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question. All will agree that it is desirable that the

payments of the working classes should be on the prin-ciple of assurance--i.e., that they should be periodical,in sickness and in health, in order that they maybe of moderate amount, and most would agree to a littleextra payment at each attendance or on the dispensingof medicines as a check upon the tendency to make frivolousdemands on the medical men. The difficulty begins whenwe come to details and to formulate schemes and rates ofpayment which will really satisfy good general practitioners.All the recent attempts to organise medical attendance onthe working classes have been more or less unsatisfactory,including those of the Metropolitan Provident Association.They have not improved on the demoralising notion pre-valent among the working-classes that medical attendanceis to be had for next to nothing. It could not be expectedthat medical men should identify themselves with an Asso-ciation which at low terms took patients of all classeswithout respect to fitness. It remains to be seen whetherany modification of the provident dispensary system can begot to work satisfactorily in London, where the conditionsof life are exceptional. It is not proved yet that any newdiscovery works better than the old club system, supple-mented by those accommodating terms on which medicalmen have always been ready to attend the humbler classesill the emergencies of sickness and disease.

THE VICTORIAN JUBILEE AND SANITARYIMPROVEMENT.

A PUBLIC conference was held at the Paddington VestryHall on Jan. 25th to consider proposals for commemoratingthe Jubilee. The following proposals were made :-(1) Arecreation ground; (2) a public library and museum; (3) a

town hall; (4) the Imperial Institute; (5) and the purchaseof the canal basin and wharves, and the removal of the dust-collecting business from the parish. This last proposal hadreference to the following motion, which Mr. Mark H. Judge z’iintends to propose in the Jubilee Committee if sufficientsupport should be forthcoming from the inhabitants :-"That in the opinion of this Committee, the dust-collect-ing and other trades which are carried on in conmxion withthe canal basin between Warwick-crescent and Praed-street,b3sides being a continual menace to the health of the parish,are, during the summer months, a serious danger to theinmates of St. Mary’s Hospital, and a source of annoyanceto the Great Western Railway Terminus, which is so oftenvisited by Her Majesty the Queen and the Ministers of theCrown; that the Committee, therefore, considers that nobetter memorial of the Victorian Jubilee could be devised inPaddington than for the Vestry to purchase the canal basinand adjacent property in order that this long-standingnuisance may be abolished and the site suitably utilised forresidential and other purposes."

This scheme was supported at length by Mr. Mark Judge,and by Mr. Edmund Owen on behalf of St. Mary’s Hospital.

NATIONAL HEALTH SOCIETY.

ON Friday evening, Jan. 28tb, a meeting was held at thePaddington Baths to inaugurate a course of health lecturesto be given by Dr. A. T. Schofield, under the auspices of theatove Society. The meeting was largely attended and theaudience representative of every grade of society, showinghow general is the interest in the all-important subject ofhealth. In the absence of Lord Randolph Churchill, whowas detained in the House of Commons, the chair was takenby the Rev. J. C. Ridgway. Among the gentlemen on theplatform were Sir Crichton Browne, Sir Spencer Wells,Dr. Priestley, Dr. Thorne Thorne, Mr. F. Treves, Rev. Dr.’Clifford, and Mr. Shirley Murphy. After some introductoryremarks by the chairman, Sir Crichton Browne addressedthe meeting, dwelling on the importance of the work ofthe National Health Society in its efforts to prevent the.origin and spread of disease by imparting knowledge throughsuch lectures as Dr. Schofield’s to all classes; Sir C. Browne:also remarked that a special feature of these lectures would’be the avoidance of technical terms and complicated ex-

pressions, and he went on to draw a favourable comparisonbetween the physical condition of Englishmen and anyother nation in the world.

Sir SPENCER WELLS pointed out that the average lengthof life was twenty years longer now than it was fifty yearsago ; this he attributed to efforts at sanitary reform, such asthose of the National Health Society.

Mr. F. TREVES said the National Health Society wasstrictly a missionary society, inasmuch as it appealed toindividuals; in this he was supported by

Dr. THORNE THORNE, who said it was essentially thework of ladies to go among the poor, and to impress uponthem both personal and general sanitary principles.The Rev. MARSHALL TREDDLE and Rev. Dr. CLIFFORD

spoke warmly in favour of the scheme of the proposedPaddington Park.

Dr. SCHOFIELD then announced that the lectures wouldtake place at the Baths, at 8 o’clock on the following even-ings:-}1 eb. 1st: Prevention of Disease. Feb. 4th : Eatingand Drinking. Feb. 8th: Use and Abuse of Stimulants.Feb. 10th: Mind and its Culture. Each lecture will befollowed at 9 o’clock by an ambulance lecture and demon-stration ; either course may be attended separately or

together.After a vote of thanks to the Chairman the meeting

separated.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5933 birthsand 3734: deaths were registered during the week endingJan. 29th. The annual death-rate in these towns, whichhad been equal to 26-5, 24-1, and 22-8 per 1000 in thepreceding three weeks, further declined last week to21’1. During the first four weeks of the current quarterthe death-rate in these towns averaged 23’6 per 1000,and was 0’7 below the mean rate in the correspond-ing periods of the ten years 1877-86. The lowestrates in these towns last week were 11’1 in Derby, 14-9in Birkenhead, 162 in Salf ord, and 174 in Wolverhampton.The rates in the other towns ranged upwards to 261 inLiverpool, 26’4 in Blackburn, 27 in Manchester, and30’6 inBristol. The deaths referred to the principal zymoticdiseases in the twenty-eight towns, which had been485 and 392 in the preceding two weeks, further declinedlast week to 371 ; they included 130 from measles, 76 fromwhooping-cough, 64 from scarlet fever, 41 from diarrhoea,37 from "fever" (principally enteric), 33 from diphtheria,and not one from small-pox. No death from any of thesezymotic diseases was registered during the week in Derby;whereas they caused the highest death-rates in Bristol,Preston, Leeds, and Hudderstield. The greatest mortalityfrom measles occurred in Hull, Bristol, Leeds, and Hud-dersfield ; from whooping-cough in Halifax and Hudders-field ; and from scarlet fever in Sheffield, Bristol, andSalford. The 33 deaths from diphtheria in the twenty-eighttowns included 22 in London and 3 in Manchester. Small-pox caused no death in London and its outer ring, or inany of the twenty-seven large provincial towns. Only1 case of small-pox was under treatment on Saturday lastin the metropolitan hospitals receiving cases of this disease.The deaths referred to diseases of the respiratory organsin London, which had been 731, 591, and 531 in the precedingthree weeks, further declined last week to 432, and were128 below the corrected average. The causes of 90, or 2’4:per cent., of the deaths in the twenty-eight towns lastweek were not certified either by a registered medicalpractitioner or by a coroner. All the causes of death wereduly certified in Bristol, Portsmouth, Norwich, and Wolver-hampton. The largest proportion of uncertified deaths wereregistered in Blackburn, Plymouth, Halifax, and Sheffield.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 29-9,26-1, and 23-7 per 1000 in the precedingthree weeks, rose again to 24’7 in the week endingJan. 29th ; this rate exceeded by 3’6 the mean rate duringthe same week in the twenty-eight large English towns.The rates in the Scotch towns last wPpk ranged from14’6 and 18’7 in Perth and Edinburgh, to 29-7 in Glasgow and