499

last week in Leeds, Bristol, West Ham, Manchester, IHull, Newcastle-on-Tyne, Salford, and in 41 smaller towns ;four uncertified causes of death were registered during theweek in London and in Birmingham, and two each in Liver-pool, St. Helens, Preston, and South Shields.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in eight of the principalScotch towns, which had been equal to 14-3 and13’ 5 per 1000 in the two preceding weeks, further de-clined to 12 - 8 in the week ending August 8th. During thefirst six weeks of the current quarter the annual death-ratein these eight towns averaged 13 2 per 1000, and exceededby 1’ 3 the mean rate during the same period in the 76English towns. Among the eight Scotch towns the death-rates during the week under notice ranged from 8’ 9 inPerth and 10 - 0 in Aberdeen to 14’ 5 and 17 ’ 0 in Greenockand Dundee. The 450 deaths in the eight towns showed afurther decline of 26 from the numbers returned in the two

preceding weeks, and included 73 which were referred tothe principal epidemic diseases, against 66 and 61 in the twoprevious weeks; of these 73 deaths, 47 resulted from diarrhoea,15 from whooping-cough, four from measles, three fromscarlet fever, two from diphtheria, and two from "fever,"but not one from small-pox. These 73 deaths were equal toan annual rate of 2 ’ per 1000, the mean rate from the samediseases in the 76 English towns during the week being2 . 3 per 1000. The deaths attributed to diarrhoea in the

eight towns, which had been 30 tn each of the two pre-ceding weeks, increased to 47 in the week under notice;they included 30 in Glasgow, 10 in Dundee, and three inEdinburgh. The 15 fatal cases of whooping-cough showeda further decline from recent weekly numbers, and included11 in Glasgow and three in Dundee. Of the four fatalcases of measles, three occurred in Glasgow, and two ofthe three deaths from scarlet fever were returned in Edin-burgh. The two deaths referred to "fever" were both

registered in Glasgow, one being a case of enteric and theother of cerebro-spinal meningitis. The deaths referred todiseases of the respiratory organs in the eight towns, whichhad been 50 and 41 in the two preceding weeks, rose to54 in the week under notice, but were one below thenumber returned in these towns in the correspondingweek of last year. The causes of 16, or 3’6 6 per cent., ofthe deaths registered in the eight towns during the weekwere not stated or not certified; in the 76 English townsduring the same week the proportion of uncertified causesof death did not exceed 0 - 7 per cent.

HEALTH OF DUBLIN.

The annual rate of mortality in Dublin, which had steadilydeclined in the four preceding weeks from from 20 - 0 to 16 - 8 8per 1000, rose again to 18 5 in the week ending August 8th.During the first six weeks of the current quarter the death-rate in Dublin averaged 18’1 per 1000 ; the mean rate duringthe same period did not exceed 11 - 2 in London and12-1 in Edinburgh. The 140 deaths of Dublin residentsduring the week under notice showed an increase of13 upon the number returned in the previous week,and included 23 which were referred to the principalepidemic diseases, against numbers increasing steadily from11 to 19 in the five preceding weeks. These 23 deathswere equal to an annual rate of 3’0 per 1000, therate during the week from the same diseases being1-9 9 in London and only 0-7 in Edinburgh. Of the23 deaths from these epidemic diseases in Dublinlast week, 18 resulted from diarrhoea, two from measles,and one each from diphtheria, whooping-cough, and"fever," but not one either from scarlet fever or small-pox. The deaths attributed to diarrhoea, which had beennine and 12 in the two preceding weeks, further rose to 18last week ; and the two fatal cases of measles correspondedwith the number in the previous week. The 140deaths from all causes during the week included 34of infants under one year of age and 27 of personsaged upwards of 60 years ; the deaths of infantsshowed an increase upon recent weekly numbers. Four

inquest cases and five deaths from violence were registered,and 48, or 34-3 per cent., of the deaths registered duringthe week occurred in public institutions. The causes of foar,

or 2 ’ 8 per cent., of the deaths registered were uncertified ;the proportion of uncertified causes of death last weekdid not exceed 0’ 3 per cent. in London, but was 3’ 5 percent. in Edinburgh.

THE SERVICES.

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

E. H. Meaden to the President, additional, for three months’course of study at the Seamen’s Hospital, Greenwich.Staff Surgeons : A. H. Vizard, K. H. Jones, and J. C. G.Reed to the President, additional, for three months’ courseof study at West London Hospital; T. D. Halahan tothe President, additional, for three months’ course of studyat Dreadnought Hospital, Greenwich; G. R. MacMahon tothe Blake, reappointed on recommissioning ; M. I. Smith tothe Leander, reappointed on recommissioning; and J.Stoddart to the Pathfinder. Surgeons : G. A. S. Hamiltonto the ’ox; J. J. H. Rooney to the Leander; and H. H.Babington to the Blake, reappointed on recommissioning.The under-mentioned Surgeons have been promoted to the

rank of Staff Surgeon in His Majesty’s Fleet-viz., GeorgeRoss, John Scarbrough Dudding, Noel Hugh Harris, HenryCyril Adams, Llewellyn Lindop, Charles Thomas Baxter,William Ernest Gribbell, Robert William Basil Hall, HardyVesey Wells, Robert Bernard Scribner, Arthur Izod Sheldon,John Whelan, and Cecil Rodney Rickard (dated August 2nd,1908).

ROYAL ARMY MEDICAL CORPS.

Lieutenant-Colonel Hugh B. Mathias, D.S.O., is secondedfor service with the Egyptian army (dated July 23rd, 1908).The under-mentioned Captains to be Majors (dated

July 29th, 1908) :-George B. Riddick, Henry Hewetson,George E. F. Stammers, Charles F. Wanhill, Wilfrid E.Hudleston, and Martin P. Corkery.

Lieutenant Ronald E. Todd, from the seconded list, to beLieutenant (dated July 29th, 1908).

VOLUNTEER CORPS.

Royal Engineers (Volunteers): lst Gloucestershire : Theunder-mentioned officer resigns his commission : Surgeon-Lieutenant Charles E. Lansdown (dated March 31st, 1908).

Rifle: 2nd Volunteer Battalion, The Queen’s (Royal WestSurrey Regiment): Surgeon-Captain Paget D. Minchinresigns his commission (dated March 31st, 1908). 3rdVolunteer Battalion, The Lincolnshire Regiment: Theunder-mentioned officer resigns his commission: Surgeon-Captain John Bruce (dated March 31st, 1908). 1st VolunteerBattalion, The Leicestershire Regiment: Surgeon-Lieu-tenant-Colonel and Honorary Surgeon-Colonel Robert B.Smith resigns his commission, with permission to retain hisrank and to wear the prescribed uniform (dated March 31st,1908). 2nd Volunteer Battalion, The South StaffordshireRegiment: The undermentioned officer resigns his com-mission : Surgeon-Lieutenant Thomas Hutchinson (datedApril lst, 1908). 24th Middlesex Volunteer Rifle Corps:The under-mentioned officer resigns his commission : Surgeon-Lieutenant Wyndham A. Milligan (dated March 30th, 1908).

INDIAN MEDICAL SERVICE EXAMINATION.

The result of the July examination was announced onAugust 1st. There were 47 candidates, of whom 41 ulti-

mately entered for the examination : of these 37 qualified,the first 20 being admitted as lieutenants on probation, whileone withdrew during the examination. 13 of the successfulcandidates possessed University degrees. The names of thesuccessful candidates, with the marks obtained by each outof a possible maximum of 5100, are given below :-

B DEATH OF A CBNTEXARIA MEDICAL OFFICER.I In its issue of July 18th the M< .0 Inruc announces the

500

death on June 14th, at Cobhamberrie, 59, Pevensey-road,St. Leonards-on-Sea, of Thomas Lambert Hinton, retiredsurgeon, M.R.C.S., of the lst Bengal Fusiliers, aged 109years.years.

THE ROYAL NAVAL HOSPITAL, HASLAR.Their Majesties the King and Queen made a tour of

inspection of the Royal Naval Hospital, Haslar, on

August 8th.THE TERRITORIAL FORCE.

Several gunners were injured at the Lydd camp on

August 5th when 500 horses belonging to the LondonTerritorial Artillery Brigades stampeded. The horses werefrightened by a violent storm which suddenly swept overthe camp.

Correspondence.

THE LATE SIR THOMAS STEVENSON.

"Audi alteram partem."

To the Editor of THE LANCET.

SIR,-It was my great privilege to make the acquaintanceof Sir Thomas Stevenson 25 years ago. He took great interestin the case of Reg. v. Flannigan and Higgins, especially ontwo points. One was the rapid elimination of arsenic by thekidneys, the other the yellow staining of the intestinesdescribed by Dr. Campbell Brown and Mr. Edward Davies.I sent him full details of all the four cases which we proved; iit was admitted by the prisoner Flannigan that seven othervictims had died from the same poison. It was in this casethat arsenical fly-paper was used, probably for the first time.Dr. Stevenson came to Liverpool in July, 1889, to giveevidence in the case of Reg. v. Maybrick. I was

present in court when he was called and can amplyconfirm all that was stated in your obituary. Hehad to undergo cross - examination from the ablest z,of all advocates of that day, the eminent lawyer who was

then Sir Charles Russell and who died Lord Russell ofKillowen. He was aided by a learned confrere, then Mr.Pickford, now Mr. Justice Pickford, while both had theassistance of the late Dr. Tidy and Mr. F. T. Paul of

Liverpool. Dr. Stevenson held his own and gave his evidencein a manner which greatly impressed all who heard him. It

may be remembered that much hostile feeling was manifestedtowards the witnesses for the prosecution and Dr. Stevensonwrote to me afterwards stating that when he returned to thehotel to which I had recommended him he was refused all

help from porters and had to carry his own luggage to a cab.When subsequently I informed the late Sir James Poole ofthis he stated, " If I had heard of it at the time I wouldhave gone to the hotel and sacked everyone, from Ludlow

(manager) to the youngest page, there and then."On June 18th, 1891, Dr. Stevenson wrote to me asking meto meet him on the following day on his arrival in Liverpoolwhere he was coming to make the examination of a body tobe exhumed in one of our cemeteries. It was that of a

gentleman who had been a resident in Liverpool for manyyears but who had lived in London before his death, whichhad occurred in May. I accompanied him to the cemeteryand he was shown the grave where the deceased had beeninterred on June lst. It was exhumed and examined onthe following day. There were rumours of poisoning. Thestrictest secrecy was enjoined and nothing appeared inthe papers till nearly a fortnight afterwards. The post-mortem examination revealed natural disease and no traceof poison could be detected by the most careful analysis.After Dr. Stevenson’s return to London I was able to quotehim cases showing the illegality of examining accused

persons without their consent, even if such had been orderedby a coroner or magistrate ; these he acknowledged andreproduced in the fourth edition of Taylor’s Medical Juris-prudence."

" He asked me to see him whenever I went toLondon, and I did so on several occasions. His kindnessand geniality I shall never forget. His death is indeed amost serious loss to the profession.

I am, Sir, yours faithfully,Liverpool, August 10th, 1908. F. W. LOWNDES.F. W. LOWNDES.

BILATERAL DISLOCATION OF THESHOULDER.

To the Editor of THE LANCET.

SIR,-I was much interested in the annotation -on this

subject in THE LANCET of to-day and should like to add tothe list of cases one that occurred in my practice so long agoas 1876. The cause in this case was simple ; the man fellabout 6 feet through an open trap about two feet wide, andthe arms catching the sides were simultaneously dislocated.My friend, Mr. Eales, administered chloroform and I easilyreduced the dislocations by extension with the heel in theaxilla.

I should like to mention a method by which I havesometimes succeeded in reducing shoulder dislocations whenrecent, and which is perhaps not very well known. The

patient lies on his back on a bed or couch ; the injured armis drawn out at a right angle to the body, and the elbowcompletely flexed. The thumb of the surgeon (right forright shoulder or left for left) is placed on the head of thehumerus in the axilla, the fingers rest on the acromion andspine of the scapula. Traction is made from the flexed elbowwith alternating rotation whilst firm pressure is kept up bythe thumb on the head of the humerus. It is surprising howeasily the reduction is effected by this manipulation.

I am, Sir, yours faithfully,WILLIAM THOMAS, F. R. C. S. Eng.

Birmingham, August 8th, 1908.WILLIAM THOMAS, F.R.C.S. Eng.

ESPERANTO AND MEDICINE.To the Editor of THE LANCET.

SIR,-I observe with interest and pleasure that you aredevoting increasing attention to Esperanto. It is only fittingthat the medical fraternity should support a movement whichowes its origin to the genius and devotion of one of theirnumber and which has many of the profession among itsleaders.

I need not occupy your time further than to state thatsince the inclosed statistics were prepared more recent

figures have become available. On July 5th last there were1029 Esperanto societies throughout the world, 103 outsidesocieties which use Esperanto, 284 towns in which an

Esperanto consulate may be found, and 61 Esperantoperiodicals. These figures will be found in the OficialaGazeta Esperantista, which I send, as it does not often fallinto the hands of the public. Though entirely in Esperanto,the bulk of the information can easily be understood, and aglance through the gazette will convey some idea of the vastdiffusion of the Esperanto language.The North-Eastern Railway has taken up the language and

the corporation of Blackpool publish an official guide in

Esperanto. Having used the language constantly during thepast five years for every kind of communication and with allsorts of people, some decidedly illiterate, I am satisfied thatEsperanto will stand thorough investigation and is alreadybeginning to be very useful as the true solution of theperennial language problem.

I am, Sir, yours faithfully,G. DOUGLAS BUCHANAN.

Esperantista Konsulejo, Glasgow, August 6th, 1908.

** The official guide bears out Mr. Buchanan’s letter.

We have received several communications on the merits anddemerits of Esperanto as a universal language, but we

cannot discuss these in detail in our columns. Whethermodifications in construction and terminology would makeEsperanto an easier or a more logical language is one point;the other, to which we have made allusion, is the fact that

Esperanto is already becoming useful for the disseminationof medical knowledge.-ED. L.

G. DOUGLAS BUCHANAN.

BIRMINGHAM.

(FROM OUR OWN CORRESPONDENT.)

Appointment of Medical Officers for the Salterley Grange<SMOM7K.

AT a recent meeting of the health committee of the citycouncil a consulting physician and a medical superintendentfor the new sanatorium at Salterley Grange were appointed.