HEALTH OF LARGE ENGLISH TOWNS IN THE FIFTEENTH WEEK OF 1879
562 patent funicular sheath is a rather common congenital defect, as is proved by the frequency of hernia into it, the corresponding variety of hydrocele is quite exceptional, and is not even mentioned by Mr. Curling; but descent of peritoneal fluid will occur as often in the one case as the other. Mr. Curling enters a very decided protest against Vidal's practice of incising the tunica albuginea for acute inflammation of the testis. He considers the treatment to be unsafe in practice" and
... practice" and "founded on wrong views in pathology." His remarks on the importance of completely curing epididymitis should be read by all who have the charge of such cases ; distressing cases of sterility, arising from neglect in this matter, are not very uncommon. The etiology of varicocele sadly wants elucidation, and some of the common statements will hardly bear examination. The difference in length in the veins on the two sides is so trifling that we must hesitate to accept it as even a partial explanation of the greater frequency of the affection on the left side. It would be interesting to know whether acquired inequality in length of the two lower limbs has been found to influence the relative degree of varicosity of the veins on the two sides. It is usually held that the peculiar termination of the left spermatic vein in the renal vein is an important element in the production of varix ; but before accepting this doctrine it is well to reflect that in obstructive heart and lung disease, where there is notable renal congestion, as evidenced by scanty and albuminous urine, left varicocele is not commonly met with; it should occur if the prevailing belief be correct. While, however, these and some other points are not fully discussed in this work, we can honestly recommend our readers to study it, for they will receive such sound practical instruction as cannot but be of service to them. THIS is the third edition of a well-known work by a wellknown author, who himself, as he confesses, the subject of one variety of the malady on which he writes, has been compelled to winter abroad, and has thus gleaned a variety of practical experiences as to many places in the South of Europe and on the shores of the Mediterranean, the results of which appear in the book before us. There is abundant room for a work which shall be a direction in the matter of travel for remedial purposes. One man pitches upon the Riviera, a second on the Cape, a third on Egypt, a fourth on Davos, and a fifth on some inaccessible and semi-barbarous settlement on the tops of the Andes. A pulmonary cripple is taught to believe that, as he reads, this particular place is the elysium for him, the haven where he would be. Nothing is usually said of the wretched roads, the vile accommodation, the villainous smells, and the nasty cooking. A book on climate for the use of pulmonary physicians and their clients is much needed. Is Works. 1879. THIS quartette of pamphlets, selected from dozens-aye, we may say scores-of others, are pretty fair samples o: sanitary literature, as it is concocted in the last quarter of the nineteenth century; for if pamphleteering could make us clean, we should be clean indeed ! No. 1 contains some very plainly instructive plates showing how a house ought to be sewered and ventilated, and how most of them are in the present day arranged in this respect. The first sentence of the title might have been omitted, as savouring too much of the catch-penny style. Dr. Ransome treats his subject philosophically and scientifically, but there is little of the practical in his lecture, and as one "for the people " we cannot quite call it a success. Mr. Hinckes Bird is one of those enthusiastic sanitary reformers who probably do some good by repeating familiar scraps of information. The last above-quoted is the cheapest and the best of this small parcel, for it details in an eminently practical manner certain statistical and other particulars in connexion with the Lower Thames Valley sewage scheme, the failure of which in the House of Commons we commented on emphatically a short time ago. Mr. Nelson brings the per. spicuity of an experienced and well-read lawyer to bear on his work, and so we have here an explanatory show of technicalities, which may be usefully read by all interested, whether they have supported Mr. Heywood's scheme, or, like Alderman Knight, think it a comparatively easy as well as an economical matter to dispose of the sewage by taking it out to sea. HEALTH OF LARGE ENGLISH TOWNS IN THE FIFTEENTH WEEK OF 1879. DURING last week 4722 births and 3511 deaths were registered in twenty of the largest English towns. The births were 460 below, whereas the deaths exceeded by 141, the average weekly numbers during 1878. The deaths showed, however, a further decline of 340 from the high numbers returned in the five preceding weeks. The annual rate per 1000, which in the four previous weeks had slowly declined from 29'1 to 27'2, further fell last week to 248. During the first thirteen weeks of this year, ending 29th ult., the death-rate in these towns averaged 27'5 per 1000 ; in the corresponding periods of the four years 1875-8 it was equal to 28'9, 26'2, 24'2, and 25'2 respectively. The lowest rates in the twenty towns last week were 15'0 in Portsmouth, 20'8 in Leicester, 21'2 in Brighton, 21'3 in Newcastle-upon-Tyne, and 21'4 in Salford. The ratio in the other towns ranged upwards to 26'7 in Oldham, 27'0 in Manchester, 29'2 in Wolverhampton, 32'3 in Plymouth, and 32'5 in Norwich. The seven principal zymotic diseases caused 388 deaths in the twenty towns last week, showing a decline of 43 from those returned in the previous week ; they included 145 from whooping-cougb, 76 from scarlet fever, 70 from measles, , and 39 from fever, principally enteric. The annual deathrate from these seven diseases averaged 2'7 per 1000 in thetwenty towns ; it ranged from 0'0 and 1'5 in Plymouth and -Brighton, to 3'7 in Leeds and Norwich, and 4'9 in Wolverhampton. Whooping-cough was somewhat less fatal than in the previous week ; it caused the largest proportional : number of deaths in Manchester and Leeds. Scarlet fever L showed the greatest fatality in Nottingham, Oldham, Newcastle-upon-Tyne, and Leeds ; and measles in Norwich, , Wolverhampton, and Newcastleupon -Tyne. Enteric fever caused 3 deaths both in Portsmouth and Bradford. Small-pox caused 12 more deaths in London, but not one in any of the large provincial towns. The number , of small-pox patients in the Metropolitan Asylum Hospitals ' declined during the past six weeks from 353 to 236 on ' Saturday last; 37 new cases of small-pox were, however, admitted to these hospitals during the week. f VACCINATION GRANTS.-The following gentlemen have received Government grants for efficient vaccination :-> Mr. W. A. Sumner, St. Marylebone (fourth time); and f Mr. Thomas Tomlinson, of Maldon, Essex.