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VITAL STATISTICS OF LONDON DURING DECEMBER, 1920.
197
Obituary. CHARLES HIGGENS, F.R.C.S.ENG., ’CONSULTING OPHTHALMIC SURGEON TO
GUY’S HOSPITAL.
Mr. Charles Higgens, who died suddenly while out shooting on Dec. 28th last, was born in 1846, and was educated at Brighton College and at Guy’s Hospital Medical School, qualifying with the M.R.C.S. Eng., L.R.C.P. Lond., and L.S.A. in 1868. In 1871 he became F.R.C.S. Eng., and was appointed surgeon to the Central London Ophthalmic Hospital, and was assistant ophthalmic surgeon at Guy’s Hospital two years later. In 1883 he became senior ophthalmic surgeon to Guy’s and lecturer on ophthalmology in the medical school. Retiring in 1906 he was elected consulting surgeon. He was also for many years ophthalmic surgeon to the French Hospital and surgeon to the County of London War Hospital during the war. Such is a brief record of Charles Higgens, who was a man of very lovable personality, and who enjoyed great and well-deserved popularity as well as the respect of a vast number of colleagues, senior and junior, and of pupils, all of whom admired his professional skill and resourcefulness and his high simple standards of conduct. The following is a picture of him by one who worked for many years in close association with him. As a colleague Charles Higgens was markedly generous
seemed sometimes to be inspired with a genuine desire to tire out everybody else but himself. His manner of death 1 was, I think, such as he would have wished." Mr. Higgens left behind him very little written work beyond contributions to Guy’s Hospital Reports, to the Transactions of the Royal Medical and Chirurgical Society, and of the Ophthalmological Society, and occasionally to the columns of THE LANCET. Among the last may be mentioned a note published in 1894 on 1925 Extractions of Cataract, and a paper published in 1907 on 130 Consecutive Extractions of Cataract without a Failure. In 1879 he published a little book on Ophthalmic Practice, and in 1903 the Manual of
Ophthalmic Practice, referred to above, which was marked by the simplicity and straightforwardness of the accounts given of a number of diseases of the eye, and by the sensible and judicious advice in respect of treatment. _______________
URBAN VITAL STATISTICS.
(Week ended Jan. 15th, 1921.) English and Welsh Towns.-In the 96 English and Welsh towns, with an aggregate population estimated at 183 million persons, the annual rate of mortality, which had been 15-1, 16’6, and 14-0 in the three weeks, declined to 12-8 per 1000. In London, with a population of 4 million persons, the death-rate was 12’6, or 0-3 per 1000 below that recorded in the previous week, while among the remaining towns the rates ranged from 3-8 in Ilford, 4-8 in Ealing, and 4-9 in Acton, to 21-7 in Merthyr Tydfil, 23-9 in and always appreciative of work done for him by his Sunderland, and 24-2 in Tynemouth. The principal epidemic juniors. He entrusted both his private and hospital work diseases caused 224 deaths, which corresponded to an annual to them in any absence, and his experience was frankly rate of 0-6 per 1000, and comprised 92 from infantile shared with them. To his equals he was always cheery, diarrhcea, 69 from diphtheria, 31 from whooping-cough, 20 wise, and full of common sense; and his honesty made him from measles, 8 from scarlet fever, 3 from enteric fever, and 1 from small-pox. Whooping-cough caused a death-rate as ready to discuss any failures and disappointments in his of 2-0 in Warrington, but the mortality from the remaining cases as his successes, a trait that is not too frequently met with, while it is of far greater value for any man who is diseases showed no marked excess in any of the towns. The beginning an ophthalmic career to hear of the difficulties fatal case of small-pox belonged to Bristol. There were 4413 which may have to be avoided than to receive any long list cases of scarlet fever, 2597 of diphtheria, and 1 of small-pox of triumphs. His operating was good, he being of wiry phv- i under treatment in the Metropolitan Asylums Hospitals sique, tireless, and entirely self-confident. He impressed" , and the London Fever Hospital, against 4608, 2588, and 1 his patients into confidence by his obvious capacity for the respectively at the end of the previous week. The causes work he had to do-the assurance that he was equal to his job. of 26 of the 4556 deaths in the 96 towns were uncertified, He invented no new operations, but he performed the "simple of which 7 were registered in Birmingham, and 3 each in extraction"of cataract in a perfect way, and his large prac- Manchester and Blackpool. tice was easily accounted for when one had an intimate Scottish Towns.-In the 16 largest Scottish towns, with an knowledge of his straightforward way with his patients and aggregate population estimated at nearly 2 million persons, his manual dexterity. As a consultant his younger colleagues the annual rate of mortality, which had been 16-2, 18-4, and found him of great value; you could always take a difficulty 18-4 in the three preceding weeks, fell to 15-9 per 1000. to Charles Higgens and be sure of sympathy and a concentra- The 329 deaths in Glasgow corresponded to an annual tion on it; he took the obvious and straightforward line, and rate of 15-6 per 1000, and included 11 from infantile diarrhoea, was quite explicit in his decision. He did not always give 5 from diphtheria, 4 from whooping-cough, and 1 each from elaborate reasons for his views-they were the result of long small-pox, measles, and scarlet fever. The 133 deaths in years of large and varied experience-but neither did he Edinburgh were equal to a rate of 15-5 per 1000, and included bother his head about possibilities and eventualities unlikely 7 from influenza, 3 from measles, and 1 each from scarlet to occur. fever, diphtheria, and infantile diarrhoea. He wrote little compared to some other ophthalmic Irish Towns.-The 145 deaths in Dublin corresponded to surgeons holding positions as big; a small ophthalmic an annual rate of 17-9, or 0-8 per 1000 above that recorded text-book of his had a large sale some years ago, but in the previous week, and included 4 from infantile diarrhcea. is now out of date and submerged by the never-ceasing The 146 deaths in Belfast were equal to a rate of 18-1 per stream of similar publications. More than anything else and included 2 from whooping-cough. 1000, was he roused to write in censure of any " money-seeking merchants " in the profession, but only as a vent to his own VITAL STATISTICS OF LONDON DURING feelings. Extreme honesty was his marked and finest trait, and such views were too outspoken for any but an editor DECEMBER, 1920. thirsting for litigation, whom happily he never found. In IN the accompanying table will be found summarised his private life he was a sportsman at heart. Hunting statistics relating to sickness and mortality in the City of and shooting were his relaxations on every opportunity, London and in each of the metropolitan boroughs. With and advancing years never damped his ardour in these to the notified cases of infectious diseases, it appears regard directions. that the number of persons reported to be suffering from one From such a description there emerges a very or other of the ten diseases notified in the table was equal to accurate picture of the man, and there may be added an annual rate of 12-3 per 1000 of the population, estimated to it some extracts from a sympathetic note received at 4,358,309 persons; in the three preceding months from Mr. Tom Bird, consulting anaesthetist to Guy’s the rates had been 11-3,16-3, and 15-8 per 1000. Among the metropolitan boroughs the lowest rates from these Hospital, who lived with his friend for 14 years pre- diseases were recorded in Paddington, Chelsea, the City Mr. Bird says :ceding Higgens’s marriage. of Westminster, St. Marylebone, and Lambeth ; and " We resided together at 38, Brook-street in congenial the highest in Hammersmith, Stoke Newington, Bethnal companionship for 14 years. Our domestic partnership was Green, Stepney, Poplar, and Deptford. One case of broken in one sense by Higgens’smarriage, but our personal small-pox was notified during the month from the and professional friendship remained inviolable until his borough of Hampstead. The prevalence of scarlet fever passing away. I had reason to know the results of a great was 26 per cent. less than in the preceding month; deal of his work, and positively I do not remember a single this disease was proportionally most prevalent in Hammeroperation of his that went wrong in the half century over smith, Bethnal Green, Stepney, Poplar, Bermondsey, which my experience of that work extends-I am speaking, and Deptford. The Metropolitan Asylums Hospitals conof course, of the operation per se. He was advanced in years tained 4729 scarlet fever patients at the end of the month, when the war placed upon him hard work at the military against 3683, 5117, and 5508 at the end of the three prehospital at Portland, but he delighted in the work, and ceding months; the weekly admissions averaged 590,
preceding
198 ANALYSIS OF SICKNESS AND MORTALITY STATISTICS IN LONDON DURING DECEMBER. 1920. (Sloeciabby compiled,for THE LA...’WET.)
’"
Including membranous croup.
against 603, 873, and 780 in the three preceding months. Diphtheria was slightly less prevalent than in the preceding month; the greatest proportional prevalence of this disease was recorded in Fulham, Islington, Stoke Newington, Holborn, Shoreditch, and Poplar. The number of diphtheria patients under treatment in the Metropolitan Asylums Hospitals, which had been 1773, 2284, and 2604 at the end of the three preceding months, numbered 2615 at the end of December; the weekly admissions averaged 316, against 266, 364, and 360 in the three preceding months. The prevalence of enteric fever was about equal to that in the four preceding months ; of the 28 cases notified during the month, 4 belonged to Lambeth, 3 to Kensington, 3 to Camberwell, and 2 each to Fulham, St. Pancras, Poplar, and Southwark. There were 15 cases of enteric fever under treatment in the Metropolitan Asylums Hospitals at the end of the month, against 14, 19, and 16 at the end of the three preceding months ; the weekly admissions averaged 2, against 3, 4, and 3 in the three preceding months. Erysipelas was proportionally most prevalent in Hammersmith, Fulham, the City of Westminster, Shoreditch, Bethnal Green, and Southwark. The cases of puerperal fever included 5 in Lambeth, 4 each Paddington, Hammersmith, Hackney, and Stepney, 3 in Bermondsey, and 3 in Woolwich. The 15 cases of cerebrospinal meningitis included 3 in Stepney, 3 in Poplar, and 2 in Wandsworth. No case of poliomyelitis was notified during the month.
43 in
The mortality statistics in the table relate to the deaths of civilians actually belonging to the several boroughs, the deaths occurring in institutions having been distributed among the boroughs in which the deceased persons had previously resided. During the five weeks ended Jan. lst, 1921, the deaths of 6165 London residents were registered, equal to an annual rate of 14-8 per 1000; in the three preceding months the rates had been 9-9, 10-5, and 13’6 per 1000. The death-rates ranged from 11’0 in Hampstead, 11’6 in Greenwich, 12’1 in Woolwich, 12’3 in Wandsworth, 12-9 in St. Marylebone, 13-3 in Deptford, and 13-4 in Lewisham, to 16in Islington, 16-3 in Bethnal Green, 16-4 in Holborn, 16-4 in Lambeth, 17-7 in Finsbury, The 6165 17-7 in Southwark, and 17-8 in Kensington. deaths from all causes included 269 deaths which were referred to the principal infectious diseases; of these, 7
resulted from measles, 34 from scarlet fever, 118 from diphtheria, 19 from whooping-cough, 1 from enteric fever, and 90 from diarrhoea and enteritis among children under 2 years of age. No death from any of these diseases was recorded in the City of London. Among the metropolitan boroughs the lowest death-rates from these diseases were recorded in St. Marylebone, Hampstead, Bermondsey, Wandsworth, Deptford, and Greenwich; and the highest in Islington, Stoke Newington, Holborn, Finsbury, Shoreditch, and Poplar. The 7 deaths from measles were less than one-twelfth of the average number in the corresponding period of the five preceding years ; of these, 2 belonged to Paddington. The 34 fatal cases of scarlet fever exceededthe average by 18 ; of these, 3 belonged to each of the boroughs of Stepney, Poplar, Lambeth, Camberwell, and Lewisham. The 118 deaths from diphtheria exceeded the average number by 33 ; the greatest proportional mortality from this disease occurred in Hammersmith, Islington, Stoke Newington, Holborn, Finsbury, and Poplar. The 19 fatal cases of whooping-cough were about one-third of the average; of these, 3 belonged to Kensington, 3 to Bethnal Green, and 3 to Battersea. One death from enteric fever was registered during the month, against an average of 6. The 90 fatal cases of infantile diarrhoea showed a decline of 10 from the average; the greatest proportional mortality from this disease occurred in Kensington, the City of Westminster, Islington, Shoreditch, Lambeth, and Camberwell. In conclusion, it may be stated that the aggregate mortality in London during December from these principal infectious diseases was 23 per cent. below the average in the corresponding period of the five preceding years.
ROYAL SANITARY INSTITUTE.-A sessional
meeting
will be held on Jan. 28th in the Guildhall, Exeter, at 4.30 P.M., jointly with the West of England branch of the Society of Medical Officers of Health, when a discussion on the Sanatorium Question will be opened by Dr. E. Ward. The chair will be taken by Professor H. R. Kenwood. On Jan. 29th at 9.30 A.M. a short discussion on Housing will be opened by Dr. P. H. Stirk and will be followed by a visit to new houses and insanitary areas. Those proposing to attend are asked to notify the honorary local secretary, Dr. P. H. Stirk, SouthernhayW., Exeter, not later than Jan. 22nd.
Obituary. CHARLES HIGGENS, F.R.C.S.ENG., ’CONSULTING OPHTHALMIC SURGEON TO
GUY’S HOSPITAL.
Mr. Charles Higgens, who died suddenly while out shooting on Dec. 28th last, was born in 1846, and was educated at Brighton College and at Guy’s Hospital Medical School, qualifying with the M.R.C.S. Eng., L.R.C.P. Lond., and L.S.A. in 1868. In 1871 he became F.R.C.S. Eng., and was appointed surgeon to the Central London Ophthalmic Hospital, and was assistant ophthalmic surgeon at Guy’s Hospital two years later. In 1883 he became senior ophthalmic surgeon to Guy’s and lecturer on ophthalmology in the medical school. Retiring in 1906 he was elected consulting surgeon. He was also for many years ophthalmic surgeon to the French Hospital and surgeon to the County of London War Hospital during the war. Such is a brief record of Charles Higgens, who was a man of very lovable personality, and who enjoyed great and well-deserved popularity as well as the respect of a vast number of colleagues, senior and junior, and of pupils, all of whom admired his professional skill and resourcefulness and his high simple standards of conduct. The following is a picture of him by one who worked for many years in close association with him. As a colleague Charles Higgens was markedly generous
seemed sometimes to be inspired with a genuine desire to tire out everybody else but himself. His manner of death 1 was, I think, such as he would have wished." Mr. Higgens left behind him very little written work beyond contributions to Guy’s Hospital Reports, to the Transactions of the Royal Medical and Chirurgical Society, and of the Ophthalmological Society, and occasionally to the columns of THE LANCET. Among the last may be mentioned a note published in 1894 on 1925 Extractions of Cataract, and a paper published in 1907 on 130 Consecutive Extractions of Cataract without a Failure. In 1879 he published a little book on Ophthalmic Practice, and in 1903 the Manual of
Ophthalmic Practice, referred to above, which was marked by the simplicity and straightforwardness of the accounts given of a number of diseases of the eye, and by the sensible and judicious advice in respect of treatment. _______________
URBAN VITAL STATISTICS.
(Week ended Jan. 15th, 1921.) English and Welsh Towns.-In the 96 English and Welsh towns, with an aggregate population estimated at 183 million persons, the annual rate of mortality, which had been 15-1, 16’6, and 14-0 in the three weeks, declined to 12-8 per 1000. In London, with a population of 4 million persons, the death-rate was 12’6, or 0-3 per 1000 below that recorded in the previous week, while among the remaining towns the rates ranged from 3-8 in Ilford, 4-8 in Ealing, and 4-9 in Acton, to 21-7 in Merthyr Tydfil, 23-9 in and always appreciative of work done for him by his Sunderland, and 24-2 in Tynemouth. The principal epidemic juniors. He entrusted both his private and hospital work diseases caused 224 deaths, which corresponded to an annual to them in any absence, and his experience was frankly rate of 0-6 per 1000, and comprised 92 from infantile shared with them. To his equals he was always cheery, diarrhcea, 69 from diphtheria, 31 from whooping-cough, 20 wise, and full of common sense; and his honesty made him from measles, 8 from scarlet fever, 3 from enteric fever, and 1 from small-pox. Whooping-cough caused a death-rate as ready to discuss any failures and disappointments in his of 2-0 in Warrington, but the mortality from the remaining cases as his successes, a trait that is not too frequently met with, while it is of far greater value for any man who is diseases showed no marked excess in any of the towns. The beginning an ophthalmic career to hear of the difficulties fatal case of small-pox belonged to Bristol. There were 4413 which may have to be avoided than to receive any long list cases of scarlet fever, 2597 of diphtheria, and 1 of small-pox of triumphs. His operating was good, he being of wiry phv- i under treatment in the Metropolitan Asylums Hospitals sique, tireless, and entirely self-confident. He impressed" , and the London Fever Hospital, against 4608, 2588, and 1 his patients into confidence by his obvious capacity for the respectively at the end of the previous week. The causes work he had to do-the assurance that he was equal to his job. of 26 of the 4556 deaths in the 96 towns were uncertified, He invented no new operations, but he performed the "simple of which 7 were registered in Birmingham, and 3 each in extraction"of cataract in a perfect way, and his large prac- Manchester and Blackpool. tice was easily accounted for when one had an intimate Scottish Towns.-In the 16 largest Scottish towns, with an knowledge of his straightforward way with his patients and aggregate population estimated at nearly 2 million persons, his manual dexterity. As a consultant his younger colleagues the annual rate of mortality, which had been 16-2, 18-4, and found him of great value; you could always take a difficulty 18-4 in the three preceding weeks, fell to 15-9 per 1000. to Charles Higgens and be sure of sympathy and a concentra- The 329 deaths in Glasgow corresponded to an annual tion on it; he took the obvious and straightforward line, and rate of 15-6 per 1000, and included 11 from infantile diarrhoea, was quite explicit in his decision. He did not always give 5 from diphtheria, 4 from whooping-cough, and 1 each from elaborate reasons for his views-they were the result of long small-pox, measles, and scarlet fever. The 133 deaths in years of large and varied experience-but neither did he Edinburgh were equal to a rate of 15-5 per 1000, and included bother his head about possibilities and eventualities unlikely 7 from influenza, 3 from measles, and 1 each from scarlet to occur. fever, diphtheria, and infantile diarrhoea. He wrote little compared to some other ophthalmic Irish Towns.-The 145 deaths in Dublin corresponded to surgeons holding positions as big; a small ophthalmic an annual rate of 17-9, or 0-8 per 1000 above that recorded text-book of his had a large sale some years ago, but in the previous week, and included 4 from infantile diarrhcea. is now out of date and submerged by the never-ceasing The 146 deaths in Belfast were equal to a rate of 18-1 per stream of similar publications. More than anything else and included 2 from whooping-cough. 1000, was he roused to write in censure of any " money-seeking merchants " in the profession, but only as a vent to his own VITAL STATISTICS OF LONDON DURING feelings. Extreme honesty was his marked and finest trait, and such views were too outspoken for any but an editor DECEMBER, 1920. thirsting for litigation, whom happily he never found. In IN the accompanying table will be found summarised his private life he was a sportsman at heart. Hunting statistics relating to sickness and mortality in the City of and shooting were his relaxations on every opportunity, London and in each of the metropolitan boroughs. With and advancing years never damped his ardour in these to the notified cases of infectious diseases, it appears regard directions. that the number of persons reported to be suffering from one From such a description there emerges a very or other of the ten diseases notified in the table was equal to accurate picture of the man, and there may be added an annual rate of 12-3 per 1000 of the population, estimated to it some extracts from a sympathetic note received at 4,358,309 persons; in the three preceding months from Mr. Tom Bird, consulting anaesthetist to Guy’s the rates had been 11-3,16-3, and 15-8 per 1000. Among the metropolitan boroughs the lowest rates from these Hospital, who lived with his friend for 14 years pre- diseases were recorded in Paddington, Chelsea, the City Mr. Bird says :ceding Higgens’s marriage. of Westminster, St. Marylebone, and Lambeth ; and " We resided together at 38, Brook-street in congenial the highest in Hammersmith, Stoke Newington, Bethnal companionship for 14 years. Our domestic partnership was Green, Stepney, Poplar, and Deptford. One case of broken in one sense by Higgens’smarriage, but our personal small-pox was notified during the month from the and professional friendship remained inviolable until his borough of Hampstead. The prevalence of scarlet fever passing away. I had reason to know the results of a great was 26 per cent. less than in the preceding month; deal of his work, and positively I do not remember a single this disease was proportionally most prevalent in Hammeroperation of his that went wrong in the half century over smith, Bethnal Green, Stepney, Poplar, Bermondsey, which my experience of that work extends-I am speaking, and Deptford. The Metropolitan Asylums Hospitals conof course, of the operation per se. He was advanced in years tained 4729 scarlet fever patients at the end of the month, when the war placed upon him hard work at the military against 3683, 5117, and 5508 at the end of the three prehospital at Portland, but he delighted in the work, and ceding months; the weekly admissions averaged 590,
preceding
198 ANALYSIS OF SICKNESS AND MORTALITY STATISTICS IN LONDON DURING DECEMBER. 1920. (Sloeciabby compiled,for THE LA...’WET.)
’"
Including membranous croup.
against 603, 873, and 780 in the three preceding months. Diphtheria was slightly less prevalent than in the preceding month; the greatest proportional prevalence of this disease was recorded in Fulham, Islington, Stoke Newington, Holborn, Shoreditch, and Poplar. The number of diphtheria patients under treatment in the Metropolitan Asylums Hospitals, which had been 1773, 2284, and 2604 at the end of the three preceding months, numbered 2615 at the end of December; the weekly admissions averaged 316, against 266, 364, and 360 in the three preceding months. The prevalence of enteric fever was about equal to that in the four preceding months ; of the 28 cases notified during the month, 4 belonged to Lambeth, 3 to Kensington, 3 to Camberwell, and 2 each to Fulham, St. Pancras, Poplar, and Southwark. There were 15 cases of enteric fever under treatment in the Metropolitan Asylums Hospitals at the end of the month, against 14, 19, and 16 at the end of the three preceding months ; the weekly admissions averaged 2, against 3, 4, and 3 in the three preceding months. Erysipelas was proportionally most prevalent in Hammersmith, Fulham, the City of Westminster, Shoreditch, Bethnal Green, and Southwark. The cases of puerperal fever included 5 in Lambeth, 4 each Paddington, Hammersmith, Hackney, and Stepney, 3 in Bermondsey, and 3 in Woolwich. The 15 cases of cerebrospinal meningitis included 3 in Stepney, 3 in Poplar, and 2 in Wandsworth. No case of poliomyelitis was notified during the month.
43 in
The mortality statistics in the table relate to the deaths of civilians actually belonging to the several boroughs, the deaths occurring in institutions having been distributed among the boroughs in which the deceased persons had previously resided. During the five weeks ended Jan. lst, 1921, the deaths of 6165 London residents were registered, equal to an annual rate of 14-8 per 1000; in the three preceding months the rates had been 9-9, 10-5, and 13’6 per 1000. The death-rates ranged from 11’0 in Hampstead, 11’6 in Greenwich, 12’1 in Woolwich, 12’3 in Wandsworth, 12-9 in St. Marylebone, 13-3 in Deptford, and 13-4 in Lewisham, to 16in Islington, 16-3 in Bethnal Green, 16-4 in Holborn, 16-4 in Lambeth, 17-7 in Finsbury, The 6165 17-7 in Southwark, and 17-8 in Kensington. deaths from all causes included 269 deaths which were referred to the principal infectious diseases; of these, 7
resulted from measles, 34 from scarlet fever, 118 from diphtheria, 19 from whooping-cough, 1 from enteric fever, and 90 from diarrhoea and enteritis among children under 2 years of age. No death from any of these diseases was recorded in the City of London. Among the metropolitan boroughs the lowest death-rates from these diseases were recorded in St. Marylebone, Hampstead, Bermondsey, Wandsworth, Deptford, and Greenwich; and the highest in Islington, Stoke Newington, Holborn, Finsbury, Shoreditch, and Poplar. The 7 deaths from measles were less than one-twelfth of the average number in the corresponding period of the five preceding years ; of these, 2 belonged to Paddington. The 34 fatal cases of scarlet fever exceededthe average by 18 ; of these, 3 belonged to each of the boroughs of Stepney, Poplar, Lambeth, Camberwell, and Lewisham. The 118 deaths from diphtheria exceeded the average number by 33 ; the greatest proportional mortality from this disease occurred in Hammersmith, Islington, Stoke Newington, Holborn, Finsbury, and Poplar. The 19 fatal cases of whooping-cough were about one-third of the average; of these, 3 belonged to Kensington, 3 to Bethnal Green, and 3 to Battersea. One death from enteric fever was registered during the month, against an average of 6. The 90 fatal cases of infantile diarrhoea showed a decline of 10 from the average; the greatest proportional mortality from this disease occurred in Kensington, the City of Westminster, Islington, Shoreditch, Lambeth, and Camberwell. In conclusion, it may be stated that the aggregate mortality in London during December from these principal infectious diseases was 23 per cent. below the average in the corresponding period of the five preceding years.
ROYAL SANITARY INSTITUTE.-A sessional
meeting
will be held on Jan. 28th in the Guildhall, Exeter, at 4.30 P.M., jointly with the West of England branch of the Society of Medical Officers of Health, when a discussion on the Sanatorium Question will be opened by Dr. E. Ward. The chair will be taken by Professor H. R. Kenwood. On Jan. 29th at 9.30 A.M. a short discussion on Housing will be opened by Dr. P. H. Stirk and will be followed by a visit to new houses and insanitary areas. Those proposing to attend are asked to notify the honorary local secretary, Dr. P. H. Stirk, SouthernhayW., Exeter, not later than Jan. 22nd.