744

highest rates were 28’5 in Plymouth, 30-7 in Cardiff, 32-2 inPreston, and 32’6 in Manchester. The deaths referred tothe principal zymotic diseases, which had been 599 and680 in the preceding two weeks, further rose last week to694; they included 386 from diarrhoea, 66 from scarletfever, 63 from whooping-cough, 62 from measles, 58 from"fever" (principally enteric), 58 from diphtheria, and 1from small-pox, The lowest death-rates from thesediseases were recorded in Bristol, Nottingham, Leicester,and Derby, and the highest in Bradford, Preston, Wolver-hampton, and Norwich. The greatest mortality frommeasles occurred in Birkenhead, Manchester, and Cardiff; from scarlet fever in Manchester, Wolverhampton, andLiverpool; from whooping-cough in Oldham, Hudder:field,Halifax, and Norwich; from "fever" in Birkenhead, Plymouth, and Preston; and from diarrhoea in -Blackburn,Bradford, Preston, Norwich, and Wolverhampton. The58 deaths from diphtheria included 38 in London, 3 inLiverpool, 3 in Birmingham, and 3 in Salford. One deathfrom small-pox was registered in London, but not one inany of the twenty-seven provincial towns. No small-poxpatients were under treatment at the end of the weekeither in the Metropolitan Asylum Hospitals or in theHighgate Small-pox Hospital. The number of scarlet feverpatients in the Metropolitan Asylum Hospitals and inthe London Fever Hospital at the end of last week was1681, against numbers increasing from 1427 to 1596 on thepreceding five Saturdays; the patients admitted duringthe week were 206, against numbers increasing from 118to 211 in the previous seven weeks. The deaths referredto diseases of the respiratory organs in London, whichhad been 210 and 187 in the preceding two weeks, roseagain last week to 222, and almost corresponded with thecorrected average. The causes of 68, or 1’8 per cent., ofthe deaths in the twenty-eight towns were not certifiedeither by a registered medical practitioner or by a coroner.All the causes of death were duly certified in Portsmouth,Bristol, Hull, Sunderland, and in eight other smallertowns. The largest proportions of uncertified deaths wererecorded in Liverpool, Oldham, and Halifax.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 17’8 and 19 6 per 1000 in the precedingtwo weeks, declined again to 18’7 in the week endingSept. 27th, and was 1’3 below the rate that prevailed duringthe same period in the twenty-eight large English towns.The rates in the eight Scotch towns ranged from 9’2 inGreenock and 12’5 in Perth to 22 2 in Glasgow and 22-9in Paisley. The 483 deaths in the eight towns showeda decline of 23 from the number in the previous week,and included 34 which were referred to diarrhoea, 12 to

whooping-cough, 11 to " fever," 6 to scarlet fever, 5 tomeasles, 4 to diphtheria, and not one to small-pox. In all,72 deaths resulted from these principal zymotic diseases,against numbers increasing from 65 to 89 in the precedingfour weeks. These 72 deaths were equal to an annualrate of 2’8 per 1000, which was 0 9 below the meanrate last week from the same diseases in the twenty-eightEnglish towns. The fatal cases of diarrhoea, which hadrisen from 18 to 41 in the preceding three weeks, declinedlast week to 34, of which 14 occurred in Glasgow and9 in Edinburgh. The deaths from whooping-cough, whichhad been 25 in each of the previous two weeks, declinedto 12 last week, and included 8 in Glasgow and 3 in Edin-burgh. The 11 fatal cases of "fever" exceeded thoserecorded in any preceding week of this year, and included8 in Glasgow. The 6 deaths from scarlet fever and the5 deaths from measles showed a slight decline from thosereturned in the previous week. Of the 4 fatal cases ofdiphtheria, 3 occurred in Glasgow. The deaths referred todiseases of the respiratory organs in the eight towns,which had been 84 and 74 in the preceding two weeks,rose again last week to 95, and exceeded the number inthe corresponding week of last year by 6. The causes of57, or 1-2 per cent., of the deaths in the eight towns lastweek were not certified.

-

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 17’3 and 19.4per 1000 in the preceding two weeks, further rose to 20’8during the week ending Sept. 27th. During the thirteenweeks of the quarter ending on Saturday last the death-rate in the city averaged 20’2 per 1000, the rate for the

same period being 18’1 in London and 16’6 in Edinburgh.The 141 deaths in Dublin showed an increase of 10 upon thenumber in the previous week; they included 13 which resultedfrom diarrhoea, 4 from "fever, 1 from measles, 1 fromwhooping-cough, and not one either from scarlet fever"diphtheria, or small-pox. Thus the deaths referred to theprincipal zymotic diseases, which had been 15 and 13 inthe preceding two weeks, rose again last week to 19; theywere equal to an annual rate of 2-8 per 1000, the rate fromthe same diseases being 2 5 in London and 2 9 in Edin.burgh. The deaths from diarrhoea, which had been 11 and4 in the preceding two weeks, rose again last week to 1&The fatal cases of " fever," which had been 2 and 4 in theprevious two weeks, were again 4 last week. The mortalityfrom measles and from whooping-cough showed a declinefrom that recorded in the preceding week. The deaths ofinfants under one year of age in Dublin last week showeda marked increase upon recent weekly numbers, while thoseof elderly persons showed a decline. Six inquest cases and3 deaths from violence were registered during the week;,and 45, or nearly a third, of the deaths occurred in publicinstitutions. The causes of 21, or nearly 15 per cent., ofthe deaths were not certified.

THE SERVICES.

INSPECTION OF SOLDIERS’ RATIONS.A SECOND class of officers has been ordered to assemble

at Aldershot to receive instruction in reference to thequality of soldiers’ rations, forage of horses, &c. Threeofficers are detailed from the Cavalry Brigade, three joinfrom the Royal Artillery, whilst the three Infantry Brigadesprovide fourteen officers. All ranks from Major to Second!Lieutenant are represented.ARMY MEDICAL STAFF.-Surgeon-Major Daniel Charles

Grose Bourns, F.F.P.S. Glasgow, has been placed on tempo-rary half-pay on account of ill-health (dated Sept. 15th,1890); Surgeon-Major Paul Connolly retires on retired pay(dated Oct. 1st, 1890).ARMY MEDICAL RESERVE OF OFFICERS. - Surgeon

Robert de la Poer Beresford to be Surgeon-Major, rankingas Major (dated Oct. lst, 1890). ADMIRALTY. - The following appointments have been

made :-Staff Surgeon Alexander M. French to the Beagle(dated Sept. 30th, 1890). Surgeons: George A. S. Bell tothe Neptune (dated Sept. 30th, 1890); E. C. A. Ramsay to beSurgeon and Agent at Fleetwood (dated Sept. 26th, 1890).VOLUNTEER CORPS. -Rifle: 1st Volunteer Battalion,

the Duke of Cornwall’s Light Infantry: Josiah TelferThomas, Gent., to be Acting Surgeon (dated Sept. 27th,1890).-20th Middlesex (Artist’s): Richd. Reginald Sleman,-Gent., to be Acting Surgeon (dated Sept. 27th, 1890).

Correspondence."THE LEUCOCYTE AS THE SURGEON’S

FRIEND."

" Audi alteram partem."

To the Editors of THE LANCET.

SIRS,-I have read with the greatest interest the letterson the above subject which have appeared in the last twonumbers of THE LANCET. It is plain that it is impossibleto discuss fully in a letter this vast and important question,and if I crave for a little of your valuable space, it is merelyto enter my protest against the conclusions contained at’the end of Dr. Kanthack’s letter-namely, that "it hasyet to be proved that (1) phagocytes in Ruffer’s andMetschnikoff’s sense really exist; and (2), if so, that theyare really leucocytes." I have no wish to defend here theaccuracy of Metschnikoff s experiments. Everyone who-ba3 carefully examined, as I have, some of his marvellouspreparations or repeated his experiments must be convincedof the truth of every one ot Metschnikofl’s statements.Dr. Kanthack, who gives a list of papers written to dis-prove the Russian observer’s assertions, forgets to mentionthat during the last two years Metschnikoff has fullyanswered the objections raised against his theory. I musbtherefore refer the reader to the "Annales de 1’Institute