1255VITAL STATISTICS.-THE SERVICES.

for his most generous gift and hinted that others might beinduced to take a like action.A report was received from Dr. Radcliffe Crocker on the

International Conference on the Prevention of VenerealDiseases, held at Brussels in September last.-The PRE-SIDENT thanked Dr. Crocker for having represented theCollege.

Dr. W. S. Church was re-elected a representative of theCollege on the Council of University College, Bristol.A report was received from the Committee of Management

dated Oct. 9th. Amongst other matters dealt with it wasannounced that the committee recommend that theRochdale Municipal Technical School be added to the listof institutions recognised by the Board as a place of instruc-tion in chemistry, physics, and practical chemistry. Dr.Edward Liveing who retired by rotation from the committeewas re-elected on the motion of Dr. NORMAN MOORE,seconded by Dr. VIVIAN POORE.The SENIOR CENSOR (Dr. PYE-SMITH) proposed, and the

REGISTRAR (Dr. LIVEING) seconded, that Dr. W. D. Halli-burton be re-elected a member of the LaboratoriesCommittee.This was agreed to.The REGISTRAR moved for the second time that By-law

163 be altered so as to read as follows :-The fee to be paid for admission as a Member of the College shall be

40 guineas except when the candidate for the Membership is a Licen-tiate of the College, in which case the fee already paid for the Licenceshall be deducted from the 40 guineas.This was seconded by the SENIOR CENSOR and adopted.The quarterly report of the examiners for the Licence was

received and adopted.After some further formal business the PRESIDENT dis-

solved the Comitia.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 33 of the largest English towns 6545 births and 462:deaths were registered during the week ending Oct. 28thThe annual rate of mortality in these towns, which ha(been 18’6 and 19-0 per 1000 in the two preceding weeksfurther rose last week to 21’1, and was identical with the deathrate in London, and with the mean rate in the 32 provinciatowns. The lowest death-rates in these towns were 10’1 irCardiff, 12’7 in Croydon and in Derby, 13’4 in Norwich, anc14’0 in Plymouth. The highest rates were 24’8 in Salford.27 3 in Sheffield, 27-7 in Liverpool, and 29-7 in Bristol.The 4623 deaths in these towns included 487 which werereferred to the principal zymotic diseases, against 436 and457 in the two preceding weeks; of these, 130 resulted fromdiphtheria, 98 from measles. 93 from "fever" (principallyenteric), 89 from diarrhoea, 37 from whooping-cough, 36 fromscarlet fever, and four from small-pox. The lowest death-rates from these diseases were recorded in Plymouth, Cardiff,Derby, Preston, and Halifax; and the highest rates inPortsmouth, Swansea, Birkenhead, Salford, Sheffield, andHull. The greatest mortality from measles occurred in

Nottingham, Birkenhead, Salford, and Sheffield ; fromscarlet fever in Burnley; from whooping cough in Gates-head ; from "fever" in Nottingham, Sheffield, and Sunder-land ; and from diarrhoea in Bristol, Wolverhampton,Liverpool, Manchester, Salford, and Gateshead. The 130deaths from diphtheria included 58 in London, 13 inSheffield, seven in Leeds, six in Portsmouth, six in Swansea,and six in Birmingham. Four fatal cases of small-pox wereregistered last week in Hull, but not one in any other of the33 large towns, and no small-pox patients were undertreatment in any of the Metropolitan Asylums Hospitals.The number of scarlet fever patients in these hospitalsand in the London Fever Hospital on Saturday last, Oct. 28th,was 3504, against 3003, 3217, and 3408 at the end of thethree preceding weeks; 414 new cases were admitted duringthe week, against 461, 455, and 447 in the three precedingweeks Influenza was certified as the primary cause

of 18 deaths in London. The deaths referred to diseasesof the respiratory organs in London, which had increasedfrom 133 to 306 in the five preceding weeks, further rose lastweek to 478, and were 160 above the corrected average. Thecauses of 56, or 1’2 per cent., of the deaths in the 33 townswere not certified either by a registered medical practitioneror by a coroner. All the causes of death were duly certifiedin Leicester, Manchester, Salford, Bradford, Leeds, and I’in 12 other smaller towns ; the largest proportions of i

uncertified deaths were registered in West Ham, Birmingham,Liverpool, Sheffield, and Hull.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 18-1 and 17-3 per 1000 in the two precedingweeks, rose again to 17’9 during the week ending Oct. 28th,.but was 32 per 1000 below the mean rate during the sameperiod in the 33 large English towns. The rates in the

eight Scotch towns ranged from 10 in Leith and 13’5 inPerth to 18’8 in Greenock and 20 3 in Glasgow. The 546.deaths in these towns included 27 which were referredto diarrhoea, nine to measles, eight to diphtheria, eight to’’ fever," six to scarlet fever, and one to whooping-cough. In.all, 59 deaths resulted from these principal zymotic diseases,against 75 and 63 in the two preceding weeks. These59 deaths were equal to an annual rate of 19 9 per 1000,which was 0’3 below the mean rate last week from thesame diseases in the 33 large English towns. Tne fatal casesof diarrhoea, which had decreased from 193 to 26 in theseven preceding weeks, rose again last week to 27, of which13 occurred in Glasgow, four in Edinburgh, three inDundee, and three in Paisley. The deaths from measles,which had been 15 and 13 in the two preceding weeks,further declined to nine last week and included eight-in Glasgow. The fatal cases of diphtheria, which hadbeen three and four in the two preceding weeks, furtherrose last week to eight, of which three were recordedin Edinburgh, two in Glasgow, and two in Greenock. Thedeaths referred to different forms of "fever," which hadbeen nine and 13 in the two preceding weeks, declined againto eight last week, and included four in Glasgow and two in.Dundee. The six fatal cases of scarlet fever correspondedwith the number in each of the two preceding weeks, andincluded three in Glasgow. The deaths referred to diseasesof the respiratory organs in these towns, which had been 102and 84 in the two preceding weeks, rose again to 108 lastweek, but were 11 below the number in the correspondingperiod of last year. The causes of 20, or nearly 4 per cent.,of the deaths in these eight towns last week were notcertified.

___

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 33 6 and 37’3per 1000 in the two preceding weeks, declined again to 36 4during the week ending Oct. 28th. Daring the past fourweeks the death-rate in the city has averaged 34’1per 1000, the rate during the same period being 19’0 inLondon and 17-7 in Edinburgh. The 244 deaths registeredin Dublin during the week under notice were six belowthe number in the preceding week, and included 63which were referred to the principal zymotic diseases, against68 and 64 in the two preceding weeks ; of these, 44 resulted-from measles, nine from diarrhoea, seven from "fever," twofrom diphtheria, one from scarlet fever, and not one eitherfrom small-pox or whooping-cough. These 63 deaths wereequal to an annual rate of 9-4 per 1000, the zymotic death-rate during the same period being 2-0 in London and 1’6 inEdinburgh. The deaths resulting from measles, which hadbeen 44 and 52 in the two preceding weeks, declinedagain last week to 44. The fatal cases of diarrhoea, whichhad decreased from 27 to four in the four preceding weeks,rose again to nine last week. The deaths referred to-different forms of fever, which had been seven and four inthe two preceding weeks, rose again last week to seven.

The mortality both from measles and from scarlet fevercorresponded with that in the preceding week. The 244-deaths in Dublin last week included 45 of infants underone year of age and 55 of persons aged upwards of 60years ; the deaths of infants exceeded the numbers recordedin the preceding week, while those of elderly persons showeda decline. Nine inquest cases and eight deaths from violencewere registered; and 79, or nearly a third, of the deaths.occurred in public institutions. The causes of 13, or morethan 5 per cent. of the deaths in the city last week were notcertified.

THE SERVICES.

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

John S. Lambert to the Excellent. Staff Surgeons : P. E.Maitland to the St. George; C. Strickland to the Jitno;

1256 "INFANT FOODS AND SCURVY RICKETS."

J W. Slaughter to the Cambrian,. W. W. Pryn to the IMinerva; J. A. Moon to the Arethusa,. J. C. F. Whicberto the Monarch for the Penelope; and G. F. Wales to theMelamp1l8. Surgeons : L, Kilroy to the Bosoa7Ven for theJMO// Henry C. Whiteside to the Magpie; W J.Codrington to the St (}ellrqe,. W. H. Pope to the In’f/o,.J W. Bird to the u1a-tervu; A. W. B. Givesay to theTh1lnderer; ; T. T. Jeans to the Doris; and E R. Grazebrookto the Irnpregnable.

ROYAL ARMY MEDICAL CORPS.

Surgeon-General T. F. O’Dwyer actq as Principal MedicalOfficer on the Staff of Lieutenant- General Kelly-Kenny,C B., who commands at Aldershot in the absence of SirRedvers Buller, V.C., G.C.B., K.C.M.G. Majlr E V. A.

Phipps proceeds to Aldershot for field service with the10th Hussars. Lieutenant N. N. G Rattray has arrivedat Colchester for temporary duty. Captain T B Beachhas left Woolwich. Lieutenant H. N Nicholls assumesmedical charge of the Royal Artillery and details,Marlborough Lines. Surgeon-Major E J. Hunter, A M R,is appointed to the medical charge of troops, GosportBarracks and Surgeon-Major E. T. Crouch, A.M.R, to themedical charge of the troops at Forts Gomer and Grangeand Browndown Camp Lieutenant-Colonel B B Connolly(retired) assumes charge of the Auxiliary Hospital andduties of Sanitary Officer, Woolwich Garrison. CaptainLewis will be transferred to the Home Establishment witheffect from Dec. 18th next. Captain R Fawsett is

appointed Medical Officer to the composite squadron ofHousehold Cavalry for service in South Africa.The undermentioned appointments are made to the Staff

of the Lines of Communication in South Africa :-ColonelW F. Stevenson to be Principal Medical Officer; MajorG. H. Sylvester to be Medical Officer. The undermentionedappointments are made to the Staff of the Natal FieldForce in South Africa : Lieutenant.Colonel R. Exhamto be Principal Medical Officer; Major J. F. Batesonto be Medical Officer. 4th Division: Lieutenant-ColonelS. H. Carter to be Senior Medical Officer -LondonGa;ette.

VOLUNTEER OFFICERS’ DECORATION.The Queen has conferred the Volunteer Officers’ Decoration

upon the undermentioned officers of the Volunteer Force :-Scottish DistrÙ:t: : Rifle: : ’]’he Queen’s Rifle VolunteerBrigade the Royal Scots (Lothian Regiment) : Surgeon-Lieutenant-Colonel Charles Watson MacGillivray. The

Glasgow Cornpanies Volunteer Medical Staff Corps : Sur-

geon-Captain George Thomas Beatson.

TRANSVAAL WAR NOTES.

The tender sympathy of the Queen is once more mademanifest by her action in directing that suitable articles ofcl thing for the use of the wounded on arrival from SouthAfrica should be sent to Netley Hospital.Rumours of the disregard of the ethics of war as recognised

by all civilised nations have been circulated about theBoers, but in the absence of confirmation it behoves us tosuspend judgment on a foe who in other ways has provedhimself worthy of our steel. In the meantime we are gladto hear on the authority of a telegram to the 1’Únes. thatMaior J. F. Donegan, R.A.M.C., Principal Medical Officerat Glencoe, has telegraphed his thanks to the State Secretaryat Pretoria on behalf of British officers and men in hospitalfor the extreme kindness shown by both Boer officers andmen.

We think that the Secretary of State for War and themilitary author.ties are to be congratulated on having exer-ci5ed a wise discretion in causing it to be known that everyfacility will be afforded to such officers, non-commissionedomcers, and men as may desire to avail themselves of theinoculation method of protection against attacks of entericfever Since this method of prophylactic treatment wasfirst originated by Protestor Wright "Of Netley it has been

experimentally tried with such an amount of success as

to warrant, ar, any rate, it being pursaed on a larger scale.Professor Wright has not only been carrying out his methodat home but in India also, where, as everyone knows,enteric fever is so widely prevalent among our Europeantroops as to amount to a scourge. Enteric fever so com-

monly occurs among troops on field service everywhere, andour experience of it in South Africa has been such thatit is highly desirable that no probable safeguard that cance taken should be neglected.

A NEW TREATMENT FOR P1(IMOS(S.

Starting with the theory that phimosis is solely due to"atre-ia of the preputial mucous membrane," the elasticcsutaneoui covering being in no wise blameable, a Frenchnaval surgeon, Dr. Isambert, has heen led to device a < ew

method of treatment, which is described in t,l1e Archives deMedecine Navale for September hy a brother officer, Dr.

,

Dunnart. In order to keep the mobile organ under controlthe operator attaches three Pean’s forceps equidistantlyround the prepuce, in the free margin of which he thenmakes three minute notches with a pair of scissors. Nxt,inserting the sharp blade of the instrument into eachnotch successively, he divides the mucous membrane longi-tudinally as far as the balano-preputial furrow, takingcare to avoid injury to the skin, the loose cellular tissuebetween the two structures rendering this a comparativelyeasy matter. Free dilatation of the constricting envelopeis thus made feasible and the glans penis can be readilyliberated. The prepuce having been retracted sutures shouldbe applied where necessary, and a liberal allowance of iodo-form gauze having been laid on the process is complete.Before commencing the operation Dr. Isambert washes outthe sub-preputial space with an antiseptic solution, and healso secures anaesthesia by means of cocaine injections. Inthe opinion of the reporter the whole procedure leavesnothing to be desired. The loss of blood is insignificant, thenatural protector of the gland is preserved, and cicatrisationtakes place so rapidly that the patient’s loss of service isreduced to a minimum. For the first few days the iodafcrmdressing should be renewed frequently, if possible after eachmicturition

DEATHS IN THE SERVICES.Fleet Surgeon Michael Joseph McCarthy (retired), on

Oct. 24th, at Torquay, aged 45. He entered the service in1877, was made staff surgeon in 1889, fleet surgeon in 1898,and retired in the following year. As surgeon to the

Carysfort he served with the Royal Marine Battalion duringthe operations in the Eastern Soudan, 1884 (Egyptian menat,Khedive’s bronze star).

GREENWICH HOSPITAL PENSION.The Lords Commissioners of the Admiralty have awarded

the Greenwich Hospital Pension of 50 a year, renderedvacant in consequence of the death of Fleet Surgeon RobertWillcox, R.N., to Deputy Inspector-General of Hospitals andFleets Henry Harkan, R N.

Correspondence.

" INFANT FOODS AND SCURVY RICKETS."

"Audi alteram partem." "

/’c the Editors of THE LANCET.

SIRS,-The annotation on this subject in THE LANCET ofOct. 28th touches a point of great practical importance inview of the ever-increasing use of " artificial" foods as sub-stitutes for the fresh milk of the mother or of the cow. Thesefoods are aid to be sterile and in all probability they arequite free from pathogenic microbes. Moreover, the best ofthem are chemically close imitations of human milk, thoseintended for quite young infants being free from starch, andthey often appear highly digestible. And yet their exclusiveuse is attended with serious danger, as is shown

by the above-mentioned annotation and by the follow-ing two cases which I saw in consultation. Both ofthe children were fed from birth on Allen andHanburys’ foods, of which there are three kinds, designedrespectively for children under the age of three months, fromthree to six months, and from six months and upwards.No. 1 is stated to be made from "fresh cow’s milk so modifiedas to present all the constituents of human milk in their truerelative proportions."Both patients were the children of well-to-do parents

living under excellent sanitary conditions. The first(seen in 1897) was an infant, aged nine months, whountil three weeks previously had been fed solely on

. these foods. The child had six teeth and had appa-, rently thriven until nine weeks before I saw it. Then the. right ankle began to swell, the child grew pale and bad

profuse night sweats. When seen the right leg from the ankle