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many establishments in London where customers by nomeans of the humbler class are satisfied with conditionswhich in their own homes would fill them with disgust, andcomplete asepticism is seriously aimed at in very fewinstances. The skill of the barber is, perhaps, better to berelied on than the cleanliness of his apparatus. On theother hand, the man whose instruments are dirtiest is to someextent the most likely to shave carelessly and to cut hiscustomer.

A Quack’s Performances.Bertram Mortimer, whom some daily newspapers have

described as a "medical specialist " and who has practisedquackery of a very gross character with unusual audacity,has now in addition to his sentence for stealing luggage inLondon, and to the term of four years’ penal servitude towhich he was condemned at Exeter, been ordered to undergosix months’ imprisonment for fraud at Swansea. His realname has been mentioned as W. J. Powell, and his aliasMortimer has also been spelt Mortimore. Other sentences

upon him passed during earlier stages of his career were forprocuration and bigamy. In the circumstances, it is to be

hoped that when he is released from the various terms ofimprisonment now imposed upon him, some of which he will,perhaps, endure concurrently, the police will keep a sharplook-out in order to prevent the renewal of his crimes. Is italso too much to hope that this gentleman’s advertisementswill be omitted from certain daily newspapers ?

Looking Back.FROM

THE LANCET, SATURDAY, July 10th, 1830.

INSANE POOR.

IT appears by returns lately made to Parliament, whichhave just been printed by order of the House of Commons,that the number of pauper lunatics and idiots in the severalcounties of England and Wales amounts to very nearly tenthousand, 5145 of these being females. By adding to thisnumber, the amount of lunatics ascertained to be confined inpublic or private asylums, and those in the army and navy,a total of 13,665 is produced,-a mass which, according tothe calculations of Sir Andrew Haliday, is three times

greater than it was twenty years since. The judicious andhumane disposal of such a large and increasing body of

paupers, demands and must obtain, through the interferenceof Parliament, or the benevolence of the wealthy, a moreconsiderate attention than mere parochial care will bestow onthem, and this in some counties it has received. In severalof them, public lunatic asylums have been established, andhave proved highly economical and advantageous, par-ticularly in consequence of the facilities they have affordedfor the early treatment of the malady. The following state-ments, extracted from the reports of the Armagh and Wake-field Asylums, furnished a marked confirmation of thebenefits resulting from attention to cases of lunacy, while theattack is recent. In the former, within the last year,of 32 old cases admitted, only one recovered. In theWakefield Asylum, of 44 cases admitted in which thefirst attack had taken place within the three months,28 were cured within six months ; and of 23cases of twelve months standing, nine were restoredwithin two years from admission. We perceive bythe pamphlet of Dr. Palmer, a magistrate of Devon andSomerset, that the establishment of a pauper lunatic asylumin the former county also, is under serious consideration, andwill probably be carried into effect.

SALE OF SPIRITS OF WINE WITHOUT A LICENSE.-The

following letter is extracted from the last number of theGazette of Health. It cannot be too widely circulated

"Treasury Chambers, May 26, 1830." SIR,-Having laid before the Lords Commissioners of

his Majesty’s Treasury your memorial, praying that you maybe permitted to sell spirits of wine, by retail, without license,

I am commanded by their Lordships to acquaint you, thatyour request cannot be complied with. I am, Sir,

Your obedient servant,"GEO. R. DAWSON.*

"Dr. R. Reece, 8, Bolton Row."

* Rt. Hon. Geo. Robert Dawson, P.C., of Castle-Dawson, Co. Derry,Ireland, Secretary of the Treasury and later, of the Admiralty.

’

"GRO. R. DAWSON.*

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8722 births and 3662deaths were registered during the week ending July 4th.The annual rate of mortality in these towns, which haddeclined in the nine preceding weeks from 15 7 7 to 11 8 8 per1000, was again equal to 11 - 8 in the week under notice.During the 13 weeks of the past quarter the annual death-rate in these towns averaged only 13.8 8 per 1000, and inLondon during the same period it did not exceed 13 - 3.The lowest annual death-rates in the 76 towns during theweek under notice were recorded in Hornsey, Willesden,Walthamstow, and Wallasey, in each of which urban districts.the rates were below 5 per 1000 ; the rates in the other townsranged upwards, however, to 18.0 in Manchester, 18.2 inMerthyr Tydfil, 18 - 3 in Bootle, 18-4 in Burnley, and 21 5 inHuddersfield. The death-rate in London during the weekdid not exceed 10-9. The 3662 deaths in the 76 towns.during the week were fewer by two than the numberreturned in the previous week, and included 299 whichwere referred to the principal epidemic diseases, an

increase of but three upon the low number in the previousweek; of these 299 deaths, 92 resulted from diarrhoea,76 from measles, 63 from whooping-cough, 40 from

diphtheria, 22 from scarlet fever, and six from"fever" (principally enteric), but not one from small-pox.The deaths from these epidemic diseases last week were

equal to a mean annual rate of but 1 0 0 per 1000, corre-

sponding with the low rate from the same diseases in each ofthe three preceding weeks ; the rate from these diseases inLondon was again so low as O. 8. No death from any ofthese epidemic diseases was registered last week in Derby,Norwich, Birkenhead, York, or in 12 other smaller towns;. ;.the annual death-rate from these diseases ranged upwards,however, to 2-3 in Rochdale and in Smethwick, 2 - 7 in:Rhondda, 2 - 8 in Salford, and 3 - 4 in Merthyr Tydfil. Thedeaths attributed to diarrhoea in the 76 towns, which hadbeen 63, 64, and 70 in the three preceding weeks, further roseto 92 in the week under notice, and caused annual death-rates equal to 1.1 in Walsall, 1 - 3 in Coventry, and 2.0 0 inMerthyr Tydfil. The 76 fatal cases of measles showed, how-ever, a further decline from the numbers returned in thethree preceding weeks ; the highest annual rates from thisdisease were 1 - 2 in Leyton, 1 - 3 in Salford, 1 - 8 in Rochdale,and 2-0 in Stockton-on-Tees. The 63 deaths from whooping-cough also showed a further decline of 10 from the de-creasing numbers in recent weeks ; they caused, how-ever, a rate of 1-4 in Merthyr Tydfil. Of the 40fatal cases of diphtheria, an increase of five upon thenumber returned in each of the two previous weeks, tenoccurred in London and its suburban districts, and threeboth in Liverpool and in Birmingham. The 22 deaths fromscarlet fever included 11 in London and its suburbs, andthree in Liverpool. Only six deaths during the week werereferred to "fever" in the 76 towns. The number ofscarlet fever patients under treatment in the MetropolitanAsylums and London Fever Hospitals, which had declinedin the nine preceding weeks from 2938 to 2553, had furtherfallen to 2529 during the week ending July 4th; 322 newcases of this disease were admitted to these hospitals duringthe week under notice, against 289, 310, and 365 in thethree preceding weeks. The deaths in London referredto pneumonia and other diseases of the respiratoryorgans, which had steadily declined in the ten precedingweeks from 301 to 107, rose again to 120 in the week undernotice, but were seven below the corrected number in thecorresponding week of the five years 1903-07. Sixdeaths in London were directly referred to influenza,during the week. The causes of 29, or 0.8 per cent.,of the deaths registered in the 76 towns last week were not

117

-certified either by a registered medical practitioner or by a.coroner. All the causes of death were again duly certifiedin Leeds, Bristol, West Ham, Bradford, NewcastIe-On-Tyne,and in 54 other smaller towns ; six uncertified causes ofdeath were, however, registered during the week in Liver-pool and three in London and in Sheffield.

, HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in eight of the principalScotch towns, which had been equal to 14’ 7 and 14’ 5

per 1000 in the two preceding weeks, further declinedto 12-5 in the week ending July 4th, a lower rate

than had prevailed in these towns in any previous week ofthis year. During the 13 weeks of the past quarter theannual death-rate in these eight towns averaged 16’ 4 per1000, and exceeded by no less than 2 ’ 6 the mean rate duringthe same period in the 76 large English towns. Among the- eight Scotch towns the death-rates during the week undernotice ranged from 10 ’ 5 and 10 ’ 7 in Aberdeen and Edin-burgh to 15’ 3 in Greenock and 15 6 in Paisley. The 540deaths in the eight towns showed a decline of 70 from thenumber returned in the previous week, and included41 which were referred to the principal epidemic diseases,against 51 and 40 in the two preceding weeks; ofthese 41 deaths, 13 resulted from whooping-cough,11 from diarrhoea, seven from "fever," four from scarletfever, and three from both measles and diphtheria, butnot one from small-pox. These 41 deaths were equal to anannual rate of 1’ 2 per 1000, the mean rate from the same- diseases in the 76 English towns during the same week being1’0. The 13 fatal cases of whooping-cough in the eighttowns exceeded by one the number in the previous week,and included six in Glasgow, three in Edinburgh, and two inAberdeen. The 11 deaths attributed to diarrhoea were fewer

by five than the number in the preceding week ; six werereturned in Glasgow and two in Aberdeen. The seven deathsreferred to "fever" exceeded the numbers returned inrecent weeks, and included six certified as cerebro-spinalfever; five occurred in Glasgow, and one each in Edin-

burgh and Leith. The four fatal cases of scarlet feveralso showed an increase, including two in Dundee. Diph-theria and measles each caused two deaths in Glasgow.The deaths referred to diseases of the respiratory organsin the eight towns, which had been 73 and 67 in thetwo preceding weeks, were 68 in the week under notice,and were* fewer by 12 than the number returned inthese towns in the corresponding week of last year. Thecauses of 15, or 3 - 4 per cent., of the deaths registeredin the eight towns during the week were not stated or notcertified ; in the 76 English towns during the same weekthe proportion of uncertified causes of death did not exceed0’ 8 per cent.

-

HEALTH OF DUBLIN.

The annual rate of mortality in Dublin, which had beenequal to 16 5 and 16’ 0 per 1000 in the two preceding weeks,rose again to 17’ 7 in the week ending July 4th. Duringthe 13 weeks of the past quarter the death-rate in Dublinaveraged 20’4 per 1000; the mean rate during the sameperiod did not exceed 13-8 in London and 15-5 in

Edinburgh. The 134 deaths of Dublin residents regis-tered during the week under notice showed an increaseof 13 upon the number returned in the preceding week,and included 11 which were referred to the principalepidemic diseases, against 14 and 11 in the two precedingweeks. These 11 deaths were equal to an annual rate of1’5 per 1000, the rate during the week from the samediseases being only 0’ 8 in London and 0’ 9 in Edinburgh. Ofthe 11 deaths from these epidemic diseases in Dublin, sevenresulted from measles, two from whooping-cough, andtwo from scarlet fever, but not one from diphtheria,"fever," diarrhoea, or small-pox. The fatal cases of measles,which had been five and four in the two preceding weeks,rose to seven in the week under notice. The 134 deathsfrom all causes in the city during the week included 16of infants under one year of age and 39 of persons agedupwards of 60 years ; the deaths of infants showed a markeddecline from the numbers returned in recent weeks. Fourinquest cases and eight deaths from violence were regis-tered, and 57, or 42’ 5 per cent., of the deaths during theweek occurred in public institutions. The causes of all but

one of the 134 deaths registered in Dublin during the weekwere duly certified ; while in Edinburgh the causes of five,or 6 - 9 per cent., of the 72 deaths were not certified.

THE SERVICES.

THE DIRECTOR-GENERAI. 01<’ THE MEDICAL DEPARTMENTOF THE ROYAL NAVY.

Inspector-General of Hospitals and Fleets James Porter,C.B., Director-General of the Medical Department of theNavy, has been granted the relative rank of Vice-Admiral inHis Majesty’s Fleet (dated May llth, 1908).

ROYAL NAVY MEDICAL SERVICE.

Deputy Inspector-General of Hospitals and Fleets

Christopher Pearson has been promoted to the rank of

Inspector-General of Hospitals and Fleets in His Majesty’sFleet. Fleet Surgeon William Eames has been promoted tothe rank of Deputy Inspector-General of Hospitals andFleets in His Majesty’s Fleet. Deputy Inspector-Generalof Hospitals and Fleets Howard Todd has been pro-moted to the rank of Inspector-General of Hospitals andFleets in His Majesty’s Fleet. Fleet Surgeon William

Henry Norman has been promoted to the rank of DeputyInspector-General of Hospitals and Fleets in His Majesty’sFleet.The following appointments are notified :&mdash;Fleet-Surgeon :

E. H. Meaden to the President, additional, for London

Recruiting Headquarters, temporary. Surgeons : R. H.McGiffin to Royal Marines, Plymouth, and W. Bastian tothe .BMM’A. Civil Practitioner: J. A. Dickie to be

Surgeon and Agent at Sandbanks.ARMY MEDICAL SERVICE.

Surgeon-General William L. Gubbins, C.B., M.V.O., to beDeputy Director-General, vice Surgeon-General W. J.Fawcett, C.B., M.B. (dated June 24th, 1908).

ROYAL ARMY MEDICAL CORPS.Lieutenant Frederick E. Bissell to be Captain (dated

June 3rd, 1908).Lieutenant-Colonel R. S. F. Henderson to be Secretary to

the Principal Medical Officer, His Majesty’s Forces in India,vice Lieutenant-Colonel H. B. Mathias, D.S.O.

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Captain William P. Peake to be Surgeon-Major(dated June 17tn, 1908).

Surgeon-Major John A. Jones to be Surgeon-Lieutenant-Colonel (dated Jan. 17th, 1908).

IMPERIAL YEOMANRY.Leicestershire (Prince Albert’s Own) : Surgeon-Captain

Walter W. Nuttall resigns his commission (dated March 31st,1908).

VOLUNTEER CORPS.

Royal Garrison Artillery (TTOlzcn.teers) : lst BerwickshireSurgeon-Lieutenant Irvine K. Hermon resigns his com-

mission (dated March 31st, 1908). lst Gloucestershire

(Gloucester and Somerset): The undermentioned officer

resigns his commission (dated March 31st, 1908) : Surgeon-Captain Alexander Ogilvy.6 3rd Volunteer Battalion, The Gloucestershire Regi-

ment : The undermentioned officer resigns his commission(dated March 31st, 1908) : Surgeon-Captain Frederick St. J.Bullen. 2nd Volunteer Battalion, The Prince of Wales’sVolunteers (South Lancashire Regiment): SupernumerarySurgeon-Major Frederic J. Knowles (Brigade Surgeon-Lieutenant-Colonel, Senior Medical Officer, South LancashireVolunteer Infantry Brigade) to be Surgeon-Lieutenant-Colonel, remaining supernumerary (dated March 24th, 1908).

THE ROYAL NAVAL HOSPITAL, DEVONPORT.The Lords of the Admiralty on June 30th officially

inspected the Royal Naval Hospital, Devonport. Their lord-ships were received by the Commander-in-Chief (Admiral SirW. Fawkes). Amongst others present were Inspector-general H. T. Cox, Deputy-Inspector-General J. J. Dennis,Deputy-Inspector-General F. J. Lilly, and the hospitaltaff. The officers’ block and the medical and surgicalwards were inspected. The victualling yard was afterwardsvisited.