NOTES OF THE MONTH.

DANGEROUS FIREPLACES.

A HOUSE was lately burned down at Liverpool owing to some cinders or sparks finding their way through a crack or defect in the hearthstone, and thus reaching the woodwork of the floor. There is no doubt that fires occur in this manner more frequently than is generally suspected, but at the same time it may be said that occurrences of this kind should be of the preventable class, as it is owing to a wanton neglect or avoidance of ordinary care in building, and, in fact, it is a contravention of one of the fundamental provisions of the modern Building Act or of the Local Board rules in force. Ihese rules demand that such hearth or slab shall be of stone, slate, or other incombustible substance, and shall be laid wholly upon stone or iron bearers or upon brick trimmers, and shall be solid for a thickness of seven inches at the least. The simplest and most convenient method, and therefore generally in use, is to turn a brick trimmer, or flat arch, 18 inches wide, under the hearthstone and concealed in the thickness of the wood floor; and as it is also enacted that such hearth shall be wholly bedded on an incombustible material, the haunches of the arch are usually filled in with concrete to form a level face to receive the hearth or slab. It there'ore follows that if a defect should arise in the hearthstone itself, and any ashes or sparks should find their way through any such aperture, the danger is arrested by means of the brickwork or concrete with which the sparks come next in contact. If this legalised construction is adopted and carried out in a workmanlike manner there can be no excuse for casualties of the description reported, and it is gratifying to know that builders are sharply looked after by the district surveyors, or those in authority, and although their vigilance is occasionally evaded, such mishaps nowa-days are reduced in number; and when it is remembered how many fireplaces exist in an ordinary house, the only wonder is how successfully these scamped constructions are minimised. Antiquity can hardly be advanced as an excuse for careless builders, as the Act of 1774 specifies a very similar sound construction, and, indeed, the fear of fire animated the framers of the Act throughout, as it is described as an Act for the better regulation of buildings, and for the more effectually preventing mischiefs by fire within the Cities of London and Westminster, and herein perhaps lies the difficulty, as it was not until many years later that the provinces and country towns took their cue in this respect from the metropolis, although a Building Act was passed in 1667, as a result of the Great Fire. Another recent instance of neglecting ordinary precautions may be noted in a house at Notting Hill, built within the last twenty years, where the flames from the fireplace made their way into the room through the chimney-jambs or sides. These are specified to be at least one brick thick, i.e. about nine inches, but there are bricks and bricks; a soft, ill-burnt brick will soon crumble away if not protected, and a violent stirring of the fire may complete its downfall, and bring the flames in contact with the adjoining woodwork. These points, though apparently slight, and the danger being covered by a coat of plaster, have an unpleasant way of f rcing their importance upon the uninitiated, and the grievance is the greater as the

householder has no real remedy, and as a rule no responsible party to proceed against, if even it were worth while to do so. An unfortunate case, bearing upon this in a measure, may be cited. It was brought before Mr. Justice Field and a common jury not very long since. The plaintiff occupied a house in Bayswater, and the defendant one adjoining. The defendant's chimney caught fire, and at the same time a fire broke out in the plaintiff's house on the drawing-room floor. It appeared that the houses were built about twelve years ago by the same owner, and that a half-brick had been left out in the flue just under the joists of the plaintiff's drawing-room, and by this neglect the fire had made its way through the aperture. When, however, it was stated in evidence that the aperture was in plaintiff's wall, and that his neighbour could not by reasonable examination have discovered it, it was admitted that the action could not be supported. It will thus be seen how much depends upon a little care and common-sense precaution in the construction at the beginning.

THE BOUNDARY COMMISSION.

It is refreshing and delightful to find the work of a Government Department done in a business-like and practical fashion; and, in common we suppose with most people, we have been agreeably surprised at the favourable manner in which the proposals of the Boundary Commissioners for the redistribution of electoral districts have been almost everywhere received. It is worth while pointing out, however, that the real difficulties-those, namely, in which the wishes of the great manufacturing districts of the North are concerned-have yet to be grappled with; and the Commissioners have been cautiously feeling their way in these districts, by sending in advance their Assistant Commissioners to feel the local pulse as to the divisions of towns which appear most generally suitable. The work of the Commission has certainly been got through with admirable promptitude and despatch; but we shall still be greatly surprised if they are within sight of the end of their labours when Parliament resumes. There is one point to which reference may properly be made at this juncture, though its interest is prospective only. Students of the redistribution scheme will probably have observed that municipal and Parliamentary boroughs are proposed by it to be made conterminous, which is not always the case at present. This unification of the limits of the municipal and Parliamentary borough has apparently been regarded by the framers of the Bill as a principle; but they have forgotten that the restless ambition of Town Councils is for ever tending towards the enlargement of their borders. Every year one or another of our great towns becomes greater still in the matter of superficial area, through the absorption of outlying suburbs. The municipal borough of Bradford, for instance, has been twice extended, the last occasion being in 1881. The Parliamentary borough of the same name has remained as it was, so that its population is now 15,000 less than that of the municipal borough. The new Redistribution Bill proposes to make the two conterminous. But, suppose the Town Council of Bradford, a year or two hence, folds other districts to its ample municipal bosom, how will the Parliamentary borough fare then, if its unity with the municipal borough is to be regarded as a principle? Will it

expand by automatic process, will it remain unexpanded, or will new redistribution, on a microscopic scale, be every now and then be necessary to readjust boundaries? The selection of one from the proverbial three courses above suggested we leave to any of our legislators who may be interested in the question.

66

THE SMOKE NUISANCE AT OLDHAM. THE town councillors of Oldham have been much exercised in mind regarding the smoke nuisance arising from some of the factories, but the proverbial wisdom among a multitude of councillors' is conspicuous by its absence. At a meeting of the Sanitary Committee, when the facts were again laid before the conscript fathers, it was decided to defer | the question once more, and it was also suggested that the smoke inspector, amongst others, should be discharged, although he had made a number of observations and tabulated them carefully. To discharge an official who had done his duty, be it observed, because the authorities had failed to do their portion of the work, is, to say the least, uncalled for and premature. In the metropolis, as we have often pointed out, the authorities, acting under the Smoke Abatement Act of 1853 (amended 1856), carry out their duties effectively and with great vigilance, and the same may be said of some of the provincial towns, notwithstanding the many difficulties in the way. A furnace fire when first lighted, and when replenished, must necessarily emit a considerable amount of smoke, and to meet this unavoidable fact a short time is allowed for the fire to become clear, or comparatively so, and the following saving clause also appears in the Metropolitan Act:'Provided always, that the words "consume or burn the smoke" shall not be held in all cases to mean consume or burn all the smoke," and that the justice or justices before whom any person shall be summoned may remit the penalties enacted by this Act, if he or they shall be of opinion that such person has so constructed or altered his furnace as to consume or burn as far as possible all the smoke arising from such furnace, and has carefully attended to the same, and consumed or burned as far as possible the smoke arising from such furnace.' The time referred to varies generally from five to twelve minutes, this latter being apparently the grace which is allowed to the Oldham manufacturers; but, in spite of this limit, the owners of the objectionable chimnies seem to think they are entitled to a run of half an hour, and one sapient member implied that any interference with their selfishness will cripple their trade and drive it from the town. It is obviously wrong to entrust the sanitary regulations of a town to those who are afraid to put in force the proper legislative action, and the sooner an impartial administration is effected the better for the general good, and also for the individual malcontents, in spite of their short-sighted policy. By the use of anthracite coal a great deal of smoke may be avoided at the outset, and a good stoker may, without any apparatus or specially constructed furnace, considerably diminish the nuisance; and, bearing upon this, an Engineer's letter to the Times on this burning question, on a small scale, however, may be quoted. There are among the varieties of coal two distinct types. The so-called smokeless coals have their carbon in large and gases in small proportions; their structural appearance is crystalline, from having been more or

less coked during some freak of nature. As they require more oxygen when burning than other coal, from their excess of carbon, they send up the chimney proportionately larger volumes of nitrogen and carbonic acid, both of which, being invisible, escape the name of smoke. That they require a great draught is the unscientific expression for a large supply of atmospheric air; they may smoulder with less, but will not burn without it: hence they are rarely suitable to our liking in existing grates. House coal, from being of a laminated structure, is the other type. Its carbon is in smaller and gases in larger proportions. The laminated form of house coal can be used to good purpose, since it presents well-defined faces, which are the front and back of the coal as it was in the coal measures, and also shows ends where it was broken off. Now, if either face of a lump be tapped with a hammer in the coalcellar, it will open out without loss into shaped pieces, suitable for being put on the fire; but if it be struck random blows it may be smashed up into odd bits, which, being pitched on the fire in a haphazard way, burn as best they may, when unnecessary soot is the consequence. Or, better still, put the lump on hot embers at the end of the fire with a face downwards, and in a minute or so the upper face will be seen to split along the laminæ, when with a gentle tap it falls to pieces, and, igniting with the best advantage, may be spread.'

It will have been seen that offenders are not treated with undue harshness, or want of notice, and being in possession of various ways and means of doing right, it rests very much with themselves as to whether they are open to conviction, mentally or legally.

POPULAR APPRECIATION OF INFECTIOUS

HOSPITALS.

We have recently recorded in these columns several gratifying instances of the growing appreciation by the public of the utility of infectious hospitals. Writing to the sanitary authorities of the Gloucestershire Combined District, Dr. Bond observes that the hospital at Cirencester affords ample proof of the fallacy of the statements which the opponents of these institutions are so fond of urging, that patients cannot be got to enter them, and that parents especially will not allow their children to be taken to them. During the past year the hospital had a more severe strain put upon its resources than in any previous year, twenty-five cases having been admitted to it, and of these more than half were under twelve years of age. The period during which the patients remained in the hospital varied from nine to forty-five days, with an average of 264 days. In no case was anything charged beyond the bare expense of food; medicine and medical attendance being debited to general establishment charges, which are divided between the two authorities (poorlaw and sanitary) in agreed proportions. The total cost of the patients was 497. 11s. 74d, which gives an average cost per diem of Is. 4d. The total amount charged to patients was 6l. 12s. 2 d., and 27. Is. Id. was charged to the urban sanitary authority, from whose district all the patients were received, the remainder being paid by the board of guardians of the whole area. Certainly, as Dr. Bond observes, money could scarcely be spent better than this. It is especially to be hoped that this evidence may not be without its influence upon

the Corporation of Gloucester, who, for some unaccountable reason, cannot be prevailed to unite with the rural authority for the erection and maintenance of a joint hospital.

THE PARASITES OF FISH.

IN connection with the mackerel scare' of last summer, it is somewhat remarkable that a similar panic at the same season of the year should have prevailed at Madras. The agitation became so widespread that the Government determined upon an investigation into the subject, which was entrusted to Dr. M. C. Furnell, the deputy sanitary commissioner of the province. Upon making inquiry, Dr. Furnell was unable to trace a single case of illness arising from eating fish ; and he attributes the scare principally to sensational newspaper paragraphs, and the somewhat hasty conclusion of certain officials. Appended to the report is a list of the entozoa which infest fish, and Dr. Furnell discusses the question how it happens that these are so seldom transferred to mankind, who, in India, are such large fish-eaters. He thinks that there are two, if not three, obvious answers to this question. First, that the parasites are generally found in the liver and intestines, and more frequently in the free cavity just outside the viscera, between that and the body proper, not so often in the fish itself. The ova are not unfrequently found in the flesh, but more often in the coats of the intestines; and it is not the custom for even the lowest classes to eat fish entrails, which are thrown away and the entozoa with them. The life of these entozoa (with the exception of some of the filaria or thread-worms), when once removed from fishes, is very feeble. Water raised to the boiling point effectually kills them. Careful experiments have shown that even in cysticerci (beef measles), when exposed for five minutes to temperature of 135° to 140°, life becomes absolutely extinct. Dr. Furnell found that much less than this is fatal to most entozoa. All the soft parenchymatous cestodes die when removed from their hosts, and put in fresh water to await their turn for examination under the microscope. In an hour, and in most in considerably less time, all signs of vitality have departed. It is not, therefore, very surprising that even simple cooking renders them harmless. It is possible also, though on this point

a

Dr. Furnell writes with diffidence, that the fish entozoa do not find man a congenial territory for their existence, or unquestionably more cases would come under notice.

NOTIFICATION OF CASES OF MEASLES. DR. SPOTTISWOODE CAMERON, in his last report on Huddersfield, repeats a plea he made some time ago for the compulsory notification of cases of measles and röthlen. He points out to the Town Council, who possess ample power to require this under their Local Act, that measles is a disease very difficult to check if it once gets a fair start, and it is a disease about which a very great amount of culpable negligence in the matter of disinfection exists. The fact that eighty deaths have happened in one year in Huddersfield sufficiently shows how very fatal it may be. Dr. Cameron does not ask his authority to depart from their usual practice of declining, except in very

special circumstances, to take cases of this disease into hospital. The children usually affected are too young for this; but there are many means that can be adopted at their own homes, such as separating the sick from the healthy, the careful disinfection of the house and the patient's clothing, the prevention of other members of the family from attending schools and the like, which would help to keep this disease within more reasonable limits. When an epidemic occurs, the sanitary officials are almost powerless to cope with it; but, if they had information of the cases as they arose, much might be done to prevent the disease from ever assuming an epidemic form. The outbreak of last year emphasized the belief that an epidemic gathers virulence as it extends; it began mildly, and as the number of cases increased the proportion of fatal cases amongst them increased also. If, therefore, the disease may be prevented from becoming epidemic, it may, by the same means, be kept less virulent. Most cases are not attended by a medical man, and the householder will himself be bound to report, so that no cost will be entailed. Dr. Cameron regrets that this course was not adopted last year, and proceeds to show how he dealt with the disease in its absence. Nearly 200 houses were visited in one portion of the town where the disease was most violent, and disinfectants distributed with instructions how to use them. The school authorities were communicated with, and their co-operation obtained in preventing the attendance of children from infected houses. It is only by taking such measures very early that any great good can be expected to result. Once measles has obtained the upper hand in a crowded neighbourhood, little can be done to arrest its spread. There is no question but that the notification of cases of this disease would be of immense utility to healthofficers in their efforts to stay the spread of infection, especially as the disorder, like other zymotic complaints, is regarded as a trifling illness, and as inevitable to childhood as dentition.

PURITY OF MILK.

THE following circular has just been addressed to all cowkeepers and milk-dealers delivering milk from the rural districts into the city of Coventry ::-'The Dairies, Cowsheds, and Milkshops Order, 1879.—

Jan. 9, 1885, St. Mary's Hall, Coventry.-Sir,-As

you sell milk in Coventry, and it concerns the public health here to know that all milk brought into Coventry comes from dairies in which sanitary requirements are observed, I am instructed by the sanitary committee of this city to inquire, for their satisfaction, whether your dairy is registered under the Dairies, Cowsheds, and Milkshops Order, 1879. A note or certificate from the sanitary inspector of your district addressed to me would be sufficient. Your obedient servant, FREDERIC BOOKER, Inspector of Nuisances.'

SANITARY MATTERS IN AUSTRALIA. YOUNG communities like the Australian colonies ought not to show such heavy death-rates as European countries, which are only now and with difficulty working down the accumulated sanitary arrears of centuries. The last recorded death-rates of these colonies are unduly large when their circumstances are taken into consideration, and some of the towns

especially seem to need thorough overhauling. From the last report of the Central Board of Health of South Australia we extract the following figures as to the death-rates-New South Wales, 16:03 per 1,000; Queensland, 17.99; Victoria, 15.31; South Australia, 1455; Western Australia, 14:16; Tasmania, 1579; New Zealand, 1119; City of Melbourne, at least 179 per 1,000, and more if our English method of calculation were adopted; City of Adelaide, 19'93 per 1,000. The sanitary administration of this last town by its local board appears to have been scandalously bad, and probably the same thing would have to be said of other capitals. Our antipodean cousins will evidently soon have to learn the lesson that has been so easily acquired by certain of our municipalities here of raising loans for sanitary purposes.'

THE PURIFICATION OF WATER.

AT the last meeting of the American Franklin Institute, Dr. William H. Wahl, the secretary, alluded to the experiments that were being conducted under the direction of Chief Engineer Ludlow, of the Water Department of Philadelphia, with the object of purifying the water supply by a system of artificial aeration. These experiments had proved very encouraging, and promised to yield important practical results. The plan employed, which is that suggested by Dr. Albert R. Leeds, differs from others that have been employed for a similar purpose. Laboratory experiments made by Dr. Leeds indicated that the advantageous action of atmospheric air in modifying and, in part, removing the impurities of water in contact with it, was greatly increased by producing the intermingling of the two fluids under pressure. The greater the pressure the greater is the absorption of oxygen, and consequently the greater the reduction of the impurities. The precise measure of this increase has not yet been ascertained. In order to try the experiment on a larger scale, and in such a manner as to afford some evidence of its value in practical | operation, one of the Fairmount turbine engines (No. 8) was altered so as to convert it, in part, into an air-pump, by simple mechanical artifices unnecessary to describe. The result reached by the action of the pumps thus modified was the delivery of about 20 per cent. by volume of free air into the water discharged into the main, this proportion being that which had been shown by experiments of Professor Leeds to be sufficient to surcharge the

water.

By subsequent comparison of samples of water from the Fairmount pool taken into the pump, and of the water discharged into the Corinthian basin after passing through 3,600 feet of main, the results of the experiment were made apparent. The percentage of oxygen in the aerated water was 17 per cent. greater than before; that of carbonic acid was 53 per cent. greater; and that of the total dissolved gases 16 per cent. greater. The percentage of free ammonia was diminished to 1-5 of its former amount. The percentage of free oxygen represents the excess over and above what was required to effect the oxidisation of the organic impurities. These results are most favourable, and point clearly to the entire feasibility of reducing the percentage of organic matters contained in water unduly contaminated with sewage, within the limits of safety.

THE PUBLIC HEALTH
DURING DECEMBER 1884.

THE mean temperature during the month of December at the Royal Observatory, Greenwich, was 40°8; it was 10.7 above the average December temperature in one hundred years, and exceeded that recorded in the corresponding month of either of the two preceding years. An month, while during the other sixteen days it was below excess of temperature prevailed on fifteen days of the the average.

The warmest day of the month was the 6th, when the mean was 52°0, and as much as 9°.3 above the average; the coldest day was the 30th, when the mean was only 330, and 5°5 below the average. Rain was measured at Greenwich on eighteen days during the month, to the aggregate amount of 25 inches, which exceeded by half an inch the average December rainfall in sixty-one years. During the year 1884 the rainfall did not exceed 18.0 inches, which was less than that recorded in any year since 1864 (when the amount was only 16.5 inches), and no less than 7.3 inches below the average annual rainfall in sixty-one years. As one inch of rain represents a weight of water equal to one hundred tons per acre, it follows that the deficiency of rain during last year was equal to about 730 tons per acre. The sun was above the horizon during 242.7 hours during December, but only 13.3 hours of bright sunshine were recorded at Greenwich; this amount was considerably below the average, though it slightly exceeded that registered in the corresponding period of 1883. Southwesterly winds prevailed during the first three weeks of the month, after which the wind was easterly until the end of the year.

In the twenty-eight large English towns dealt with by the Registrar-General in his weekly return, which have an estimated population of more than eight millions and three-quarters, 28,334 births and 19,115 deaths were registered during the five weeks ending the 3rd inst. The annual birth-rate, which in the two preceding months had been 34'9 and 33.8 per 1,000, further declined to 337 during December, but exceeded the rate recorded in the corresponding month of the preceding year. The lowest birth rates in these twenty-eight towns last month were 28.3 in Huddersfield, 28.5 in Brighton, and 29:4 in Bristol; in the other towns the rates ranged upwards to 38.9 in Preston, 401 in Sunderland, and 415 in Cardiff. In London the birth-rate last month was equal to 33.1 per 1,000, while in the twenty-seven provincial towns it averaged 34*3.

The annual death-rate in the twenty-eight towns, which had been 20.5 and 21.7 per 1,000 in the two preceding months, further rose to 22.8 during December, and exceeded by 0.9 per 1,000 that recorded in the correlowest annual rate of mortality last month in these towns sponding period of 1883, which was 21.9 per 1,000. The was 18.7 in Portsmouth. The rates in the other towns, ranged in order from the lowest, were as follow:-Huddersfield, 201; Plymouth, 2015; Birkenhead, 208; Sheffield, 211; Brighton, 212; Wolverhampton, 212; London, 217; Leeds, 217; Bristol, 219; Birmingham, 220; Bradford, 224; Derby, 224; Nottingham, 22.5; Salford, 230; Bolton, 24'4; Hull, 24'5; Newcastle-uponTyne, 24'5; Sunderland, 25'3; Oldham, 25·3; Liverpool, 255; Halifax, 25.6; Leicester, 259; Manchester, 26·5; Norwich, 267; Blackburn, 26.8; Cardiff, 303; and the highest rate during the month, 32'3 in Preston. While the death-rate in London during December, as above stated, did not exceed 21.7 per 1,000, it averaged 237 in the twenty-seven provincial towns. The 19,115 deaths from all causes in the twenty-eight towns during the five weeks of December included 1,869 which were referred to the principal zymotic diseases, of which 406 resulted from measles, 399 from whooping-cough, 318 from scarlet fever, 226 from 'fever' (principally enteric), 187 from small-pox, 182 from diphtheria, and 151 from diarrhoea. These 1,869 deaths were equal to 9.8 per cent. of the

total deaths, and to an annual rate of 2.23 per 1,000. This zymotic rate showed a further slight decline from those in recent months, and was below that recorded in the corresponding period of either of the two preceding years 1882-83, when it was 2.82 and 2.71 per 1,000 respectively. The death-rate in London from the principal zymotic diseases was equal to 2.1 per 1,000 during December, and was slightly below the average rate in the twenty-seven provincial towns, among which the zymotic death-rate ranged from 07 and 0·8 in Huddersfield and Portsmouth, to 33 in Bristol, 36 in Preston, 42 in Leicester, and 7.3 in Cardiff.

Measles was the most fatal zymotic disease in the twenty-eight towns during December last. The rate of mortality from this disease, which in the two preceding months had been 0.27 and 0.42 per 1,000, further rose last month to 0:48; in London the death-rate from this disease was 0.33 per 1,000, whereas in the twenty-seven provincial towns it averaged o·62, and showed the highest proportional fatality in Bristol, Leicester, and Cardiff. The death-rate from whooping-cough, which had been 0.30 and 0.37 per 1,000 in the two preceding months, further rose during December to 0:48, which differed but slightly from the rates in recent corresponding periods. This disease continues to be considerably more fatal in the provincial towns than in London, and was most prevalent in Bristol, Norwich, and Preston. The rate of mortality from scarlet fever, which in the two previous months had been 0.38 to 0'45 per 1,000, declined again last month to 0.38, and was considerably below that recorded in the corresponding month of either of the two previous years. In London the scarlet fever deathrate was 0.30 per 1,000, while in the twenty-seven provincial towns it averaged 0:45, and was proportionally most prevalent in Halifax, Newcastle-uponTyne, and Sunderland. The mortality from 'fever' (principally enteric or typhoid), which had been 0:41 and 035 per 1,000 in the two preceding months, further fell during December to 0.27; this disease showed the largest fatality in Norwich and Cardiff. The death-rate from diphtheria showed a slight increase upon that recorded in the previous month; this disease was proportionately more than three times as fatal in London as in the aggregate of the provincial towns. During the five weeks of December 187 deaths from small pox were registered in the twenty-eight towns, showing a considerable further increase upon the numbers in the three preceding months. This increase, however, was confined to London, for while the fatal cases of this disease registered in the metropolis have steadily increased during recent months, those occurring among the twenty-seven provincial towns have shown a decline. Of the 187 deaths from small-pox during December, 180 were registered in London, 3 in Liverpool, 2 in Birkenhead, I in Brighton, and 1 in Cardiff. Judged by the returns of the Metropolitan Asylum Hospitals, the prevalence of small-pox in London continued to increase during December. The number of small-pox patients under treatment in these hospitals, which had been 536 and 884 at the end of the two preceding months, further rose to 1,076 at the end of December. The average weekly number of new patients admitted to these hospitals, which had been 73, 84, and 203 in the three previous months, further increased to 217 during December.

The rate of infant mortality in the twenty-eight towns, measured by the proportion of deaths under one year of age to births registered, was equal to 151 per 1,000 during December, against 165 and 159 in the corresponding periods of the two preceding years, 1882 and 1883. In London the rate of infant mortality was equal to 136 per 1,000, whereas in the twenty-seven provincial towns it averaged 163, and ranged from 110 and 127 in Brighton and Plymouth, to 206 in Oldham, 213 in Halifax, 223 in Cardiff, and 249 in Norwich.

The death-rate from diseases of the respiratory organs, judged by the metropolitan returns, was considerably below the average during December. The weekly number

of deaths referred to these diseases in London averaged 470, and the annual death-rate was equal to 5'9 per 1,000, In Liverpool the annual rate of mortality from these diseases was last month equal to 7.3 per 1,000.

The causes of 505 of the 19,115 deaths registered in the twenty-eight towns during the five weeks of December were not certified, either by a registered medical practitioner or by a coroner. These uncertified deaths were equal to an annual rate of 2.6 per cent. of the total deaths, which showed a slight further increase upon the proportions in recent months. In London the proportion of uncertified deaths was only 14 per cent., while in the twenty-seven provincial towns it averaged 3'6, and ranged from o'o and 0.7 in Derby and Plymouth, to 6'2 in Liverpool, 74 in Oldham, and 8.2 in Hull.

Among the population living in the outer ring of suburban districts around London, estimated at rather more than 1,000,000 persons, the annual death-rate from all causes during December was equal to 19.9 per 1,000, against 2019 and 17.9 in the corresponding periods of 1882 and 1883. During the five weeks ending the 3rd inst. 104 fatal cases of small-pox, 33 of measles. 29 of diphtheria, 29 of whooping cough, 25 of fever,' 17 of scarlet fever, and 10 of diarrhoea were recorded in the outer ring. These 247 deaths were equal to an annual rate of 24 per 1,000, which exceeded that recorded in the corresponding month of either of the two preceding years. The fatality of small-pox, measles, fever,' and whooping-cough showed an increase, while that of scarlet fever and diphtheria declined. Of the 104 deaths from small-pox recorded in the outer ring during December, 85 occurred in West Ham district (including 16 of London residents registered in the Metropolitan Asylum Hospital at Plaistow), 5 in Tottenham, 7 in Croydon, and 3 in Barking Town. Of the 25 fatal cases of fever,' 7 occurred in Tottenham sub-district, and 9 deaths were referred to measles in the sub-district of Mitcham.

NOTIFICATION OF INFECTIOUS
DISEASES.

IN a table on page 330 are published uniform statistics relating to sickness and mortality in thirty-two of the thirtynine urban sanitary districts of England and Scotland in which the notification of infectious diseases is compulsory. The estimated population of the thirty-two districts for which we are enabled to publish complete statistics for the month of December last is more than two-and-a half millions of persons. The annual rate of mortality from all causes per 1,000 persons estimated to be living in these towns, which in the two preceding months had been 20.51 and 21.91 respectively, further rose during December to 24:00. In the twenty-eight large English towns dealt with by the Registrar-General in his weekly returns, the death-rate during December last averaged 22.80 per 1,000, and was, therefore, 120 below the mean rate in the thirty-two towns in the accompanying table. The rates of mortality last month were considerably below the average in Barrow-inFurness, Heywood, Reading, Accrington, and Birkenhead ; while they showed an excess in Dundee, Burnley, Preston, and Stalybridge. The death-rate from the eight infectious diseases dealt with in the table averaged 0.71 per 1,000 in the thirty-two towns furnishing this information, showing a further decline from the rates recorded in the two preceding months, which had been 0 98 and 0.91 per 1,000 respectively. No death from any of these diseases was returned in Accrington, Hartlepool, Lancaster, or Macclesfield, and only a single fatal case in Leek, Heywood, and Warrington, while they caused the highest rates of mortality in Burtonupon-Trent, Bury, Halifax, Preston, Salford, and Stalybridge. Small-pox caused I death in Birkenhead; scarlet fever was proportionally most fatal in Halifax, Preston, and Rotherham; diphtheria in Burton-upon-Trent and Salford; and enteric fever in Halifax, Aberdeen, and Bury.