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traces of vaccination were discernible. No case of small-pox has come within the cognisance of either of the medicalsuperintendents of any person who had been efficiently vacci-nated and successfully revaccinated. The nurses and servantsemployed from time to time at the various hospitals duringthe epidemic have enjoyed almost absolute immunity frominfection, and the few-some half-dozen amongst nearlyone thousand-who contracted the disease whilst dischargingtheir duties had, from some cause or other, escaped revac-cination before entering the wards. Experience has there-fore irrefutably proved that, were vaccination efficiently per-formed in infancy, within the period prescribed by the Vac-cination Act, and revaccination successfully accomplishedat puberty, small-pox, instead of being, as it is at present,a common and extremely fatal disease, would be a compara-tively rare one and so little fatal that few, if any, deathswould result from it.

I am, Sir, your obedient servant,W. F. JEBB, Clerk.

The Metropolitan Asylum District, Norfolk-street,Strand, Oct. 30th, 1879.

W. F. JEBB, Clerk.

EPSOM COLLEGE.

JAMES WILLIAMSON, M.D.

To the Editor of THE LANCET.SIR,-Those parents who have boys at Epsom have been

informed, by circular, that an outbreak of scarlatina hasoccurred at the school-the second within eighteen months.It requires no inspiration to know that there is somethingradically wrong either in the sanitary condition of the schoolbuildings or in the supervision of the boys. One of twothings has happened. Either the fever has broken out onthe spot de novo, or it has been imported. If the former,there must be some serious defect in the hygienic arrange-ments ; if the latter, there must be a looseness of disciplinenot pleasant for parental contemplation. In either case astrict inquiry is demanded, and the application of promptremedies. The present members of Council are, no doubt,amiable and excellent men, but the question is not one ofprivate character ; it is this-Do these amiable gentlemenconstitute an efficient " governing body," or do they delegatelegislative as well as administrative functions to the localauthorities ?The prosperity of Epsom is a matter of great importance

to the medical profession, and it cannot but be seriouslyjeopardised by these repeated outbreaks of a dangerousdisease. It is clearly the duty of the members of Council tomake a searching inquiry into the origin of the outbreak;and if they fail in this duty, parents will not fail to make asearching inquiry into the propriety of infusing new bloodinto the existing governing body, or of superseding it alto-gether. Yours faithfully, 1Mildmay-park, N. JAMES WILLIAMSON, M.D.

"LOOKING AT HOME."To the Editor of THE LANCET.

SIR,-Yesterday application was made at our Town Hallto inspect the register of " houses certified to be in a propersanitary condition," and information was given that two hadpassed the examination and received the certificate. Somuch for the " move made in the right direction" last

January.There is much required to place this town in a proper

sanitary condition. Perhaps the knowledge that yourcolumns are always open to advance the cause of publichealth, and your attention called to the town of Ramsgate,may arouse the Improvement Commissioners to a conscious-ness of the fact that sanitary requirements are of paramountimportance, and that it is their duty to preserve the naturalsalubriousness of this place from deterioration bv avoidablecauses. Yours obediently, F. R. C. S.Ramsgate, Nov. 4th, 1879.

HEALTH OF IRELAND.—During the quarter ended30th September last, there were registered in the 799 regis-trars’districts in Ireland 32,918 births, a number equal toan annual birth-rate of 24-6 per 1000 ; and 20,423 deaths,representing an annual mortality of 15’2 per 1000. Deathsfrom the principal zymotic diseases numbered 1996, or 9’8per cent. of the total deaths registered.

BIRMINGHAM.(From our own Correspondent.)

THE General Hospital having just completed the hun.dredth year of its existence as a medical charity, the com.mittee have issued a circular to the governors, suggestingthat this important event should be commemorated. It wasthe first medical charity established in Birmingham, and is,in addition, one of the oldest in the provinces. When first

opened, although designed to hold 100 beds, only 40 wereprovided ; while at the present time it contains 250, whichare nearly always fully occupied. It has numbered amongits physicians such worthies as Ash, Withering, and John.stone, while the names of Freer, Wood, and Hodgson haveadorned its list of surgeons. The suggestion of the com.mittee is that the memorial should take the shape of a sub.urban hospital, devoted to the treatment of chronic cases, suchas affections of the bones or internal organs, spinal diseases,ulcers, the sequelae of typhoid and scarlet fevers, measles,and such like. The committee do not at present intend todo more than notify to the public their intention, and, ifpossible, to secure a fitting site for the proposed hospital.No active canvass for subscriptions will be prosecuted untilthe prevailing commercial depression has given place to moreprosperous times.The annual meeting of the governors of the Queen’s Col-

lege was held on the 24th ult. In their report to thegovernors the Council state that the medical department isin a very prosperous condition, eighty-three students beingin attendance upon the classes. The only changes that havtaken place in the teaching staff are the appointment of Dr,Bostock Hill to the chair of Chemistry, and the election ofMr. C. B. Suckling to the office of medical tutor. A letterhaving been read from the Earl of Lichfield resigning hisposition as President, a resolution was passed expressingregret at his lordship’s resignation, and a deep sense of theservices which he has rendered to the institution. It wasdecided to defer election of another President for a shorttime. The entry of new students is large and in excess oflast year. The students’ annual dinner was to be held onthe 13th inst., at the Grand Hotel; Mr. Furneaux Jordan,Professor of Surgery at the Queen’s College, being in thechair.The collections on Hospital Sunday were this year devoted

to what are known as the amalgamated charities-viz., theDispensary, the Children’s, the Women’s, the Orthopaedic,Homceopathic, and the Dental Hospitals, and the Ear andThroat Infirmary. Notwithstanding the bad times, thepeople of Birmingham have nobly responded to the appeal fortheir aid, the large amount of ;jE4920 lls. 2. having alreadybeen received, and there is little doubt but that in a fewdays at least 95000 will be obtained.

PARIS.(From our own Correspondent.)

THE clinical chair of Mental Medicine has at last been

organised at St. Anne under the direction of Professor Ball.Great difficulty had been experienced in settling this ques-tion. Even as it stands, the clinical service is a miserableaffair, containing only male patients, and organised in de-fiance of the principles which common sense has led mentalpractitioners to adopt in the construction of asylums for theinsane. Such as it is, however, it will allow Professor Ballto break at last the compulsory silence to which he has beencondemned for more than two years after his nomination.M. Laboulbene, the new professor of History of Medicine,

commenced his course of lectures last Thursday, and waswarmly received by a large audience. The agrégés of theFaculty have always been glad enough to rise to the profes-sorate by a nomination to this chair, but it has hithertobeen looked upon only as a stepping-stone to more desirableappointments, the Professor of History of Medicine gene-rally having been allowed to permute when another vacancyoccurred amongst his colleagues. This state of things wasfar from satisfactory. The prestige of the chair was lowered,and the number of students attending was always limited.It is understood that M. Laboulbene engaged that, in case ofelection, he would never seek to permute. Such an under-