PutuHisis AND SANATORIA. 213 
Tables of the consumptive death rate for five-years’ periods in 
Edinburgh and Glasgow shewed a fall in each period. This was 
markedly the case in the city of Glasgow, and was a most 
gratifying result of the action of the Town Council in regard to 
sanitary matters. Dr Ross also shewed a diagram illustrating 
the consumptive death rate in the burgh of Maxwelltown, for 
which he is medical officer. It shewed the extreme fluctuations 
which you got in small communities. To get a proper idea of 
the rate of mortality in Maxwelltown you would require to take 
a longer period than ten years. Last year it was below one per 
thousand. If that would only continue, they would have great 
reason to congratulate themselves on the reduction of the death 
rate in that burgh. Exhibiting a diagram which shewed by 
curved lines the rate of mortality in Scotland generally and in the 
county of Dumfries from consumption during the last twenty-five 
years, Dr Ross said this would almost make one pessimistic, as it 
shewed that the death rate of Dumfriesshire had often been the 
largest of any county in Scotland. A coloured map indicating 
_ the distribution of the disease in the county during the past fifteen 
years shewed that the death rate was highest in Nithsdale. 
Another diagram shewed the death rates in the landward part of 
Dumfriesshire during the last twenty-five years from consumption 
and from zymotic diseases respectively. |The zymotic diseases, 
he explained, include smallpox, scarlet fever, diphtheria, 
typhoid, whooping cough, measles. From the period 1881 to 
1890 the zymotic diseases and the phthisis diseases had a 
mortality not very greatly differing from each other; but from 
1890, when the change in local government occurred, as the 
years went on, and more and more was being done by the local 
authorities for prevention of zymotic diseases, the death rate from 
these diseases gradually declined, while there was very little 
difference in the death rate from phthisis, for which nothing had 
been done. This was an indication to local authorities that when 
they had done as much for phthisis as they had done for zymotic 
diseases they would bring about a corresponding improvement. 
Turning to the consideration of preventive measures, Dr Ross 
showed photographs of bottle spittoons for use by consumptive 
patients, and he spoke of the great danger from infected sputum. 
When he went about the infirmary, he remarked, he was struck 
by this, that there was an enormous number of cases of glandular 
