1857

this is almost unavoidable," continues Mr. Pinching, and healso has grave doubts whether the channel of communicationthrough which the infection was carried to the town of

Zagazig will ever be discovered. The place is in constantcommunication with Port Said, where there was plague lastyear, and the Greeks and Jews among whom the diseaseoccurred frequently travel to and from Alexandria with allkinds of merchandise.On June 2nd a suspicious case was signalled from Minieh,

which is a considerable town situated in Middle Egyptand having a population of 20,404, of whom not more than280 are foreigners. Dr. Bitter and Dr. H. C. Goodman

proceeded there on June 3rd and found a young man, anative, about 25 years of age, suffering from suspicioussymptoms. The case having been bacteriologicallydiagnosed as plague, measures similar to those at

Zagazig were promptly taken, and up to the date of thereport no further cases had been discovered. There was, itis true, an old woman, a Copt, whom the local inspectorthought presented symptoms resembling those of plague,but when at last she was found and examined the bacterio-logical results were negative. As soon as the relatives ofthis patient heard of the coming of the officials from Cairothey were stricken with unreasoning terror and concealedthe poor creature in some remote oubliette, whence it wasonly after a lengthened search that Dr. Goodman wasable to rescue her. All efforts to trace the source of theinfection remained fruitless. Some 16 days before the youngman had been at a fair in the vicinity, and according to thelocal sanitary inspector it was on his return that he first fellill.On June 6th a native, about 25 years of age, was observed

to be suffering from marked symptoms of plague at

Mansourah, which is a large town in the delta standingon the Phatnitic branch of the Nile with about 35,000inhabitants, including 1639 foreigners. Graham Bey, whoexamined the case bacteriologically, pronounced it to be oneof plague, and the man subsequently died. It was

ascertained that he had arrived at Mansourah on June 5th,having left Zagazig three days previously. All the customarysanitary measures were put in force, and up to June 9th nofurther outbreak had been reported.The following case, the last on the list, is incomplete, for

it is not stated what punishment, if any, was meted out tothe inhuman clerk. On June 7th the corpse of a Soudaneseboy who had died from plague was found in the closed houseof a clerk employed in the Parquet at Zagazig. When thisperson and his family found their servant" in extremis theyleft him in the house to die by himself, locked the door, andall fled" to Kafr-el-Zayat, which is another Deltaic townsituated on the Canopic branch of the Nile. This Govern-ment clerk, who must have been a man of some education,knew perfectly well that his servant was suffering from adisease which the sanitary officials were doing their utmostto subdue, and yet he " in no way notified the case but leftthe wretched boy to die in a most heartless manner, and didhis best to infect a town which up to the present hasremained immune."In conclusion Mr. Pinching says: " I think it my duty tc

point out to your Excellency that I consider the position oithe country with regard to the probability of the diseaseassuming an epidemic form is more serious than it has beerfor the last two years." The head of the Egyptian sanitar3department bases this important warning on the fact thaiseveral towns far apart from each other are known to havEbeen contaminated, as well as on the probability that othe]intermediate towns and villages must have likewise becomEinfected without information to that effect reaching him"Happily, the general health of the country is at presengood, and the mortality in general, and in the towns infectedlow."

THE NEW WING AT ST. THOMAS’SHOSPITAL.

ON June 20th Lord Lister opened a new wing at St.Thomas’s Hospital. The building consists of two operatingtheatres with anaesthetic rooms, a children’s ward, andvarious rooms for staff, assistants, store room, &c. The costof these additions to the accommodation of the hospitalis about .620,000.

The special points to be noticed with regard to thetheatres are the marble auditoriums of three rows only ; therounding off of all angles to prevent the collection of dust ;the sterilisation of instruments under the surgeon’s eyein the theatres ; provision for purifying soiled clothes,and mackintoshes by steam ; and the sterilisation ofinstruments, dressings, ligatures, &c., solely by means ofheat. Lighting is effected by means of a window in theroof and by electricity. All persons engaged in the opera-tion on the floor of the theatre will wear sterilised overallsand clean rubber boots which are only to be used in thetheatre. The lower 6-7 feet of the walls are of marmoriteslabs and the upper parts are of white enamel. The passageoutside the theatre is forbidden to all except operators andassistants.The children’s ward is prettily decorated with Doulton

ware panels in shades of pink, blue, and green, illustratingfairy tales and nursery rhymes. These tiles are the gift ofMr. S. G. Holland, one of the governors of the hospital, inmemory of his daughter Lilian. Outside the children’sward, which contains 15 cots, there is a balcony about ninefeet wide covered by a sloping roof. The view of the riverThames and the Houses of Parliament is, however, un-fortunately obstructed from this balcony by the inelegantroof of the nurses’ dining room, and it is to be hoped thatit is not yet too late to remedy a decided fault.The other rooms include a staff room (apart from the

theatre) where tea will be served to the visiting staff, anansesthetic recovery room next to the lift, and store-rooms.The ventilation of the block is accomplished by means ofthe Plenum system. The air is cleaned by three screensof cocoanut matting over which water is trickling con-tinuously. Between each screen and outside them are

coils of pipes for heating or cooling the air which is drivenby a fan worked by a two-horse dynamo.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 33 of the largest English towns 6333 births and 3301deaths were registered during the week ending June 22nd.The annual rate of mortality in these towns, which had been16’3, 15’2, and 14’5 per 1000 in the three preceding weeks,rose again to 15’0 per 1000 last week. In London the death-rate was 13’8 per 1000, while it averaged 15-8 in the 32large provincial towns. The lowest death-rates in thesetowns were 8’0 in Brighton, 10’7 in Norwich and in Ports-mouth, 10’8 in Croydon, and 11’5 in Huddersfield ; thehighest rates were 18’3 in Manchester, 18’4 in Sunder-land, 18’8 in Halifax, and 21’1 in Liverpool. The3301 deaths in these towns last week included 356which were referred to the principal zymotic diseases,against 320 and 357 in the three preceding weeks; ofthese 101 resulted from measles, 77 from diarrhcealdiseases, 68 from whooping-cough, 59 from diphtheria,37 from scarlet fever, 13 from "fever" " (principallyenteric), and one from small-pox. No death from any ofthese diseases was registered last week in Derby or in

Burnley ; in the other towns they caused the lowest death-rates in Croydon, Norwich, Blackburn, and Huddersfield,and the highest rates in West Ham, Bolton, Salford, Halifax,and Hull. The greatest proportional mortality from measlesoccurred in West Ham, Bolton, and Hull; from whooping-cough in Plymouth, Sunderland, and Newcastle; and fromdiarrhoeal diseases in Wolverhampton, Liverpool, and Bolton.The mortality both from scarlet fever and from "fever"showed no marked excess in any of the large towns. The59 deaths from diphtheria included 18 in London, fivein Sheffield, four in Salford, and four in Halifax. One fatalcase of small-pox was registered in Liverpool, but not one inany other of the 33 large towns ; and only one small-poxpatient was under treatment on Saturday last, June 22nd.in the Metropolitan Asylums hospitals. The number of scarletfever patients in these hospitals and in the London FeverHospital at the end of the week was 2707, against numbersincreasing from 1522 to 2594 on the eight precedingSaturdays ; 368 new cases were admitted during the week,against 317, 314, and 323 in the three preceding weeks.The deaths referred to diseases of the respiratory organsin London, which had been 240, 187, and 159 in the three pre-ceding weeks, further declined last week to 150, and were 53