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THE IMPORTANCE OF VITAL STATISTICS.
THE IMPORTANCE OF VITAL STATISTICS.
South Africa is much the
same
whichever
colony he proposes
to practise in.
Cape Colony.-No person may practise in Cape Colony as medical practitioner without a licence signed by the Colonial Secretary of the province and the recommendation of the Colonial Medical Council is required. The fee for the licence is R5and women are eligible for the licence. a
633
but for those who desire to pursue further the study of general statistical science the work of Mr. A. L. Bowley may confidently be reoommended.1 We would, however, utter a note of warning against indiscriminate reliance
called statistical statementa"in the discussion of medical problems. It has been often contended against the use of numerical methods in questions of this kind that should be made to the. Colonial Medical Council "anything may be proved by statistics." To this the obvious retort is that 11 without statistics you can prove nothing." It at Cape Town. Natal.—Here also. application for a licence to practise is not in the legitimate use, but in the abuse, of statistics medicine in the colony must be made to the Colonial that the real fault lies-in endeavouring to strain from Secretary of the province. The application will be granted mere collections of figures conclusions which they are not upon the approval of the Natal Medical Council and the fee fitted to support. Mr. Bowley speaks of statistics, as "the science of counting." " Counting," he says,, "appears at for registration in Natal is one guinea,. Southern Rhodesia..-The admission fee for the practice of first sight to be a very simple operation. Butt as a matter of medicine in Rhodesia is .S5and application for the licence fact, when we come to large numbers-e.g., the population should be made to the Administrator of Rhodesia at Salis- of the United Kingdom-counting is by no means easy ...... bury, Rhodesia. It would be well also to write to the Secretary and in no way can absolute accuracy be attained when the of the British South Africa Company, London Wall, E.C. numbers surpass certain limits. Great numbers are not Transvaal and the Orange River Colony.-The Transvaal counted correctly to a unit, they are estimated, and we Medical Council (Pretoria) and the Medical and Pharmacy might, perhaps, point to this as a division between arithmetic Council of the Orange River Colony, Bloemfontein, grant and statistics, that whereas arithmetic attains exaotness a licence to practise on payment of Z10 and oC7 10s. statistics deal with estimates, sometimes very accurate but respectively. Proof of registration by the General Medical never mathematically exact....... Statistics is rightlydtfined Council of Great Britain must be supplied. as the science of averages. Out of a great number of men the type is found-the average, about which all measurements THE COLONIAL MEDICAL SERVICE are grouped according to some definite law. The problem is, In the following countries there are medical departments to determine whether the type or the grouping about regulated from the Colonial Office:—British Guiana, Jamaica, then, it changes and in what way....... Great numbers and the and Windward Leeward Islands, British Trinidad, Tobago, from them have great inertia. The total Honduras, Fiji, Ceylon, Straits Settlements, Federated averages resulting the total income, the birth and death-rates, ohange population, Malay Straits, Hong-KoDg, Mauri’ius, Seychelles, Gibraltar, a single family St. Helena, Falkland Islands, Gambia, Sierra Leone, Uganda, very littie. Similar quantities relating to It is this constancy of great numbers that fast. very change the Gold Coast, Lagos, and Northern and Southern Nigeria. makes statistical measurements possible." Mr. Bowley then The last six of the countries enumerated have been formed into the West African Medical Staff, a definite and well- goes on to contrast statistics with arithmetic in the applica" In a monograph a single tion of both to organised service. The particulars of the Colonial Medical family is studieddemography. the occupation, the earnings of its : were in full in THE LANCET, April 29th, Service published the way these earnings are spent ...... areet down, 1905, p. 1151, and all information concerning any vacancies members, but this study is not, so far, statistical. In demography in the service can be obtained from the Colonial Office. we study the same quantities when groups of families are concerned; the number of families engaged in celtain industries and their average receipts, expenditure, and savings THE IMPORTANCE OF VITAL STATISTICS. -here we have statistics. In the monographic method the individual is everything ; in the statistical method, nothing." WE have on a previous occasion pointed out that it would With respect, more especially, to statistics of mortality, it be greatly to the advantage of the medical profession and should be realised, in limine, that the individual facts with the public if our practitioners enjoyed a more intimate which we have to deal are by no means of uniform value. acquaintance with such of the methods of statistics as are Take, for example, the returns of death from malignant appropriate for medical purposes. We do not for a moment disease. It is obvious that greater accuracy must attach to propose to oppress further the already overburdened medical the diagnosis of, say, 100 cases of cancer in a hospital where aspirant by requiring him to master the intricaces of the the clinical diagnoses are tested by microscopical aid during integral or differential calculus. The construction of life life, or by post-mortem examination, than would attach to tables could scarcely have been perfected without the help the diagnosis of the same number of cases occurring in of higher mathematics, but the necessary calculations have country houses where necropsies are extremely rare. Again, already been elaborately worked out by the late Dr. Farr, as regards the ages at death, it is notorious that the registers the acknowledged founder of the science of vital statistics, are very untrustworthy. In many cases the ages of old people and Dr. T. E. Hayward of St. Helens has recently pub- are unknown, and in all cases the statement of age in the lished detailed instructions, with mathematical formulas, registers is derived from the relatives of the deceased, who, for the compilation of shortened life tables. With the for purposes of life insurance, are sometimes. interested in aid of these a medical officer of health of average concealing the truth. And it is to be feared that the ability may readily construct a life table for his own published statistics of mortality are not infrequently vitiated district. A fair working acquaintance with ordinaryarith- by the act of the local authorities who, although prompt to metic and algebra, and especially with logarithmic calcula- exclude from their returns the deaths of strangers occurring tions, will furnish the medical student with most of the within their domains, show no corresponding anxiety to mathematical equipment that he is likely to need ; but include the deaths of their own refidents should they occur within these limits he should certainly be versed in the outside the district boundalies. We need not go further ordinary " techniqueof vital statistics and should be into the various advantages attending a study of right familiar with the application of statistical methods to the statistical methods, or detail other openings for statistical solution of the everyday questions of preventive medicine. fallacies; we will conclude by conveying to our readers the Of text-books on vital statistics there is fortunately, no assurance that the acquisition of the power to understand dearth. The well-known manuals of Newsholme, Whitelegge, arguments drawn from figures can only be fully attained by and Hamer, especially the first mentioned, will supply the a certain amount of special work in the desired direction. student with the necessary instruction. But perhaps the 1 Elements of Statistics, most useful information within a moderate compass for the by A. L. Bowley. P. S. King and Son. student of medicine will be found in the article on Medical Statistics included in the first volume of the new edition of Professor Allbutt’s "System of Medicine." This article LITERARY INTELLIGENCE.-A new volume for is contributed by a well-known authority on the subject, students will be published on Sept. 5th by Messrs. J. and A. and as volume I. contains in addition useful essays by Churchill entitled ’’A Short Practice of Medicine," the recognised experts in climatology and on the geography of author being Dr. R A. Fleming, lecturer on the principles disease it will be appreciated by the medical student and practice of medicine at the Edinburgh Medical School. as well as by the practitioner, both of whom need such The volume is a large one, as the work is intended to be information in a trustworthy and an assimilable form. comprehensive, and some of the illustrations will be in The extent of statistical proficiency required for medical colour. A large sale is evidently expected, as the moderate purposes is specified in each of the books just referred to, price of 10s. 6d. will be asked.
Applications
on so
634 Messrs. Squire and Son, Lond,; mittee, Lond., Hon. Secretary of. Messrs. Spiers and Pond, Lond,; OUR CURRENT NUMBER Messrs. Smith, Elder, and Co,, Y. J. Pentland, Edinburgh; Being almost exclusively devoted to information especially P.-Mr. Lond.; Messrs. Sharland and Mr. L. Mr. C. F. Posse, Lond. ; interesting to Students we are necessarily compelled to Price, Malvern; Messrs. Parke, Co., Auckland, New Zealand. defer the publication of communications on other imDavis, and Co., Lond. ; Dr. F. J. W.-Dr. F. J. Woollacott, Lond,; Messrs. J. Wright and Co., portant subjects. Poynton, Lond. Bristol; Mr. H. B. Wilkinson, We tender our best thanks to those gentlemen who have at con- R.-Dr. R. G. Robson, Jodhpur, Blackadon ; Messrs. Warner, siderable personal trouble kindly supplied us with the India; Mr. Horace W. Randall, Sheppard, and Wade, Leicester; Dr. A. G. returns and prospectuses upon wkich the information given Southend-on-Sea; Dr. Clifford White, Lond.; Mr, Silva Rodrigues, Sno-Paulo, in this Students’ Number of THE LANCET relative to the C. E. G. Walker, Dewsbury; Brazil; Dr. J. C. S. Rashleigh, Mr. W. H. Griffin Wilkes, various medical examining bodies, hospitals, and medical Okehampton; Messrs. ReitWalsall; Mr. A. Willmott, Lond. ; schools of the United Kingdom is based. We regret that meyer and Co., Lond.; Mr. J. W. Mr. V. Wood, Lond.; Wand in some cases, however, owing to proofs having been either Root, Bournemouth; Reading Manufacturing Co., Leicester; not returned at all or too late, certain inaccuracies may be Mercury, Manager of ; Miss West Bromwich District HosE. M. Routledge, Newport; found. pital, Secretary of; W. P. G.; ’ Messrs. E. J. Reid and Co., Messrs. W. Wood and Co., New Lond. -
’
TO ADVERTISERS.
advertisement columns this week announcements have unavoidably been held over.
Oming to the some
pressure
on our
Communications, Letters, &c.,
have been
received fromA.-Dr. B. Anningson, Cambridge;
Wigan; HullAdvertising Agency,
Messrs. Arnold and Sons, Lond. Manager of. B.—Dr. F. T. Bond, Gloucester; J.-Mr. W. Judd, Lond. ; Messrs. Messrs. David Bryce and Son, W. and A. K. Johnston, EdinGlasgow; Mr. J. W. Benson, burgh. Lond. K.-Dr. Arthur Keith, Bredgar; C.-Mr. E. R. Haines Cory, Mr. R. C. B. Kerin, Bourne End. Bournemouth; Dr. L. P. Colat, L.-Mr. H. K. Lewis, Lond.; Tsivory, Madagascar; Messrs. Messrs. J. Lang and Son, Lond.; J. and A. Churchill, Lond.; Dr. Isabel Logie, NewportonMessrs. Cosenza and Co., Lond.; Tay ; Dr. W. Lane, Weymouth; Messrs. Cassell and Co., Lond.; Messrs. Lee and Martin, BirMessrs. T. Cook and Co., Lond.; mingham ; Messrs. Lee and Messrs. E. Cook and Co., Lond.; Nightingale, Liverpool; Messrs. Messrs. S. Clark and Co., Lond.; Larcom and Veysey, Lond.; F. Chorlton-cumMr. W. Clarke, L. M. D. Hardy. D.-Mr. S. M. Dodington, Henst- M.—Professor E. A. Minchin, Lond. ; Mr. N. Mayne, Longford; ridge ; Messrs. Dawson and Sons, Medical Society of Victoria, Lond. Melbourne, Hon. Treasurer of ; E.-East Suffolk Hospital, Ipswich; Medical Fortnightly, St. Louis, Eccles and Patricroft Hospital, U.S.A., Managing Editor of; of. Secretary Mr. R. McCowen, Tralee; Male F.-Mr. G. Fingerhut, Lond.; Nurses’ Temperance Co-operaMessrs. Ferris and Co., Bristol; tion, Lond.; Mr. E. Merck, Mr. J. FitzGerald, Queenstown; Lond.; Manhu Food Co., LiverMessrs. Folkard and Hayward, Messrs. Maconochie Bros., pool, Messrs. Lond.; Foster, Brown, Lond.; Mr. T. Bingham Marshall and Co., Montreal; Mrs. Fryer, Lechlade ; Mr. S. B. Lond. Pontypool; Nlidland Counties G.-Mr. R. Groves, Lond.; Glasgow Herald, Birmingham; Dr. F. S. Eye Infirmary, Secretary of. Mackenzie, York; Messrs. Max H.—Mr. W. G. Humphrey, Lond.; L. Schultze and Co., Peterhead. Colonel F. Howard, R.A.M.C., Lond.; Mr. S. Harvey, Lond.; N.-Mr. F. W. North, Grantham; Mr. Reginald Nitch - Smith, Messrs. Haasenstein and Vogler, Lond.; Noise Abatement ComCologne; Dr. P. W. Hampton,
Mason,
B.—Mr. Henry Smith, Egremont;
York; Messrs. H. Wilson Son, Lond.
Letters, each with enclosure, acknowledged from-
are
and
also
A.-Mr. F. N. Allen, Crookes; Cyprus ; J. H. G.; J. W. P,; J. A. C. A. P. A. E.; A. G.; Aberdeen City District Lunacy Board, K.-Mr. R. V. Khedkar, Edin. Secretary of; Ashton-underburgh.
Lyne District Infirmary, Secre- L.—Staff-Surgeon G. Ley, R.N., Channel Fleet; L. C. tary of; Messrs. Armour and Co., Lond. M.-Mr. G. B. Messenger, Lond.; B.-Mr. C. A. G. Browne, Lond.; Mr. E. Birchall, Birmingham; Dr. J. Biernacki, Plaistow ; Dr. J. H. Bell, Lochranza; Messrs. W. H. Bailey and Son, Lond. C.-Dr. C. S. Crichton, Newton; Messrs.
Curling, Wyman,
Dr. J. B. McOutcheon, Blaengarw ; Messrs. Manlove, Alliott, and Co., Nottingham; Dr. J. Moore, Enfield ; Mr. W. Morgan, liond.; Medicus, Chorlton-cum-
Hardy.
and
N.-Dr. A. Noble, Luthermuir; Northern Medical Association, Co., Lond.; C. S. B.; Messrs. Carruthers and Son, Inverness; Glasgow ; N. G. ; N. T. Messrs. Cleaver and Co., Lond.; P.-Mr. C. M. Perry, Leatherhead; C. G. P.; C. W.; Messrs. J. and Dr. W. P. Panckridge, PetersA. Carter, Lond.; Mr. C. Colat, field ; Miss Perkins, Lend.; Bordeaux.
D.-Mr. G. Dr. H.
Plymouth F.
Darker, Lond.;
Davies, Lond. F. G. Ernst, Lond.;
Borough Asylum,
Blackadon, Secretary of. R.-Mr. J. Randall, Liverpool;
Dr. A. Maitland Ramsay, E. N. T.; E. B. M. Glasgow; R. W. F.-Professor A. Fraser, Dublin ; S.—Mr. D. Sen, Malda, India; Mr. F. T. Fagge, Buxton ; ; Standard Emulsion Co., New F. E. F. York; Dr. D. Shannon, Glasgow; St. John Ambulance Association, G.-Dr. P. Goold, Macroom; GlasLond., Secretary of; Mr.J. gow Royal Infirmary, Secretary of. Sampson, York. H.-Mr. J. Heywood, Manchester ; T.-Mr. Hugh Taylor, Llandovery; Mr. R. R. Harper, Lond.; T. J. D.; T. M. C.; Dr. J. Taylor, Dr. T. B. Heggs, Sittingbourne ; Lond. Messrs. T. Holland and Son, V.-Velox, Cardiff. Lond. ; Mr. J. Hart, Lond.; W.-Mr. J. Williams, Bradford; Mr. W. H. Hunt, Lingfield; Captain R. H. Willis, R.M., H. G. E., Lond.; Messrs. Hill Messrs. Willows, Gosport; and Hoggan, Glasgow. Francis, Butler, and Thompson, I.-International Plasmon, Lond. Lond.; Dr. W. K. Walker, J.-Dr. M. Joannides, Nicosia, Glasgow.
E.-Mr.
South Africa is much the
same
whichever
colony he proposes
to practise in.
Cape Colony.-No person may practise in Cape Colony as medical practitioner without a licence signed by the Colonial Secretary of the province and the recommendation of the Colonial Medical Council is required. The fee for the licence is R5and women are eligible for the licence. a
633
but for those who desire to pursue further the study of general statistical science the work of Mr. A. L. Bowley may confidently be reoommended.1 We would, however, utter a note of warning against indiscriminate reliance
called statistical statementa"in the discussion of medical problems. It has been often contended against the use of numerical methods in questions of this kind that should be made to the. Colonial Medical Council "anything may be proved by statistics." To this the obvious retort is that 11 without statistics you can prove nothing." It at Cape Town. Natal.—Here also. application for a licence to practise is not in the legitimate use, but in the abuse, of statistics medicine in the colony must be made to the Colonial that the real fault lies-in endeavouring to strain from Secretary of the province. The application will be granted mere collections of figures conclusions which they are not upon the approval of the Natal Medical Council and the fee fitted to support. Mr. Bowley speaks of statistics, as "the science of counting." " Counting," he says,, "appears at for registration in Natal is one guinea,. Southern Rhodesia..-The admission fee for the practice of first sight to be a very simple operation. Butt as a matter of medicine in Rhodesia is .S5and application for the licence fact, when we come to large numbers-e.g., the population should be made to the Administrator of Rhodesia at Salis- of the United Kingdom-counting is by no means easy ...... bury, Rhodesia. It would be well also to write to the Secretary and in no way can absolute accuracy be attained when the of the British South Africa Company, London Wall, E.C. numbers surpass certain limits. Great numbers are not Transvaal and the Orange River Colony.-The Transvaal counted correctly to a unit, they are estimated, and we Medical Council (Pretoria) and the Medical and Pharmacy might, perhaps, point to this as a division between arithmetic Council of the Orange River Colony, Bloemfontein, grant and statistics, that whereas arithmetic attains exaotness a licence to practise on payment of Z10 and oC7 10s. statistics deal with estimates, sometimes very accurate but respectively. Proof of registration by the General Medical never mathematically exact....... Statistics is rightlydtfined Council of Great Britain must be supplied. as the science of averages. Out of a great number of men the type is found-the average, about which all measurements THE COLONIAL MEDICAL SERVICE are grouped according to some definite law. The problem is, In the following countries there are medical departments to determine whether the type or the grouping about regulated from the Colonial Office:—British Guiana, Jamaica, then, it changes and in what way....... Great numbers and the and Windward Leeward Islands, British Trinidad, Tobago, from them have great inertia. The total Honduras, Fiji, Ceylon, Straits Settlements, Federated averages resulting the total income, the birth and death-rates, ohange population, Malay Straits, Hong-KoDg, Mauri’ius, Seychelles, Gibraltar, a single family St. Helena, Falkland Islands, Gambia, Sierra Leone, Uganda, very littie. Similar quantities relating to It is this constancy of great numbers that fast. very change the Gold Coast, Lagos, and Northern and Southern Nigeria. makes statistical measurements possible." Mr. Bowley then The last six of the countries enumerated have been formed into the West African Medical Staff, a definite and well- goes on to contrast statistics with arithmetic in the applica" In a monograph a single tion of both to organised service. The particulars of the Colonial Medical family is studieddemography. the occupation, the earnings of its : were in full in THE LANCET, April 29th, Service published the way these earnings are spent ...... areet down, 1905, p. 1151, and all information concerning any vacancies members, but this study is not, so far, statistical. In demography in the service can be obtained from the Colonial Office. we study the same quantities when groups of families are concerned; the number of families engaged in celtain industries and their average receipts, expenditure, and savings THE IMPORTANCE OF VITAL STATISTICS. -here we have statistics. In the monographic method the individual is everything ; in the statistical method, nothing." WE have on a previous occasion pointed out that it would With respect, more especially, to statistics of mortality, it be greatly to the advantage of the medical profession and should be realised, in limine, that the individual facts with the public if our practitioners enjoyed a more intimate which we have to deal are by no means of uniform value. acquaintance with such of the methods of statistics as are Take, for example, the returns of death from malignant appropriate for medical purposes. We do not for a moment disease. It is obvious that greater accuracy must attach to propose to oppress further the already overburdened medical the diagnosis of, say, 100 cases of cancer in a hospital where aspirant by requiring him to master the intricaces of the the clinical diagnoses are tested by microscopical aid during integral or differential calculus. The construction of life life, or by post-mortem examination, than would attach to tables could scarcely have been perfected without the help the diagnosis of the same number of cases occurring in of higher mathematics, but the necessary calculations have country houses where necropsies are extremely rare. Again, already been elaborately worked out by the late Dr. Farr, as regards the ages at death, it is notorious that the registers the acknowledged founder of the science of vital statistics, are very untrustworthy. In many cases the ages of old people and Dr. T. E. Hayward of St. Helens has recently pub- are unknown, and in all cases the statement of age in the lished detailed instructions, with mathematical formulas, registers is derived from the relatives of the deceased, who, for the compilation of shortened life tables. With the for purposes of life insurance, are sometimes. interested in aid of these a medical officer of health of average concealing the truth. And it is to be feared that the ability may readily construct a life table for his own published statistics of mortality are not infrequently vitiated district. A fair working acquaintance with ordinaryarith- by the act of the local authorities who, although prompt to metic and algebra, and especially with logarithmic calcula- exclude from their returns the deaths of strangers occurring tions, will furnish the medical student with most of the within their domains, show no corresponding anxiety to mathematical equipment that he is likely to need ; but include the deaths of their own refidents should they occur within these limits he should certainly be versed in the outside the district boundalies. We need not go further ordinary " techniqueof vital statistics and should be into the various advantages attending a study of right familiar with the application of statistical methods to the statistical methods, or detail other openings for statistical solution of the everyday questions of preventive medicine. fallacies; we will conclude by conveying to our readers the Of text-books on vital statistics there is fortunately, no assurance that the acquisition of the power to understand dearth. The well-known manuals of Newsholme, Whitelegge, arguments drawn from figures can only be fully attained by and Hamer, especially the first mentioned, will supply the a certain amount of special work in the desired direction. student with the necessary instruction. But perhaps the 1 Elements of Statistics, most useful information within a moderate compass for the by A. L. Bowley. P. S. King and Son. student of medicine will be found in the article on Medical Statistics included in the first volume of the new edition of Professor Allbutt’s "System of Medicine." This article LITERARY INTELLIGENCE.-A new volume for is contributed by a well-known authority on the subject, students will be published on Sept. 5th by Messrs. J. and A. and as volume I. contains in addition useful essays by Churchill entitled ’’A Short Practice of Medicine," the recognised experts in climatology and on the geography of author being Dr. R A. Fleming, lecturer on the principles disease it will be appreciated by the medical student and practice of medicine at the Edinburgh Medical School. as well as by the practitioner, both of whom need such The volume is a large one, as the work is intended to be information in a trustworthy and an assimilable form. comprehensive, and some of the illustrations will be in The extent of statistical proficiency required for medical colour. A large sale is evidently expected, as the moderate purposes is specified in each of the books just referred to, price of 10s. 6d. will be asked.
Applications
on so
634 Messrs. Squire and Son, Lond,; mittee, Lond., Hon. Secretary of. Messrs. Spiers and Pond, Lond,; OUR CURRENT NUMBER Messrs. Smith, Elder, and Co,, Y. J. Pentland, Edinburgh; Being almost exclusively devoted to information especially P.-Mr. Lond.; Messrs. Sharland and Mr. L. Mr. C. F. Posse, Lond. ; interesting to Students we are necessarily compelled to Price, Malvern; Messrs. Parke, Co., Auckland, New Zealand. defer the publication of communications on other imDavis, and Co., Lond. ; Dr. F. J. W.-Dr. F. J. Woollacott, Lond,; Messrs. J. Wright and Co., portant subjects. Poynton, Lond. Bristol; Mr. H. B. Wilkinson, We tender our best thanks to those gentlemen who have at con- R.-Dr. R. G. Robson, Jodhpur, Blackadon ; Messrs. Warner, siderable personal trouble kindly supplied us with the India; Mr. Horace W. Randall, Sheppard, and Wade, Leicester; Dr. A. G. returns and prospectuses upon wkich the information given Southend-on-Sea; Dr. Clifford White, Lond.; Mr, Silva Rodrigues, Sno-Paulo, in this Students’ Number of THE LANCET relative to the C. E. G. Walker, Dewsbury; Brazil; Dr. J. C. S. Rashleigh, Mr. W. H. Griffin Wilkes, various medical examining bodies, hospitals, and medical Okehampton; Messrs. ReitWalsall; Mr. A. Willmott, Lond. ; schools of the United Kingdom is based. We regret that meyer and Co., Lond.; Mr. J. W. Mr. V. Wood, Lond.; Wand in some cases, however, owing to proofs having been either Root, Bournemouth; Reading Manufacturing Co., Leicester; not returned at all or too late, certain inaccuracies may be Mercury, Manager of ; Miss West Bromwich District HosE. M. Routledge, Newport; found. pital, Secretary of; W. P. G.; ’ Messrs. E. J. Reid and Co., Messrs. W. Wood and Co., New Lond. -
’
TO ADVERTISERS.
advertisement columns this week announcements have unavoidably been held over.
Oming to the some
pressure
on our
Communications, Letters, &c.,
have been
received fromA.-Dr. B. Anningson, Cambridge;
Wigan; HullAdvertising Agency,
Messrs. Arnold and Sons, Lond. Manager of. B.—Dr. F. T. Bond, Gloucester; J.-Mr. W. Judd, Lond. ; Messrs. Messrs. David Bryce and Son, W. and A. K. Johnston, EdinGlasgow; Mr. J. W. Benson, burgh. Lond. K.-Dr. Arthur Keith, Bredgar; C.-Mr. E. R. Haines Cory, Mr. R. C. B. Kerin, Bourne End. Bournemouth; Dr. L. P. Colat, L.-Mr. H. K. Lewis, Lond.; Tsivory, Madagascar; Messrs. Messrs. J. Lang and Son, Lond.; J. and A. Churchill, Lond.; Dr. Isabel Logie, NewportonMessrs. Cosenza and Co., Lond.; Tay ; Dr. W. Lane, Weymouth; Messrs. Cassell and Co., Lond.; Messrs. Lee and Martin, BirMessrs. T. Cook and Co., Lond.; mingham ; Messrs. Lee and Messrs. E. Cook and Co., Lond.; Nightingale, Liverpool; Messrs. Messrs. S. Clark and Co., Lond.; Larcom and Veysey, Lond.; F. Chorlton-cumMr. W. Clarke, L. M. D. Hardy. D.-Mr. S. M. Dodington, Henst- M.—Professor E. A. Minchin, Lond. ; Mr. N. Mayne, Longford; ridge ; Messrs. Dawson and Sons, Medical Society of Victoria, Lond. Melbourne, Hon. Treasurer of ; E.-East Suffolk Hospital, Ipswich; Medical Fortnightly, St. Louis, Eccles and Patricroft Hospital, U.S.A., Managing Editor of; of. Secretary Mr. R. McCowen, Tralee; Male F.-Mr. G. Fingerhut, Lond.; Nurses’ Temperance Co-operaMessrs. Ferris and Co., Bristol; tion, Lond.; Mr. E. Merck, Mr. J. FitzGerald, Queenstown; Lond.; Manhu Food Co., LiverMessrs. Folkard and Hayward, Messrs. Maconochie Bros., pool, Messrs. Lond.; Foster, Brown, Lond.; Mr. T. Bingham Marshall and Co., Montreal; Mrs. Fryer, Lechlade ; Mr. S. B. Lond. Pontypool; Nlidland Counties G.-Mr. R. Groves, Lond.; Glasgow Herald, Birmingham; Dr. F. S. Eye Infirmary, Secretary of. Mackenzie, York; Messrs. Max H.—Mr. W. G. Humphrey, Lond.; L. Schultze and Co., Peterhead. Colonel F. Howard, R.A.M.C., Lond.; Mr. S. Harvey, Lond.; N.-Mr. F. W. North, Grantham; Mr. Reginald Nitch - Smith, Messrs. Haasenstein and Vogler, Lond.; Noise Abatement ComCologne; Dr. P. W. Hampton,
Mason,
B.—Mr. Henry Smith, Egremont;
York; Messrs. H. Wilson Son, Lond.
Letters, each with enclosure, acknowledged from-
are
and
also
A.-Mr. F. N. Allen, Crookes; Cyprus ; J. H. G.; J. W. P,; J. A. C. A. P. A. E.; A. G.; Aberdeen City District Lunacy Board, K.-Mr. R. V. Khedkar, Edin. Secretary of; Ashton-underburgh.
Lyne District Infirmary, Secre- L.—Staff-Surgeon G. Ley, R.N., Channel Fleet; L. C. tary of; Messrs. Armour and Co., Lond. M.-Mr. G. B. Messenger, Lond.; B.-Mr. C. A. G. Browne, Lond.; Mr. E. Birchall, Birmingham; Dr. J. Biernacki, Plaistow ; Dr. J. H. Bell, Lochranza; Messrs. W. H. Bailey and Son, Lond. C.-Dr. C. S. Crichton, Newton; Messrs.
Curling, Wyman,
Dr. J. B. McOutcheon, Blaengarw ; Messrs. Manlove, Alliott, and Co., Nottingham; Dr. J. Moore, Enfield ; Mr. W. Morgan, liond.; Medicus, Chorlton-cum-
Hardy.
and
N.-Dr. A. Noble, Luthermuir; Northern Medical Association, Co., Lond.; C. S. B.; Messrs. Carruthers and Son, Inverness; Glasgow ; N. G. ; N. T. Messrs. Cleaver and Co., Lond.; P.-Mr. C. M. Perry, Leatherhead; C. G. P.; C. W.; Messrs. J. and Dr. W. P. Panckridge, PetersA. Carter, Lond.; Mr. C. Colat, field ; Miss Perkins, Lend.; Bordeaux.
D.-Mr. G. Dr. H.
Plymouth F.
Darker, Lond.;
Davies, Lond. F. G. Ernst, Lond.;
Borough Asylum,
Blackadon, Secretary of. R.-Mr. J. Randall, Liverpool;
Dr. A. Maitland Ramsay, E. N. T.; E. B. M. Glasgow; R. W. F.-Professor A. Fraser, Dublin ; S.—Mr. D. Sen, Malda, India; Mr. F. T. Fagge, Buxton ; ; Standard Emulsion Co., New F. E. F. York; Dr. D. Shannon, Glasgow; St. John Ambulance Association, G.-Dr. P. Goold, Macroom; GlasLond., Secretary of; Mr.J. gow Royal Infirmary, Secretary of. Sampson, York. H.-Mr. J. Heywood, Manchester ; T.-Mr. Hugh Taylor, Llandovery; Mr. R. R. Harper, Lond.; T. J. D.; T. M. C.; Dr. J. Taylor, Dr. T. B. Heggs, Sittingbourne ; Lond. Messrs. T. Holland and Son, V.-Velox, Cardiff. Lond. ; Mr. J. Hart, Lond.; W.-Mr. J. Williams, Bradford; Mr. W. H. Hunt, Lingfield; Captain R. H. Willis, R.M., H. G. E., Lond.; Messrs. Hill Messrs. Willows, Gosport; and Hoggan, Glasgow. Francis, Butler, and Thompson, I.-International Plasmon, Lond. Lond.; Dr. W. K. Walker, J.-Dr. M. Joannides, Nicosia, Glasgow.
E.-Mr.