1061 1

tions and additions, but we must defer these remarks untilanother occasion. Meanwhile we urge all who are in-

terested in the best mode of administering out-patientrelief to think over what we have written, and to

use their influence where possible to induce the hos-

pital managers to take prompt action in the direction ofthe remedies here discussed and suggested.

MESSRS. BOWER AND KEATES’ CASE.

As we intimated last week, the treatment of Messrs. Bowerand Keates-in the first instance by the parents of the childwhose life they tried to save by the skilful performance oftracheotomy, and in the second instance by the Public Pro-secutor-was the subject of discussion at a meeting ofmedical men at the house of Sir William Jenner on Mondaynight. The meeting, from considerations of cubic space,was necessarily limited in size. But it was a thoroughlyrepresentative gathering, including men identified with mostof the hospitals, physicians, surgeons, and general practi-tioners from the various districts of the metropolis and itsneighbourhood. Sir William Jenner read various letters fromgentlemen unable to be present, both in town and from theprovinces; amongst these were Sir Andrew Clark, Sir SpencerWells, and Sir Joseph Lister. Those present included SirWilliam Jenner, who of course presided, Sir William Gull,Sir James Paget, Mr. Bryant, Dr. Mahomed, Dr. LauderBrunton, Dr. Bright, Dr. Wilson Fox, Dr. FrederickRoberts, Dr. Russell Reynolds, Dr. Quain, Mr. Jackson,Dr, Stoker Mr. Jonathan Hutchinson, Mr. Propert, Mr.Brockwell, Dr. Glover, and others. The following resolu-tions were, moved and unanimously agreed to; the first bySir James Paget, seconded by Dr. Moxon ; the second byDr, James Paget, seconded by Dr. Russell Reynolds :—

"1. That a Committee be formed for the purpose ofcollecting subscriptions to defray the legal expenses incurredby Messrs. Bower and Keates in their defence againstthe charge recently brought against them, and of preparinga statement by which subscribers may express theirsympathy with these gentlemen and their conviction thatthe treatment of the case for which they were prosecutedwas right. The Committee to consist of the followinggentlemen :-Sir William Jenner, Sir James Paget, Dr.Wileon Fox, Dr. Moxon, Mr. Bryant, Mr. Hutchinson, Mr.Jackson, Dr. Glover, Mr. Sidney Turner, Dr. Bright, Dr.Quain, Dr. Mahomed, and Dr. Burnet."Dr. Quain was appointed treasurer of the fund which it is

proposed to raise, and Drs. Mahomed and Burnet honorarysecretaries."2. That the Council of the Royal College of Physicians

and the Council of the Royal College of Surgeons berequested to consider the propriety of representing to theSecretary of State for the Home Department that it is verydesirable that there should be some arrangement by whichthe public prosecutor may obtain the assistance of skilledadvisers when he is solicited to institute prosecutions ofmedical practitioners."

"

On the motion of Dr. Glover, a vote of thanks to the Chair-man was carried by acclamation. Dr. Glover said that SirWilliam Jenner’s kindness and guidance in this matter wouldgive new comfort and assurance to medical men in doingtheir duty fearlessly.

, The feeling of the profession on this subject may begathered from the fact that already something like X200has been subscribed. The first list of subscriptions is

appended. Without anticipating the careful statementof the case which may be expected shortly from thecommittee, we may at once say for the profession at largethat no case can be more entitled to sympathy, and,let us add, sympathy in a very practical form, than thatof Messrs. Bower and Keates. It is trying enough tohave to discharge difficult professional duties even whenthey are generously appreciated ; but after doing so tobe charged in law courts with malpraxis, to be subjectedto misrepresentation, and to be mulcted to the extent ofnearly a thousand pounds, is worse still. But worse remainsbehind. The interposition of the Pablic Prosecutor adds

enormously to the injury sustained by the practitioners inthis case, by, first, giving importance to allegations which noperson free from prejudice could consider seriously ; and,secondly, by throwing the whole costs of the defence onthe defendants, though the prosecution was characterised bythe presiding magistrate as " persecution." The cruel injurydone to the defendants in this case is not lessened by theanswer of the Home Office to the defendants contained inTHE LANCET of December 1st, to the effect that "theaction of the Public Prosecutor was limited to securingcomplete investigation of the circumstances." This com-plete investigation carried on privately by the Trea-sury, though scarcely warranted by the facts, mighthave been harmless. But carried on in court, and atthe defendants’ cost, is indeed a use of the office of PublicProsecutor which, however kind in theory, is simply ruinousin practice. We cannot believe that such a misuse of theoffice will recur. The Royal Colleges will but dischargetheir duty in respondmg to the appeal of the profession asrepresented at the meeting of Monday night, by makingsuch representations to the Government as will secure thatthe Public Prosecutor will not lay himself open to thecharge of being a public persecutor.The following subscriptions were promised at the meeting’:

Sir William Jenner, M.D....... jE25 0 0Messrs. Wakley, Proprietors of THE

The following gentlemen, who either attended the meetingor were unavoidably prevented from doing so, also promisedsubscriptions, but the sums were not stated :-Sir WilliamGull, Sir Andrew Clark, Sir Spencer Wells, Sir JosephLister, Mr. J. Allen (Alexandra-road, N.W.), Mr. EdgarBarker (Hyde Park-street), Mr. J. Blackstone (Albert-terrace, N.W.), Dr. Blades (Kennington Park-road), Dr.Blasson (Edgware), Dr. Lauder Brunton, Mr. W. F. Butt(Park-street, W.), Mr. Brudenell Carter, Mr. Arthur Durham,Dr. Easton (Norfolk-cresceut), Dr. Gibbings (Dalston), Dr.Robert Harris (Hackney), Mr. Christopher Heath, Mr. E.Reynolds Ray (Dulwich), Dr. Russell Reynolds, Dr. H.Cooper Rose (Hampstead), Dr. Sergeant (Camberwell). Mr.Septimus Sibley (Harley-street, W.), Dr. Scocker (Peckham-ry e).

Subscriptions will be received by Dr. Quain, treasurer ofthe fund.

WILLS OF MEDICAL MEN.

THE will and codicil of Thomas Jervis, M.D., of 32,Connaught-square, who died on October 3rd last, were

proved on the 16th ult. by Mr. Stroud Lincoln Cocks, Mr.Frederick Benham, and Mr. John Jervis, the son, the

executors, the value of the perqonal estate amounting toupwards of ;1:62,000. The testator, subject to legacies tohis executors, Mr. Cocks and Mr. Benham, leaves all his realand personal estate upon trust for his children in equal shares.The will of Francis Henry Wilson Isles, M.D., M.R.C.S.,

of Watford, Herts, who died on Sept. 19th last, was proved

1062

on the 8th ult. by Mrs. Georgiana Isabella Isles, the widowand sole executrix, to whom he gives and devises all his realand personal estate absolutely. The value of the personalestate amounts to over ;f;7600.The will and codicil of William Highmore, M.D., of

Sherborne, Dorset, who died on August 28th last, has beenproved by Mr. Robert Newman Barnes Mathews, and Mr.Nathaniel Joseph Highmore, the son, the executors, thevalue of the personal estate amounting to over ;f;7300. Thetestator leaves to his wife Mrs. Fanny Matilda Highmore;f;100 and his furniture and effects ; and makes some specificbequests to his sons Nathaniel Joseph and George Edward iWilliam. The residue of his real and personal estate is tobe held upon trust for his wife for life, and then for hischildren, regard being had to the amounts to which thechildren of his first marriage were already entitled.The will of William Yarde, M.D., formerly Staff Surgeon

R.N., late of Fernlea, Beechen Cliff, South Bath, who diedon September 19th last, was proved on the 10th ult. byMr. Giles Yarde, Mr. John Yarde, and the Rev. EdwardYarde, the brothers, the executors, the value of the personalestate exceeding .E4400. The testator makes some specificbequests to his brothers and to a nephew, and leaves anannuity to his housekeeper and some pecuniary legacies.One-fourth of the residue of his property is to be held upontrust for his sister Mrs. Ann Yarde and her children, andthe other three-fourths are to be divided between his threebrothers.The will and codicil of Abiather Brown Wall, M.D.,

formerly of Bishop’s.road, Bays water, but late of LazareLodge, Isle of Man, who died on June 29th last, was provedon the 2nd ult. by Mr. Reginald Bligh Wall, the son, Mr.John Fuller, and Mr. Charles Jeremiah Mayhew, theexecutors, the value of the personal estate exceeding ;f;4000.The testator leaves Lazare Lodge and the land attachedthereto to his son Reginald, ;f;100 each to his wife and tohis executors; and some specitic bequests. The residue ofhis real and personal estate is to be held upon trust for hiswife for life, and at her death he distributes it between hisdaughter Mrs. Mary Fuller and his sons Abiather andSeptimus.

-

The following legacies have recently been left to hospitalsand other medical charities :—Mr. James Coulthart, formerlyof 228 and 230, Old-street, cabinet-maker, but late of 299,Liverpool-road, E500 each to the Royal Hospital forDiseases of the Chest, City-road, and the Royal Hospitalfor Incurables.-Mrs. Elizabeth Borradaile, of St. Leonards-on-Sea, £ 100 each to the British Home for Incurablesand the Royal Medical Benevolent College at Epsom,and nineteen guineas to the New Hospital at Hawkhurst,Kent.-Mr. George Digby Wingfield Digby, late of SherborneCastle, Dorset, £ 2000 to the Yeatman Memorial Hospital atSherborne.-Mr. Samuel Lancaster, late of St. Peter’sChambers, Cornhill, and of Walthamstow, £500 each to theSeamen’s Hospital, Wanstead, the City of London Hospitalfor Diseases of the Chest, Victoria-park, the Royal Hospitalfor Consumption, Ventnor, the Royal Hospital for Incurables,Putney, the Royal Hospital for Diseases of the Chest, City-road, the London Hospital, the Throat Hospital, Golden-square, the Truss Society, Finsbury, and the General ThroatSociety, Gray’s-inn; and £250 each to the WalthamstowDispensary and the Walthamstow and Leyton Hospital forChildren.-Miss Elizabeth Ann Cook, late of Neen Solars,Salop, £200 each to the London National Hospital for theParalysed and Epileptic, the London Hospital for Consump.tion and Diseases of the Chest, and the Birmingham EyeInfirmary.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

In twenty-eight of the largest English towns, 5365 birthsand 3568 deaths were registered during the week ending the8th inet. The annual death-rate in these towns, whichhad been equal to 22.7 and 23’0 per 1000 in the two preced-ing weeks, declined last week to 21-6, a lower rate than inany recent week. During the first ten weeks of the currentquarter the death-rate in these towns averaged 21’1 per1000, against 21’2 and 21’9 in the corresponding periodsof 1881 and 1882. The lowest rates in these towns lastweek were 14’0 in Oldham, 16.6 in Bradford, and 16’7 in

Portsmouth. The rates in the other towns ranged upwardsto 26’1 in Manchester. 26’2 in Halifax, 26’5 in Birkenhead,and 32 8 in Preston. The 449 deaths referred to the prin.cipal zymotic diseases in the twenty-eight towns showed adecline of 18 from the number in the previous week; theyincluded 131 from scarlet fever, 98 from measles, 73 fromwhooping-cough, 59 from "fever" (principally enteric), 39from diarrhoea, 35 from diphtheria, and 14 from small.pox. These zymotic diseases caused last week the lowestdeath-rates in Portsmouth and Norwich, and the highest inSunderland and Leeds. Scarlet fever was most fatal in Leeds.Newcastle-upon-Tyne, and Preston; measles in Birkenhead,Salford, and Derby ; whooping-cough in Brighton and Hud.dersfield ; and "fever" in Wolverhampton and Plymouth.Of the 35 deaths from diphtheria in the twenty-eight towns,23 occurred in London and 3 in Nottingham. Small-poxcaused 5 deaths in Sunderland, 4 in Birmingham, 3 inLiverpool, and 2 in London. The number of small-poxpatients in the metropolitan asylum hospitals, which had beenbut 47 and 49 on the two preceding Saturdays, rose to 74 atthe end of last week, a higher number than has been undertreatment in these hospitals since May last ; 29 new caseswere admitted last week, against but 8 and 11 in the twoprevious weeks. The Highgate Small-pox Hospital contained7 patients on S&turday last, 3 new cases having beenadmitted during the week. The deaths referred to diseasesof the respiratory organs in London, which had been 493 and453 in the two preceding weeks, further declined last week to448, and were 56 below the corrected weekly average. Thecauses of 84, or 2 ’3 per cent., of the deaths in the twenty-eight towns last week were not certified either by a registeredmedical practitioner or by a coroner. All the causes ofdeath were duly certified in Portsmouth, Leicester, and inthree other smaller towns. The proportions of uncertifieddeaths were largest in Wolverhampton, Oldham, andSheffield.

-

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been equal to 25’1 and 227 per 1000 in the twoprevious weeks, further declined to 21’7 in the week endingthe 8th inst.; this rate was 0 ’I above the mean rate duringthe same week in the twenty-eight large English towns.The rates in the Scotch towns ranged from 13’6 and 17’0 inLeith and Perth, to 23’4 and 248 in Glasgow and Aber-deen. The deaths in the eight towns included but 70 whichwere referred to the principal zymotic diseases, against 97and 79 in the two preceding weeks ; 16 resulted from diph-theria, 16 from whooping-cough, 10 from scarlet fever, 10from diarrhoea, 9 from "fever" (principally enteric), 8from measles, and 1 from small-pox. These 70 deathswere equal to an annual rate of 3 0 per 1000, whichexceeded by 0’3 the mean rate from the same diseasesin the large English towns. l’he rates from these dis-eases in the Scotch towns ranged last week from nilin Leith and Perth to 3’9 in Glasgow and 4’8 in Aberdeen.The fatal cases of scarlet fever, which had been 30 and 16in the two previous weeks, further declined to 10 last week,of which 6 occurred in Glasgow and 3 in Edinburgh. The16 deaths from whooping-cough showed, however, an

, increase upon recent weekly numbers, and included 12 inGlasgow and 3 in Aberdeen. The 16 deaths referred to

diphtheria corresponded with the number in the previousweek; 5 were returned in Aberdeen, 4 in Glasgow, and 3 in

, Paisley. The 9 fatal cases of ’fever" showed afurtherdeclinefrom recent weekly numbers. Of the 8 deaths from measles 4occurred in Glasgow and 4 in Edinburgh. The fatal caseof small-pox was registered in Glasgow, and was stated to beunvaccinated. The 115 deaths referred to acute diseasesof the lungs in the eight towns showed a further declinefrom recent weekly numbers, and were no fewer than 70below the number in the corresponding week of lastyear. The causes of 71, or 14 per cent., of the deathsin the eight towns were not certified.

___

HEALTH OF DUBLIN.

The rate of mortality in Dublin, which had been equal to133 0 and 25’7 per 1000 in the two previous weeks, rose againt to 33’3 in the week ending 8th the inst. The mean death-rater in the city during the first ten weeks of the current quarter was equal to 26’9 per 1000 in Dublin, whereas it did nott exceed 20 0 in London and 19-2 in Edinburgh. The 223ideaths in Dublin showed an increase of 51 upon the number