The Public Health Commissioner in his annual review shows that the outstanding statistical data concerning health during the year 1925 are briefly as follows:

(1) The birth rate fell down from 34.45 per mille in 1924 to 33.65 per mille in 1925;

(2) The death rate fell from 28.49 per mille in 1924 to 24.72 per mille in 1925;

(3) The infantile death rate fell from 189 in 1924 to 174 in 1925.

He shows that taking the year as a whole rainfall was within 25 per cent of the normal except in Orissa and the Madras Coast North where it was in moderate excess and in Baluchistan, Sind, Rajputana and Gujarat, where it was in large defect.

Birth ratios exceeded death ratios in all provinces except Coorg, where the death rate was in

excess by 3.05. Central Provinces (16.63), Delhi 11.94), Bihar and Orissa (11.9), Bombay (11.0), Punjab (10.09), Ajmer-Merwara (9.68), Madras (9.3) were among the big birth increases. Deaths throughout British India numbered 5,967,918 as compared with 6,879,286 in the preceding year a decrease of 911,368. Registered births exceeded registered deaths by 2,157,490 against 1,438,117 in 1924, all provinces excepting Coorg having contributed to this. The death was 24.72 as against 28.49 in 1924 and a quinquennial mean of 27.74. The urban death rate was 29.65 against 31.65 and the rural rate was 24.30 against 28.19 in 1924. In Delhi, Bengal and Bihar and Orissa the rural rates exceeded the urban ones; in Coorg the urban rate exceeded the rural one by 26.37 in Burma by 17.45 and in the United Provinces by 11.54.

rate

Of the total mortality, 1,416,983 deaths, or 23.7 per cent occurred during the first year of life, against 1,589,128 and 22.8 per cent respectively in 1924. In England and Wales the corresponding figures for 1924 and 1925 were 11.6 per cent and 11.3 per cent respectively. The infantile death rate calculated on the births recorded during the year was 174 as against 189 in 1924, 176 in 1923 and 175 in 1922. In British India 702,571 (49.58 per mille) of the infantile deaths occurred during the first month of life against 48.1 in 1924 and 49.5 in 1923. This equals 86 per thousand of live births-a rate again in excess of the total Infantile mortality rate in England and Wales, which was 75 per mille births registered. In "all towns" with over 10,000 inhabitants in the

United Provinces, Assam, Bombay, Central Provinces and the rural areas of Bombay the death rates decreased, while in the rural areas in Madras and "all similar towns" in Burma and Madras they increased. The accuracy of the figures is subject to the known defects in registration, as to which the Public Health Commissioner writes. "The checking which has been attempted in various provinces varies according to the ideas of the public health departments concerned. The prevailing impression, one gathers, is that little progress Is able to be recorded anywhere and it is very difficult, with economic and other conditions being what they are, to visualise any very rapid or drastic amelioration."

Admissions.

Period.

Officers.

iceable decrease in deaths from all other animal s except bears in almost all provinces.

Deaths from snake bite fell from 19,867 to 19,258. Decreases occurred in Madras, the United Provinces, the Punjab, Burma, Bihar and Orissa, the Central Provinces and Berar and Assam but Bombay and Bengal have reported slight increases.

During the year 21,605 wild animals were reported to have been destroyed, of which 1,609 were tigers, 4,660 leopards, 2,485 bears and 2,361 wolves. A sum of Rs. 1,55,667 was paid in rewards, against Rs. 1,69,765 in the previous year. The number of snakes destroyed in India proper decreased from 47,106, to 41,004, and the rewards paid for their destruction were Rs. 1,579 as against Rs. 1,403 in the previous

There were 3,956 State-Public, Local Fund and Private-Aided Civil Hospitals and Dispensaries in India at the end of 1925, as compared with 3,669 in 1924 an increase of 287. The total number of patients treated was 41,135,578 (732,975 in-patients and 40,402,603 out-patients) as compared with 38,686,249 (694,783 in-patients and 38,686,249 out-patients) in 1924. The increase was noticeable in all provinces except Assam and the United Provinces. The greatest reduction was in Cachar district of Assam, partly due to the levy of a fee of one anna per out-door patient on each new case.

LEPROSY

It is exceedingly difficult to give anything approaching an accurate estimate of the total number of lepers in the Indian Empire to-day. The census figures of 1921 give the total as 102,513, as against 109,094 in 1911. But it is doubtful if this figure represents anything more than the more advanced cases and possi

bly a majority of this number are the begging and pauper lepers who are seen all over the country. Dr. E. Muir, M.D., F.R.C.S., the Leprosy Research Worker at the Calcutta School of Tropical Medicine, says that "we think that it would not be an over estimate to put down the number of lepers in India somewhere between a half and one million."

Early in the year 1924, the British Empire Leprosy Relief Association was constituted in England, with H. R. H. The Prince of Wales as Patron, the Viscount Chelmsford as Chairman of the General Committee and H. E. the Viceroy of India as one of the Vice-Presidents, Following its formation and in view of the good results being obtained from the newest treatment of leprosy, H. E. the Viceroy felt that the time was auspicious for the inauguration and carrying on of an earnest campaign with the object of ultimately stamping out leprosy from India.

His Excellency invited certain gentlemen representing various interests to form an Indian Council of the Association, which he formally inaugurated at a public meeting in Delhi on the 27th January 1925.

The number of Mental Hospitals throughout British India was 23, compared with 22 in 1924 and their total population 10,992 against 9,712 in 1924. The criminal population of the mental hospitals numbered 564 in 1925 against 569 in 1924.

There were in 1925 eight Medical Colleges in India and 23 Medical Schools. There is at Dehra Dun an X-Ray Institute wherein training is given in radio-diagnosis, radio-and electric-therapy and radiology, the number of students in 1925 being 62. There are officially maintained X-Ray installations at Delhi and Simla.

IN INDIA.

His Excellency is its President and Sardar Saheb Balwant Singh Puri, Honorary Secretary of the Association.

A special research worker on a Salary of Rs. 1,200-75-1,500 has been appointed for five years who is working under Dr. E. Muir, M.D., F.R.C.S., in the School of Tropical Medicine and Hygiene, Calcutta, where doctors are trained in the special treatment of leprosy.

The whole of the first year of the Indian Council was occupied with preliminary organising work and very early, in its second year, 1926, it began to put its work into operation. The Central Committee is under the finally adopted scheme vested with the task of promoting research, preparing and publishing propaganda material and arranging for the training of doctors in the diagnosis and treatment of leprosy. Measures for the accommodation and treatment of leprous patients and other schemes of purely local interest are the concern of Provincial Committees working as agents of the Indian Council. One of the early decisions of the Council therefore related to the apportionment of the revenue of the Fund as between the Central and Provincial Governments. It was decided that the total revenue, less the income of contributions received from Ruling Princes, which. according to their wishes, has been ear-marked for the promotion of research under the direcion of the Central Committee, should so be allocated that the amount distributed to Provincial Committees should not be less than 50 per cent. of the total.

Two circulars were early in 1926 issued to the Provinces setting forth in detail the approved plan of action for the Central and Provincial Committees. In pursuance of the proposals made in it permanent local Committees to administer the funds to be allotted to them from the head quarters and to direct and control the anti-leprosy campaign in their respective provinces were formed and by the close of the year all the Provinces has constituted branches. In order to secure uniformity in certain broad principles relating to the anti-leprosy campaign to be undertaken by the Provincial Committees and with a view to its conformity with the latest scientific information about the nature of the disease, the Indian Council issued in the early part of 1926 a "Memorandum on the method of conducting the anti-leprosy campaign in India." This document sought to bring out the following main points which according to the latest scientific researches should be the bases upon which all efforts ultimately to eradicate leprosy must rest:

(1) Pauper lepers form only a small fraction of the leper population, and the disease is common among all classes of the community.

(2) Segregations is not the most appropriate method of dealing with lepers, for

(a) financially it would be impossible;

(b) any attempt to impose forcible segregation would drive patients, particularly those who are suffering from the earlier stages of the disease, to conceal their misfortune, and, as has been the case where such means have been adopted, only the more advanced and obvious lepers would be segregated.

(3) The majority of the advanced cases are not highly infectious and are less amenable to treatment, while the early cases in which the

disease has made but little outward manifes

tation, can be controlled by treatment.

(4) The strongest hope of stamping out the disease lies in providing facilities for the treatment of early cases.

The Indian Council, therefore, while it did not desire to minimise the usefulness of homes and asylums for the care of lepers, strongly recommended that the efforts of the Provincial Committees should, for the present at least, be concentrated upon the establishment of dispensaries to serve the following objects:

(a) to induce patients to come forward at an early stage in the hope of recovery instead of hiding their malady till it becomes more advanced, more infectious and less remediable; and so

con

(b to shut off the sources of infection as the number of infectious cases will tinually tend to diminish and the opportunities for infecting the next generation, will become fewer.

The Provincial Committees have all placed the question of the training of doctors and the starting of treatment centres where facilities will be available for the proper diagnosis and treatment of the disease, in the forefront of their programmes and their resources have in many cases been supplemented by local Governments by the grant of substantial financial assistance.

A general appeal for funds was made on the formation of the Indian Council and closed in January 1926. Realisations produced Rs. 20,00,000. This was invested and forms the capital of the Association, to which it yields an annual revenue of Rs. 1,21,000.

infant mortality. It has been calculated that every year no fewer than 2 million Indian babies die, while many others survive only to grow weak and feeble from unhygienic surround ings during infancy. A noteworthy feature has been the further progress of the infant welfare movement, which owes much to the AllIndia Maternity and Child Welfare League initi ated by Lady Chelmsford and also to the Indian Red Cross Society, which aims at gradually establishing a network of child welfare centres

in most of the larger towns in India. The in. stitution of an all India Baby Week, an undertaking to which Her Excellency the Countess of Reading has devoted great and successful enthusiasm has also given a stimulus to the work and promises to be an important perennial aid to its progress. In all the great centres of population, work is now being done for the training of midwives, for the instruction of mothers and for the care of babies. Training centres for Indian and Anglo-Indian women have been opened in order to spread the elements of infantile hygiene to other parts of India. Most hopeful sign of all, Indian ladies are beginning to interest themselves in this work in large numbers. But such is the magnitude of the

taken, if any appreciable reduction is to be made in the appalling mortality of young children. The admirable work done year by year by the National Association for supplying Female Medical Aid to the Women of India is recognised by the Government of India, which subsidises this organisation with a grant of Rs. 3,70,000 a year for the maintenance of the Women's Medical Service of India.

Centres of Activity - The Child Welfare

Directory gives the following list of places where the movement is already at work:

Bombay. The centre of much active and enthusiastic welfare work; the Lady Willingdon Maternity Homes near the people's chawls being unique of their kind in India. The Bombay Infant Welfare Society founded by Lady Lloyd has already established 8 Infant Welfare Centres where prenatal, maternity and child welfare work is being carried on.

Poona. The work carried out by the Seva Sadan Society of Poona deserves special mention in this connection. Child welfare centres have been established in several places throughout the Presidency and are in charge of Public