LOCAL GOVERNMENT BOARD.

178 the United States, Switzerland, and other countries, during the Universal Exhibition of 1889.1 The last congress was held at Liege in Belgium. The Organising Committee of the forthcoming congress has its headquarters at Paris and its President is Dr. Albert Robin who is President of the General Association of Medical Men practising in the health resorts of France. Then there are Dr. Leudet of Eaux-Bonnes, ex-President of the Hydrological Society ; Professor Fredet of the Medical School of Clermont Ferrand ; Dr. de Ranse, and others. But all communications must be addressed to the Secretary-General of the congress, Dr. Fernand Berlioz, Ecole de Medecine de Grenoble, hère, France. To be a member of the congress it suffices to forward a subscription of 20 francs and all the printed reports will be sent gratuitously to the members. Reports on the following subjects will be presented to the Congress and discussed : The Action of Mineral Waters on the Tissues, by Professor J. Renault of Lyons ; Practical Methods for the Bacteriological Analyses of Mineral Waters, by Dr. Bordas ; Chemical Analyses of Mineral Waters and their Therapeutic Applications, by Dr. Garrigon ; and the Legal Measures that should be taken to Prevent Frauds in the Sale of Mineral Waters, by Dr. Bouloumie. These papers come under the head of scientific Hydrology." Then there is to be a section of Clinical Hydrology"in which reports on the Hydromineral Treatment of Pulmonary Phthisis, by Dr. Leudet and Dr. Schleumer, and other papers on the Treatment of Skin Diseases, Diseases of the Digestive Organs, and of Constitutional Weakness in Children by the Use of Mineral will be read A fourth section deals Waters, Baths, &c., with Climatology and reports will be submitted on the Influence of Temperature and Altitude on the Respiratory Functions ; on the Meteorological Conditions Necessary for the Installation of a Sanatorium ; and on the Indoor and Outdoor Treatment at Sanatoriums. Finally, there is a Geological section where the question of the preservation of mineral waters, the relations of the mineral waters of the Dauphin6 and the geology of the soil, the statistics of the the mineral springs of Savoy and the Dauphine, and the geological conditions and the origin of the mineral waters of Of course, Oriol and La Motte (Isere) will be discussed. many other questions will arise out of these French papers, particularly as members representing other nationalities will also read papers. It is likewise to be hoped that there will be some discussion on the sanitary condition of the various health resorts, for this is a very important question which many local authorities are apt to neglect. In view of the interest of the congress itself and the splendid opportunity of visiting some of the most celebrated and beautiful thermal stations of Europe it is very probable that the meeting will be numerously attended.

England,

ROYAL COLLEGE OF SURGEONS OF ENGLAND. ELECTION OF PRESIDENT. the Council was held on July 10th, the President, Sir HENRY G. HowsE, being in the chair. The PRESIDENT reported the re-election of Mr. Howard Marsh, and the election of Mr. John Hammond Morgan, C.V.O., Mr. Henry Hugh Clutton, and Mr. Charles William Mansell Moullin as members of Council. The PRESIDENT stated that Mr. Moullin being fourth on the poll would be the substitute member of Council for the late Sir William Mac Cormae. Mr. Marsh, Mr. Morgan, Mr. Clutton, and Mr. Moullin were introduced, made declarations in the terms of the oath prescribed by the Charter of 1800, and took their seats as members of the Council. Sir Alfred Cooper was nominated a trustee of the Cancer Research Fund to represent the Royal College of Surgeons of A QUARTERLY

meeting of

England. The Council nominated the President and Mr. John and Mr. Henry Morris as members of the Executive Committee to be constituted under the Cancer Research Fund scheme and these members were instructed to elect in the name of the College the president and the vicepresidents of the Cancer Research Fund. Mr. Henry Morris

Langton

1

See THE LANCET, Oct. 19th, 1889,

p. 813.

appointed treasurer of the fund subject to the approval of the Royal College of Physicians of London. A Member of the College who had previously been struck off the Medical Register by the General Medical Council was removed from being a Member of the College. The PRESIDENT stated that the committee appointed to receive a deputation Jrom the Association of Licentiates of the Royal College of Physicians of London and Members of the Royal College of Surgeons of England would submit a report at the next meeting of the Council. Sir Henry Greenway Howse was unanimously re-elected President of the College and Mr. John Tweedy and Mr. A. VT. Mayo Robson were elected Vice-Presidents. The following appointments were made :-Hunterian Professors Mr. Charles Stewart, Mr. William McAdam Eccles, and Mr. Arthur Keith ; Arris and Gale Lecturer : Mr. John Herbert Parsons ; Erasmus Wilson Lecturer : Dr. Charles Bent Ball, Hon. F.R.C.S. Eng.

was

met in Paris

public Health LOCAL

and

Poor Law.

GOVERNMENT

BOARD.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Birmingham Urban -District.-Dr. Alfred Hill records a satisfactory diminution in the number of cases of enteric fever, a result which he ascribes largely to the provision of isolation accommodation for this disease. The general death-rate of the city for 1901 was 19’9 per 1000, as against an average for the last quinquennium of 20-4. The ward rates for 1901 ranged from 29 - to 13-1 1 per 1000. In the three wards having the lowest general rate measles caused a death-rate of 0 28, as against a rate of 0-99 per 1000 in the three wards having the highest general death-rate. Somewhat similar divergencies occurred in the case of and diarrhoea. With scarlet fever, on the the wards with the lowest general death-rate yielded a higher scarlet fever case-rate than the wards with the highest general death-rate. The highest rate with respect to enteric fever and diphtheria was, however, in the three wards with the highest general death-rate. From phthisis the death-rate was 2-70 per 1000 in the bad wards and only 1-14 in the good ones. The cancer and heart-disease rates in the two groups were nearly identical. Diphtheria antitoxin is distributed gratuitously by the sanitary authority and a very gratifying diminution of fatality-rate has been apparent. The women health visitors have, as usual, done good service in Birmingham, and amongst other things they have turned their attention to children who were sent home from school in consequence of having vermin in their hair. in house llVUh’)C for the lJlit:’ The J...!..lv accommodation J-U ctjUimtJCLiUll labouring classes J.U J..G1JUUU.l.l.L15 Birmingham is, Dr. Hill reports, quite inadequate, and he urges the town council to undertake the provision of such dwellings. He has also made a representation under the Housing of the working Classes Acts in respect of an unhealthy area possessing a population of some 2429. The mean death-rate of the whole area for the last two years was 39-5 5 per 1000. Manchester Urban District.-In his last quarterly report Dr. J. Niven states that during the period in question eight cows were proved to be suffering from tuberculous udders. Of these eight, one was killed, two are still at the farms, concerning three there is no information available, and the remaining two were sold in the open market. The want of all proper control over cows with tuberculous udders is deplorable and it is to be hoped that some reform in this direction will soon be brought about. When milk is taken from the Manchester railway stations and, on examination, is found to be tuberculous, the farm which furnished the sample is forthwith visited, and milk from cows with suspicious-looking udders is examined, first microscopically, and secondly, by means of inoculation. No action is taken until the milk has been definitely established to be tuberculous. Cardiff Port Sanitary District.-The disinfection of the holds of ships and the destruction of rats therein are matters of such importance from the point of view of the prevention of diseases that a further reference 1 to certain experiments

whooping-cough other

hand,

Birmingham

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THE

LANCET, June 21st, 1902, p. 1801.

179

recently carried out at Cardiff with the Clayton fire- scarlet fever in Burnley, Stockton-on-Tees, and West xtinguishing apparatus may be useful. Dr. Edward Walford, Bromwich ; from whooping-cough in South Shields, who supervised the experiments, caused a number of rats Bootle, Barrow-in-Furness, and Norwich; from "fever" in .confined in a cage to be placed in different parts of the hold Ipswich and Barrow-in-Furness ; and from diarrhoea in .of a ship and the sulphur dioxide generated by the Clayton Preston and Bootle. The mortality from diphtheria showed apparatus was forced in at an average strength of 10 per no marked excess in any of the large towns. Of the deaths cent. The rats placed at the bottom of the hold were killed from small-pox registered during the week 13 belonged to almost immediately and those placed about three feet below London, two to Swansea, and one each to Croydon, Tottenthe level of the deck were dead after three hours. In addition ham, and Walthamstow, but not one to any other of the 76 to these experiments strips of fabric were soaked in liquid large towns. The number of small-pox patients under treatcultures of plague, cholera, enteric fever, and anthrax ment in the Metropolitan Asylums hospitals, which had been .organisms and were exposed in small glass dishes with loose 861, 837, and 677 at the end of the three preceding weeks, After an exposure of 12 hours to the sulphur fumes had further declined to 579 at the end of the week ; - covers. .all save the anthrax culture were killed. From this it is 57 new cases were admitted during the week, against 107, The number inferred that all the non-sporing organisms were killed and 129, and 58 in the three preceding weeks. that hence the experiments were satisfactory, as sporing and of scarlet fever patients in these hospitals and in the jiarmfnl organisms are not likely to be encountered in London Fever Hospital on Saturday, July 12th, was 2352, against 2450, 2496, and 2432 in the three preceding weeks ; practice in the holds of ships. Brighton Urban District.-Dr. A. Newsholme furnishes in 272 new cases were admitted during the week, against 378, ihis current annual report figures showing foi each of the 276, and 255 in the three preceding weeks. The deaths referred last three years the number of cases of diphtheria amongst to diseases of the respiratory organs in London, which scholars attending the several elementary schools in had been 173, 194, and 168 in the three preceding weeks, Brighton. The board school rates for 1901 averaged from further declined to 159, and were 12 below the corrected 0’2 to 7’7 per cent. of the average attendance, while the average number. The causes of 41, or 0’ 9 per cent., of the voluntary school rates ranged from 0’ 2 to 4’ 3 per cent. As deaths in the 76 towns were not certified either by a registered All the causes of to this discrepancy between the board and voluntary schools medical practitioner or by a coroner. Dr Newsholme fails to find an adequate explanation in death were duly certified in West Ham, Portsmouth, .geographical distribution or in structural defects. He is of Leicester, Bolton, Salford, Bradford, Leeds, Cardiff. and in opinion that there must be differences in administration, 48 other smaller towns ; the largest proportions of uncertified deaths were registered in Ipswich, Liverpool, and South more particularly in the direction of the eagerness on the part of the school board authorities to whip up absentees, Shields. .and hence the liability to bring together children suffering from slight sore-throat, &c. This is certainly an interesting HEALTH OF SCOTCH TOWNS. speculation, but we should be glad to see the comparison The annual rate of mortality in the eight Scotch towns, made in other towns before altogether accepting the thesis. which had been 192 and 16 -3 per 1000 in the two preceding We are glad to see that Brighton is, in common with many further declined to 16’2 per 1000 during the week weeks, other towns, now affording facilities for the supply of ending July 12th, but showed an excess of l-7 per 1000 diphtheria antitoxin and that a supply of this material can over the mean rate during the same period in the 76 large be obtained at the public health offices during the day and English towns. The rates in the eight Scotch towns ranged .at the police-offices during the night. Dr. Newsholme very from 13 ° 5 in Aberdeen and 14 ° 4 in Greenock to 17 -9 in properly urges the early administration of antitoxin, and he Edinburgh and 19’2 in Paisley. The 523 deaths in these points out the desirability of not waiting until the nature of towns included 22 which were referred to measles, 15 to the disease is definitely established. Certainly very valuable diarrhoea, 14 to whooping-cough, six to "fever,"three to time may be lost by waiting, and the delay is not unlikely and two to scarlet fever, but not one to small-pox. to turn the scale between life and death. Dr. Newsholme diphtheria, In all 62 deaths resulted from these principal infectious has never seen any injurious effects from 500 units adminis- diseases in the week, against 54, 57, and 66 in the three pretered as a prophylactic, and the Brighton Corporation has weeks. These 62 deaths were equal to an annual rate ceding sanctioned a payment of 2s. 6d. for every dose thus of 1 ’9 per 1000, which was also the death-rate in the week administered at the request of the medical officer of health from the The same diseases in the 76 large English towns. to children living in the same house as a child already fatal cases of measles, which had been 18, 15, and 13 in the suffering from diphtheria-that is to say, if the parents are three preceding weeks, again rose to 22, and included 12 too poor to bear the expense. in Edinburgh, four in Glasgow, and three in Paisley. The deaths from diarrhoea, which had been 17, 16, and 24 in the three preceding weeks, fell again to 15 and VITAL STATISTICS. included eight in Glasgow and four in Edinburgh. The fatal cases of whooping-cough, which had been 14 and 16 in the two preceding weeks, again declined to 14 and HEALTH OF ENGLISH TOWNS. included six in Glasgow and three in Edinburgh and in IN 76 of the largest English towns 8661 births and 4120 Aberdeen. The deaths from scarlet fever numbered two deaths were registered during the week ending July 12th. while the fatal cases of diphtheria were three and showed The annual rate of mortality in these towns, which had a decline from recent weekly numbers. The deaths slight been 14-9. 15 ° 1, and 15 ° 4 per 1000 in the three preceding referred to diseases of the organs in these towns, weeks, declined to 14’55 per 1000 last week. In London which had been 101 and respiratory 87 in the two preceding weeks, the death-rate was 14 - 6 per 1000, while it averaged 14 ’4 in further declined to 74 and were just below the number the 75 other large towns. The lowest death-rates in these in the of last year. The causes of corresponding period towns were 7 ’66 in King’s Norton, 6 ’22 in Walthamstow, 6’5 19, or nearly 4 per cent., of the deaths registered in these Grimsby and in Rotherham, 7’1in Great Yarmouth, 8’0 in eight towns last week were not certified. East Ham and in Leicester, 83in Hornsey, and 93 in Handsworth ; the highest rates were 20’1in Bootle and in SunderHEALTH OF DUBLIN. land, 21’1 1 in Manchester, 21’9 9 in Newcastle-upon-Tyne, and The death-rate in Dublin, which had been 17’9, 19’9, 23 ’3 in Coventry. The 4120 deaths in these towns in the same week included 533 which were referred to the principal and 19’1 per 1000 in the three preceding weeks, further infectious diseases, against 476 and 522 in the two preceding declined to 16’9 per 1000 during the week ending July weeks; of these 533 deaths 131 resulted from whooping- 12th. During the previous four weeks the death-rate had cough, 124 from diarrhoea, 116 from measles, 54 from averaged 19’2 per 1000, the rates during the same period diphtheria, 45 from scarlet fever, 45 from fever" (prin- being 14-6 in London and 17-4 in Edinburgh. The 123 cipally enteric), and 18 from small-pox. In Hornsey, deaths of persons belonging to Dublin registered during the Reading, Leicester, and four other smaller towns no death week under notice showed an excess of 16 from the number from any of these diseases was registered ; while they caused in the preceding week, and included 17 which were referred the highest death-rates in Norwich, Bootle, Wigan, War- to the principal infectious diseases, against 10, eight, and rington, Burnley, Barrow-in-Furness, and West Bromwich. nine in the three preceding weeks; of these, six resulted The greatest proportional mortality from measles occurred from measles, four from "fever"" and also from diarrhoea, in Bristol, Birkenhead, Bootle, Rhondda, Rochdale, two from whooping-cough, and one from diphtheria, but Plymouth, Warrington, and Barrow-in-Furness ; from not one from small-pox or scarlet fever. These 17 deaths were ____

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