937VITAL STATISTICS.-REPORTS AND ANALYSES

the average was 3-4-rather less than half. Ante-

partum haemorrhage gave an average of 6-5 deaths

per annum in 1926-29, an average of 2 in 1932-33.The lowered incidence of these two complicationscontinued up to the present year. Eclampsia wasrecognisedly a toxsemic death, and half at least ofthe serious cases of antepartum haemorrhage wereprobably toxamic in origin. In the period 1933-34placenta prsevia caused 5 deaths in 1933 and 9 deathsin 1934, as against 1-7 for the three preceding years.The figures, although not large, did suggest thatantenatal work had contributed to a fall in puerperalsepsis and in the recognised toxaemias of pregnancy,Dr. Veitch Clark had analysed the source of pro-

fessional attendance on childbirth in Manchester forthe years 1930-33 (see Table). In 1933 out of 12,633births, 4362 were attended by midwives, 971 by

City of Manchester Births Attended by Doctois and]J! idwive"

* =Mdwife only present at birth. t =Doctor actually presentat birth.

doctors, and 6088 went to hospitals and nursing-homes. The balance of 1,212 cases were attendedin their own homes by the extern practice of St.

Mary’s Hospital. Over 10,000 received attentioneither from midwives or in hospital. Of the 110midwives in the city practising midwifery only 50were dependent solely on midwifery for their living,and 18 of these lived with relations. Of the 60 others,all married women, 45 were definitely not in full-time practice, and 15 also carried on domestic duties.No woman, he said, could maintain her manual skilland sustain her knowledge unless fully occupied inthe practice of her profession and assured of a reason-able competency. He would prefer a scheme wherebythe midwives were part of the extern connexion witha hospital with an income guaranteed by the local’authority. Only 900 cases per annum out of the 12,000were attended by doctors in their private capacity,with additional 2413 cases on the formal request ofmidwives. There were 650 practitioners in activework in Manchester, and obviously experience inobstetrics was not available in sufficient amount tomaintain skilled practice. That being so he saw nopractical solution of the difficulty in a revision of themedical curriculum, but rather in the developmentof post-graduate work. But while expert work wasessential the enlightened cooperation of the mothersshould be secured by direct personal contact inantenatal and postnatal clinics.

INFECTIOUS DISEASEIN ENGLAND AND WALES DURING THE WEEK ENDED

APRIL 6TH, 1935

Notifications.-The following cases of infectiousdisease were notified during the week : Small-pox, 0 ;scarlet fever, 2256 ; diphtheria, 1264 ; enteric fever,28 ; acute pneumonia (primary or influenzal), 1486 ;puerperal fever, 45 ; puerperal pyrexia, 112 ; cerebro-spinal fever, 36 ; acute poliomyelitis, 1 ; encepha-litis lethargica, 12 ; continued fever, 1 (Battersea) ;dysentery, 20 ; ophthalmia neonatorum, 75. Nocase of cholera, plague, or typhus fever was notifiedduring the week.

The number of cases in the Infectious Hospitals of the LondonCounty Council on April 13th, was 3737, which included:Scarlet fever, 1122 ; diphtheria, 1602 ; measles, 22 ; whoop-ing-cough, 347 ; puerperal fever, 23 mothers (plus 8 babies) ;encephalitis lethargica, 270 ; poliomyelitis. 2. At St.Margaret’s Hospital there were 17 babies (plus 10 mothers)with ophthalmia neonatorum.

- Deas.—In 121 great towns, including London,there was no death from small-pox or enteric fever,29 (0) from measles, 8 (1) from scarlet fever, 24 (4)from whooping-cough, 45 (7) from diphtheria, 37 (12)from diarrhoea and enteritis under two years, and184 (33) from influenza. The figures in parenthesesare those for London itself.

The number of influenzal deaths remains almost stationary,the reported deaths for the last few weeks (working backwards)being 184, 181, 175, 145, 139, 83, 91, 83, 91, 71, 56. Thisweek these deaths were reported from 59 great towns, Man-chester reporting 15, Birmingham 10, Portsmouth, Sunderland,and Stoke-on-Trent each 7, Blackburn, Smethwick, and Swanseaeach 6, Croydon and Liverpool each 5. (During the same weekGlasgow reported 11 deaths, as against 33 in the previousweek.) Wigan, Birmingham, and Wolverhampton each reported3 fatal cases of measles. Three deaths from diphtheria occurredat Bournemouth and at Shemeld.

The number of stillbirths notified during the weekwas 275 (corresponding to a rate of 44 per 1000 totalbirths), including 44 in London.

REPORTS AND ANALYSES

SEAGER’S EGG FLIP

(SEAGER, EVANS AND CO., LTD., MILLBANK DISTILLERY, DEPTFORDBRIDGE, LONDON, S.E.8)

THIS preparation is a thickish yellow permanentemulsion tasting pleasantly of egg and sweetenedwine. When analysed, the following results wereobtained :—

Alcohol ...... 20’0 per cent. (by volume).Total solids ...... 14’0" "

consisting of-Carbohydrates.... 8’0" "

Proteins.... 1’71 ,, "

Fat 3’26" "

Mineral matter 0’4" "

Preservatives were tested for with negative results.The analytical figures are consistent with a 10 percent. emulsion of egg-yolk in a sweetened wine of20 per cent. alcohol content.

This "flip " is a convenient and agreeable form of

taking eggs. In addition it is an obvious food tonicwhich is available for consumption at a moment’snotice, and therefore particularly suited for use inthe sick-room.

SCARBOROUGH HosPITAL.-It was stated at theannual meeting that jE300 was lost last year through roadaccidents. The Mayor pointed out that it was no credit tothe motoring public as a whole that they did not respondmore freely towards the cost of these accidents. The newhospital is being built, but there has been some delayin its progress because of the underground water at thefoundations. A further ;B;8000 has been added to thefunds but 20,000 is still required. The new hospitalwill cost about E5000 more to run than the old, and theboard has decided to adopt a contributory scheme. ,