"Thus, the rate of mortality of illegitimate children during the first year is shown to be more than double that of those born in wedlock; and the comparative estimate for the first three, as compared with the remaining nine months, is still higher, as may be better understood from the following summary of the preceding table: "It is impossible to adduce an argument in favour of maternal breast-nursing more potently convincing than that which the preceding figures supply. 66 In the case of the illegitimate there is another cause whereby the rate of early mortality is materially augmented-the absence, namely, of timely medical aid in the event of sickness. This is not necessarily owing to unskilfulness on the part of the practitioner employed: it is more probably due to neglect or delay in summoning such aid when required—a resource, however, which must, no doubt, be often much influenced by scantiness of means.' ART. 10.-On the Prevalence of Suicide in England. (Social Science Review, October, 1862.) The following are notes of a paper read before the Social Science Congress : : During the five years 1852-56, according to the Registrar-General's returns, 5415 suicides were committed in this country (including Wales), showing an annual average of nearly six suicides (587) to 100,000 persons living at all ages, and of 26 to 10,000 deaths from all causes. In 1838-40 the annual average of suicides amounted to a fraction more than 6 (6-2) in 100,000 population, and to 28 in 10,000 deaths from all causes. It would seem, then, that in the two periods, 1838-40 and 1852-56, the tendency to suicide was nearly stationary. There would appear, therefore, to be no sufficient reason for the very prevalent belief that suicide has of late years largely increased in the kingdom. Again, the belief that England is "the classic land of suicide"can no longer be entertained in the face of these figures. The number of suicides in France, during the seventeen years 1836-52, averaged about 8 (8.3) in 100,000 population-1 in 12,013 inhabitants. In England, as we have seen, the proportion in the two periods, 1838-40, 1852-56, was 1 in 17,039 and 1 in 16,129 inhabitants. But then the English statistics of suicide are at the best imperfect. The Registrar-General's returns do not show, probably by XXXVII. 2 one-tenth, the whole amount of suicides actually distinguished as such at the time of death. The Home Office returns of suicide now, however, extend over five years, 1856-60, and show an annual average of 6·7 per 100,000 population, or 1 in 14,906 inhabitants; a proportion in excess of the Registrar-General's returns for 1852-56, still comparing most favourably with those for France. The positive records we possess certainly show that, as far as our present information extends, England holds only a second or thirdrate position in the suicide scale among civilized nations. Even The justness of this conclusion will become still more apparent by a glance at the Prussian statistics of suicide. In 1834, according to Dr. Morel, the proportion of suicides in that kingdom was 1 in 9,941 inhabitants, and in 1843, 1 in 8,081. In the three years 1850-52 the number averaged 38 in 100,000 deaths from all causes. France, then, as well as England, must yield the sad precedence to Prussia in this matter, unless the progress of suicide in France since 1852 has been such as to overtake that which had previously been observed in Prussia. It is very noteworthy that the most recent statistical return on the health of the army shows a proportion of suicides occurring among the troops on the Home Station more than double that found in civil life! The proportion of suicides occurring among 1,000,000 males of the military age (20.40) in civil life, may be estimated approximatively, according to the Registrar-General's returns for 1852-56, at 124 6. But the proportion occurring in the troops on the Home Station in 1859 (20 in a strength of 71,715 men) shows a ratio of no less than 278 8 in 1,000,000! It is difficult to escape the conclusion, even if subsequent returns prove that the proportion of suicide in 1859 was exceptional, that the causes leading to so extraordinary an excess of suicide among the troops at home, and those which have given rise to the recent outbreak of murders by soldiers, have much in common. However this may be, there can be no question that the army returns of suicide confirm the necessity, made too apparent by the late murders, for a careful inquiry into such grievances as may exist among the troops. The returns of suicide in the navy show also an excess over those occurring in civil life, but not so great as in the army. The average proportion of suicides annually occurring among the sailors on the Home Station, to 1,000,000 of the strength, was, in the three years 1856-58, 135.4. (B) CONCERNING ACUTE DISEASES. ART. 11.-On Epidemics.' By Dr. STOKES, Regius Professor of Medicine in the University of Dublin. (British Medical Journal, January 10, 1863.) In his introductory address at Meath Hospital, Dr. Stokes says:"What is it that causes an epidemic? is one of the most difficult of questions. Why, in the pressure of an epidemic, one man sickens while another escapes-why essential maladies observe laws of periodicity, we cannot tell; why locality affects their general characters and organic results, is yet unexplained; nor why, on the other hand, after travelling their tens of thousands of miles, destroying their victims under the most varied conditions of climate, soil, food, temperature, they yet preserve much, if not all, of the original character, remains an open question. Many discussions have arisen on this point, and a fierce controversy has raged between the contagionists and non-contagionists. The advocates on both sides can bring forward plenty of isolated facts in support of their theories; but the argument from isolated cases is of little value. That there is an origin for epidemic disease, besides contagion, is self-evident; that it is propagated by contact, is another question. I have been in the habit of referring to the mode of settling this matter. It was to compute against the occurrence of a certain circumstancenamely, if there was no such thing as contagion. My father, when Professor of the Practice of Medicine in the Royal College of Surgeons, directed his attention very much to the subject of contagion. He was a strong advocate of the doctrine of contagion. Perhaps he went too far in his belief in the exclusiveness of the doctrine of contagion. He thought that in looking at the general circumstances which attended the spread of an epidemic in this country, the probabilities for or against the doctrine of contagion might be submitted to calculation. One of his most intimate friends was the late celebrated Dr. Brinkley, Bishop of Cloyne, who was at one time the Astronomer Royal of Ireland. He was admittedly one of the very first mathematicians of his day, and was especially skilled in that difficult part of mathematical investigation, the doctrine of chances. Now, in the progress of an epidemic in Ireland, in a family of twelve persons, the disease has been known to attack eleven out of the twelve. In some cases the passing of the fever through so large a proportion as eleven individuals out of twelve has taken a very considerable period of time, as you may readily understand. It has taken about three months to go through them all. Now, my father proposed these two problems to the Bishop of Cloyne for solution:- An epidemic prevails so severely that one person out of seven sinks. A family of twelve is selected in a particular district before the epidemic has visited it. What is the chance that eleven out of the family shall take the disease, supposing the sickness of one of the family does not promote the sickening of another-that is, supposing the disease not to be contagious, and supposing the family to be not unusually liable to the disease?' The answer furnished by Dr. Brinkley is, that the probability against such an event is 189.600,000 to 1. That is a very singular and extraordinary result. The whole subject is yet to be worked out. It is interesting to observe that Humboldt, in his Cosmos, speaking of epidemic diseases, says that their origin and nature is among the most difficult of problems, and he suggests that some light may be thrown on the matter, when the laws of terrestrial magnetism are fully determined. What we do know of these mysterious phenomena may be thus stated:-That, although having certain characteristics which are common to all, they exhibit marked and special differences. Thus the plague differs from cholera, cholera from typhus, and so on. That they are in a greater or less degree propagated by contagion. That epidemics of the same disease have not always the same characters. That their mortality is greater on their first outbreak in any locality. That they travel over vast distances, and although they may arise in warm latitudes, they preserve their characters in cold ones; the cholera of Central India and of St. Petersburg was the same disease. That their advent and disappearance are often sudden. That they are not symptomatic of any known anatomical change, but they often induce local diseases which are secondary to the general malady. That their symptoms are, to a great degree, under the laws of periodicity. That, as far as we know, the disease is not to be met by any specific cure. That, as yet, all explanations of their origin are insufficient or obviously erroneous. Lastly, that anatomy only throws a negative light upon their nature, telling us rather what they are not than what they are. The plague of the Levant, which has preserved its character since the time of Thucydides; the black death; the sweating sickness; the typhus and yellow fevers, and the Asiatic cholera-in a word, the great causes of the wholesale destruction of man, act by some influence not yet discovered even by microscopic anatomy; so that we come to the strange conclusion that the diseases most fatal to man are those least connected with organic change, which, when it is met with, is secondary, inconstant, and insufficient to explain their symptoms. Such is the present state of our knowledge." ART. 12.-State of Epidemic Diseases in Great Britain in 1861-62. By Mr. J. N. RADCLIFFE, one of the Honorary Secretaries to the Epidemiological Society. (Proceedings of the Epidemiological Society, December 1, 1862.) This report refers to the twelve months ending September 30, 1862. The following is a recapitulation of some of the principal facts recorded:-The health status of the English population, as estimated from the unusually low rate of mortality throughout the year, was generally good, notwithstanding dearness of provisions and an excessive amount of pauperism. The health status of the Scottish population was markedly below the average, as shown by the large amount of sickness prevalent in the last quarter of 1861, and the high rate of mortality since the commencement of 1862. The average death-rate of Scotland, it is well to remark, is below that of England. Thus, during the six years 1855-60, the annual proportion of deaths in England was 219 per 10,000 population: during the same period in Scotland the proportion was 208. The high range of temperature in the winter months, and low range during the summer, in England exercised a favourable influence over the health, notwithstanding much wet and variability of weather. In Scotland similar conditions of temperature and weather existed, but to an exaggerated extent; and the great changes which were experienced, and especially the undue humidity of the atmosphere, were apparently the fostering causes of the influenza and throat affections, which appear to have been more common there than in England. The epidemic diseases most prevalent in England were continued fever, scarlatina, measles, diphtheria, whooping-cough, and small-pox. In Scotland the same diseases, with the exception of small-pox; also, and more particularly, sore-throat, often assuming a diphtheritic character, and accompanied by diphtheria, played the chief part in the epidemiology of the twelve months. In both parts of the kingdom continued fever prevailed most commonly in the autumn quarter of 1861; and in England the affection would appear to have been more general in the northern than in the southern portion of the kingdom. In both countries scarlatina was widely prevalent in the northern districts in the last quarter of 1861; but the disease became more active in the southern district in the third quarter of 1862. Measles prevailed extensively, and in some instances very fatally, in the winter quarter in England. In Scotland the disease appears to have been most prevalent in the spring and summer quarters. Diphtheria was, in England, principally fatal in the autumn quarter, but the disease prevailed, more or less, in every registration district during the year. In Scotland the disease, together with sore-throat, appears to have been epidemic throughout the year. Whooping cough was widely prevalent in England during the winter quarter; in Scotland, during the winter and spring quarters. Influenza was epidemic in Scotland in the autumn and winter quarters. Finally, small-pox broke out in many districts of England, but more particularly in the eastern, south-western, and northern counties, and in Yorkshire. In no instance did an outbreak of any of the different diseases referred to as occurring in England assume what may be termed "general proportions.' The outbreaks were essentially local; but the dispersion of the various maladies, or of their centres of manifestation, over the kingdom,-the cropping out of exaggeration of these diseases in different localities, and the effects they apparently exercised upon the sickness and mortality of certain districts, without heightening the death-rate of the whole kingdom,-present a study of great interest. From this study it is reasonable to conclude that, in dealing with these local outbreaks of epidemic disease in ordinary periods, the best chance is afforded of warding off the widespread and more deadly outbreaks of extraordinary periods. The detailed mortuary returns for Scotland extend, as yet, only to the year 1857; but the returns for England are brought down to 1860. From the latter, then, may be obtained information as to the status of the several epidemic diseases most prevalent in the twelve months discussed, immediately prior to that period. Since 1857 the mortality from continued fever has slowly declined; in that year the deaths from this cause amounted to 19,016; in 1860 they were 13,012. In 1855 the mortality from scarlatina was 17,314; in 1856 and 1857, the number of deaths from this disease fell considerably, |