569MEDICAL CERTIFICATES FOR THE LONDON BOARD SCHOOLS.

had been playing at gymnastics." " We are of opinion that

if such was the case Dr. Gourley was fully justified in sayingthat a medical man could not certify without making a post-mortem examination, and, further, it was a fit and propercase for complete investigation. We are at a loss to

understand the equity of the coroner’s observations to Dr.Gourley: "You want to open the body and get yourtwo guineas fee"; and when the latter indignantly repelledthe assertion it was met by such a rejoinder as "whetheryou want it or not you won’t get it." The coroner had

it in his power to order or refuse a necropsy, but surely itwas not necessary to embellish his decision with remarks

imputing dishonourable motives to a medical man.

MEDICAL CERTIFICATES FOR THE LONDONBOARD SCHOOLS.

WE would remind our readers that a second meeting ofmedical practitioners will be held at 20, Hanover-square at4 P.M. on Thursday, March 5th, to receive the report of thecommittee which met upon Feb. 13th and to discuss the

propriety of medical men giving any more certificates so longas the Board persists in its unseemly attitude of revising thesecertificates at the bidding of a lay official. All medical men,

especially those connected with hospitals or dispensaries, areearnestly invited to attend.

ANTI-TYPHOID SERUM.

IN view of the interest aroused in the profession bythe recent reports on Dr. Chantemesse’s experiments at

the Pasteur Institute with anti-typhoid serum, and in

answer to several correspondents, we may inform our

readers that Messrs. Burroughs, Wellcome, and Co. are

prepared to supply anti-typhoid serum in phials of 10 c. c.each. In making this announcement we do not endorse thestatement of the results of the use of the remedy which haveappeared in certain lay papers ; on the other hand, thesource of the therapeutic discovery is so good that, im-probable as some of the results may seem, it cannot butreceive the respectful attention of the profession.

RECENT ENGLISH MORTALITY.

THE Registrar-General’s recently issued quarterly returnfor the last three months of 1895 and his fifty-seventh annualreport dealing exhaustively with the vital statistics of 1894enable us to consider the changes in the rates of mortalityin England and Wales in recent years. During the fiveyears 1861-65 the mean annual death-rate in England andWales was 22’6 per 1000, whereas in successive quinquennialperiods the mean rate steadily fell to 19’4 in 1881-85 and18-9 in 1886-90. The mean rate in the ten years 1881-90did not exceed 19’1, against 21-4 in 1871-80 and 22-5in 1861-70. Thus, measured by the recorded death-rate,the improvement in the public health, which practicallydates from the Public Health Acts of 1872 and 1875, wasconsiderably greater in 1881-90 than in the previous decade1871-80. The rates of mortality in 1890 and 1891 showed adecided increase owing to influenza mortality, which also,to some extent, raised the rates in 1892 and 1893. In 1894the English death-rate fell to the unprecedentedly low figureof 16-6 per 1000. Prior to 1894 the rate had never fallenbelow 18, and only three times below 19 per 1000-namely,18-9 in 1881, 18-1 in 1888, and 18-2 in 1889. The death-ratein 1895 rose again to 18-7 per 1000, showing an excess of2-1 upon the unprecedentedly low rate in 1894, but was, withonly three exceptions, lower than the rate recorded in Englandand Wales in any year since civil registration commenced in1837. It is, also, eminently satisfactory to note that the meandeath-rate in the first half of the current decade-that is, inthe five years 1891-95-did not exceed 18’7 per 1000, against

19-4 and 18’9 in the two preceding quinquennia. Thus,notwithstanding the fatal effects of influenza, the Englishdeath-rate in the five years ending with December last waslower than in any preceding five-year period for whichrecords exist. One of the most unsatisfactory features ofrecent English mortality is the absence of the due propor-tional decline in infant mortality, measured by the deathsunder one year to registered births. During the ten years1881-90 infant mortality measured in this manner averaged142 per 1000; but in the five years 1891-95 the rate increasedto 151 per 1000, although the death-rate at all ages continuedto decline and was lower than in any previous quinquennium.This increase of infant mortality concurrently with a decliningdeath-rate at all ages calls for careful investigation. Thenew English life table, based upon the mortality experienceof the ten years 1881-90, which will probably find place in theDecennial Supplement which should shortly be published,will throw some light upon the relative increased expectationof life at birth and at subsequent ages, and will be full of £interest.

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CASE OF CEREBRAL TUMOUR.

IN the Journal of the American Medical Association Dr.Dufour of Washington relates a case of a woman aged fifty-sixwho suffered from paralysis of the muscles supplied by thethird, fourth, and sixth nerves of the left side, and exoph-thalmos and optic atrophy in the same eye. Some months

before she had been operated on for empyema of the left

antrum, and when seen there was free drainage through thenostril. She was treated with iodide of potassium andmercury, but apparently with only small doses of theformer drug. There was no benefit derived from the

treatment, and the upper division of the fifth nerve

became involved and the pain in the head intense. A

re-opening of the antrum gave a little relief for a few

days only. Her condition gradually deteriorated, the rightoptic nerve began to atrophy, word deafness became

manifest, and her mind wandered. She died about a yearafter she was first seen. At the necropsy there was found tobe a gumma of the dura mater in the anterior part of themiddle fossa involving the left temporo-sphenoidal lobe.This growth surrounded the internal carotid artery and theleft optic nerve and exerted pressure on the cavernous sinusof that side. A second gumma was found in the left olfac.

tory region, and a third lay in the angle at the right of theoptic commissure. The last-mentioned lesion probablyaccounted for the late affection of the right optic nerve.

THE LEICESTER BACTERIOLOGICAL INSTITUTE

GREAT changes have come over the relations betweenmedicine and microscopy during the last twenty years. Not

long ago the entire outfit of a microscopist was quiteportable, and for medical work the manipulations requiringmost practical dexterity were staining, injecting, hardening,and section-cutting ; but the discovery of cultivable patho-genic micro-organisms forthwith converted the microscope-room into a laboratory provided with sterilisers and in-

cubators and plentifully furnished with tables and shelvesfor glass flasks and test tubes. Previously to this the termlaboratory was used chiefly to signify a building in requestamong chemists, and incubators were a specialty of the

embryologist, being required for hatching fowls’ eggs. In

towns where medical schools existed the requisites for

conducting bacteriological research were in course of timeintroduced, but other places had no such facilities untilMessrs. John Richardson and Co. of Leicester fitted up theLeicester Bacteriological Institute in the Stanley-road andplaced it under the control of the Leicester Medical Society.Practitioners in the Midlands have thus at hand the means of

carrying on original research work in the investigation of