II. ON THE HEALTH OF THE TROOPS SERVING IN THE United Kingdom. Sickness and Mortality. The average strength of warrant officers, non-commissioned officers and men serving in the United Kingdom during the year 1893, was, according to the annual returns furnished by medical officers, 100,105. This does not include certain men detached from their corps, the average number of whom is computed to have been 2,123. The most important of the statistics of sickness and mortality among the troops quartered in the three great divisions of the Kingdom, England and Wales, Scotland, and Ireland, and also among those in the United Kingdom as a whole, are shown in the following table : * Calculated on strength, including men detached (England and Wales, 1,089; Scotland, 11; Ireland, 1,023), 2,123 in number. Comparing the above with the corresponding table in the previous year it is observed that in England and Wales the admission rate shows a decline of 1.6 per 1,000, the death rate an increase of 100, and the constantly sick rate also an increase of 195. The average sick time to each soldier was longer by just over half a day, and the average duration of each case of sickness by nearly a whole day. Compared with the average ratios for the preceding seven years the admission rate has declined by 13.2, but the death and constantly sick ratios both show an increase, though only fractional. The average sick time to each soldier and the average duration of each case of sickness are longer by about a third and two-thirds of a day respectively. The admission, death, and constantly sick rates in Scotland are all higher than in the preceding year, by 55'4, 1·52, and 2·14 per 1,000 respectively. The average sick time to each soldier was longer by two-thirds of a day, but the United average duration of each case of sickness shorter by about a fifth of a day. Kingdom. Compared with the average rates for the previous seven years the admission and constantly sick rates show a decline of 38.5 and 2.89 per 1,000 respectively, but the death rate shows an increase of 59. The average sick time and average duration of each case of sickness were shorter in this comparison by just over a day and by two-thirds of a day respectively. In Ireland, as compared with the previous year, there is a decline in the admission, death, and constantly sick rates of 485, 09, and 93 per 1,000 respectively. The sick time to each soldier is shorter by over a third of a day, but the average duration of each case of sickness longer by nearly a whole day. In comparison with the rates for the previous seven years there is also a decrease in the admission rate of 66'8, in the death rate of 72, and in the constantly sick rate of 162 per 1,000. The average sick time and duration of cases show a decline of over half a day in the former, but an increase of over a day in the latter. In the United Kingdom, as a whole, the admission rate shows a decline of 9.7 per 1,000 as compared with 1892, but the death and constantly sick rates have increased by 75 and 1:35 respectively. The average sick time to each soldier was longer by nearly half a day, and the average duration of each case of sickness by nearly a whole day. In comparison with the previous ten years there is a decrease in the admission rate of 48.9, in the death rate of 34, and in the constantly sick rate of 89. The average sick time was shorter by a third of a day, but the duration of each case of sickness longer by nearly a day. The total loss by death and final discharge was 2,129 men, equal to a ratio of 20-83 per 1,000, above the rate of the previous year by 2:07. The principal statistics of sickness and mortality, arranged according to the different groups and orders of diseases, are given in Abstract I. for the whole of the troops in the United Kingdom, and in Abstracts A., B., and C. for the troops quartered in England and Wales, Scotland, and Ireland respectively. GENERAL DISEASES.-Diseases dependent on Morbid Poisons.-There were 8 cases of small-pox against 6 in 1892. The admissions for other eruptive fevers numbered 1,463, with 14 deaths. Scarlet Fever caused 843 admissions and 14 deaths. Of these 764 occurred in England and Wales, principally in the Aldershot, North-eastern, and Woolwich Districts. In Scotland there were only 7 cases. In Ireland 72 cases occurred, principally in the Dublin and Belfast Districts. Of the 14 deaths 12 occurred in England, 5 being at Aldershot. Measles caused 157 admissions but no deaths. Of the remaining cases of eruptive fevers, 440 were cow-pox, 9 chicken-pox, and 14 epidemic rose rash. Enteric Fever.-There were 151 admissions and 22 deaths, against 132 and 23 in 1892. The admission rate 15 is above the last year's rate by 2 and also the previous decennial rate by a similar figure. The death rate was 21 as compared with 22 in 1892, and 29 the average of the previous 10 years. The per-centage of mortality to attack was 146, as contrasted with 174 in 1892. In England and Wales there were 103 admissions and 16 deaths. In Scotland only 3 admissions. In Ireland there were 45 cases, with 6 deaths. In England the largest number of cases in any station was 49 at Aldershot with 9 deaths. Most of the cases occurred in the Marlborough Lines, the sanitary condition of which has been investigated by a special committee. The next largest number of cases was 8 at Bodmin, with 1 death. The cause was attributed to the water supply. There were 5 cases each at Sunderland and Shoeburyness. In the former the general insanitary condition in the neighbourhood was supposed to be the cause. In the latter no insanitary defects could be discovered in the barracks, but the neighbouring village of Shoeburyness is most insanitary. The remaining cases were scattered over a large number of stations, but no serious outbreak was brought to notice. In Ireland, out of the 45 cases reported, 25 with 3 deaths occurred in Dublin. The exact cause is not known, but Dublin, as stated in last year's report, is notoriously unhealthy where enteric fever is concerned. United Other Continued Fevers caused 459 admissions, being in the ratio of 4-6 per 1,000. Compared with last year there is an increase of 8 per 1,000. Dysentery caused 46 admissions and 1 death, as against 34 and no death in 1892. Influenza caused 1,676 admissions and 2 deaths, the equivalent ratios being 16.7 and 02 per 1,000, as against 17.9 and '05, the rates for last year. The largest number of cases in England and Wales occurred in the South-Eastern, Aldershot, and Home Districts. In Ireland the cases occurred principally in the Curragh and Dublin Districts. There were 46 cases in Scotland. The remaining admissions in sub-group 1 included 46 of mumps and 4 of diphtheria, one of which proved fatal. Malarial Fevers caused 587 admissions with a ratio of 5.9 per 1,000, lower fractionally than both last year's rate and the average for the previous seven years. Ague accounted for 572 cases, remittent fever for 4, and malarial cachexia for 11. Septic Diseases caused 242 admissions and 15 deaths, or ratios of 2.4 and 15 per 1,000, higher than last year's rates by 8 and 09 respectively. Of the total cases erysipelas caused 234 and 10 deaths. Venereal Diseases.-The admissions for primary syphilis were 5,694, or a rate of 56.9 per 1,000, compared with 667 in 1892. The number of men constantly sick was 579 26, or a ratio of 5'79, compared with 6.12 in 1892 and 6.35 the average rate for the previous seven years. In England and Wales the admission and constantly sick rates were 655 and 667, both lower than in 1892. In Scotland these rates were 25·7 and 2·09, about identical with those of last year. In Ireland the ratios equalled 35-8 and 3.69 per 1,000, both being considerably below those for 1892. Simple venereal ulcer caused 1,764 admissions, and 133-13 men were constantly sick, the ratios being 176 and 133 per 1,000 respectively. If the sickness from this cause be added to that from primary syphilis, it is seen that the admission rate for primary venereal sores in the United Kingdom was 74.5 per 1,000, and the constantly sick rate 7·12. As compared with the rates for the previous year there is a decrease of 4.6 per 1,000 in the former, but an increase of 10 in the latter. Taking the previous seven years' average rate in comparison there is a decrease of 17.3 and 80 respectively. In England and Wales the admission rate was 83.5 and the constantly sick rate 8.04, showing, as compared with last year, a decrease of 2.3 in the former, and an increase of 43 in the latter. Compared with the average of the previous seven years there is a decrease in both these rates of 147 and 52 per 1,000 respectively. In Scotland the rates were 441 and 2.97, being an increase of 3-4 and 05 on last year's rates, but showing a decrease of 11.3 and 101 when compared with the average rates for the previous seven years. In Ireland the admission and constantly sick ratios were 52.2 and 4.97, compared with 661 and 5·95 in 1892, and 795 and 671 the average rates of the previous seven years. Secondary Syphilis.-The admissions for this disease in the United Kingdom numbered 3,188. There were 6 deaths, and 331 59 men were constantly sick from this cause. The admission rate was 31.8, and the constantly sick rate 3:31. As compared with 1892 there is a decrease in both rates of 2.0 and '03 per 1,000 respectively, and in comparison with the average rates for the previous seven years one of 5.2 and 06 respectively. In England and Wales the rates equalled 351 and 3.74, compared with 374 and 3.74 in 1892, and 39.5 and 3'66 the average rates for the previous seven years. In Scotland there was a decrease in all the rates, and this was also the case in Ireland. Gonorrhoea. The admissions numbered 8,838, and the average constantly sick was 626 04. The equivalent ratios were 88.3 and 6·25, the former being the same as, and the latter showing a slight increase compared with, last year. In comparison with the seven years' average rate there is a decrease of 6.5 in the admission rate, but an increase of 07 in the constantly sick rate. In England and Wales the admission and constantly sick rates were 93-8 and 6:64, an increase in each case on the last year's ratios of 15 and 25 per 1,000. As regards comparison with the seven years' average rates there is a decrease of 34 in the admission rate, but an increase of 24 in the constantly sick rate. In Scotland the ratios were 865 and 4-81 respectively, an increase on both rates and in both comparisons. In Ireland the ratios were 723 and 5:32 United per 1,000. In this case there is also a decrease in both rates and in both Kingdom. comparisons. Taking all forms of venereal disease together the admissions were 19,484, and the average number constantly sick 167002, the total admission ratio being 1946 per 1,000, and the constantly sick rate 16 68. As compared with the previous year there is a decrease of 6'6 per 1,000 in the admission rate, but an increase of 22 in the constantly sick rate. Compared with the seven years' average rates there is a decrease in the former of 29'0 and in the latter of 79. In England and Wales alone the ratios for admissions and constantly sick were 212-4 and 18.42 per 1,000, a decrease in the former of 31, but an increase in the latter of 68. Compared with the seven years' average rates there is a decrease in both cases. In Scotland these rates equalled 149.0 and 9.07, compared with 133-2 and 7·90 in 1892, and 159 6 and 9.81 per 1,000, the average rates for the previous seven years. In Ireland the admission rate was 148.6, and the constantly sick rate 12 62. In comparison with 1892 and the average of the previous seven years there is a substantial decrease in all these rates. The greatest prevalence of venereal disease in any district was in the Channel Islands 327.5, this was followed by the Home district with 291.2, the Eastern with 250-3, the Woolwich with 250.1, the Western with 233.8, and the Dublin with 222-2 per 1,000. The district showing the lowest rate of prevalence was that of Cork with 92-4. In the previous year the greatest prevalence was in the Home district, followed by the Channel Islands, and Dublin districts. The lowest rate, as in the present year, was in the Cork district, 86:3 per 1,000. Compared with corresponding ratios in the previous year increase of admis sion rate is observed in eight districts, in the Belfast by as much as 53'8, in Dublin by 497, and in Aldershot by 369. In the Channel Islands the admission rate decreased by 484, in the Woolwich district by 411, and in the Thames by 26.9. In the Home district the admission rate was almost identical with that of the preceding year. Parasitic Diseases numbered 27 as against 33 in the previous year. Scurvy caused 1 admission. Alcoholism 152 and 5 deaths, 7 of the admissions were for deliriuin tremens. Debility and malformations caused 692 admissions, being in the ratio of 6.9 per 1,000 which was below last year's rate. Rheumatism caused 3,609 admissions and 8 deaths (including that of a man absent from his corps), the respective ratios being 36·1 and 08 per 1,000, as against 35'6 and '06 in 1892. Out of the total number of admissions 393 were for rheumatic fever, England showing 296 of these, Scotland 5, and Ireland 92. The deaths were 6 in England, 1 in Scotland, and 1 in Ireland, and 6 were due to rheumatic fever. Tubercular Diseases.-For these diseases 306 admissions and 78 deaths (including those of 6 men absent from their corps) are recorded, the respective ratios being 31 and 76 per 1,000, almost identical with the rates for the previous year, and only slightly lower than the average rate for the previous seven years. Of the total number of admissions 291 were for tubercle of lung, and 69 of the deaths were due to this cause. Of these 209 admissions and 46 deaths were in England, 8 admissions and 3 deaths in Scotland, and 74 admissions and 20 deaths in Ireland. Other diseases of Group D. caused 464 admissions and 17 deaths, including those of 3 men detached from their corps, being in the ratios of 46 and 17 per 1,000, the first showing a decrease of 6, but the latter an increase of '6 as compared with last year. Amongst the admissions were 274 for nonmalignant new growths, 98 for anæmnia, 16 for purpura, 13 for malignant new growth, and 11 for diabetes. Of the deaths, 11 were due to malignant new growth, 4 to diabetes, and 2 to purpura. LOCAL DISEASES.-Diseases of the Nervous System.-There were 824 admissions and 32 deaths, including that of a man absent from his corps, being in the ratios of 8.2 and 31 per 1,000 as against 87 and 25 in the previous year. The diseases causing most admissions were neuralgia 333, and epilepsy 210. Of the 138 cases of mental disease 58 were admitted for dementia, 32 for melancholia, and 29 for mania. The deaths included 9 of United Kingdom. inflammation of membranes of brain, 5 of apoplexy, 4 of paralysis, and 3 of cerebral hæmorrhage. Diseases of the Eye caused 1,069 admissions, being in the ratio of 107 per 1,000, slightly under the rate of the previous year. Out of the total number of admissions 644 were for conjunctivitis, 110 for keratitis, and 89 for iritis. Diseases of other Organs of Special Senses.-898 admissions are returned with a ratio of 90 per 1,000, being an increase on last year's rate of 10. There were no deaths. Of the admissions 865 were for affections of the ear and 33 for those of the nose. Diseases of the Circulatory System caused 939 admissions and 44 deaths, including those of 2 men detached from their corps. The corresponding ratios were 9'4 and 43 per 1,000, being slightly above those of last year, and almost identical with those for the seven years' average. Of the admissions 410 were for palpitation, 334 for valve disease of heart, and 139 for varicose veins. Of the deaths 24 were due to valve disease of heart, 5 to aneurysm of aorta, 4 to fatty degeneration of heart, and 3 to pericarditis. Diseases of the Respiratory System.-6,128 admissions and 132 deaths, including those of 10 men detached from their corps, are recorded, the ratios being 61.2 and 1.29 per 1,000. Compared with last year these rates show a decrease of 7.9 and '04 respectively, and in comparison with the average rates for the previous seven years there is also a decrease of 68 and 12 per 1,000 respectively. Of the total admissions bronchitic affections show 4.643 admissions, pneumonia 781, and pleurisy 364. The majority of the deaths were due to pneumonia in 93 cases, pneumonic phthisis in 15, bronchitis in 9, pleurisy in 7, and hæmoptysis in 2. Diseases of the Digestive System caused 12,917 admissions and 43 deaths, including those of 3 men detached from their corps, being in the ratios of 1290 and 42 per 1,000, as against 1206 and 26 in 1892, and 1054 and 35 the average rates of the previous seven years. Of the admissions, 9,292 were for affections of the mouth and throat, 1,165 for dyspepsia, 678 for diarrhoea, and hepatitis, including jaundice, 335. Of the deaths 13 were due to peritonitis, 4 to enteritis, and 3 each to abscess of liver, hepatitis, and cirrhosis of liver. Diseases of the Lymphatic and Glandular System. These caused 1,540 admissions, the ratio being 15'4 as compared with 147 last year. Nearly the whole of the admissions were due to inflammation and suppuration of glands. There were no deaths. Diseases of the Urinary System.-240 admissions and 16 deaths are recorded, including that of a man detached from his corps, being in the ratios of 2.4 and 16 respectively, as against 27 and 10 the rates for last year. The principal causes of admission were incontinence of urine 102 cases, Bright's disease 46 cases, nephritis 27 cases, and cystitis 24 cases. The deaths were due in 13 instances to Bright's disease, in 2 to nephritis, and in 1 to abscess of kidney. Diseases of the Generative System caused 3,213 admissions and 2 deaths, the corresponding ratios being 32-1 and 02 per 1,000. In comparison with the rates for the previous year there is an increase in the admission rate of 6·6, and in the death rate of 02, and as compared with the average rates for the preceding seven years a decrease of 65, and an increase of 01 respectively. The principal causes of admission, apart from simple venereal ulcer, were balanitis 607 cases, orchitis 526, stricture of urethra 110, varicocele 81, and phimosis 46. The 2 deaths were due to extravasation of urine. Diseases of the Organs of Locomotion caused 850 admissions but no deaths. The admission ratio was 8.5 compared with 8.3 per 1,000 in 1892. The principal causes of admission were synovitis 517 cases, contraction 69, flat foot 54, and ostitis and inflamed bursa 52 cases each. Diseases of the Connective Tissue.-For these diseases 2,461 admissions and 2 deaths, including that of a man detached from his corps, are returned, being in the ratios of 246 and 02 per 1,000 respectively, compared with 22-8 and 01 in 1892, and 230 and 02 the average rates for the previous seven years. The large majority of the cases were due to abscess, as were also the 2 deaths. Diseases of the Skin gave 6,602 admissions, but no death is recorded. The admission rate, 659, compares favourably with 712 the rate in 1892, and with |