in the case of the Royal Military Academy atWoolwich it is satisfactory to find that the committee hasno particular fault to find with the system and course pur-sued there. It is with the Royal Military College at Sand-hurst that the committee appears to be so much dissatisfiedand to have expressed its belief that the military trainingof young officers at that institution fails to develop know-ledge or to promote efficiency. Mr. Brodrick having, as wemay suppose, settled on a scheme for the future Royal ArmyMedical Corps, will have now to occupy his attention witharmy educational reform.
THE UNIFORM OF MEDICAL OFFICERS OF THE YEOMANRYAND VOLUNTEER CORPS.
We have recently received inquiries from correspondentswith regard to the proper I I kit " for medical officers of theyeomanry and volunteer corps. The following may thereforeprove of use to many of our readers :-Medical officers ofyeomanry wear the uniform of their respective corps (para-graph 352, Regulations for Yeomanry Cavalry. 1898).As regards volunteers : 1. Regimental medical officers ofvolunteer corps wear the uniform of their respective corps,with sword and pouch-belts as for officers of the RoyalArmy Medical Corps, silver being substituted for gold (para-graph 917, Volunteer Regulations). 2. Brigade-surgeonlieutenant-colonels may wear either their regimental uni-form or the uniform of officers holding similar appointmentsin the Royal Army Medical Corps (paragraph 915, VolunteerRegulations). 3. Officers of the Royal Army Medical Corps(Volunteers) will wear the same uniform as officers of theRoyal Army Medical Corps, silver being substituted for gold(paragraphs 903, 909 F., 910, 893, 894, and 899). 4. Officers
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gazetted to volunteer infantry brigade bearer companies willwear thesame uniform as Royal Army Medical Corps (Volun-teers) except that the title of the company will appear on thehelmet plate and shoulder strap (paragraph 851). Particularsof the uniform of yeomanry and volunteers do not appear inthe Dress Regulations, but sealed patterns are kept in thedepartment for " dress " in the War Office, where informa-tion on any point can be obtained.
THE ARMY RANK OF THE DIRECTOR-GENERAL OF THEARMY MEDICAL SERVICE.
In connexion with the new system of army medicaladministration, by which, as we have previously announced,the Director-General is to occupy a more influential positionin the councils of the War Office as the responsiblerepresentative of the Army Medical Department, it is
satisfactory to learn that he will in future rank officiallyas a lieutenant-general and not as a major-general, as hashitherto been the case. It was no doubt deemed necessaryto take this step in order to put the Director-General in hisproper position in his official dealings with the headquarterstaff and also to raise his military rank above that which isheld by senior administrative officers serving under him. Onthese and other grounds the change is to be regarded as adesirable and wise one.
DEATHS IN THE SERVICES.Civil Surgeon Birch, at St. Helena, on May 28th, from
enteric fever.
Sir T. J. Gallwey has arrived at Simla and taken up hisappointment as Surgeon-General of His Majesty’s Forces andPrincipal Medical Officer of India.
Correspondence.
ETHER v. CHLOROFORM.
"Audi alteram partem."
To the Editors of THE LANCET.
SIRS,-Anent the correspondence in your columns as tothe relative safety of ether and chloroform, will you allowme to recall that some years ago I pointed out in yourjournal that the only really reliable data bearing on thissubject were comprised in the admirable records of theadministration of anaesthetics as tabulated in the St.Bartholomew’s Hospital annual reports, which go back asfar .as 1875. As the subject still continues to attract inan increasing degree the attention of the profession I shouldlike to set forth the results up to date, so that, so far asthe occurrence of fatalities is concerned, there should infuture be no ambiguity.With regard to chloroform, the hospital records for the 16
years 1875-1890 show 13 deaths in 19,526 administrations.Since then the course of events has been as follows :-
Thus during the 26years 1875-1900 chloroform was adminis- Itered 42,978 times, with 33 fatalities or 1 in 1300.
During the 16 years 1875-1890 ether was administered21,332 times with only four deaths. In 12,941 of these cases
1 THE LANCET, Feb. 8th, 1890, p. 317.
ether was preceded by "gas," only one fatality belonging tothis category ; in the other 8391 cases ether alone was
given and thr4p deaths occurred. Since this period the etherrecord has been as follows :-
Thus, during the 26 years 1875-1900 ether was administered37,277 times, with only four fatalities, or 1 in 9319. In24,060 of these cases ether was preceded by I I gas," and onlyone fatality occurred. In 13,217 cases ether alone was givenand three fatalities occurred, or 1 in 4405.
It follows from the foregoing that ether is a very muchsafer anaesthetic than chloroform (in the proportion of 1300to 9319) ; but much safer than either of these agents aloneis ether preceded by "gas."
"
I am, Sirs, yours faithfully,Clifton, Bristol, May 31st, 1902. W. ROGER WILLIAMS.
THE FEEBLE-MINDED AND CRIME.To the Editors of THE LANCET.
SIRS,-Miss Dendy’s paper on the above subject inTHE LANCET of May 24th, 1902, p. 1460, is a valuablecontribution towards the discussion of a social problemof great importance and magnitude. The views there ex-
pressed coincide very nearly with the conclusions whichI have drawn from four years’ work in connexion withthe schools for the mentally defective under the LondonSchool Board. Important as the education of the feeble-minded is, it forms but a small, and by far the least difficult,part of the problem what to do with the feeble-minded.The work that is being done in this direction by publicbodies and private individuals is, in my opinion, often
largely thrown away because there exists no subsequent pro-vision for the needs of a great number of those whom weattempt to educate.
In 1892 the London School Board first established specialcentres for the instruction of the mentally deficient and thereare now nearly 2500 children on the rolls of these classes.Sufficient time has therefore elapsed to make it possible toform some opinion on what the future of children thus edu-cated is likely to be. A certain number of the children passedas mentally deficient are passed out after a period of specialtraining into the ordinary schools. These comprise largelyin my experience cases of two types, the first neuroticexcitable children below par mentally but without markedmental abnormality, the second stolid and apathetic childrenwith sluggish brains but usually well nourished physically.Children of both these types do badly in the large classes ofordinary schools ; they stagnate, or in the one case tend tonervous breakdown and in the other develop into hopelessdullards or truants. Under the individual training of the
special classes they improve greatly and are usually able toreturn in time to the ordinary schools and rank henceforth asnormal individuals. To these may be added another typecommon enough in the poorer districts-children stunted inbody and mind from underfeeding and apparently incapableof learning anything. To the fact that in the defectivecentres, thanks to private charity, food is generally obtain-able for really necessitous cases is due, I think, the strikingimprovement which often takes place in these cases. Butthe number of children returned to ordinary schools is small ;I have not at present the exact statistics but they wouldhardly exceed 10 or 15 per cent. A few cases at the other