760

in Lincolnshire, Worcestershire and Hutlandshire showinga favourable record in this respect. The mortality fromenteric (or typhoid) fever was lower in 1905 than inany other year on record. Compared with the decennialaverage the mortality of England and Wales from this diseasewas lower by 31 per cent. The behaviour of enteric feverin 1905 is, however, remarkable in this respect, that whilst,on the one hand, the urban group of counties experienced aconsiderable descrease as compared with the average, on theother hand the rural group of counties experienced an in-crease. This abnormal difference may, however, be explainedby the circumstance that a severe outburst of enteric feveroccurred in Lincolnshire in the early part of the year.

MEDICINE AND THE LAW.

Water Rates for liledical lilen.AT Watford Dr. S. I. Lightfoot was summoned recently

for the non-payment of part of the water rate levied uponhim by the Watford urban district council. In addition tothe rate of Is. in the E for water for domestic use he hadbeen charged 5s. for water used in his garden and 10s.for water used in his dispensary. No agreement as to thewater supplied for the two latter purposes had been enteredinto and Dr. Lightfoot had paid the 5s. rate but had declinedto ’pay the 10s. The Bench decided that in the absence ofan agreement to pay the special rate the summons must bedismissed, so that the defendant was successful in resistingthe prosecution but was not able to obtain a decision as towhether the water used by him in his dispensary should becovered by the payment made for water supplied for domesticpurposes only.Bill to Abolish the I’zerv of the Body at Coroners’ Inquests. IMr. Luke White, who is the coroner for North-East York- I

shire, has just introduced a Bill in Parliament "to dispensewith the compulsory viewing of bodies on the holding ofcoroners’ inquests." The Bill is supported among others byMr. Bramsdon, the coroner for Portsmouth. So far back as1879 a Coroners Bill was being considered by a SelectCommittee of the House of Commons which (Clause 5) wouldhave given this relief. Later, in 1898 and 1899, circularswere sent out by the Home SEcretary to coroners and theirdeputies inquiring if the proposed change was in their

opinion desirable. In March, 1900, it was elicited from SirMatthew White Ridley, then Home Secretary, by Mr. JohnWilson that a majority of replies to the circular favouredthe suggested reform and a very large majority desiredsome change, but the nature of such change was

the cause of a very great difference of opinion.At present an inquest on the death of man" is voidunless the body has been viewed by the coroner, by the

identifying witness, and by the inquest jury. The lastshould not view the body until they have been sworn in, asprior to that they are not a jury. This rule is very oftenignored by coroners. In the absence of an identifyingwitness and where charges of negligence or violence

precedent to the death are preferred the inquest jury havelittle need nowadays to view the body of what in our moderncongested civilisation must in most cases be that of anentire stranger. A summary of the history of this ancientcustom was given in THE LANCET of Nov. 18th, 1905,p. 1501.

The Overlying and Accidental Bitrning of Children.A Bill to amend the Prevention of Cruelty to Children

Act, 1904, has been introduced in the House of Commons byMr. Bramsdon, M.P, and has among its "backers" " Mr.T. P. O’Connor, M.P., and Mr. Rufus Isaacs, K.C., M.P.The object of the proposed law is to prevent the overlyingof young children by adults sleeping with them in the samebed and also the accidental burnings and scaldings which sofrequently result from the absence of a fireguard. It willbe remembered that a conference was held towards the endof last summer by some members of the executive com-mittee of the National Society for the Prevention of

Cruelty to Children and a deputation of members of theCoroners’ Society and of the British Medical Associa-

tion, at which this subject was discussed and at whichthe forms which preventive legislation might take were

suggested. These were described and commented upon ina leading article in THE LANCET of Sept. 15th, 1906, p. 749.

When the Act of 1904, the amendment of which is nowproposed, was first introduced the Rev. Benjamin Waugh triedto get included in it clauses making it "exposure" " of a childto leave it alone with an unprotected fire and also the" perilous overcrowding of any infant in bed or the going tobed drunk with any infant." These proposed additions tothe law were, however, struck out and the new Bill embodiesthe proposals made by Mr. C. L. Rothera, the coroner forNottingham, at the conference referred to, by which the lawshall be invoked whenever it shall be proved that deathhas taken place owing to the causes under discussion.In other words, it is not proposed that the act of taking achild to bed with grown up persons shall in itself be

punishable or the act of leaving a child alone in a roomwith an unguarded fire, even when injury to the child

results, but that if the death of a child shall be proved tohave been due to these causes then the neglect involvedshall become an offence within the meaning of the Preven-tion of Cruelty to Children Act, 1904. It has no doubt beenfelt that the suggestion of possible inquisitorial supervisionof the homes of the poor would injure the prospects of auseful measure in Parliament but that none could objectto a Bill designed on the face of it to protect lives bypunishing those responsible for unnecessary deaths. Wecan only repeat what we have said before-that industrious,kind-hearted, and sober parents are not likely to beinjuriously affected by such a law and that the ingenuityof parents and of manufacturers called upon to meeta new demand should soon provide at a low costsuch apparatus as the cots and fireguards required. Theamendment of the law is urgently needed in order thatit may be possible to punish (with such severity as may beappropriate to the individual case) parents who are notsober, not kind-hearted, and not hard-working, who reck-lessly fail to provide for the safety of their offspring, andthrough whose neglect poor little children die premature andpainful deaths. There is no fear that our jadgep, magis-trates, or juries will allow undeserved punishment to fallupon fathers and mothers whose children’s deaths are due tounavoidable circumstances. All parents and persons havingthe custody of children, however, will have to consider therisks involved and to take precautions which will diminishnot only the number of deaths that now take place butinjury, suffering, and ill-health not resulting in actual lossof life. The extent of this suffering may be judged from thefact that in recent years the deaths from the causes indicatedhave amounted to between 3000 and 4000 per annum.

Looking Back.FROM

THE LANCET. SATURDAY, March 14th, 1829.

DOUBLE PUPIL IN ONE EYE.

A remarkable case of double pupil was observed by Pro-fessor Pacini, of Lucca, in a young man who, in his child-hood, had, from an unknown external cause, been affectedwith chronic inflammation of the left eye, which had left itin the following state :-The external parts of the eye arehealthy, the cornea is perfectly transparent, except at itsexternal part, where there is a small pterygium ; the pupilis elliptic, the fourth part of a line in height, and one linein breadth, and immoveable even in the strongest light.The upper eye-lid being raised, another pupil, three linesand a half in its largest, and one line in its smallestdiameter, is discovered at the upper portion of theiris ; it is somewhat directed towards the internal angleof the eye, and likewise insensible to light. The partsbehind it are perfectly transparent. The young man islong sighted, and squints, the left eye being constantlyturned towards the nose ; whenever he looks at an objectwith both eyes, he sees it simple and distinct; if the healthyeye be closed, and the accessory pupil covered, the objectappears confused, but if seen with the superior pupil only,it appears simple and distinct. Whenever he looks with themorbid eye at an object placed before him, he sees its righthalf only, and that double ; in order to see it simple, he isforced to direct the eye towards the external angle, andeven then the right half is seen more distinctly and some-what higher than the other. Objects appear of the’same

761

size, whether seen with the morbid or healthy eye; and con-tinued exertion of the former produces a disagreeable sensa-tion in the interior of the globe, so that he is obligedrepeatedly to close the eyelids.-Journ. des Progr.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8236 births and 5605deaths were registered during the week ending March 9th.The annual rate of mortality, which had been equal to 17’ 1and 18’ 4 per 1000 in the two preceding weeks, declinedagain to 18’ 2 in the week under notice. During the firstten weeks of the current quarter the death-rate in thesetowns averaged 19’ 5 per 1000, the rate during the sameperiod in London being 19’7. The lowest death-rates inthe 76 towns during the week were 8’ 1 in Hornsey, 10’ 2 inWallasey, 10’ 4 in Northampton, and 10’ 7 in Ipswich;the rates in the other towns ranged upwards to 25’ 8 inNorwich, 26 4 in Huddersfield, 28’ in Merthyr Tydfil,and 30 - 1 in Bury. The 5605 deaths in the 76 townsshowed a decline of 47 from the number returned in the

previous week, and included 470 which were referred to theprincipal epidemic diseases, against 390 and 440 in the twopreceding weeks; of these, 205 resulted from measles, 105from whooping-cough, 69 from diphtheria, 35 from scarletfever, 33 from diarrhoea, 23 from " fever " (principallyenteric), and not one from small-pox. The deaths fromthese epidemic diseases were equal to an annual rate of1’5 5 per 1000 in the 76 towns, the rate from the same diseasesbeing also 1 . 5 in London. No death from any of theseepidemic diseases was registered in Oldham, Huddersfield,Hornsey, Coventry. or in four other of the 76 towns : theannual rate therefrom, however, ranged upwards to 5’2 inGrimsby, 5’3 in West Bromwich, 5’4 in East Ham, and6’2 2 in St. Helens. The 205 fatal cases of measles showeda marked further increase upon recent weekly numbers andcaused an annual rate of 3’ 4 per 1000 in East Ha,m, 4’ 4 inGrimsby, 5’1 1 in St. Helens, and 5 3 in West Bromwich.The 105 deaths from whooping-cough were fewer by 12 thanthose in the previous week, the highest annual rates therefrombeing 1 ’2 2 in York, 1’4 in Nottingham and in South Shields,and 1 - 9 in East Ham. The 69 deaths referred to

diphtheria showed an increase of nine, and were pro-portionally most numerous in Derby. Scarlet fever wasmost fatal in Newport (Mon.), and diarrhoea in Rhonddaand Bournemouth. The deaths from "fever" showed nomarked excess in any of the towns. Cerebro-spinalmeningitis caused one death in St. Helens. No case ofsmall-pox has been under treatment in the MetropolitanAsylums Hospitals since the end of June last. The numberof scarlet fever patients under treatment in the Metro-

politan Asylums Hospitals and in the London FeverHospital, which had steadily declined in the ten pre-ceding weeks from 3846 to 2878, was again 2878 inthe week under notice ; 306 new cases of this diseasewere admitted to these hospitals during the week, against368 322 and 326 +:1-1.0 three "Y’1.-ran;1*B" .«eeoa 0 The I368, 322, and 326 in the three previous weeks. Thedeaths in London referred to pneumonia and other diseasesof the respiratory organs, which had been 379 and 432in the two preceding weeks, declined again to 405 in theweek under notice, but were eight above the correctedaverage number in the corresponding week of the last fiveyears. The causes of 55, or 1. 0 per cent., of the deathsregistered during the week were not certified either by aregistered medical practitioner or by a coroner. All thecauses of death were duly certified in Bristol, West Ham,Bradford, Newcastle-on-Tyne, and in 44 other of the 76towns ; the proportion of uncertified deaths, however, showeda marked excess in Preston, Sheffield, Hull, Middlesbrough,and Gateshead.

____

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in eight of the principalScotch towns, which had been equal to 18. 8 and20 3 in the two preceding weeks, further rose to 20’ 6in the week -ending March 9th, and exceeded the meanrate in the 76 English towns by 2’ 4. The rates in the eightScotch towns ranged from 13’ 2 and 16’ 5 in Greenockand Perth to 22-4 in Aberdeen and 22 5 in Leith. The716 deaths in the eight towns showed an increase of tenupon the number in the previous week, and included 112

which were referred to the principal epidemic diseases.against 71 and 98 in the two preceding weeks. These 112deaths were equal to an annual rate of 3’ 2 per 1000, whichexceeded by 1’ 7 the rate from the same diseases in the 76English towns ; they included 52 which were referred to"fever," 26 to whooping-cough, 15 to diphtheria, 13 to

diarrhoea, six to measles, and not one either to scarlet feveror small-pox. The deaths referred to "fever," which hadbeen 49, 25, and 47 in the three previous weeks, further roseto 52 in the week under notice, and included 32 in Glasgow,ten in Leith, nine in Edinburgh, and one in Dundee ; 28 ofthe 32 deaths from "fever" in Glasgow, seven of the ninein Edinburgh, all the ten in Leith, and the death in Dundeewere certified as cerebro-spinal meningitis. The 26 fatalcases of whooping-cougb, against 27 and 25 in the two pre-vious weeks, included 21 in Glasgow and three in Paisley.The 15 deaths referred to diphtheria showed a considerableincrease upon recent weekly numbers ; seven occurred inGlasgow, three in Dundee, and three in Paisley. The fatalcases of diarrhoea were also more numerous, including six inGlasgow, three in Edinburgh, and two in Aberdeen. Measlescaused three deaths in Aberdeen and two in Glasgow. Thedeaths in the eight towns referred to diseases of the respira-tory organs, including pneumonia, which had declined from178 to 124 in the four preceding weeks, rose again to 149 inthe week under notice, and exceeded the number in the corre-sponding week of last year by 24. The causes of 22, or

3. 1 per cent., of the deaths registered in the eight townsduring the week were not certified or not stated ; the meanproportion of uncertified deaths in the 76 English .towns .during the same week did not exceed 1 - 0 per cent.

HEALTH OF DUBLIN.

The annual death-rate in Dublin, which had been equalto 31 - 4, 27’1, and 28.6 per 1000 in the three precedingweeks, declined to 25’ in the week ending March 9th.

During the first ten weeks of the current quarter the death-rate in the city averaged 28’ 3 per 1000; the mean rate

during the same period did not exceed 19’5 in Londonand 20-0 0 in Edinburgh. The 189 deaths of Dublin resi-dents registered in the week under notice showed a declineof 25 from the number in the previous week, and includedten which were referred to the principal epidemic diseases,showing a slight increase upon recent weekly numbers.These ten deaths were equal to an annual rate of1.3 3 per 1000, and included seven from whooping-cough, one each from measles, diphtheria, and diarrbcea,and not one either from small-pox, scarlet fever, or " fever."The fatal cases of whooping-cough corresponded with thenumber in the previous week. Four deaths were also referredto cerebro-spinal fever. The deaths in the city included29 of infants under one year of age and 51 of personsaged upwards of 60 years ; both these numbers showed amarked decline from the numbers in the previous week.Three deaths from violence and seven inquest cases wereregistered; and 73, or 38’ 6 per cent., of the deathsoccurred in public institutions. The causes of four, or 2. 2per cent., of the deaths registered during the week werenot certitied ; the percentage of uncertified deaths in theweek under notice was equal to 4’ 5 in E(linburgh, whileit did not exceed 0-2 in London. The 167 deaths regis-tered in Belfast during the week ending March 9th included21 certified as due to cerebro-spinal meningitis or cerebro-spinal fever.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments are notified :-Staff Surgeon i

T. W. Philip, to the Topaze.

ROYAL HORSE GUARDS.

Captain Percival J. Bodington, from the Royal ArmyMedical Corps, to be Surgeon-Captain, vice St. John B.Killery, who exchanges (dated March lat, 1907).

ROYAL ARMY MEDICAL CORPS.

Captain J. S. Bostock has arrived at Portsmouth for duty.Major T. B. Beach, from Chatham, has been appointed tothe Royal Arsenal, Woolwich, for duty.