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INDIA-RUBBER TRACHEOTOMY TUBES.
643 who steps at once into the front rank. Alma Tadema is well represented. Oulessand Gregory giveus some
painter,
Then there are some and Marcus Stone, bits of Marks refined work by delightful truthful and picturesque illustrations of the Venice life of to-day by Henry Woods, charming peeps of English scenery by Earle, a very powerful work, " The Attempted Assassination of William the Silent," by Claude Calthrop,"and There is a rare bit of a thousand other beautiful things. truthful landscape painting by C. E. Johnson, which has received the compliment of being purchased by the Council, who have likewise conferred the like honour upon "Toil and Pleasure," by John R. Reid. A farmer’s family are picking " turmuts" in a field, over which are scrambling sportsmen in pink, in pursuit of a fox. Which is the "toil,"by the way? Our space will not allow of more than a mention of Mrs. Butler’s (née Thompson) à Propos illustration of Dr. Brydon, the sole survivor of the disaster in the Khyber Pass, arriving under the walls of Jellalabad. It is a work of great power, full of interest, which is only too painful.
admirable specimens of portraiture.
HEALTH OF LARGE ENGLISH TOWNS IN THE SEVENTEENTH WEEK OF
1879.
DURING last week 5428 births and 3664 deaths were registered in twenty of the largest English towns. The births exceeded by 246, and the deaths by 159, the average weekly numbers during 1878. The deaths showed a decline of 125 from those returned in the previous week ; and the annual rate per 1000, which had been equal to 24’8 and 25’9 in the two preceding weeks, declined again last week to 24’9. During the four weeks ending on Saturday last the deathrate in these towns averaged 26’2 per 1000, whereas in the corresponding periods of 1877 and 1878 they did not exceed 25,3 and 25’8 respectively. This increase of mortality may be attributed to the unseasonably low temperature which has prevailed. The lowest rates in the twenty towns last week were 17’2 in Bradford, 18’6 in Portsmouth, 18’8 in Brighton, and 20’8 in Wolverhampton. The rates in the other towns ranged upwards to 28’2 in Norwich, 28’8 in Plymouth, and 29’5 in Leicester. The high death-rates in these four last-mentioned towns were not, to any considerable extent, due to exceptional zymotic fatality. The deaths referred to the seven principal zymotic diseases in the twenty towns were 426 last week, against 388 and 420 in the two preceding weeks. They included 147 from whoopingcough, 81 from scarlet fever, 80 from measles, and 38 from fever, principally enteric. The annual death-rate from these seven diseases, which averaged 3’0 per 1000 in the twenty towns, ranged from 0’7 in Wolverhampton, and 1’2 both in Bristol and Portsmouth, to 4’0 in Sheffield, 4’1 in Sunderland, and 4’2 in Oldham. Whooping-cough showed the Sheffield, and greatest proportional fatality in Oldham. The fatal cases of measles were most excessivein Salford and Newcastle-upon-Tyne. Two more deaths were referred to diphtheria in Plymouth, and 3 from fever in caused 10 more deaths in Newcastle-upon-Tyne. London, but not one in any of the nineteen large provincial towns. The Metropolitan Asylum Hospitals contained 222 small-pox patients on Saturday last, against numbers declining steadily from 353 to 232 in the eight preceding weeks. No less than 50 new cases of small-pox were, however, admitted to these hospitals during last week, against 37 and 47 in the two previous weeks.
Birmingham,
Small-pox
INDIA-RUBBER TRACHEOTOMY TUBES. To the Editor of THE LANCET. have heard from two sources during the past weeli SIR,—I that elastic tracheotomy tubes are being manufactured -without a layer of canvas between the layers of rubber, and witb so weak a
connexion between the tube and its collar that these
can be pulled asunder on making the slightest traction. A tube of this kind was, indeed, placed in my hands by a friend on Friday last. If the question, however, were one merely of good or bad construction I should not, of course, have troubled you with any communication on the subject ; but as the employment of these ill-made tubes would be always dangerous, and might be attended, if one broke while in use, by serious consequences, it seems my duty to ask you kindly to insert this note of warning. The advisability of testing the strength and elasticity of the tubes may not occur to a surgeon who is using them for the first time. I am. Sir. Your obedient HRT-vnnt W. MORRANT BAKER.
"PLAGUE IN RUSSIA." To the Editor of THE LANCET. SIR,—I have read Dr. Bareskoff’s letter in your issue of April 12th with some interest. He speaks of the popular belief, that the infection of the disease known in Russia as Siberian plague is communicated by flies. No further remarks having appeared on the subject, I write to say that I believe the disease in question is a form of what is known as " malignant pustule," and that isolated cases are not rare in all parts of Europe. I was staying in Germany during a hot summer about four or five years ago, when there was a regular panic all through the country on account of the number of deaths arising from, or attributed to, the bite of flies, which were supposed to convey the infection from deer, cattle, or other animals suffering from a disease called " milzbrand," and known in England as " the blood." If I remember right, the cases were most numerous about Berlin or Potsdam, but several deaths were recorded from other parts ; and there was an instance of the disease (though fortunately not fatal) in the house where I was staying, on the Lower Rhine, and we were greatly afraid that we might have been placed in quarantine by the local authorities. I believe the disease is also well known in France, and attributed to the same cause. I know nothing of its presence otherwise in England, and, not being a medical man, will abstain from offering any comment on the above. V O1lrR- &c
W.
F.
KIRBY,
Assistant Naturalist in Dublin Museum of Science and Art.
THE CAMPAIGN IN SOUTH AFRICA FROM A MEDICAL POINT OF VIEW.
(From
a
Correspondent.)
Concluded from p. 611.
make a few remarks, which I will do with and write caution, only what I have seen. As I before stated, during the years of drought, the class of fever with which we had to do was for the most part typhoid, with fatal cases presenting appearances pathognomonic of that disease; but now cases came under observation of what I and my confrères were wont to term "mixed fever," but which I would call " typhoidfever plus South African climate. These cases came in from the town and neighbourhood, more especially from the line of railways in process of construction into the interior, where in cuttings men are exposed to intense heat and live in tents under no sanitary precaution whatever. This class of patients presented the following symptoms :-Intense headache, early cerebral disturbance, pain in the eyeballs and intolerance of light, pain in the neck and limbs, considerable liver and spleen enlargement and tenderness; constipation at first, and the tongue large, furred, and indented with the teeth. Uncertain at first what might be the type of disease with which we had to do, the usual chalk and soda and compound rhubarb mixtures were prescribed, folI
WILL now
painter,
Then there are some and Marcus Stone, bits of Marks refined work by delightful truthful and picturesque illustrations of the Venice life of to-day by Henry Woods, charming peeps of English scenery by Earle, a very powerful work, " The Attempted Assassination of William the Silent," by Claude Calthrop,"and There is a rare bit of a thousand other beautiful things. truthful landscape painting by C. E. Johnson, which has received the compliment of being purchased by the Council, who have likewise conferred the like honour upon "Toil and Pleasure," by John R. Reid. A farmer’s family are picking " turmuts" in a field, over which are scrambling sportsmen in pink, in pursuit of a fox. Which is the "toil,"by the way? Our space will not allow of more than a mention of Mrs. Butler’s (née Thompson) à Propos illustration of Dr. Brydon, the sole survivor of the disaster in the Khyber Pass, arriving under the walls of Jellalabad. It is a work of great power, full of interest, which is only too painful.
admirable specimens of portraiture.
HEALTH OF LARGE ENGLISH TOWNS IN THE SEVENTEENTH WEEK OF
1879.
DURING last week 5428 births and 3664 deaths were registered in twenty of the largest English towns. The births exceeded by 246, and the deaths by 159, the average weekly numbers during 1878. The deaths showed a decline of 125 from those returned in the previous week ; and the annual rate per 1000, which had been equal to 24’8 and 25’9 in the two preceding weeks, declined again last week to 24’9. During the four weeks ending on Saturday last the deathrate in these towns averaged 26’2 per 1000, whereas in the corresponding periods of 1877 and 1878 they did not exceed 25,3 and 25’8 respectively. This increase of mortality may be attributed to the unseasonably low temperature which has prevailed. The lowest rates in the twenty towns last week were 17’2 in Bradford, 18’6 in Portsmouth, 18’8 in Brighton, and 20’8 in Wolverhampton. The rates in the other towns ranged upwards to 28’2 in Norwich, 28’8 in Plymouth, and 29’5 in Leicester. The high death-rates in these four last-mentioned towns were not, to any considerable extent, due to exceptional zymotic fatality. The deaths referred to the seven principal zymotic diseases in the twenty towns were 426 last week, against 388 and 420 in the two preceding weeks. They included 147 from whoopingcough, 81 from scarlet fever, 80 from measles, and 38 from fever, principally enteric. The annual death-rate from these seven diseases, which averaged 3’0 per 1000 in the twenty towns, ranged from 0’7 in Wolverhampton, and 1’2 both in Bristol and Portsmouth, to 4’0 in Sheffield, 4’1 in Sunderland, and 4’2 in Oldham. Whooping-cough showed the Sheffield, and greatest proportional fatality in Oldham. The fatal cases of measles were most excessivein Salford and Newcastle-upon-Tyne. Two more deaths were referred to diphtheria in Plymouth, and 3 from fever in caused 10 more deaths in Newcastle-upon-Tyne. London, but not one in any of the nineteen large provincial towns. The Metropolitan Asylum Hospitals contained 222 small-pox patients on Saturday last, against numbers declining steadily from 353 to 232 in the eight preceding weeks. No less than 50 new cases of small-pox were, however, admitted to these hospitals during last week, against 37 and 47 in the two previous weeks.
Birmingham,
Small-pox
INDIA-RUBBER TRACHEOTOMY TUBES. To the Editor of THE LANCET. have heard from two sources during the past weeli SIR,—I that elastic tracheotomy tubes are being manufactured -without a layer of canvas between the layers of rubber, and witb so weak a
connexion between the tube and its collar that these
can be pulled asunder on making the slightest traction. A tube of this kind was, indeed, placed in my hands by a friend on Friday last. If the question, however, were one merely of good or bad construction I should not, of course, have troubled you with any communication on the subject ; but as the employment of these ill-made tubes would be always dangerous, and might be attended, if one broke while in use, by serious consequences, it seems my duty to ask you kindly to insert this note of warning. The advisability of testing the strength and elasticity of the tubes may not occur to a surgeon who is using them for the first time. I am. Sir. Your obedient HRT-vnnt W. MORRANT BAKER.
"PLAGUE IN RUSSIA." To the Editor of THE LANCET. SIR,—I have read Dr. Bareskoff’s letter in your issue of April 12th with some interest. He speaks of the popular belief, that the infection of the disease known in Russia as Siberian plague is communicated by flies. No further remarks having appeared on the subject, I write to say that I believe the disease in question is a form of what is known as " malignant pustule," and that isolated cases are not rare in all parts of Europe. I was staying in Germany during a hot summer about four or five years ago, when there was a regular panic all through the country on account of the number of deaths arising from, or attributed to, the bite of flies, which were supposed to convey the infection from deer, cattle, or other animals suffering from a disease called " milzbrand," and known in England as " the blood." If I remember right, the cases were most numerous about Berlin or Potsdam, but several deaths were recorded from other parts ; and there was an instance of the disease (though fortunately not fatal) in the house where I was staying, on the Lower Rhine, and we were greatly afraid that we might have been placed in quarantine by the local authorities. I believe the disease is also well known in France, and attributed to the same cause. I know nothing of its presence otherwise in England, and, not being a medical man, will abstain from offering any comment on the above. V O1lrR- &c
W.
F.
KIRBY,
Assistant Naturalist in Dublin Museum of Science and Art.
THE CAMPAIGN IN SOUTH AFRICA FROM A MEDICAL POINT OF VIEW.
(From
a
Correspondent.)
Concluded from p. 611.
make a few remarks, which I will do with and write caution, only what I have seen. As I before stated, during the years of drought, the class of fever with which we had to do was for the most part typhoid, with fatal cases presenting appearances pathognomonic of that disease; but now cases came under observation of what I and my confrères were wont to term "mixed fever," but which I would call " typhoidfever plus South African climate. These cases came in from the town and neighbourhood, more especially from the line of railways in process of construction into the interior, where in cuttings men are exposed to intense heat and live in tents under no sanitary precaution whatever. This class of patients presented the following symptoms :-Intense headache, early cerebral disturbance, pain in the eyeballs and intolerance of light, pain in the neck and limbs, considerable liver and spleen enlargement and tenderness; constipation at first, and the tongue large, furred, and indented with the teeth. Uncertain at first what might be the type of disease with which we had to do, the usual chalk and soda and compound rhubarb mixtures were prescribed, folI
WILL now