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ENGLISH MORTALITY ASSIGNED TO ALCOHOLISM.
638
-
,
maintained except on the eleemosynary system. If this element is to be done away with a very different scale of subscriptions from that of a penny or a halfpenny will have to rule. ____
THE
DIRECT
REPRESENTATIVE
FOR
IRELAND.
upon the recorded death-rate from males and females are interesting, and among to a certain extent more trustworthy, as there appears to be no reason why the probable increase of accuracy in certifying this cause of death should affect the recorded death-rate of one sex more than another. The deathrate of males from alcoholism increased from 38 per million in 1875-78 to 60 per million in 1891-94; among females the rate increased in the same periods from 20 per million to 46 per million. Thus the increase in the recorded rate was equal to 58 per cent. among males and to It is therefore no less than 130 per cent. among females. impossible to avoid the conclusion that, whatever may be the actual increase in the death-rate from intemperance implied by the Registrar-General’s statistics, the increase must have been relatively far greater among females than among males. It should be stated that the deaths referred "delirium tremens"are not included under the heading "chronic alcoholism"and that the death-rate from this cause remained practically stationary during the twenty years. The this
figures bearing
cause
THE registered practitioners of Ireland have elected Mr. W, Thomson to be the direct representative of the profession of Ireland in the General Medical Council. Dublin will be more convinced than ever that it is for medical purposes Ireland and represents the whole profession. The registered . practitioners cannot henceforth complain that it should be It would certainly have been a variety to have seen in so. the Council a practitioner from the provinces of Ireland and representing their medical life and needs. And the theory of direct representation in Ireland seems to require - some such selection. But it has never had the support of ,such a selection. It is complimentary to men in the consulting and hospital ranks of Dublin that they should be elected by the profession generally as its representative. The ’opponents of the principle of direct representation must -allow that it has not been blindly used to represent merely THE ROYAL COMMISSION ON TUBERCULOSIS. - one branch of practice in any division of the kingdom, but THE announcement made in the House of Commons on rather for the selection of good men. Mr. Thomson is an the 3rd inst. to the effect that it had been decided to M.A. (7ion. causâ) of the Queen’s University, M.D. and M.Ch., the Royal Commission on Tuberculosis and to reappoint .and F.R.C.S.I. His sympathies are with the surgical side of extend the scope of its inquiry so that it might further medicine and he is surgeon to the Richmond Hospital. He and inquire report on administrative procedures available is besides general secretary and editor of the Transactions for the amount of tuberculous material in reduciug vf the Royal Academy of Medicine in Ireland. It would the food supplied by animals to man, is one which of Ireland has been .appear that the direct representation put Two into good hands, though they be Dublin ones, and that in the we are unable to receive with satisfaction. out of the five members who heard the evidence discussions of the Council Ireland will be well represented. which has been taken are dead ; they both held the post of chairman of the Commission, and Sir George Buchanan, ENGLISH MORTALITY ASSIGNED TO ALCOHOLISM. who succeeded Lord Basing in that position, and to whom THERE are few branches of statistics in which it is more the report is largely to be attributed, brought to bear upon necessary to observe caution than in basing conclusions upon the work a combination of administrative, scientific, and statistics of the causes of mortality. The necessity for this medical knowledge which it will be difficult to replace. -caution should not, however, deter us from discussing the But a commissioner of some such stamp will be essential to true import of mortality statistics presented to us in the secure public confidence as to " administrative procedures." reports of the Registrar-General. It is needless to point out We had hoped that this matter, which has been pending for to those whose duty it is to certify causes of death " to the years, and on which the late Commission had been sitting best of their knowledge and belief " the serious difficulties ever since July, 1890, was ripe for action. It is one of the that surround the certification of death to which an excessive gravest importance to the public health and one that calls use of alcohol has more or less directly contributed. Under for no delay that can by any means be avoided. these circumstances it would be useless to expect a near approach to actual accuracy in the statistics of deaths MEDICAL LIBRARIES IN AMERICA. assigned to alcoholism. The Registrar-General’s figures on AN interesting paper on the development of medical this subject, however, deserve consideration. The recently - issued annual report shows the annual rate of mortality libraries in America was read on Jan. llth before the assigned to chronic alcoholism in England and Wales in each Medical and Chirurgical Faculty of Maryland by Dr. James of the twenty years 1875-94. The recorded annual rate per R. Chadwick, librarian of the Boston Medical Library million persons living from this cause has shown a remark- Association. The earliest of the American medical libraries ably steady increase during this period. The actual lowest was that of the Pennsylvania Hospital in Philadelphia. It rate in these twenty years was 26 per million in 1880, and was commenced in 1762 and has increased steadily until it the highest was 57 per million in 1893. In the first four years has now reached 15,000 volumes. The library of the College of this period, 1875-78, the annual rate averaged only 29 per of Physicians in Philadelphia was begun in 1788, and in million, while in the last four years, 1891-94, the recorded 1864-65 was almost doubled in size chiefly by the gift of 2500 rate averaged 52 per million, showing an increase of 79 per volumes from Dr. Samuel Lewis, whose eventual donations Between 1882 and 1886 its -cent. Can these figures mean that the death-rate from were nearly 10,000 volumes. alcoholism has nearly doubled in the twenty years ? Or are growth was very rapid, owing to the receipt successively of they to be explained by the more accurate and courageous the libraries of Dr. William F. Jenks, Dr. Alfred Stille, Dr. certification of the cause of deaths due to alcoholic excess ? Samuel D. Gross, Dr. 1. Minis Hays, Dr. John S. Perry, and There has been undoubtedly a very considerable decline in the library of the Obstetrical Society of Philadelphia. Between the proportion of deaths attributed to diseases of the liver 1880 and 1882 Dr. S. Weir Mitchell contributed$2000 as a during the last twenty years, and we know that the journal fund, and subsequently, when president, was the Registrar-General now addresses to certifying practitioners a means of further benefiting the collection, which now consteadily increasing number of inquiries concerning ambiguous tains 49,000 volumes and 28,000 pamphlets. The library of certificates, but it is difficult to avoid the conclusion sug- the New York Hospital was founded in 1776, and now gested by the figures noted above, that they imply, at any numbers 22,000 volumes, but has practically no pamphlets. some real increase in the death-rate from alcoholism. The library of the Surgeon-General’s Office in Washington
to
,
-
,
maintained except on the eleemosynary system. If this element is to be done away with a very different scale of subscriptions from that of a penny or a halfpenny will have to rule. ____
THE
DIRECT
REPRESENTATIVE
FOR
IRELAND.
upon the recorded death-rate from males and females are interesting, and among to a certain extent more trustworthy, as there appears to be no reason why the probable increase of accuracy in certifying this cause of death should affect the recorded death-rate of one sex more than another. The deathrate of males from alcoholism increased from 38 per million in 1875-78 to 60 per million in 1891-94; among females the rate increased in the same periods from 20 per million to 46 per million. Thus the increase in the recorded rate was equal to 58 per cent. among males and to It is therefore no less than 130 per cent. among females. impossible to avoid the conclusion that, whatever may be the actual increase in the death-rate from intemperance implied by the Registrar-General’s statistics, the increase must have been relatively far greater among females than among males. It should be stated that the deaths referred "delirium tremens"are not included under the heading "chronic alcoholism"and that the death-rate from this cause remained practically stationary during the twenty years. The this
figures bearing
cause
THE registered practitioners of Ireland have elected Mr. W, Thomson to be the direct representative of the profession of Ireland in the General Medical Council. Dublin will be more convinced than ever that it is for medical purposes Ireland and represents the whole profession. The registered . practitioners cannot henceforth complain that it should be It would certainly have been a variety to have seen in so. the Council a practitioner from the provinces of Ireland and representing their medical life and needs. And the theory of direct representation in Ireland seems to require - some such selection. But it has never had the support of ,such a selection. It is complimentary to men in the consulting and hospital ranks of Dublin that they should be elected by the profession generally as its representative. The ’opponents of the principle of direct representation must -allow that it has not been blindly used to represent merely THE ROYAL COMMISSION ON TUBERCULOSIS. - one branch of practice in any division of the kingdom, but THE announcement made in the House of Commons on rather for the selection of good men. Mr. Thomson is an the 3rd inst. to the effect that it had been decided to M.A. (7ion. causâ) of the Queen’s University, M.D. and M.Ch., the Royal Commission on Tuberculosis and to reappoint .and F.R.C.S.I. His sympathies are with the surgical side of extend the scope of its inquiry so that it might further medicine and he is surgeon to the Richmond Hospital. He and inquire report on administrative procedures available is besides general secretary and editor of the Transactions for the amount of tuberculous material in reduciug vf the Royal Academy of Medicine in Ireland. It would the food supplied by animals to man, is one which of Ireland has been .appear that the direct representation put Two into good hands, though they be Dublin ones, and that in the we are unable to receive with satisfaction. out of the five members who heard the evidence discussions of the Council Ireland will be well represented. which has been taken are dead ; they both held the post of chairman of the Commission, and Sir George Buchanan, ENGLISH MORTALITY ASSIGNED TO ALCOHOLISM. who succeeded Lord Basing in that position, and to whom THERE are few branches of statistics in which it is more the report is largely to be attributed, brought to bear upon necessary to observe caution than in basing conclusions upon the work a combination of administrative, scientific, and statistics of the causes of mortality. The necessity for this medical knowledge which it will be difficult to replace. -caution should not, however, deter us from discussing the But a commissioner of some such stamp will be essential to true import of mortality statistics presented to us in the secure public confidence as to " administrative procedures." reports of the Registrar-General. It is needless to point out We had hoped that this matter, which has been pending for to those whose duty it is to certify causes of death " to the years, and on which the late Commission had been sitting best of their knowledge and belief " the serious difficulties ever since July, 1890, was ripe for action. It is one of the that surround the certification of death to which an excessive gravest importance to the public health and one that calls use of alcohol has more or less directly contributed. Under for no delay that can by any means be avoided. these circumstances it would be useless to expect a near approach to actual accuracy in the statistics of deaths MEDICAL LIBRARIES IN AMERICA. assigned to alcoholism. The Registrar-General’s figures on AN interesting paper on the development of medical this subject, however, deserve consideration. The recently - issued annual report shows the annual rate of mortality libraries in America was read on Jan. llth before the assigned to chronic alcoholism in England and Wales in each Medical and Chirurgical Faculty of Maryland by Dr. James of the twenty years 1875-94. The recorded annual rate per R. Chadwick, librarian of the Boston Medical Library million persons living from this cause has shown a remark- Association. The earliest of the American medical libraries ably steady increase during this period. The actual lowest was that of the Pennsylvania Hospital in Philadelphia. It rate in these twenty years was 26 per million in 1880, and was commenced in 1762 and has increased steadily until it the highest was 57 per million in 1893. In the first four years has now reached 15,000 volumes. The library of the College of this period, 1875-78, the annual rate averaged only 29 per of Physicians in Philadelphia was begun in 1788, and in million, while in the last four years, 1891-94, the recorded 1864-65 was almost doubled in size chiefly by the gift of 2500 rate averaged 52 per million, showing an increase of 79 per volumes from Dr. Samuel Lewis, whose eventual donations Between 1882 and 1886 its -cent. Can these figures mean that the death-rate from were nearly 10,000 volumes. alcoholism has nearly doubled in the twenty years ? Or are growth was very rapid, owing to the receipt successively of they to be explained by the more accurate and courageous the libraries of Dr. William F. Jenks, Dr. Alfred Stille, Dr. certification of the cause of deaths due to alcoholic excess ? Samuel D. Gross, Dr. 1. Minis Hays, Dr. John S. Perry, and There has been undoubtedly a very considerable decline in the library of the Obstetrical Society of Philadelphia. Between the proportion of deaths attributed to diseases of the liver 1880 and 1882 Dr. S. Weir Mitchell contributed$2000 as a during the last twenty years, and we know that the journal fund, and subsequently, when president, was the Registrar-General now addresses to certifying practitioners a means of further benefiting the collection, which now consteadily increasing number of inquiries concerning ambiguous tains 49,000 volumes and 28,000 pamphlets. The library of certificates, but it is difficult to avoid the conclusion sug- the New York Hospital was founded in 1776, and now gested by the figures noted above, that they imply, at any numbers 22,000 volumes, but has practically no pamphlets. some real increase in the death-rate from alcoholism. The library of the Surgeon-General’s Office in Washington
to
,