1880 The Lancet  
which obviates the inconvenience attending the use of syringes fitted with ordinary pistons. No packing is required in the special construction adopted. The end or sucker consists of a cup-shaped or cylindrical disc of vulcanite, which resists the action of liquids, and does not become dry. There is consequently no danger of the end of the piston failing to fit tightly in the tube, and so acting imperfectly. The free edge of the vulcanite disc is very thin, and sufficiently elastic to secure a
more » ... acuum. The principle of construcjo tion is applicable to pumps of all ; kindc, and will be readily understood on reference to the accom-Z panying woodcut. Fig. 1 shows an hypodermic syringe of the new pattern, Fig. 2 the piston on a large scale. The instrument submitted to us is of admirable make, and the arrangement described commends itself as likely to attain the full advantages claimed for it. The ingenuity of the contrivance will be appreciated; but the practical point gained is that there will be no danger of leakage, or of the passage of air through any interspace between the piston and the tube. A SIMPLE OPHTHALMOSCOPE. THE instrument figured in the accompanying sketch (to 2 scale of one-third) is manufactured by Messrs. R. and J. Beck, of London and Philadelphia, from designs and instructiom of Mr. Charles Bader, of Guy's Hospital. The focal length of the glass mirror is seven inches, and either 1'4" or 1'5" English (35 mm. or 38 mm.) in diameter. The mirror is n01 perforated, but has a sight hole of '15" (4 mm). The frame. work is of vulcanite, and carries a ledge at back to receive the lenses of the ordinary trial cases. The back of the mirror is dull black, to avoid troublesome reflection, and the object lens supplied has a focus of 2'25 inches (57 mm.) With a little practice the nature and degree of the various forms of ametropia are almost as quickly recognised with this simple ophthalmoscope as with more complicated instruments. Its other advantages are extreme lightness, its portability, and the facility for using the lenses of the trial case for corrections, instead of the more or less bulky arrangements of many pocket ophthalmoscopes. HEALTH OF LARGE ENGLISH TOWNS. FOURTH WEEK OF 1880. THE severe cold of last week caused a further marked increase of mortality. In twenty of the largest English towns, estimated to contain in the middle of this year seven millions and a half of persons, or nearly a third of the entire population of England and Wales, 5110 births and 4264 deaths were registered during last week. The births were 75 below, whereas the deaths were no less than 989 above, the average weekly numbers during 1879. The deaths showed a further increase of 523 upon the numbers returned in the two pre. ceding weeks, and the annual death-rate, which had been 24'2 and 26'0 in the two previous weeks, further rose last week to 29'7. The lowest death-rates in the twenty towns last week were 16'5 in Wolverhampton, 21 in Portsmouth" 21'4 in Sheineld, and 24-1 in Bradford. The rates in the other towns ranged upwards to 31-3 in London, 31'7 in Liverpool, 320 in Plymouth, 32'3 in Salford, in Manchester, and 35'2 in Liverpool. The deaths in the twenty towns referred to the seven principal zymotic diseases, which had been 519 and 544 in the two previous weeks, further rose last week to 600 ; they included 273 from whooping-cough, 127 from scarlet fever, 110 from measles, and 39 from fever, principally enteric. Whooping-cough showed the largest proportional fatality in Salford, Plymouth, and London; measles in Hull, Plymouth, Nottingham and Leicester ; and scarlet fever in 1'orwich and Sunderland. Of the 17 deaths referred to diphtheria in the twenty towns, 10 occurred in London, and 3 in nirmingham. Small-pox caused 12 more deaths in London and in its outer ring of suburban districts, but not one in any of the nineteen large provincial towns. The fatal cases of small-pox in London were more numerous than in any week since the beginning of July last. The number of small-pox patients in the Metropolitan Asylum Hospitals, which bad been 75 and 84 at the end of the two preceding weeks, were 80 on Saturday last; during the week 22 new cases of smallpox were admitted to these hospitals, against 8 and 21 in the two nrevious weeks. 0 Under the influence of the severe cold the fatality of lung diseases showed a further marked increase. The deaths referred to diseases of the respiratory organs in London, which had been 455, 512, and 559 in the three preceding weeks, further rose to 757 last week, and exceeded the corrected weekly average by 341, or no less than 82 per cent. ; 531 resulted from bronchitis, and 149 from pneumonia. The deaths from these diseases were equal to an annual rate of 10'8 per 1000 of the population in London ; in Liverpool the rate from the same diseases was equal to 11'2 per 1000.
doi:10.1016/s0140-6736(02)36749-7 fatcat:t5awolgsufdx3eyarbpv6qxw4a