945

VITAL STATISTICS.

HEALTH OF’ ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5681 birthsbad 3172 deaths were registered during the week endingNov. 6th. The annual death-rate in these towns, whichhad been 19’3 and 18’ó per 1000 in the preceding two weeks,further declined last week to 18’2. During the first fiveweeks of the current quarter the death-rate in these townsaveraged 18’8 per 1000, and was 1’9 below the mean rate inthe corresponding periods of the ten years 1876-85. Thelowest rates in these towns last week were 11’9 in Derby,14’2 in Birkenhead, 14’6 in Nottingham, and 16 in Birming-ham. The rates in the other towns ranged upwards to 24-5in Plymouth, 25’6 in Oldham, 25’7 in Preston, and 28 0 inWolverhampton. The deaths referred to the principalzymotic diseases in the twenty-eight towns, which haddeclined in the preceding eight weeks from 1202 to 401,further fell last week to 368, and were fewer than in anyweek since the end of June; they included 102 from diarrhoea,74 from scarlet fever, 66 from measles, 52 from "fever"(principally enteric), 42 from whooping-cough, 32 fromdiphtheria, and not one from small-pox. No death from anyof these principal zymotic diseases was recorded last week inCardiff; whereas they caused the highest death-rates inPreston, Halifax, and Wolverhampton. The greatest mor-tality from measles occurred in Halifax and Wolverhampton;from scarlet fever, in Salford, Bradford, Newcastle-upon-Tyne, and Huddersfield ; from "fever," in Plymouth ; fromwhooping-cougb, in Sunderland; and from diarrhoea, inHull, Sunderland, and Preston. The 32 deaths from diph-theria in the twenty-eight towns included 18 in London,4 in Portsmouth, 3 in Norwich, and 2 in Manchester. Small-pox caused no death in London and its outer ring, or in

any of the twenty-seven large provincial towns. Only 2cases of small-pox were under treatment on Saturday lastin the metropolitan hospitals receiving cases of this disease.The deaths referred to diseases of the respiratory organsin London, which had been 290 and 295 in the precedingtwo weeks, were last week 293, and were 103 below thecorrected average. The causes of 69, or 2’1 per cent., of thedeaths in the twenty-eight towns last week were notcertified either by a registered medical practitioner or bya coroner. All the causes of death were duly certified inNottingham, Portsmouth, Brighton, and in seven othersmaller towns. The largest proportions of uncertified deathswere registered in Sheffield, Halifax, and Blackburn.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 18’2 and 18’6 per 1000 in the preceding twoweeks, further rose to 22-1 in the week ending Nov. 6th;this rate was 4’0 above the mean rate during the sameweek in the twenty-eight large English towns. The ratesin the Scotch towns last week ranged from 11’1 and 18’1 inGreenock and Dundee, to 24’0 in Glasgow and 24’7 in Edin-burgh. The 545 deaths in the eight towns last week showeda further increase of 85 upon the number in the previousweek, and included 21 which were referred to diarrhoea, 16to scarlet fever, 15 to whooping-cough, 10 to diphtheria, 7 to"fever " (typhus, enteric, or simple), 4 to measles, and not oneto small-pox; in all, 73 deaths resulted from these principalzymotic diseases, against 72 and 83 in the preceding twoweeks. These 73 deaths were equal to an annual rate of3’4 per 1000, which was 1’3 above the mean rate from thesame diseases in the twenty-eight English towns. Thedeaths attributed to diarrhoea, which had been 46, 25, and 22in the previous three weeks, further declined last week to 21,of which 7 occurred in Glasgow and 5 in Dundee. The fatalcases of whooping-cough, which had been 17 and 28 in theprevious two weeks, declined last week to 15, and included11 in Glasgow. The 16 deaths from scarlet fever showed adecline of 8 from the number in the previous week; 12occurred in Glasgow and 4 in Edinburgh. The 10 deathsfrom diphtheria, on the other hand, showed a considerableincrease upon recent weekly numbers, and included 4 inGlasgow, 3 in Edinburgh, and 2 in Paisley. The 7 deathsreferred to "fever," of which 4 occurred in Glasgow and2 in Edinburgh, also exceeded recent weekly numbers ; and2 of the 4 deaths from measles occarred in Glasgow. Thedeaths referred to acute diseases of the respiratory organs inthe eight towns, which had been 79 and 76 in the previous

two weeks, further rose last week to 118, but were 2 belowthe number in the corresponding week of last year. Thecauses of 75, or nearly 4 per cent., of the deaths in the eighttowns last week were not certified.

HEALTH OF DUBLIN.

The rate of mortality in Dublin, which had been 20’5-and 21-9 per 1000 in the preceding two weeks, further roseto 26-2 in the week ending Nov. 6th. During the firstfive weeks of the current quarter the death-rate in thecity averaged 228; the mean rate during the same periodwas 17’0 in London and 18 in Edinburgh. The 177 deathsin Dublin last week showed a further increase of 29 uponthe numbers returned in the preceding two weeks, andincluded 12 which were referred to diarrhoea, 8 to scarletfever, 6 to "fever" (typhus, enteric, or simple), 4 to,

diphtheria, 1 to whooping-cough, and not one either to"small-pox or measles. Thus 32 deaths resulted from theprincipal zymotic diseases, against 23 in each of the-previous two weeks; they were equal to an annual rat&of 47 per 1000, the rates from the same diseases lastweek being but 1’8 in London and 2’7 in Edinburgh. The13 deaths attributed to diarrhoea exceeded the numbersin recent weeks, as did the 6 deaths referred to " fever."’The fatal cases of scarlet fever, which had been 7 and’10 in the previous two weeks, declined again last weekto 8, while the 4 deaths from diphtheria exceeded thenumber in any week since the beginning of May. Fourinquest cases and 3 deaths from violence were registered .and 54, or nearly one-third, of the deaths occurred in publicinstitutions. The deaths both of infants and of elderlypersons showed an increase upon recent weekly numbers..The causes of 36, or nearly 20 per cent., of the deathsregistered during the week were not certified.

Correspondence.DIRECT REPRESENTATION OF THE PROFESSION

ON THE GENERAL MEDICAL COUNCIL.

" Audi alteram partem."

To the Editor of THE LANCET.SiR,—Having received circulars from Sir B. W. Foster,

Messrs. Wheelhouse, Richardson, Glover, Dolan, Brown, andCarpenter, who are candidates for election by the profession,on the General Medical Council, we deemed it advisable" on behalf of the Association of General Practitioners," to

obtain categorical answers to the following questions, which.are of vital importance to the general practitioner, and we-now ask your readers to give them careful study and con-sideration before recording their votes.

Question 1.-Are you in favour of penal legislation directed’against unqualified practitioners ?

Question 2.—Are you in favour of the protection of theprofession, by the Council, against unqualified practice ?

Question 3.-Are you in favour of the abolition of the-Apothecaries’ Society ?

Question 4.—Are you in favour of the scheme for grantinga Doctorate in Medicine which is before the board of the-conjoint Colleges?

Trusting you will favour us by inserting this correspond-ence. We remain, Sir, yours, sincerely,

H. W. VERDON, M.D., F.R.C.S.W. GIBSON BOTT, L.R.C.P., M.R.C.S.

61, Kennington Park-road, S.E., Nov. 9th. 1886.

14, Temple-row, Birmingham, Nov. 4th, 1886.My DEAR SIRS,—I am very glad to answer the questions-

you send me on behalf of the Association of General Prac-titioners :-

1. I am in favour of penal legislation directed againstunqualified practitioners, both in the interest of the profes-sion and in the interests of the public at large.

2. I am in favour of the Council using all the powers.they have, and also in favour of extending their powersagainst unqualified practice.

3. No, certainly not.! 4. Yes. I have for years advocated some scheme for-. granting the Doctorate in Medicine to all practitioners able-I to pass the necessary examinations. I have myself felt the

H. W. VERDON, M.D., F.R.C.S.W. GIBSON BOTT, L.R.C.P., M.R.C.S.