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AT the last meeting of the Liverpool Workhouse com-mittee a further increase in the number of fever cases was

reported. The number was 1104, against 954 in the previousweek.

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A BAZAAR in aid of the Norfolk and Norwich Hospitalhas been held with great success at that institution, the

receipts amounting to £463.

THE high death-rate of young children in the town of

Burslem has caused much anxiety to the local board, andit is understood that the matter will undergo investigation.

SMALL-pox is said to have broken out in the parishes ofAtherington and Ilfracombe, within the Barnstable Union.

WAR NOTES.

THE amount of intelligence furnished by the dailyjournals becomes at the end of a week so enormous thatit is impossible to condense it, or even to seize upon itsmore prominent features of interest to medical readerswithin the space at our disposal. Let us, however, take afew points, and only a few, of those which strike us as mostnoteworthy.

First, with regard to the number of medical men at theseat of war. We do not know what the case may be with theFrench army, for it has been so thoroughly disorganisedthat only a remnant of it now exists on the scene of war-fare ; but the Germans have no less than 2700 medical menwith the troops in the field, and the Militär- Wochenblatt con-tradicts the reports as to the existence of any deficiency as faras they are concerned. The provision of medical officers inthe Prussian service is at the rate of 1 to every 500, which

ought to prove sufficient for ordinary purposes, and thisstaff has been vastly increased. The medical officersof the Prussian service are highly educated men. Their

arrangements appear to have been excellent in all re-

spects, and their system of medical and sanitary admi-nistration, nursing and transport, has proved capable ofrapid extension under the exigencies of service. In addi-

tion to the medical officers with the armies of the twobelli-

gerents, there is a host of medical men of all nations-volunteers and others-in connexion with the different medi-cal aid societies. Two hundred foreign surgeons have

placed their services at the disposal of the German army;and the Russian surgeon, M. Pirogoff, of Sebastopol cele-brity, has joined the staff of the International Aid Societyat Basle. After a great battle, it would be quite impossibleto meet the requirements of the wounded in the brief space oftime at the disposal of attendants on the sick, howevernumerous; but when once this difficulty has been overcome,a,nd the disabled have been gathered up and disposed of indifferent hospitals, more time is given for the play of medi-cal arrangements and administration. A great many men,who have gone to the seat of war with the idea that theirservices would be in immediate and constant requisition,have found themselves grievously disappointed; and ourcorrespondents assure us that some young aad able sur-geons have failed to find that scope for their labours whichthey had anticipated. The international societies have ren-dered vast services, and medical volunteers in connexionwith those services have succeeded better than others infinding work. One of the obstacles in the way of English-men exists in the fact that a knowledge of both French andGerman is requisite in attending on the wounded composedof soldiers of both nations. A man requires to have at leasta good colloquial knowledge of French to make his waywith the men of that army, drawn from every departmentof the nation, and many of them speaking a provincial dia-lect or patois. Some of the German soldiers, we are told,object to be treated by doctors with whom they cannot con-

verse ; they miss the sympathy which naturally exists be-tween them and their own officers or countrymen.What appears to be wanted at the present time is a

liberal supply of money, medical comforts, clothing, anddrugs, such as chloroform, opium, chloral, and the like.Miss Garrett has, in our opinion, made two practical sug-gestions-viz., as to the desirability of establishing well-organised wayside kitchens on the various great highroadsalong which the soldiers pass; and the organisation of astaff of nurses and women to take charge of certain streetsand districts, wherever the wounded are located in privatedwellings and other places, with the view of visiting themand supervising their dietary and treatment, so that theirwants in these respects may be attended to. The establish-ment of various depots for the supply of useful articles, suchas Mrs. Seacole’s establishment afforded in the Crimea,would also be very expedient, especially if the medicalofficers and others in attendance on the sick were instructedwhere to forward their requisitions for articles of whichthey stood in need. A staff of people in connexion with suchplaces could be employed in distributing these articles. Formedical purposes in the field there is nothing handier thanthe medical field companion of our own army, as supplied byMessrs. Savory and Moore. It was De Quincy who remarkedthat if the stream of English charity was not a broad one, itflowed deep. Once let public sympathy be fairly aroused,however, and the stream is at once set in motion, and there isno limit to the flow of charity. The unparalleled horrors andextent of the present war have, at any rate, rendered thehumanity of the age conspicuous in one direction. Englandfeels the deepest sympathy for the sufferers, and about£200,000 has been already realised by subscription; butwhen we consider the extent of the misery, we may wellstand abashed before it-for it is incalculable. When we

attempt to realise what is to be the outcome of it all we arefairly lost in a maze of conjecture.

All countries have organised ambulances, and amongthem stands Italy. On the 29th of August an ambulancecomposed of medical men and students proceeded fromTurin to Bale, and made its way to Paris, but no news hassince been received from it.

Central Europe threatens to assume the aspect of onevast hospital, for these institutions are springing up every-where. In the district of Treves alone there are no lessthan forty-five hospitals, of which some have been openedby the committee of help to the wounded. There are

altogether 2530 beds, of which 1537 are occupied. The warhospitals of Germany contain a total of 65,000 beds, 50,000of which have been provided by the State, the remainderbeing due to the voluntary exertions of the charitable.Whilst this unhappy struggle continues, and long after itterminates, there will still be an immense amount of surgeryand disease on hand in the shape of the secondary affectionsfollowing gunshot wounds. Everything is now merged inthe effort to maintain the struggle and to meet the demandsof its victims, and whilst this continues we can scarcely hopefor that exact and laborious scientific observation which shalladd many new and improved metilods of treatment to ourstock of knowledge.

CITY OF GLASGOW FEVER HOSPITAL.*

THE Repcrt, lately published, of this hospital, by the phy-sician-superintendent, Dr. James B. Russell, besides fur-

nishing us with the information usually met with in suchdocuments, touches on several interesting and practicalpoints. The hospital has been in existence for five years,and during the year ending April 30th last, almost doublethe highest number of cases in any previous year have beentreated; and another feature in a year remarkable in thehistory of epidemic disease is the admission of cases of

relapsing fever into its wards. Besides the transformationof a range of uncompleted brick buildings, belonging to thedirectors of the Royal Infirmary, into fever wards for 35beds, at a cost of £ 375, the Board erected a new pavilioncontaining 34 beds. This is divided into two wards entirely

* Report of the City of Glasgow Fever Hospital, from May 1st, 1869, toApril 30the,1870.

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separate from one another, having each two apartments-alarge one with 11 I beds for the cases -while acutely ill, and asmall one with 6 beds for convalescents. Advantage wastaken of the experience of the other pavilions. The cubicand area space per bed in the ward for acute cases has

been increased, with the addition of certain arrangementsto ensure the perfect disinfection of all excreta. Altogether,the new pavilion is reported by Dr. John Russell to be as nearlyas possible a model of a hospital for the treatment of in-fectious diseases, ensuring the maximum of comfort to thepatient and the minimum of danger to the attendants andother inmates of the institution. Dr. Russell makes someremarks on the 11 unification of the interests which deal

with fever." He thinks it will be necessary, in order to

give the hands of the Sanitary Department free commandover infectious diseases, that they shall undertake the hos-pital treatment of them entirely. The prevention of diseaseis the special province of the local authority ; its treatmentmay devolve upon various public bodies and institutions.The latter receive a person suffering from fever for his indi-vidual good solely. On the other hand, when the localauthorities treat a person suffering from fever, it is becausethe patient has a " contagious " disease, and comes withinthe meaning, if not the definition, of the term " nuisance; "they do so for the public good solely. It is quite possibleto treat contagious disease in the most perfect way, so faras the sick individual is concerned, and yet fall short offull precautionary measures for the prevention of its

spread. In illustration Dr. Russell cites the suggestionrecently made to the Board of Police by the Directors ofthe Royal Infirmary regarding a convalescent home for

small-pox patients. The duty of directors to a personsuffering from small-pox is finished when he has re-

covered sufficiently to be discharged without injury to hisown health ; but their duty as custodiers of the patient isnot discharged to the public so long as it is dangerous tothe public that he should be let loose among them. Thencomes the question as to who is to determine the time thata patient is to be retained; and, as such detention neces-sarily involves financial considerations, it might fairly beasked whether the expense incurred solely for the publicgood should not fall upon the local authority?Of 2230 admissions during the year under report, 2023

were cases of typhus, 77 of enteric fever, 19 of relapsingfever, 12 of scarlet fever, 1 of small-pox, 2 of measles, 19of febricula, and 77 of other diseases.The mortality from typhus was 13’7 per cent.; the aver-

age residence of those who recovered was 23-6 days; ofthose who died, rather more than 6 days ; and over all cases,21 days. In speaking of the period at which a convalescentceases to be infectious, Dr. Russell thinks that materialsubstances, such as clothing, &c., are more frequently thevehicles of contagion than the person of a fever convalescentwho has been walking about the hospital grounds for tendays, and discharged after having been thoroughly washed.Considerations as to the latent period of typhus will gener-ally enable us to trace whether cases of fever, arising whereconvalescents have returned home, can be ascribed or notto those convalescents. The remarks on the individualsusceptibility to typhus are worth reading. Dr. Russell,from the experience which the staff of the Fever Hos-pital unfortunately provides, endeavours to trace the varia-tions in this respect. As a contrast to the experienceof typhus in the City Fever Hospital, he says that no caseof enteric fever has ever arisen, either among the staff orthe patients beside whom cases of enteric fever are treated.Of enteric fever 77 cases were admitted, with a mortality of6’4 per cent. The average residence of those who recoveredwas 45 days, and of those who died 11’6 days. The caseswere for the most part sporadic, and scattered over

thirty-six of the seventy-four sanitary districts. Entericfever means, according to Dr. -Lvlurchison, "bad drainage,and bad drinking water." As Glasgow is above suspicionin the latter respect, we must look to bad drainage for anexplanation of the local proclivities. The two districtsfrom which the maximum number of cases were admittedare the districts which always head the list. Dr. Russell’sexperience concerning relapsing fever does not differ fromthat of other observers. It is probable that the first cases

I contracted the disease in Edinburgh. He points out thatmost of the fresh centres of infection have been associatedwith the reception of lodgers; and that, once introduced inthis way into a family, this fever seemed to seize all itsmembers with a rapidity and certainty which typhus rarelyexhibits. In no case have the two fevers been associated,or in any way commingled. Nineteen cases of relapsingfever were admitted, of which only one-an old man ofseventy-died. The average residence was 28 days. Theultimate development of this fever in Glasgow remains tobe seen. Up to the 25th July it had been steadily increas-ing ; but Dr. Russell anticipates that relapsing fever willnot assume alarming proportions in Glasgow.

THE ROYAL ALBERT ASYLUM FOR IDIOTS.

IN June, 1868, we noticed the laying of the first stone ofthis valuable institution at Lancaster, and we have now toreport the opening of the first part of the new building, theformal inauguration of the complete institution being ex-pected to take place under royal patronage in 1872.

It is proposed to gather under the protection of the-

Royal Albert Asylum at least a portion of the poor idiotsand imbeciles to be found in the seven northern countiesof England,-Lancashire, Yorkshire, Cheshire, Westmor-land, Cumberland, Durham, and Northumberland. The

movement is to that extent local; but it is none the less

commendable, when it is remembered that no provisionwhatever exists in the north of England for this unfortu-nate class. It is estimated that there are 14,000 weak-minded persons in the seven counties included in the ope-rations of this asylum, and no provision previously existedfor their treatment or training. Does not this fact provethe necessity for the establishment of the Royal AlbertAsylum ? The style of architecture is Gothic, the arrangement of

details being so contrived as to meet modern tastes andideas of sound sanitary principles. The Committee havebeen fortunate in the selection of a site. Standing on aneminence said to be 150 feet above the level of the sea, theAsylum forms a very prominent object of interest fromwhatever point of the wide expanse it may be viewed. Thebuilding is of light-coloured freestone, of that durablequality so plentiful in the neighbourhood. The inside wallsare lined with brick, a small space being reserved betweenthe brick and stone. By the adoption of this plan the inte-rior of the building will be kept dry and warm, and will bemuch less susceptible to the changeable temperature whichis so characteristic a feature of the climate of this country.Only such persons will be admitted as are capable of inl-

provement. The asylum is not intended for epileptic, para-lytic, or insane persons, nor for those who are incurablyhydrocephalic. Idiocy complicated with blindness or deaf-ness will also be a disqualification. There will be two classesof patients of both sexes admitted when the building isopened-free patients and paying patients. The first-namedare those whose friends cannot afford to meet the lowestscale of payment, and they are elected by the votes of thesubscribers. The second are to be admitted bv the CentralCommittee without limit as to time. Patients admittedfree, or at the reduced scale of payment, must belong toone of the seven northern counties, but that regulation doesnot apply to the full rates of payment.The Committee have been fortunate enough to secure the

services of Dr. Shuttleworth, late assistant medical officerof the Earlswood Asylum, as their resident superintendent,and also those of Miss Bryan, who was sub-matron at Earls-wood for nine years, as their matron. The institutionowes its existence to the untiring efforts of a memberof the medical profession, Dr. De Vitré, of Lancaster,whose name will be identified with it as that of Dr. Reed iswith Earlswood.The opening ceremony on the 14th September, under the

presidency of the Duke of Devonshire, supported by theBishop of Manchester, and other local notabilities, proveda great success; and we shall hope in due time to record anequally satisfactory completion of the entire building.