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(as in Government work) on his own conduct and pro-clivities, that, as we take it, there is not much to besaid on the score of snubbing or of petty indignities.Indeed, we can confidently affirm, having had experi-ences afloat in most quarters of the world, that if thedoctor manages well, he can, in the long run, be more com-fortable, and hold his own authority in his own sphere more icompletely, than any other man in the ship. It is, of course,superlatively unpleasant to be boxed up for several monthswith a surly, ignorant, or drunken captain, or with officerspossessing the same questionable qualities ; but this, as amatter of fact, is quite exceptional. All who elect to serveafloat must expect discomforts of some sort, but we inclineto the opinion that a minimum only of them is accorded tothe ship’s doctor.
HEAT AND MORTALITY IN NEW YORK.
THE remarkable mortality which occurred in New York from sunstroke in the first week of July last, when 212deaths took place from the 11 direct effect of solar heat," as
officially returned, will no doubt lend interest to the fol-lowing extracts from the meteorological returns of NewYork and of our own Royal Observatory for the week in ques-tion, as well as for the preceding and succeeding weeks.
The registered mortality was at the rate of 17 per 1000in London and 42 in New York for the week ended 29thJune; in the next week it was 19 in London and 87 in NewYork; and in the last week of the three it was 20 inLondon and 58 in New York. The excess of mean tempe-rature in New York over London was 15.7° in the firstweek, 19 4° in the second, and 136° in the third. Notwith- ,
standing, it would appear from the official returns that thesun was hotter at some time almost every day in Londonthan in New York; but there must surely be a differencein the character or position of the thermometers to accountfor this contradictory appearance. One death from sun-stroke occurred in New York on the 29th June, and thedeaths therefrom on the succeeding seven days were 7, 34,68, 43, 44, 12, and 4, respectively ; the fatality fromdiarrhoeal diseases just doubled itself in that week, whichwill be a memorable one in the city annals.
SANITARY INSPECTION IN THE PORT OFLONDON.
The following document has been issued by the LocalGovernment Board :-"To the Mayor, Aldermen, and Commons of the City ofLondon, the Sanitary Authority of the Port of London,and to all others whom it may concern :
" We, the Local Government Board, acting under theauthority of The Public Health Act, 1872,’ and the several
other statutes in this behalf, do hereby, until the 25th dayof March next, assign to the Mayor, Aldermen, and Com-mons of the City of London, as the sanitary authority of thePort of London, all the powers, duties, capacities, liabilities,and obligations created by or arising out of the NuisanceRemoval Acts; that is to say-‘ The Nuisance RemovalAct for England, 1855,’ the Act passed in the session of the23rd and 24th years of her Majesty, intituled An Act toamend the Acts for the Removal of Nuisances and the Pre-vention of Diseases,’ ‘The Nuisances Removal Act forEngland Amendment Act, 1863,’ The Nuisances RemovalAct, No.1, 1866,’ and so much of The Sanitary Act, 1866;as relates to the amendment of the Nuisances Removal
Acts, together with all the powers, authorities, and dutiescontained in the provisions of the last-mentioned Act inregard to ships and waters, and persons engaged therein,and in regard to providing hospitals or temporary placesfor the reception of the sick, so far as those several pro-visions apply to or affect the local authorities therein men-tioned."And we do further by this order assign to the said
sanitary authority the duty of appointing a legally qualifiedmedical practitioner to be the medical officer of health, andalso a competent person to be an inspector of nuisances forthe said port, to act respectively as such officers duringthe term aforesaid.
" Given under our seal of office, this 7th day of Septem-ber, 1872.
"JAMES STANSFELD, President."JOHN LAMBERT, Secretary.’" JAMES STANSFELD, President." JOHN LAMBERT, Secretary."
REGISTERS OF HEALTH.To the Editor of THE LANCET.
SIR,-Every medical man must have felt the difficulty ofobtaining the history of patients, the accounts rendered bythemselves being imperfect and unreliable, while, for wantof communication between the various medical attendants,the treatment is apt to be uncertain and disconnected. Anaccurate record, with a view to establish some defined andconcerted plan of treatment, would be more advantageous tothe patient and more satisfactory to the practitioner.As most cases during a lifetime come under the notice of
several doctors, it is very desirable (as reference is rarelypossible) that any experience gained by a former treatmentshould be available in a subsequent and probably similaror recurring affection; such notes, carefully made, wouldbecome a valuable medical record. I propose that a
register should be kept by every patient, to commence, ifpossible, from birth, and contain a concise entry by themedical attendant of each disease or attack as it comesunder treatment, with any short note necessary for refer-ence on a future occasion, when the document should beproduced. When the patient is the subject of a specificmalady, a medical entry would be very suggestive for futuretreatment. Its perusal would afford more information thanany inquiry could give, while questions of an unpleasantcharacter could often be avoided and much time saved."The Rpgister of Health" should be inspected in the
case of children entering or returning to public or otherschools, in applications for life assurance, or other medicalexaminations, and be, in fact, analogous to the papers of aseaman, but, being only for professional notice, would be ofa privileged character.
Such a plan could not be carried out without the co-opera-tion of medical men. This, however, would give it a valueand enhance its accuracy. I enclose forms (one filled inwith my own medical history as exemplifying the plan),which I beg to suggest for the purpose, and which I intendto use in my own practice, and should be glad of youropinion as to the feasibility of carrying out these arrange-ments generally.
I am, Sir, yours very truly,I am, Sir, yours very truly,FREDERICK H. SMITH, M.D.
! Lewisham-hill, S.E., August 31st, 1872.FREDERICK H. SMITH, M.D.
THE foot-and-mouth disease is still very prevalent inHerefordshire, Worcestershire, Kent, Oxfordshire, andNorthamptonshire.