850

302, 301, and 338 in the three preceding months. The pre-valence of diphtheria showed a considerable decline fromthat recorded in the three preceding months; among thevarious metropolitan boroughs the greatest proportionalprevalence of this disease occurred in Hammersmith,Fulham, St. Pd.ncras, Bethnal Green, Stepney, and

Poplar. The number of diphtheria patients under treat-ment in the Metropolitan Asylums hospitals, which had t

1}eeJl 684, 715, and 785 at the end of the three preceding tmonths, had declined to 665 at the end of last month; 1

the weekly admissions averaged 83, against 89, 111, and 1118 in the three preceding months. Enteric fever was

rather more prevalent during August than it had been inthe preceding month ; the greatest proportional prevalenceof this disease was recorded in Fulham, St. Pancras, Hackney, 1Poplar, Wandsworth, and Camberwell. There were 121enteric fever patients in the Metropolitan Asylums hospitals ]at the end of last month, against 80, 78, and 94 at the ]end of the three preceding months ; the weekly admissionsaveraged 24, against 14, 10, and 17 in the three precedingmonths. Erysipelas was proportionally most prevalent in 1

Stepney, Poplar, Southwark, Bermondsey, and Camberwell.The 28 cases of puerperal fever notified during the monthincluded four in Fulham, three each in Islington, Stepney,and Lambeth, and two each in Southwark, Bermondsey,13-ittersea, and Woolwich. ’

The mortality statistics in the table relate to the deathsof persons actually belonging to the various boroughs, thedeaths occurring in public institutions having been dis-tributed among the boroughs in which the deceased personshad previously resided. During the five weeks endingSept. 2nd the deaths of 7260 persons belonging to Londonwere registered, equal to an annual rate of 16’ 2 per 1000 ;in the three preceding months the rates had been 14’ 0,12 - 1, and 11 9 per 1000. The death-rates last month rangedfrom 9’6 in Lewisham, 10’2 in Hampstead, 12 - 1 in theCity of London, and 12’ 2 in Paddington and in St. Maryle-bone, to 20. 5 in Bethnal Green, 21 2 in Poplar, 23 - inShoreditch and in Bermondsey, and -23 3 in Finsbury. The7260 deaths from all causes in London last month included2112 which were referred to the principal infectious diseases ;of these, 115 resulted from measles, 56 from scarlet fever,47 from diphtheria, 112 from whooping-cough, 25 fromenteric fever, one from ill-defined pyrexia, and 1756 fromdiarrhoea. The lowest death-rates from these diseases wererecorded in the City of Westminster, St. Marylebone, Hamp-stead, the City of London, and Lewisham; and the highestrates in Fulham, Hackney, Finsbury, Shoreditch, Stepney,and Poplar. The 115 deaths from measles were 56 below theaverage number in the corresponding periods of the tenpreceding years ; this disease was proportionally most fatalin Kensington, the City of Westminster, Islington, Stepney,3outhwark, and Battersea. The 56 fatal cases of scarletfever showed a slight decline from the corrected averagenumber ; among the various metropolitan boroughs thegreatest proportional mortality from this disease was

recorded in Hammersmith, Finsbury, Shoreditch, BethnalGreen, Stepney, and Southwark. The 47 deaths from diph-theria were only one-third of the average number in thecorresponding periods of the ten preceding years ; thisdisease was proportionally most fatal in St. Marylebone,Hackney, Finsbury, Bethnal Green, Bermondsey, Lambeth,and Woolwich. The 112 fatal cases of whooping-cough were26 below the corrected average number ; among the variousmetropolitan boroughs the highest death-rates from thisilise-ase were registered in Holborn, Finsbury, Shoreditch,Stepney- and Poplar. The 26 deaths referred to "fever" "

were 31 fewer than the average number in the correspondingperiods of the ten preceding years ; of these 26 deaths,five- occurred in Hackney, and two each in Hammersmith,lslington, Poplar, Lambeth, Wandsworth, and Camberwell.The 1756 fatal cases of diarrhoea were 28 below thecorrected average number : this disease was proportionallymost fatal in Fulham, Hackney, Finsbury, Shoreditch,Stepney, and Poplar. In conclusion, it may be stated thatthe aggregate mortality in London last month from theprincipal infectious diseases was more than 7 per cent.below the average.

Infant mortality, measured by the proportion of deathsamong children under one year of age to registered births,was equal to 236 per 1000. The lowest rates of infantmortality were recorded in Chelsea, St. Marylebone, Hamp-stead. Hol’born, the City of London, and Lewisham ; and thehighest rates in Fulham, Stoke Newington, Hackney,

Poplar, Southwark, and Bj.tteMea.

THE SERVICES.

ROYAL ARMY MEDICAL CORPS

Captain W. A. Woodside has arrived at York for duty inthe Northern Command. Captain J. W. H. Houghton andCaptain N. J. C. Rutherford have taken up duty in theLondon District. Lieutenant-Colonel H. W. Hubbard hasbeen appointed Medical Officer, London recruiting area.

INDIAN MEDICAL SERVICE.

The following appointments of Principal Medical Officershave been made in India :-Peshawur Division : ColonelW. L. Chester. Rawul Pindi Division : Colonel B. M.Blennerhassett. Abbottabad and Sialkote Brigades : ColonelH. R. Whitehead. Lahore Division : Colonel H. J. W.Barrow. Sirhind and Jullundur Brigades : Colonel H.Hamilton. Mhow Division : Colonel W. S. Pratt. Jubbal-pore and Jhansi Brigades : Colonel J. F. Williamson. PoonaDivision : Colonel F. W. Trevor. Aden Brigade : ColonelJ. S. Wilkins ; Lieutenant-Colonel W. G. H. Henderson toofficiate, vice Colonel Wilkins on leave. Meerut Division :Colonel W. E. Saunders. Lucknow Division : ColonelG. D. N. Leake ; Lieutenant-Colonel D. Wardrop toofficiate, vice Colonel Leake on leave. Presidency andAssam Brigades : Colonel H. K. Mackay. SecunderabadDivision : Colonel A. F. Dobson. Bangalore and SouthernBrigades: Colonel P. H. Benson. Burmah Division: ColonelT. J. H. Wilkins.

Captain H. A. F. Knapton has been appointed DeputySanitary Commissioner, Scinde Registration District. CaptainR. E. Lloyd, 9t,h Bhopal Infantry, Allahabad, has beenappointed Surgeon Naturalist, Marine Survey, Bombay.

IMPERIAL YEOMANRY.

The King’s Colonials : Surgeon-Lieutenant C. J. Symondsto be Surgeon-Captain. Nottinghamshire (SherwoodRangers) : Surgeon-Lieutenant G. Thomson to be Surgeon-Captain.

VOLUNTEER CORPS.

Royal Garrison ArtilZi3,ry (Volunteers) Ist Shropshireand Staffordshire : Surgeon-Major and Honorary Surgeon-Lieutenant-Colonel J. P. Massingham to be Surgeon-Lieu-tenant-Colonel.

Rifle: 4th Volunteer Battalion the Royal Fusiliers (Cityof London Regiment) : Henry Cecil Nicholls, to be Surgeon-Lieutenant. Surgeon-Lieutenant H. C. Nicholls is borne asSupernumerary whilst doing duty with the Bearer Companyof the lst London Volunteer Infantry Brigade. lst VolunteerBattalion the Queen’s Own (Royal West Kent Regiment) :Surgeon-Captain C. Vise to be Surgeon-Major.

VOLUNTEER OFFICERS’ DECORATION.

The Volunteer Officers’ Decoration has been conferredon the undermentioned medical officers of the VolunteerForce :-Northern Comntctnd : Northern Command, RoyalArmy Medical Corps (Volunteers) Manchester Companies:Lieutenant- Colonel and Honorary Colonel William Coates,C.B. Eastern Command: Harwich Bearer Company, RoyalArmy Medical Corps (Volunteers): Major and HonoraryLieutenant-Colonel Stanley Stenton Hoyland. East SurreyBearer Company, Royal Army Medical Corps (Volunteers) :Major and Honorary Lieutenant-Colonel John James deZouche Marshall. Welsh and Midland Contniand: 2nd (E4riof Chester’s) Volunteer Battalion the Cheshire Regiment:Supernumerary Surgeon-Captain Henry William King(Brigade Surgeon-Lieutenant-Colonel. Senior Medical Officer,Cheshire Volunteer Infantry Brigade).

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Captain Frederick H. Gervis, 17th MiddlesexVolunteer Rifle Corps, to be Surgeon-Captain. Surgeon-Major Frederick W. Gibbon to be Surgeon-LieutenantColonel.

ROYAL ARMY MEDICAL COLLEGE

Major C. G. Spencer, R.A.M.C., has joined from theCurragh on appointment as Professor of Military Surgeryin succession to Major-General W. F. Stevenson, C.B,retired. Lieutenant-Colonel Robert J. S. Simpson, C.M.G.,R.A.M.C., to be Professor of Military Medicine, viceLieutenant-Colonel K. McLeod, I.M.S., retired pay, who hasvacated that appointment.

851

DEATHS IN THE SERVICES.

Surgeon-Major-General Philip Broke Smith, M.D. Edin.,Army Medical Service (retired), and formerly of the 87thRoyal Irish Fusiliers, on Sept. 4th, at Cheltenham, aged 71years. He entered the service in September, 1857, as anassistant surgeon, was promoted surgeon in December, 1871,surgeon-major in March, 1873, deputy-surgeon-general in

May. 1882, and surgeon-major-general in October, 1892,retiring in July, 1894.

THE TRAINING OF ORDERLIES IN THE ROYAL ARMYMEDICAL CORPS.

A conjoint report of the Advisory and Nursing Boardsrecommends that the non-commissioned officers and men ofthe Royal Army Corps should be divided into the followingfour sections :-

1. Nursing Section :-(a) All non-commissioned officers above the rank of sergeant.(II) Non-commis-ioned officers and orderlies of the first, second,

and third class.(e) Compounders and operation-room attendants.(d) Skiagraphists and electrical attendants and masseurs.(e) Lunatic attendants.

2. Cooking Section :-(n) Cooks—non commissioned officers not above the rank of

sergeant.(1a) Cooks-privates.

3. Clerks’ Section:-(a) Clerks -non-commissioned officers not above the rank of

sergeant.(b) Clerks-privates.

4. General Duty Section :—

(a) Non-commissioned officers not above the rank of sergeantand men as follows : (b) for sanitation ; (c) for patho- ’logical and laboratory attendants; (d) pack store andsteward’s store; (e) carpenters; (f) gardeners; (g) ser-vants to officers ; (h) postmen ; (i) mortuary attendants;and (j) handymen generally.

It is further recommended that when eligible men enlist into, or are transferred to, the Royal Army Medical Corpsthtir advancement should depend mainly upon efficiency inthe nursing section. For selected non-commissioned officersand men for nursing, 6d. per day over and above corps payis suggested, together with a distinction in their dress. Itis advised that instead of a recruit who has passed througha course of instruction at Aldershot, in the training schooland in the Cambridge Hospital, being transferred to otherhospitals as is the case now, the recruit for the nursingsection should be transferred to specially selected hospitals,and that he should not be regarded as a proficient nurseuntil he has undergone further courses in such hospitals.Those recommended are the Royal Victoria, Herbert,Cambridge, and Connaught Hospitals ; the military hospitalsat Devonport, Colchester, Shorncliffe, Chatham, and York ;the Royal Infirmary, Dublin; the military hospitals at theCnrragb, London, Malta, Gibraltar, and Egypt. When theman joins any such hospital his training, it is recommended,should be placed in the hands of the matron, and that thistraining should not be interfered with by other duties.Efforts are to be made to encourage and enable men to passfrom one class of orderly to another. Men of the nursingsection must not be called on to do menial hospital work,presumably sweeping and scrubbing floors, for which thegeneral duty section men are available.The organisation and training of the non-commissioned

officers and men of the Royal Army Medical Corps shouldincrease their efficiency and usefulness in connexionwith their hospital and other duties if the changes andreforms recommended are adopted. They seem to be

quite in the right direction and will, we hope, stand thetest of practice.

THE LATE WAR IN THE FAR EAST.An armistice is in preparation and will be soon settled,

which will, it is trusted, put an end to the skirmishingaffrays which have been reported as having occurred inManchuria since peace was concluded. According to recentintelligence received from Tokio through Reuter’s specialservice we learn that the Official Gazette publishes a state-ment, based upon medical evidence, as to the use of ° dum-dum " bullets by the Russians in the fighting at Vladimirofand in other engagements in Sakhalin. It also recordsalleged abuses of the Red Cross on the part of the Russians.We may remark, however, that as a rule we attach but littleimportance to charges of this kind, which, although made nodoubt in good faith, we are glad to say usually turn out to beerroneous or incapable of being substantiated on furtherinquiry.

The Russki Invalid has a report of General Baron Bilder-ling on the losses in the 17th Russian Army Corps during theyear following its arrival in Manchuria.. The total numbers

compelled to leave the ranks were 445 officers and 18,128men, or more than half of the total effective. Of the officersnearly all the commanders of regiments and the greater partof those of lower rank have been either killed, wounded,or placed upon the sick list. Many officers and menreturned to the ranks after having been wounded, andwere wounded a second or a third time, or oftener. Theheaviest losses were suffered by the infantry, which lost 412officers, or 60 per cent., and 17,587 men, or more than 55per cent. The engineers lost 37 men, or 4 per cent. The

artillery lost 30 officers, or 25 per cent., and 299 men, or 7per cent. The second independent brigade of cavalry lost 13officers, or 16 per cent., and 248 men, or 14 per cent. Allthese losses, however, had been made good by reinforcementsfrom Russia.

Lord Methuen has notified, in the Eastern Command, thatcourses of instruction will be held annually, commencing onthe lst of January, April, July, and October, at the RoyalHerbert Hospital, Woolwich, and the Military Hospitals

’

at Shorncliffe, Chatham, and Colchester, for medicalofficers of Imperial Yeomanry and Volunteers who desireto qualify for promotion by being attached for 14 days toa military hospital, as laid down in the Yeomanry andVolunteer Regulations.

Fleet Surgeon J. Lloyd Thomas, R.X., of the Excellent,has been selected to represent the medical department of theRoyal Navy at the Military Medical Congress to be held atDetroit at the end of this month. The medical departmentof the Army will be represented by Colonel W. J. R.Rainsford, C.I.E., R.A.M.C., Principal Medical Officer,Bermuda.

Captain L. N. Lloyd, R.A.M.C., has been selected tosucceed Major T. W. Gibbard as adjutant of the LondonVolunteer Companies of the Royal Army Medical Corps.

Correspondence."And! alteram partem."

"

THE LANGUAGE OF THE PYGMIES.10 the Editors of THE LANCET.

SIRS,-I do not think (as your readers might be led tosuppose by a phrase in Dr. Albert Churchward’s letter of

Sept. 2nd)1 that I ever made a dogmatic assertion that thepygmies of the Congo Forest had no special language oftheir own. I have only noted or stated from time to timethat the various researches made into the question bySchweinfurth, de Compiegne, Stanley, Wolff, Von Wissmann,the Italian anthropologists who made a careful investigationof Akka pygmies brought to Italy in the eighties" " of thelast century, and myself (who have examined locally pygmiesof the Ituri Province and Mboga) have not revealed anyspecial pygmy language, any form of speech peculiar to thepygmies in the same way that the Bushman language ispeculiar to the Bushmen. But I should be one of the firstto admit that our researches into this most interestingquestion have only as yet touched the fringe of the subject.Some missionary of science ought, if possible, to live forabout a year amongst the pygmies in some part of the CongoForest before we can be quite certain that they possess nopeculiar language of their own.

All the authorities I have enumerated above have shown,consciously or unconsciously, up to the present time tt’at thepygmies whom they examined spoke a language whi. h wasshared by adjoining negroes of ordinary stature and oftenmarkedly superior physical development. Schweinfurth’sAkkas (at any rate those who were examined in Italy) -pokeMangbettu, the language of the Mangbettu people, who intheir physical type are tall negroes suggesting more than adash of ancient Caucasian intermixture. The Obongo ofDu Chaillu and the Marquis de Compiegne, in the few wordsrecorded of their speech, used a degraded Bantu dialect;and this is also the case with all the records of pygmy speechobtained from the more southern parts of the great Congo

1 THE LANCET, Sept. 9th, 1905, p. 784.