629

great misery and mortality-caused b)’ this dire pestilence maybe mitigated. "

PREOAUTIONS IN SEAPORT TOWNS.Circulars containing elaborate instructions have been issued

by the Medical Officer of the Burgh of West Hartlcpool, bythe River Town Port Sanitary Authorities, and by the Burghof Folkestone. The Port Sanitary Authority of Dover hisissued to every captain a copy of a document relatingto the cross-Channel traffic.

LIFE ASSURANCE AND THE MEDICALPROFESSION.

SINCE the appearance of our last special article contain-ing notices of the Life Assurance Companies’ Accounts wehave received a considerable number of additional reports.For the most part these documents contain very little informa-tion beyond the assurance that the issuing company, be it which it may, continues to thrive and has secured a returnof new business proportioned to the expectations of its

directors founded upon the past history of the society. To

this class must be referred the Commercial Union, whichtransacts the three branches of life, fire and marine in-

surance, and appears to succeed very respectably in everyseveral department; the Eagle, which, confining its attentionto life assurance, maintains a steady course of busi-ness upon well-established and well-approved lines ; the

Hand-in-Hand, a very old company, conducted on themutual plan, which this year submits the report forthe 195th year of its existence ; the Liverpool andLondon and Globe Insurance Company, which, giving atten-tion chiefly to the fire department, transacts an enormousbusiness in that branch, which somewhat overshadows thesmaller transactions of the life assurance department ; theNational Provident Institution, a society designed originallyto meet the requirements of the middle-class policy-holder,which has succeeded in realising its founder’s intentions in aremarkable degree ; the North British and Mercantile, a

company which has launched upon the dangerous experimentof accepting proposals for members of the Civil Service with-out requiring a medical examination, and is not very com-municative as to the present financial result ; the ProvidentClerks’ Mutual Life Assurance Association, which, as itsname imports, aims at reaching the large class of mercantileclerks, and in a very considerable measure attains its object ;the Standard, a large and well-established Scottish office, ofwhich one might expect to read some interesting details con-cerning a very widely extended business ; and the ScottishAmicable, another North British institution of large con-nexions and established reputation, which is represented bya very meagre though somewhat prolix report. Among thosewhich present points of interest in their reports mentionmust be made of the Metropolitan, an old mutual society,whose directors announce an intention to liberate their policiesin future from all conditions "not found to be absolutelynecessary." These somewhat vague words are not defined,and it is therefore impossible to judge what the extent of theremission is likely to be ; but having regard to almost completefreedom from conditions which some companies offer, it maybe taken for granted that the conditions which will remainwill not be onerous. The National Life Assurance Societyand the Scottish Widows’ Fund both report exceptionalmortality due to the visitation of influenza whichhas marked the past year, and in both cases it isobserved that the high mortality rate has been chieflynoticed among the old policy-holders. The directorsof the Star Life Office, on the contrary, remark thatinfluenza has touched them only slightly, a difference whichis probably in great measure a mere matter of accident,although it may be partly due to a different age dis-tribution among the lives at risk. The Star, as a youngeroffice, and one which has experienced very great expansion inrecent years, would probably have a smaller proportion ofaged policy-holders upon its books, and to that extent itwould, quite consistently with the record of the othersocieties already mentioned, enjoy a comparative immunityfrom the attacks of influenza. Last may be mentioned theUnion Assurance Society, which, established so long agoas the reign of Queen Anne, has exhibited within the past

three or four years a. power of growth unexampled in its ownearlier record, to which the return now made public puts ifitting crown.

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ANNUAL REPORT OF THE LOCAL GOVERN-MENT BOARD FOR IRELAND.

FROM the twentieth annual report, which has just beenissued, it appears that there has been a further decline in theaverage daily number of persons relieved in the workhouses,while there has also been a slight decrease in the averagedaily number of persons who received out-door relief. The

average daily number in the workhouses was 40,742, and onout-door relief 62,229, or a total of 104,078, which was less.than the average daily number in workhouses and on out-relief by 1053. During the year ended March 5th last thetotal number of deaths in the various workhouses was 10,937,showing an increase of 1130 deaths as compared with thenumber for the preceding year. Of these, fever caused 337,against 296 ; lung disease 2208, against 1843 ; phthisis 1171,against 1021; brain disease 363, against 359; and heart disease-598, as compared with 570. There were for the twelve monthsended Sept. 29th last 47,625 persons admitted into the-workhouses for sickness, being a decrease of 7835 as com-pared with the previous year, a decrease of 12,847 in thenumber admitted who were not sick, and a decrease of 918in the number suffering from fever or other contagiousdisease. In the various dispensary districts the medicalofficers attended 394,880 new cases at the dispensaries andl161,362 persons at their own homes, or a total of 556,242 ;gave certificates for 1901 dangerous lunatics, and vaccinated)or revaccinated 90,693 people. The vaccination returns showan increase of 415. There were 13 cases of small-poxtreated by dispensary medical officers and 3 deaths in work-houses during the year. During the winter of 1891-92 asecond well-marked outbreak of influenza became epi-demic in Ireland. This latter visitation was not attendedwith symptoms quite so severe as those which occurredin the outbreak during 1889-90, and it has differed fromthe former epidemic in one important respect. The pre-vious epidemic as a rule spared the aged, whereas themore recent outbreak has fallen with impartial severityupon persons of all ages. From reports received it

appears that very large numbers of the population were-affected with influenza during the past winter, and, in con-

sequence of persons of advanced age having suffered, the:

mortality in proportion to the numbers attacked has beengreater than that recorded during the prevalence of the formerepidemic. As regards fever, there were 2916 cases attendedby dispensary medical officers, being a decrease of 1369 ; anda decrease of twenty-one in the cases of scarlet fever treated,the numbers being 1238 and 1259 respectively. The MedicallCharities expenditure amounted to £166.330, under whichheading is included the cost of medicines and medicalappliances, salaries of medical officers and apothe-caries, vaccination fees and other expenses, showing anincrease of ;E4989 over that of the previous year. TheBoard sanctioned loans, amounting to £189,177 18s. 4d.,.to various towns in Ireland, principally for sewerage-and water-supply, which, added to previous sums allocated,constitute a total of 2,273,302 18s. 6d. for the seventeen

years ended March 31st, 1892. The total number of lunatics,.epileptic lunatics, idiots and epileptic idiots in workhouseswas 2024, against 1888 the previous year. The followingextract from the fortieth report of the inspectors of lunatics,referring to the condition of lunatics in workhouses, has beersforwarded to each Board of Guardians by the Local Govern-ment Board, pending legislation, as a means of immediate-

improvement :-1. That in all cases paid officers should be-made responsible for the care and treatment of lunaticinmates. 2. That mechanical restraint should never be used

except by the recorded direction of the medical officer, inwhose charge strait waistcoats and other instruments ofrestraint should be kept. 3. That so far as possible separate-day-room and dormitory accommodation should be provided.4. That every effort should be made to find employment for

, such insane patients as are able to work. There is no betteremployment for men than spade labour, or than laundry work

, forwomen, and both occupations might be provided in nearlytll, the workhouses. 5. That cold and dark idiot cells should be; disused.