737

by the London hospitals. I would advocate more elasticity iin our hospital system, and should like to see all the senior Imembers of the staff, surrounded by their skilled assistants, 1

engaged in the investigation of disease. Would it not alsobe one way of meeting the reproach levelled at the hos-pital authorities that the medical out-patients’ work isinsufficiently performed. I should like also to refer toanother matter which has been forced on my attention bya visit to Hopital St. Louis. The extraordinarily realisticrepresentations of disease in wax modelling, the admira-tion of all who see them ; and I refer now not so much tothe beautiful reproductions of skin disease as to M. Pean’ssurgical collection. How infinitely better are they in manyrespects than faded specimens in spirit. It would bedifficult perhaps for the poorer school to afford this luxury,but surely the Royal College of Surgeons might take thematter up and help their poorer brethren. Wax modellersof the greatest merit have existed in this country before, andmoney is all that is needed to supply the deficiency again."Dr. Fox then concluded with words of exhortation and adviceto the students for the better running of the race that wasset before them.

_____________

PRISON STATISTICS.

THE crop of reports by various prison authorities, whichripens at the present season of the year, conveys on thepresent occasion a very pleasant impression that the

improvement in respect of criminality, which has beentraceable in these records for many years past, continues atthe present time with unabated strength. The case is statedwith characteristic humour by the General Prisons’ Boardof Ireland, a body which has the oversight in that countryboth of the local and convict prisons, and has recently beenconsidering a proposal for the building of a new publicworks prison. This, they say, having regard to thenumber of prisoners subject to their jurisdiction, hasbecome quite impracticable ; first, because the amount ofprison labour available for the purpose is not sufficient for Ithe completion of the work within a reasonable time, and inthe second place because, "at the present rate of declinein the number of convicts, by the time the buildingswere complete there would be but a very small numberavailable to inhabit it." The statistical fact to whichthis light-hearted allusion is made is by no means peculiarto Ireland. Perhaps it is a little optimistic to lookforward to a time when there will be but a smallnumber of persons " available to inhabit our prisons,but it is a striking and most gratifying fact that, in

spite of the growth of population in Great Britain duringthe past twelve years, the prison population has during thesame period declined, by a steady and continuous process ofdiminution, by one-third of the whole number in 1878.Moreover, the significance of this fact is heightened by thecircumstance that a commensurate reduction has occurredin the number of persons known or suspected by the policeto be habitual criminals, so that the present low rate ofcrime may with much reason be attributed to the operationof those moral and material influences which " make forrighteousness." "In respect of the general health of the prisoners, all the

reports concur in remarking that the death-rate has beenvery low, and the effect of the influenza epidemic scarcelyperceptible.The English Commissioners refer with very justifiable

pride to the case of the Shrewsbury Prison, recentlyrebuilt under their auspices. Here typhoid fever hadbecome endemic, and was not displaced even by a com-plete renovation of the system of water-supply. Theauthorities in these circumstances took the strong andproper course of rebuilding, all other expedients havingfailed ; and this year they have the satisfaction of recordingthat this radical remedy has had the desired effect, andthat since the work was completed the prisoners have beenentirely free from the maladies resulting from imperfectsanitation.There are two points both of capital importance in the

theory of crime and its repression to which the Commissionersrefer, but, as it seems to us, only inadequately, in their report.The first of these relates to the identification of criminals,and the second to their physique. By way of illustratingthe English system of identification the preface to thE

register of habitual criminals for 1889 is reprinted in thepresent report. From this it appears that only persons whohave been convicted more than once, and against whom aprevious conviction has been proved on the second trial, areadmitted to the register. Furthermore, the descriptionsgiven appear to be very inadequate, depending chiefly on thediscovery of distinctive marks, such as scars, for instance,upon the person. This is evidently one of the "things whichthey do better in France," and we should have been glad togather that the English authorities had the adoption of somesurer and completer system of identification under dis-cussion. Upon the question of the criminal’s physiquealso they seem to have been content with very vague andunmeaning generalities. "As to the physical and mentalcapacity of the frequently convicted prisoners, seven

governors consider them to be of a low and inferior type,either physically or mentally, or both ; and eight say thatthey are generally strong, healthy, and intelligent, withthe notable exception of the drunkards and vagrants, whoare either physically or mentally considered to be of a low-standard." This short paragraph contains all that theCommissioners contribute to what is perhaps the mostimportant discussion connected with their work. Inacknowledging the very painstaking way in which theirreport has been prepared and its high value considered as awhole, we must with reluctance make a reservation on thispoint, and add that we hope that future reports will gofurther in the direction of elucidating this profoundlyinteresting and important topic, and in particular that theCommissioners will not be content with vague expressions.of opinion by the governors, but will obtain definite medicaldata on the authority of the medical officers of their prisons.

THE EFFECT OF BIRTH-RATE UPONDEATH-RATE.

ACCURATELY speaking, the birth-rate can have no real’effect upon the death-rate except by its influence upon theage constitution of the population on which both rates arecalculated. It is, however, an obvious fact that the death-rate of a population depends to a very great extent uponthe proportions in which such population consists of personsliving at ages when the normal rate of mortality is high,.and of persons living at other ages when the rate islow. It requires no special knowledge of vital statistics to-arrive at the conclusion that a high birth-rate meansa high proportion of children in the population, andthat a low birth-rate implies on the other hand alow proportion of children. Hence the continual reasser--tion of the old fallacy that a high birth-rate causes a highdeath-rate and vice verst’c. This fallacy arises from a toopartial knowledge of the effect of varying birth-rates upon.the age constitution of a population. A well-marked,and therefore useful, example of this fallacy occurred re-cently in an article by a correspondent in The Timeson French and English mortality. The writer of thearticle asserted that under equal sanitary conditionsthe death-rate in France ought to be considerablylower than that in England, because the mean birth-rate in France is only 23 per 1000, whereas in Englandit i,3 31 per 1000, and added : "Consequently, thereare less children of an age when the mortality is greatest."’It is quite true that the birth-rate in France is remarkablylow (indeed, scarcely higher than the death-rate); and it isequally true that, as a consequence of this low birth-rate,the proportion of children in the French population isabnormally low. In England and Wales 136 of every 1000-of the enumerated population in 1881 were children underfive years; while the French census in the same yearshowed only 92 of each 1000 to be children of these ages.The Times correspondent would appear not to be aware thatthe death-rate among persons aged upwards of sixty yearsexceeds that among children under the age of five years.The English Life Table (No. 3), constructed by Dr.

i Farr, shows the annual death-rate of persons aged upwardsi of sixty years to be 71’7 per 1000, against 6 7 among

children aged under five years. It is, moreover, a fact that, the disproportion of persons aged upwards of sixty years in; England and France is much greater than that of children.i While 1000 of the English population contained in 1881 only

738

74 persons aged upwards of sixty years, 1000 of thA Frenchpopulation contained 123 persons at these ages. Thus the

proportion of young children and elderly persons (all liableto high death-rates), taken together, was 209 per 1000 inEngland and 215 in France. It follows, therefore, that the<age distribution of the French population is not favour-able to the French death-rate, as The Times corre-

spondent asserts. Indeed, if the true effect of the different.s.ge constitution of the English and French populations becarefully calculated, it will be found that, all other con-ditions being equal, the French death-rate would exceedthe English rate by 1’3 per 1000. It is well noted, how-ever, in the article under notice, that in the five yearsending 1888 the French recorded death-rate was 22’3 per1000, while the English recorded rate was only 18’9 per 1000,showing a difference of 3’4, of which only rather more than athird can be attributed to the effect of different age constitu-tion. French mortality statistics are at present very defective,- especially in the matter of causes of death, but such statisticsas are published point conclusively to a sanitary condition,especially in towns, far inferior to that which now prevailsin this country. Although the birth-rate in France ii low,the death-rate of children is excessive; and so far as informa.tion is available, exceptionally high death-rates from diph-theria, enteric fever, diarrhoea! diseases, and small-pox pre-vail verv generally in the urban population, of which alonestatistics of causes of death are at-present published.

THE MILITARY EXHIBITION.

IN the department of the Military Exhibition devoted toillustrating the method of aiding the wounded, and of con-veying them from the fighting lines to the various stationsand hospitals until they are finally deposited within the"base hospital," a very lucid idea of this part of thework of the Army Medical Service may be gained.The walls of the room are painted to represent the

battle-field, beneath which are seen figures demonstratingthe mode of removing the wounded from the line of fire tothe waggons which are to convey them to the dressing- station. An embankment of earth, previously dug up, isutilised as a protection to the wounded soldiera. Onevehicle, which is capable of holding four patients in thesitting posture, is occupied by two wounded soldiers. Byremoving the centre-boards of this waggon two stretcherscan be suspended, one on each side of the waggon. Awell-executed group represents some wounded soldiers, whohave been temporarily attended to, lying in differentpostures prepared for and awaiting their removal to thedressing station. The dressing station at the Exhibition isof course represented on a scale commensurate with thebuilding, and is supposed to be placed some 2000 yardsfrom the firing line, and in the most convenient positionout of the line of fire. Medical officers are seen attendingfurther to the wounded, and preparing them for removal if,possible to the field hospital. Of course, this station isfitted up with all the appliances necessary for dressing severewounds. From this station the patients who are wellenough are removed by ambulance waggons and other’means to the field hospital. The next group represents awaggon which has just been brought down with woundedsoldiers from the dressing station. The patients are placedthere on stretchers, and remain in this hospital (themovable field hospital, as it is otherwise called) until anopportunity presents itself for their removal to the basehospital, or until they are in a fit state to be removed. Many,however, are too ill to be removed at once to the rear. Camelsand elephants are seen carrying stores and appliances to thewounded. An arrangement called the "Camel Crate,"capableof carrying four men in the sitting position or two in the proneposition, is exhibited. One of the most instructive thingsto be seen in this department is the ordinary field kitchen,which can be thrown up in a very few minutes and utilisedfor cooking purposes at the field hospital. A large supplyof medical stores, including valuable instruments, splints,and a full medical armamentaria, is provided here. AnAshantee hammock for one wounded man is also ex-

hibited. The tents comprising the hospital are lighted bylanterns. In order to show the line of communication tothe base hospital, directing staff guides are placed with

I arrows pointing the way. We next arrive at the "basehospital," which is represented on account of the exigenciesof space by only one-half of an ordinary service marquee.In actual warfare, of course, the base hospital would consistof a great number of such marquees, each having four smallventilators and two large ones in the roof on each side. To

carry the patients here, an example is given of how ordinaryrailway goods waggons can be made use of for conveying thewounded by meansof stretchers slang on ropea. Ea.cliwa.ggoncan be used to carry eight persons. This part of the MilitaryExhibition brings very vividly before the mind the characterof the work performed by this branch of the public service.There is no place in the whole route, from the fore-front ofthe battle down to the base hospital, where the services ofthe medical oflicers are not held in high requisition. Weventure to think such services cannot fail to be much appre-ciated by those on whose behalf they are exercised.

Tlt(, Exhibits.-Among the more important exhibits wenotice the Maignen Filtre Rapid e. The export type ofthis filter has been sealed at Woolwich for the use of thearmy. It claims to be better than the other types exhibitedby the firm, in point of speed, efficiency, ease of manipu.lation, and for home uses. Various types of filters are

shown in working order, with the view of demonstratingby practical chemical tests what is claimed for them. Thewater-softening apparatus is particularly worthy of notice.The action of the apparatus will be demonstrated on

request. Three pocket filters are shown at work. TheSilicated Carbon Filter Company also exhibit many speci-mens. An interesting exhibit is to be seen at the EiffelAutomatic Aeration Company’s stall. A machine capableof bottling thirty dozen bottles of aerated water per hour,at an expense not exceeding one penny per dozen, workedby a boy, and small enough to be placed in anyhome, is likely to commend itself to the authorities ofhospitals and such institutions. Almost a whole sideof one room of the Exhibition buildings is devoted to

ranges and stoves and cooking apparatus of all kinds.We may mention the "Fortress" range and the "Chal.lenge" range exhibited by William Poore and Companyas being worthy of the attention of visitors. The MarshGreenall gas-heating stoves are exhibited in workingorder and in various forms. Greenall of Manchester alsoexhibits his steam washer which was awarded the prizemedal at the Sanitary Exhibition at Brighton. It is acombination of a boiler and a washing machine, no set

copper of the old and cumbrous style being required. Itsprinciple consists in utilising the expansive force obtainedby the conversion of water into steam. Its compactnessrenders it particularly useful for field or hospital use.

Hancock of Dudley exhibits means of cooking by drysteam ; and ranges and stoves for coal and gas are

exhibited by Yates, Haywood, and Co , of Rotherham.A peculiar cooking instrument, known as the "YankeeIdea," is exhibited by Poore and Co. It consists of a seriesof boilers arranged one above the other. The lowest of allcontains water, which, when converted into steam, is

conveyed to each superimposed boiler by means of a tube.Each compartment is fitted with a valve, on closing whichthe steam is shut off from the chamber. By this steamcooker" a whole dinner may be cooked at once. The"Wilmot Tea Urn" is a neat and useful article. The

principle it embodies consists of having a concentratedinfusion of tea in a jar separated from the urn itself.Water only is contained in the urn, but a patent tap drawsfrom the vessel containing the infusion and from the urnitself tea and water simultaneously, in a definite pro-portion. The tea and coffee dispensed by this apparatusare kept quite cold until mixed with the water. Bicyclesand tricycles in large numbers and of general excellencyare exhibited by many firms, the Coventry Machinists’Company having a specially good show. Hillman, Herbert,and Cooper exhibit their "Pj)emier" military safety assupplied to the Royal Marines, Royal Irish Rifles, andother cycle corps. The machine is specially fitted for roughwork, and can be arranged to carry either a gun or fishing-rod. Many others were shown illustrating the extent towhich cycles may be used in military tactics.Among the preparations exhibited, dispensed, and ex.

tolled by the various attendants may be mentioned thecocoa of Van Houtpn, " Bovril," and a species of beefextract known as "Vivo," prepared by Pearson of Liver-pool. A selection of prepared soups and a preparationcalled " Gravina " for making gravies are shown at King’s