1
1097 THE EMPEROR OF BRAZIL. FROM Milan a correspondent writes, May 27th :-" The belief that Dom Pedro had fairly passed into convalescence received a sad shock on the morning of Tuesday, the 22nd, when sudden failure of the heart, amounting to absolute syncope, summoned Drs. Semmola, Di Giovanni, and the Viscount di Motta Moia to his bedside. The restoratives at once applied rescued his Majesty from the immediate danger. So impressed, however, were his physicians with the possi- bility of a fresh seizure, that they advised the Emperor to take the final consolations of religion, which were thereupon administered. Meanwhile Dr. Charcot was again summoned from Paris, and Dom Pedro’s relatives, also by telegram, from their several places of sojourn. Throughout the 4ay the favourable condition was maintained, and a fairly good night’s rest was followed by such improve- ment that on the Wednesday morning a highly re- assuring bulletin was despatched to all the European courts. On Dr. Charcot’s arrival in the evening, a consulta- tion at once took place, and again the consensus of opinion confirmed the improvement in the Emperor’s state. The ensuing night was also one of satisfactory repose, and a bulletin setting forth the steady advance of the patient’s strength was issued at eight o’clock on the morning of Thursday, the 24th. Should this condition be gradually improved upon, it is the intention of Dom Pedro’s physicians to have him conveyed to Aix-les-Bains in the course of this week. The prognosis, however, is a most doubtful one, I considering the Emperor’s age and the complex nature of his malady. Drs. Charcot, Semmola, and Di Giovanni find in the case a true diabetic dyserasia which, with its invariably toxic effects on the nervous centres, concurrently with the impaired action of the emunctories (the kidneys and liver particularly) may at any time induce a return of the heart failure. If all continues favourable, Dr. Charcot sets out for Paris on Tuesday, the 29bh, more than ever impressed, I hear, with the skill of his Italian colleagues in diagnosis and treatment." -- ILLEGITIMATE BIRTHS AND INFANT MORTALITY IN SCOTLAND. IN the supplement to the monthly and quarterly returns, oi just issued by the R9gistrar-General for 1887, it appears B that during last year no less than 8’3 per cent. of the births a, registered in Scotland were illegitimate, or born out of tl wedlock, and further that this proportion of illegitimacy n may be said to have been constant during the last ten years, t although it shows a decline from the still higher rate that rf prevailed in the previous ten years, which was equal to r( )’8 per cent.; the mean rate in the last ten years 1878-87 having been 8’3. The proportion of illegitimacy showed the largest excess in the southern counties of Dumfries, Kirk- cudbright, and Wigtown; and in the north-eastern counties o of Aberdeen, Elgin, and Banff. The proportions in the a several counties ranged from 4’0 per cent. in Kinross, 4’5 in n Shetland, and 4-9 in Ross and Cromarty, to 16’4 in Kirk- t eudbright 16’5 in Banff. and 18’1 in Wigtown. Illegitimacy o showed, generally speaking, a much larger excess in the rural o than in the urban districts. The proportion of illegitimacy Q was 7’9 per cent. in the principal towns, 6-8 in the large c towns, 8’1 in the small towns, 10’3 in the mainland rural t districts, and 6’1 in the insular rural districts. It should be t stated that the rate of illegitimacy in Scotland is nearly B double that which prevails in England and Wales. In 1 spite, however, of the generally well-marked influence f of illegitimacy upon the rate of infant mortality, the death- t rate ot infants aged under one year is considerably lower ( in Scotland than in England. For instance, in the year 3 1885, the last for which the information has been pub- ( lished, the proportion of deaths under one year to registered 1 births was equal to 121 per 1000 in Scotland, against 138 in England and Wales. If we consider the rate of infant mortality in different districts of Scotland, it is, more- over, difficult to see any constant relation between its proportion and the rate of illegitimacy. Infant mortality appears to be entirely governed by the density of the population-that is to say, by the intensity of its urban character. We have seen that the rate of infant mortality in the whole of Scotland was equal to 121 per 1000 of the registered births. The mean proportion of infant mortality in the eight principal Scotch towns was 143 per 1000; in other large towns, ranking next in size, it was 124; in the smaller towns it was 114 ; in the mainland rural districts it was 91; and in the insular rural districts it was only 76 per 1000, and very little more than half the rate in the principal or largest towns. The rates of infant mortality in Scotland, whether for urban or rural districts, compare favourably with those in England and Wales. For instance, in the largest English towns the rate was 168, instead of 143 in the largest Scotch town; and the lowest rural rate in England was 92 in the county of Dorset, while in the insular rural districts of Scotland the rate was, as shown above, only 76 per 1000. The Scotch reports do not, uufortunately, afford the ready means for comparing the rates of infant mortality in that country for a long series of years; but certain it is that, notwithstanding the recent decline of infant mortality in England, the comparison between the two countries is in this respect markedly in favour of Scotland, in spite of the high rate of illegitimacy in that country. - THE DRAINAGE OF MARGATE. THE drainage of Margate makes slow progress, and the struggle which is taking place between the rival factions of the town is not creditable where a very simple public duty has to be performed. Owing to delays of a kind which no one but a Margate resident can understand, the town will for another season remain much in the same condition as that which last year proved so detrimental to its commercial prosperity. The last step which has been taken is the adoption of a resolution by the Margate Town Council to submit the plan of Mr. Baldwin Latham for the sewerage of the borough to Sir Douglas Galton and Sir Frederick Bramwell for their joint criticism. We presume the borough authorities will eventually come to some conclusion as to the scheme which is the best fitted to meet local require- ments, and that at length Margate will be able to claim that it no longer deserves the censure which it very properly received at the hands of Mr. Spear. CONVALESCENT AID FOR THE POOR. No medical man acquainted with the needs and labours of the working poor can have any doubt as to the real good which is implied in a system of convalescent aid. When in many cases the ends of the family earnings barely meet in time of health, it is not to be wondered at that in the event of illness overtaking any member the process of recovery is often much hindered by the urgent necessity to return to work at the earliest possible moment. There is the usual complaint of " much going out and little coming in," and the worker cannot afford to linger at home, a costly encum- brance, until the place of disease is definitely reoccupied by vigorous health. For persons emerging from illness of any kind such aid is therefore of the utmost value. It is no less advisable in many cases of incipient disease, on the principle tb at prevention is better than cure. Take, for example, phthisis or joint disease in the initial stage. In such a case timely removal to a suitable home in the country may be the one and only circumstance required to turn the balance in favour of a successful issue. What, again, must be the fate-

ILLEGITIMATE BIRTHS AND INFANT MORTALITY IN SCOTLAND

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1097

THE EMPEROR OF BRAZIL.

FROM Milan a correspondent writes, May 27th :-" Thebelief that Dom Pedro had fairly passed into convalescencereceived a sad shock on the morning of Tuesday, the 22nd,when sudden failure of the heart, amounting to absolutesyncope, summoned Drs. Semmola, Di Giovanni, and theViscount di Motta Moia to his bedside. The restoratives at

once applied rescued his Majesty from the immediate danger.So impressed, however, were his physicians with the possi-bility of a fresh seizure, that they advised the Emperor totake the final consolations of religion, which were thereuponadministered. Meanwhile Dr. Charcot was again summonedfrom Paris, and Dom Pedro’s relatives, also by telegram,from their several places of sojourn. Throughout the4ay the favourable condition was maintained, and a

fairly good night’s rest was followed by such improve-ment that on the Wednesday morning a highly re-

assuring bulletin was despatched to all the Europeancourts. On Dr. Charcot’s arrival in the evening, a consulta-tion at once took place, and again the consensus of opinionconfirmed the improvement in the Emperor’s state. The

ensuing night was also one of satisfactory repose, and abulletin setting forth the steady advance of the patient’sstrength was issued at eight o’clock on the morning ofThursday, the 24th. Should this condition be graduallyimproved upon, it is the intention of Dom Pedro’s physiciansto have him conveyed to Aix-les-Bains in the course of thisweek. The prognosis, however, is a most doubtful one, Iconsidering the Emperor’s age and the complex nature of hismalady. Drs. Charcot, Semmola, and Di Giovanni find inthe case a true diabetic dyserasia which, with its invariablytoxic effects on the nervous centres, concurrently with theimpaired action of the emunctories (the kidneys and liverparticularly) may at any time induce a return of the heartfailure. If all continues favourable, Dr. Charcot sets out forParis on Tuesday, the 29bh, more than ever impressed, Ihear, with the skill of his Italian colleagues in diagnosis andtreatment."

--

ILLEGITIMATE BIRTHS AND INFANT MORTALITYIN SCOTLAND.

IN the supplement to the monthly and quarterly returns, oijust issued by the R9gistrar-General for 1887, it appears Bthat during last year no less than 8’3 per cent. of the births a,

registered in Scotland were illegitimate, or born out of tlwedlock, and further that this proportion of illegitimacy n

may be said to have been constant during the last ten years, talthough it shows a decline from the still higher rate that rf

prevailed in the previous ten years, which was equal to r(

)’8 per cent.; the mean rate in the last ten years 1878-87having been 8’3. The proportion of illegitimacy showed thelargest excess in the southern counties of Dumfries, Kirk-cudbright, and Wigtown; and in the north-eastern counties o

of Aberdeen, Elgin, and Banff. The proportions in the aseveral counties ranged from 4’0 per cent. in Kinross, 4’5 in n

Shetland, and 4-9 in Ross and Cromarty, to 16’4 in Kirk- t

eudbright 16’5 in Banff. and 18’1 in Wigtown. Illegitimacy o

showed, generally speaking, a much larger excess in the rural o

than in the urban districts. The proportion of illegitimacy Qwas 7’9 per cent. in the principal towns, 6-8 in the large c

towns, 8’1 in the small towns, 10’3 in the mainland rural t

districts, and 6’1 in the insular rural districts. It should be tstated that the rate of illegitimacy in Scotland is nearly B

double that which prevails in England and Wales. In 1

spite, however, of the generally well-marked influence f

of illegitimacy upon the rate of infant mortality, the death- trate ot infants aged under one year is considerably lower (

in Scotland than in England. For instance, in the year 31885, the last for which the information has been pub- (lished, the proportion of deaths under one year to registered 1

births was equal to 121 per 1000 in Scotland, against 138 inEngland and Wales. If we consider the rate of infantmortality in different districts of Scotland, it is, more-over, difficult to see any constant relation between its

proportion and the rate of illegitimacy. Infant mortalityappears to be entirely governed by the density of

the population-that is to say, by the intensity ofits urban character. We have seen that the rate ofinfant mortality in the whole of Scotland was equal to 121per 1000 of the registered births. The mean proportion ofinfant mortality in the eight principal Scotch towns was143 per 1000; in other large towns, ranking next in size, itwas 124; in the smaller towns it was 114 ; in the mainlandrural districts it was 91; and in the insular rural districtsit was only 76 per 1000, and very little more than half therate in the principal or largest towns. The rates of infant

mortality in Scotland, whether for urban or rural districts,compare favourably with those in England and Wales. For

instance, in the largest English towns the rate was 168,instead of 143 in the largest Scotch town; and the lowestrural rate in England was 92 in the county of Dorset, whilein the insular rural districts of Scotland the rate was, asshown above, only 76 per 1000. The Scotch reports do not,uufortunately, afford the ready means for comparing therates of infant mortality in that country for a long series ofyears; but certain it is that, notwithstanding the recentdecline of infant mortality in England, the comparisonbetween the two countries is in this respect markedly infavour of Scotland, in spite of the high rate of illegitimacyin that country.

-

THE DRAINAGE OF MARGATE.

THE drainage of Margate makes slow progress, and thestruggle which is taking place between the rival factions ofthe town is not creditable where a very simple public dutyhas to be performed. Owing to delays of a kind which noone but a Margate resident can understand, the town willfor another season remain much in the same condition asthat which last year proved so detrimental to its commercialprosperity. The last step which has been taken is the

adoption of a resolution by the Margate Town Council tosubmit the plan of Mr. Baldwin Latham for the sewerageof the borough to Sir Douglas Galton and Sir FrederickBramwell for their joint criticism. We presume the boroughauthorities will eventually come to some conclusion as tothe scheme which is the best fitted to meet local require-ments, and that at length Margate will be able to claimthat it no longer deserves the censure which it very properlyreceived at the hands of Mr. Spear.

CONVALESCENT AID FOR THE POOR.

No medical man acquainted with the needs and laboursof the working poor can have any doubt as to the real goodwhich is implied in a system of convalescent aid. When in

many cases the ends of the family earnings barely meet intime of health, it is not to be wondered at that in the eventof illness overtaking any member the process of recovery isoften much hindered by the urgent necessity to return towork at the earliest possible moment. There is the usual

complaint of " much going out and little coming in," andthe worker cannot afford to linger at home, a costly encum-brance, until the place of disease is definitely reoccupied byvigorous health. For persons emerging from illness of anykind such aid is therefore of the utmost value. It is no lessadvisable in many cases of incipient disease, on the principletb at prevention is better than cure. Take, for example, phthisisor joint disease in the initial stage. In such a case timelyremoval to a suitable home in the country may be theone and only circumstance required to turn the balance infavour of a successful issue. What, again, must be the fate-