PROPOSED EXTENSION OF THE WESTERN HOSPITAL.

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the principal zymotic diseases during last year, we shallsee good cause for attributing to improved sanitary con-dition a considerable proportion of the recent markedreduction in the national death-rate. The death-ratein 1889 from these zymotic diseases was equal to 2’10

per 1000, which, although somewhat higher than the ex-ceptionally low rate in 1888 (1’83), was very considerablybelow the average. The mean annual death-rate from these

zymotic diseases, which had been 4’15 and 3’38 per 1000 inthe two decennial periods 1861-70 and 1871-80, fell to 2-33in the nine years 1881-89. The mortality from entericfever and from small-pox was unprecedentedly low in 1889 ;indeed, only twenty-eight fatal cases of small-pox wereregistered in England and Wales during the year. Theannual death-rate from "fever" (typhus, enteric, or ill-

defined), which was 0’90 per 1000 during the twenty years1851-70, fell to 0-49 in 1871-80, and further declined to 0-24in the first nine years of the current decennium. Thus the

rate of mortality from "fever" in the past nine years hasbeen but little more than a quarter of that which prevailedin the twenty years 1851-70, and less than half the rate inthe more recent ten years 1871-80. Infant mortality, too,shows a well-marked reduction; measured by the proportionof deaths under one year to registered births, it was144 per 1000 in 1889; although 8 above the exceptionallylow rate in 1888 when the cold and wet summer caused amarked decline of diarrhoea, mortality, it was considerablybelow the mean rate in recent years. In the ten years1871-80 infant mortality averaged 149 per 1000, whereas itfell to 141 in the ten years 1881-89.

PROPOSED EXTENSION OF THE WESTERNHOSPITAL.

THE alleged proposal to purchase three acres of land

adjoining the Western Hospital of the Metropolitan AsylumsBoard at Fulham, with a view to further extension of thebuildings, is already the cause of much discontent in theneighbourhood. It is stated that the hospital has alreadybrought about a very serious diminution in the value of houseproperty in its vicinity, and so long as the story of the diffu-sion of small-pox from its pavilions is remembered this depre-ciation is hardly likely to be altogether removed. But whatis now feared is the influence of scarlet fever and diphtheriabrought together to one centre from a number of parishes. Asyet we have no distinct evidence that these diseases operatein the same way as small-pox has done ; but that is hardlya reason for proceeding to arrange for larger aggregations ofpersons suffering from these infectious maladies, unless itcan be stated that, even under such circumstances of accu- ’,mulated infection, no risk is run by the community around.With increased knowledge as to the amount of uncontrolled ’,infection which the Compulsory Notification Act will bring I,about, we can hardly escape the necessity of providingincreased isolation accommodation for the metropolis. But,with the lessons of the past still before us, London oughtnot again to be subjected to a mere experiment without somuch as an attempt at scientific investigation as to whetherthere is not some limit to the safe aggregation of personssuffering under the various infectious fevers.

HORSE-BEEF BEEF-TEA AND SAUSAGES.

SOME features of the traffic in meat are indeed remark-

able, as the following incident shows. A few days ago anomnibus conductor was imprisoned for over-driving twoaged and exhausted horses which he had purchased for nextto nothing. In the defence it came out that these worn-out animals were not sold with a view to further work, but,according to their former owner, for another purpose. Theywere intended to furnish beef for the manufacture of

sausages and beef-tea. Comical though the statement may

seem, it is one which, if reliable, opens up a somewhat,serious question. The flesh of old, over-driven, and nottoo highly-fed horses must needs be of very inferiornutritive quality. Even if not diseased its fibrinous tough-ness and scant proportion of sound muscular tissue renderit virtually useless as food. Its use in the making ofsausages, and above all of beef-tea for invalids, is anevident absurdity. To pass it off as beef is a deliberateimposture which no quibble can excuse, and one which theLegislature has fortunately detected and declared to belegally punishable. The continuance of so disgraceful a,

practice will therefore depend solely on the success of effortsat evasion, and its best remedy must obviously be found incloser attention on the part of inspectors, and in subject-ing delinquents when convicted to such penalties as willrender their conduct unprofitable.

THE REPRESSION OF OBSCENEPUBLICATIONS.

IN spite of an Act for its repression, the distribution ofindecent publications continues to disgrace the social life ofour time. Happily, it is not now, as at one time, a flagrantand permitted abuse ; but there is no doubt that the powerof law, supported as it is by public opinion, will be ablesuccessfully to cope with and overcome it. Before thisdesirable end can be attained there are doubtless difficultiesto be met. The evil is an insidious one. Its detection will!

necessarily depend in a considerable degree on informationsupplied by private individuals, whose interest in such

matters, though genuine enough, is not always of an activekind. It is of importance, therefore, that this interestshould be awakened to vigorous action, since there is,

nothing else which can be so surely relied upon to stimulatethe vigilance of the executive in the work of correction.

Meanwhile, it is most satisfactory to note that policeofficials, on their part, are not disposed to spare the powers.entrusted to them bv the Act. The recent conviction atSwansea of a herbalist vendor of "preventatives" and cures.of specific diseases, and another for the sale of obscene

handbills, may be quoted in illustration. Here a policemanwas the principal informant. In comparison with thegravity of the offence, the fines inflicted in this case-40s.and 10s. respectively-are by no means excessive. The

position of some offenders in this particular would certainlybe but little affected by these very modest penalties.

PANCREATIC DIABETES.

SACCHARINE DIABETES was long ago referred to diseaseof the pancreas; and although the relationship was disprovedin course of time in the majority of cases, yet there havealways been some in which this organ has been found more-or less obviously altered, a condition of cirrhosis and of fattydegeneration being perhaps the most frequent lesions metwith. It may of course be suggested that such lesions aresecondary to the blood derangement, but that the pancreashas something to do with the destruction of sugar in theblood seems to follow from the researches undertaken

recently under the auspices of Lepine (Lyon lJlédical"Jan. 19th), who recognises the existence of a " pawn-creatic diabetes" and refers it to an insufficiency of fer-ment. In a dog which had been deprived of food for

thirty-six hours the pancreas was completely extir-

pated ; and twenty-four hours later (when the animal’surine was shown to contain sugar) the dog was killed andits arterial blood collected, whilst at the same time a dog ofthe same size, which had been kept fasting for sixty hours,was destroyed for the same purpose. The blood from eachwas tested for sugar (a) at the time of its being shed ;(b) half an hour later, after defibrination; and (c) fifteen