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England, the United States, Switzerland, and other countries,met in Paris during the Universal Exhibition of 1889.1 Thelast congress was held at Liege in Belgium. The OrganisingCommittee of the forthcoming congress has its headquartersat Paris and its President is Dr. Albert Robin who isPresident of the General Association of Medical Men

practising in the health resorts of France. Then there areDr. Leudet of Eaux-Bonnes, ex-President of the HydrologicalSociety ; Professor Fredet of the Medical School of Cler-mont Ferrand ; Dr. de Ranse, and others. But all communi-cations must be addressed to the Secretary-General of the

congress, Dr. Fernand Berlioz, Ecole de Medecine deGrenoble, hère, France. To be a member of the congressit suffices to forward a subscription of 20 francs andall the printed reports will be sent gratuitously to themembers. Reports on the following subjects will be pre-sented to the Congress and discussed : The Action ofMineral Waters on the Tissues, by Professor J. Renault of

Lyons ; Practical Methods for the Bacteriological Analyses ofMineral Waters, by Dr. Bordas ; Chemical Analyses ofMineral Waters and their Therapeutic Applications, byDr. Garrigon ; and the Legal Measures that should betaken to Prevent Frauds in the Sale of Mineral Waters,by Dr. Bouloumie. These papers come under the headof scientific Hydrology." Then there is to be a sectionof Clinical Hydrology" in which reports on the Hydro-mineral Treatment of Pulmonary Phthisis, by Dr. Leudetand Dr. Schleumer, and other papers on the Treatment ofSkin Diseases, Diseases of the Digestive Organs, and ofConstitutional Weakness in Children by the Use of MineralWaters, Baths, &c., will be read A fourth section dealswith Climatology and reports will be submitted on theInfluence of Temperature and Altitude on the RespiratoryFunctions ; on the Meteorological Conditions Necessary forthe Installation of a Sanatorium ; and on the Indoor andOutdoor Treatment at Sanatoriums. Finally, there is a

Geological section where the question of the preservationof mineral waters, the relations of the mineral waters of theDauphin6 and the geology of the soil, the statistics of thethe mineral springs of Savoy and the Dauphine, and thegeological conditions and the origin of the mineral waters ofOriol and La Motte (Isere) will be discussed. Of course,many other questions will arise out of these French papers,particularly as members representing other nationalities willalso read papers. It is likewise to be hoped that there willbe some discussion on the sanitary condition of the varioushealth resorts, for this is a very important question whichmany local authorities are apt to neglect. In view of theinterest of the congress itself and the splendid opportunityof visiting some of the most celebrated and beautiful thermalstations of Europe it is very probable that the meeting willbe numerously attended.

ROYAL COLLEGE OF SURGEONS OFENGLAND.

ELECTION OF PRESIDENT.A QUARTERLY meeting of the Council was held on July 10th,

the President, Sir HENRY G. HowsE, being in the chair.The PRESIDENT reported the re-election of Mr. Howard

Marsh, and the election of Mr. John Hammond Morgan,C.V.O., Mr. Henry Hugh Clutton, and Mr. Charles WilliamMansell Moullin as members of Council.The PRESIDENT stated that Mr. Moullin being fourth on

the poll would be the substitute member of Council for thelate Sir William Mac Cormae.

Mr. Marsh, Mr. Morgan, Mr. Clutton, and Mr. Moullinwere introduced, made declarations in the terms of the oathprescribed by the Charter of 1800, and took their seats asmembers of the Council.

Sir Alfred Cooper was nominated a trustee of the CancerResearch Fund to represent the Royal College of Surgeons ofEngland.The Council nominated the President and Mr. John

Langton and Mr. Henry Morris as members of the ExecutiveCommittee to be constituted under the Cancer ResearchFund scheme and these members were instructed to elect inthe name of the College the president and the vice-presidents of the Cancer Research Fund. Mr. Henry Morris

1 See THE LANCET, Oct. 19th, 1889, p. 813.

was appointed treasurer of the fund subject to the approvalof the Royal College of Physicians of London.A Member of the College who had previously been struck

off the Medical Register by the General Medical Councilwas removed from being a Member of the College.The PRESIDENT stated that the committee appointed to

receive a deputation Jrom the Association of Licentiates ofthe Royal College of Physicians of London and Members ofthe Royal College of Surgeons of England would submit areport at the next meeting of the Council.

Sir Henry Greenway Howse was unanimously re-electedPresident of the College and Mr. John Tweedy and Mr.A. VT. Mayo Robson were elected Vice-Presidents. Thefollowing appointments were made :-Hunterian Professors Mr. Charles Stewart, Mr. William McAdam Eccles, and Mr.Arthur Keith ; Arris and Gale Lecturer : Mr. John HerbertParsons ; Erasmus Wilson Lecturer : Dr. Charles Bent Ball,Hon. F.R.C.S. Eng.

public Health and Poor Law.LOCAL GOVERNMENT BOARD.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Birmingham Urban -District.-Dr. Alfred Hill records asatisfactory diminution in the number of cases of entericfever, a result which he ascribes largely to the provisionof isolation accommodation for this disease. The generaldeath-rate of the city for 1901 was 19’9 per 1000, as againstan average for the last quinquennium of 20-4. The wardrates for 1901 ranged from 29 - to 13-1 1 per 1000. In thethree wards having the lowest general rate measles causeda death-rate of 0 28, as against a rate of 0-99 per 1000in the three wards having the highest general death-rate.Somewhat similar divergencies occurred in the case of

whooping-cough and diarrhoea. With scarlet fever, on theother hand, the wards with the lowest general death-rateyielded a higher scarlet fever case-rate than the wards withthe highest general death-rate. The highest rate with respectto enteric fever and diphtheria was, however, in the threewards with the highest general death-rate. From phthisisthe death-rate was 2-70 per 1000 in the bad wards and only1-14 in the good ones. The cancer and heart-disease ratesin the two groups were nearly identical. Diphtheria anti-toxin is distributed gratuitously by the sanitary authorityand a very gratifying diminution of fatality-rate has beenapparent. The women health visitors have, as usual, donegood service in Birmingham, and amongst other things theyhave turned their attention to children who were sent homefrom school in consequence of having vermin in their hair.The house accommodation for the labouring classes inJ...!..lv llVUh’)C ctjUimtJCLiUll J-U lJlit:’ J..G1JUUU.l.l.L15 J.U

Birmingham is, Dr. Hill reports, quite inadequate, and heBirmingham is, Dr. Hill reports, quite inadequate, and heurges the town council to undertake the provision of suchdwellings. He has also made a representation under theHousing of the working Classes Acts in respect of an

unhealthy area possessing a population of some 2429. Themean death-rate of the whole area for the last two yearswas 39-5 5 per 1000.

Manchester Urban District.-In his last quarterly reportDr. J. Niven states that during the period in question eightcows were proved to be suffering from tuberculous udders.Of these eight, one was killed, two are still at the farms,concerning three there is no information available, and theremaining two were sold in the open market. The want ofall proper control over cows with tuberculous udders is

deplorable and it is to be hoped that some reform in thisdirection will soon be brought about. When milk is takenfrom the Manchester railway stations and, on examination,is found to be tuberculous, the farm which furnished thesample is forthwith visited, and milk from cows with

suspicious-looking udders is examined, first microscopically,and secondly, by means of inoculation. No action istaken until the milk has been definitely established to betuberculous.

Cardiff Port Sanitary District.-The disinfection of theholds of ships and the destruction of rats therein are mattersof such importance from the point of view of the preventionof diseases that a further reference 1 to certain experiments

1 THE LANCET, June 21st, 1902, p. 1801.

179

recently carried out at Cardiff with the Clayton fire-

xtinguishing apparatus may be useful. Dr. Edward Walford,who supervised the experiments, caused a number of rats.confined in a cage to be placed in different parts of the hold.of a ship and the sulphur dioxide generated by the Claytonapparatus was forced in at an average strength of 10 percent. The rats placed at the bottom of the hold were killedalmost immediately and those placed about three feet belowthe level of the deck were dead after three hours. In additionto these experiments strips of fabric were soaked in liquidcultures of plague, cholera, enteric fever, and anthrax

.organisms and were exposed in small glass dishes with loose- covers. After an exposure of 12 hours to the sulphur fumes.all save the anthrax culture were killed. From this it isinferred that all the non-sporing organisms were killed andthat hence the experiments were satisfactory, as sporing andjiarmfnl organisms are not likely to be encountered in

practice in the holds of ships.Brighton Urban District.-Dr. A. Newsholme furnishes in

ihis current annual report figures showing foi each of thelast three years the number of cases of diphtheria amongstscholars attending the several elementary schools in

Brighton. The board school rates for 1901 averaged from0’2 to 7’7 per cent. of the average attendance, while thevoluntary school rates ranged from 0’ 2 to 4’ 3 per cent. Asto this discrepancy between the board and voluntary schoolsDr Newsholme fails to find an adequate explanation in

.geographical distribution or in structural defects. He is of

opinion that there must be differences in administration,more particularly in the direction of the eagerness on thepart of the school board authorities to whip up absentees,.and hence the liability to bring together children sufferingfrom slight sore-throat, &c. This is certainly an interestingspeculation, but we should be glad to see the comparisonmade in other towns before altogether accepting the thesis.We are glad to see that Brighton is, in common with manyother towns, now affording facilities for the supply of

diphtheria antitoxin and that a supply of this material canbe obtained at the public health offices during the day and.at the police-offices during the night. Dr. Newsholme veryproperly urges the early administration of antitoxin, and hepoints out the desirability of not waiting until the nature of Ithe disease is definitely established. Certainly very valuabletime may be lost by waiting, and the delay is not unlikelyto turn the scale between life and death. Dr. Newsholmehas never seen any injurious effects from 500 units adminis-tered as a prophylactic, and the Brighton Corporation hassanctioned a payment of 2s. 6d. for every dose thusadministered at the request of the medical officer of healthto children living in the same house as a child alreadysuffering from diphtheria-that is to say, if the parents aretoo poor to bear the expense.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8661 births and 4120deaths were registered during the week ending July 12th.The annual rate of mortality in these towns, which hadbeen 14-9. 15 ° 1, and 15 ° 4 per 1000 in the three precedingweeks, declined to 14’5 5 per 1000 last week. In Londonthe death-rate was 14 - 6 per 1000, while it averaged 14 ’4 inthe 75 other large towns. The lowest death-rates in thesetowns were 7 ’6 6 in King’s Norton, 6 ’2 2 in Walthamstow, 6’5Grimsby and in Rotherham, 7’1 in Great Yarmouth, 8’0 inEast Ham and in Leicester, 8 3 in Hornsey, and 9 3 in Hands-worth ; the highest rates were 20’ 1 in Bootle and in Sunder-land, 21’1 1 in Manchester, 21’9 9 in Newcastle-upon-Tyne, and23 ’3 in Coventry. The 4120 deaths in these towns in the

°

same week included 533 which were referred to the principalinfectious diseases, against 476 and 522 in the two precedingweeks; of these 533 deaths 131 resulted from whooping-cough, 124 from diarrhoea, 116 from measles, 54 from

diphtheria, 45 from scarlet fever, 45 from fever " (prin-cipally enteric), and 18 from small-pox. In Hornsey,Reading, Leicester, and four other smaller towns no deathfrom any of these diseases was registered ; while they causedthe highest death-rates in Norwich, Bootle, Wigan, War-rington, Burnley, Barrow-in-Furness, and West Bromwich.The greatest proportional mortality from measles occurredin Bristol, Birkenhead, Bootle, Rhondda, Rochdale,Plymouth, Warrington, and Barrow-in-Furness ; from

scarlet fever in Burnley, Stockton-on-Tees, and WestBromwich ; from whooping-cough in South Shields,Bootle, Barrow-in-Furness, and Norwich; from "fever" inIpswich and Barrow-in-Furness ; and from diarrhoea inPreston and Bootle. The mortality from diphtheria showedno marked excess in any of the large towns. Of the deathsfrom small-pox registered during the week 13 belonged toLondon, two to Swansea, and one each to Croydon, Totten-ham, and Walthamstow, but not one to any other of the 76large towns. The number of small-pox patients under treat-ment in the Metropolitan Asylums hospitals, which had been861, 837, and 677 at the end of the three preceding weeks,had further declined to 579 at the end of the week ;57 new cases were admitted during the week, against 107,129, and 58 in the three preceding weeks. The numberof scarlet fever patients in these hospitals and in theLondon Fever Hospital on Saturday, July 12th, was 2352,against 2450, 2496, and 2432 in the three preceding weeks ;272 new cases were admitted during the week, against 378,276, and 255 in the three preceding weeks. The deaths referredto diseases of the respiratory organs in London, whichhad been 173, 194, and 168 in the three preceding weeks,further declined to 159, and were 12 below the corrected

average number. The causes of 41, or 0’ 9 per cent., of thedeaths in the 76 towns were not certified either by a registeredmedical practitioner or by a coroner. All the causes ofdeath were duly certified in West Ham, Portsmouth,

Leicester, Bolton, Salford, Bradford, Leeds, Cardiff. and in48 other smaller towns ; the largest proportions of uncertifieddeaths were registered in Ipswich, Liverpool, and SouthShields.

____

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had been 19 2 and 16 - 3 per 1000 in the two precedingweeks, further declined to 16’2 per 1000 during the weekending July 12th, but showed an excess of l- 7 per 1000over the mean rate during the same period in the 76 largeEnglish towns. The rates in the eight Scotch towns rangedfrom 13 ° 5 in Aberdeen and 14 ° 4 in Greenock to 17 - 9 inEdinburgh and 19’2 in Paisley. The 523 deaths in thesetowns included 22 which were referred to measles, 15 todiarrhoea, 14 to whooping-cough, six to "fever," three to

diphtheria, and two to scarlet fever, but not one to small-pox.In all 62 deaths resulted from these principal infectiousdiseases in the week, against 54, 57, and 66 in the three pre-ceding weeks. These 62 deaths were equal to an annual rateof 1 ’9 per 1000, which was also the death-rate in the weekfrom the same diseases in the 76 large English towns. Thefatal cases of measles, which had been 18, 15, and 13 in thethree preceding weeks, again rose to 22, and included 12in Edinburgh, four in Glasgow, and three in Paisley. Thedeaths from diarrhoea, which had been 17, 16, and 24 inthe three preceding weeks, fell again to 15 andincluded eight in Glasgow and four in Edinburgh. Thefatal cases of whooping-cough, which had been 14 and 16in the two preceding weeks, again declined to 14 andincluded six in Glasgow and three in Edinburgh and inAberdeen. The deaths from scarlet fever numbered twowhile the fatal cases of diphtheria were three and showeda slight decline from recent weekly numbers. The deathsreferred to diseases of the respiratory organs in these towns,which had been 101 and 87 in the two preceding weeks,further declined to 74 and were just below the numberin the corresponding period of last year. The causes of19, or nearly 4 per cent., of the deaths registered in theseeight towns last week were not certified.

HEALTH OF DUBLIN.

The death-rate in Dublin, which had been 17’9, 19’9,and 19’1 per 1000 in the three preceding weeks, furtherdeclined to 16’9 per 1000 during the week ending July

‘

12th. During the previous four weeks the death-rate had

averaged 19’2 per 1000, the rates during the same periodbeing 14-6 in London and 17-4 in Edinburgh. The 123deaths of persons belonging to Dublin registered during theweek under notice showed an excess of 16 from the numberin the preceding week, and included 17 which were referredto the principal infectious diseases, against 10, eight, andnine in the three preceding weeks; of these, six resultedfrom measles, four from "fever" " and also from diarrhoea,two from whooping-cough, and one from diphtheria, butnot one from small-pox or scarlet fever. These 17 deaths were