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A review of sanitary administration in London, 1856–99
46
S a n i t a r y A d m i n i s t r a t i o n in L o n d o n
tP,blicHeath
A REVIEW OF SANITARY ADMINISTRATION IN LONDON, 1856-99. IN a former issue we reviewed Dr. Allan's account of sanitary administration for close on half a century in the Strand district. We have now Dr. T. Orme Dudfield's valedictory supplement on the health, sanitary condition, etc., of Kensington during the years 1856-99. It wilt be noted that in the heading to this note we mention "London," and not "Kensington." No other heading would adequately describe the scope of Dr. Dudfield's report. Sanitary administration in Kensington has been an example to the rest of the l~fetropolis; and from Kensington have emanated some of the most influential stimuli which have resulted in reform of administrative methods. The present writer--and there must be many like him--when too busy with medical practice to pursue the investigation on his own account, has ofttimes in the past found Dr. Dudfield's monthly and annual reports an invaluable and lucid summary of everything that was being done, or ought to be, in the sanitary world. Before the appointment of a medical officer to the London County Council, Dr. Dudfield's work in these directions was shnply invaluable. We shall not attempt to summarize the statistics given in this report; they will be most useful for reference. The growth of administrative reforms is a more tempting subject. Foremost among these come improvements in hospital administration and control. The provision of a single hospital authority, free admission to hospital for all classes of the people, and depauperization of medical relief in the hospitals, are all reforms in which Kensington took a prominent and a pioneer's part. Dr. Dudfield's conclusion that of the two, isolation in hospital has had a greater influence than notification of infectious diseases in controlling infectious diseases, will probably be generally accepted, though the two are necessarily complementary. "Singly, I attach the greater value to hospitals, for means of isolation leads to disclosure of sickness, whilst without hospitals notification would be of minor influence." There is sound truth in the further remark, " F o r hospitals and notification alike we are largely indebted to the terror inspired by small-pox, and it is in respect to this loathsome disease that their combined effect has been most manifest." The paragraph as to licensed slaughter-houses deserves careful study. It might be entitled "Vested Interests v. the Interests of the Public." No sooner--as, for instance, i11 the recent strenuous attempt of the Public Health Committee of tb~ County Council to
Oc~ober,ZgOX] S a n i t a r y A d m i n i s t r a t i o n in L o n d o n
47
obtain the substitution of a limi%ed number of public for the private slaughter-houses--does %he Butchers' Trade Protection Society initiate its operations, than the question is shelved by the Council. As Dr. Dudfield pu£s iL " L o n d o n in sanitary matters generally lags behind the great provincial towns." Will the metropolitan boroughs improve on the record of their predecessors, or will overlapping between central and local administration and laxity in the latter continue to be prevailing features ? Dr. Dudfield's summary of work during the last forty years is a worthy record of much accomplished, which has had a wide influence in determining sanitary improvements throughout the Metropolis, and in shaping the course of such reforms as have been successfully initiated.
ALCOHOL AND SUSCEPTIBILITY TO [NFECTION.--The results of an extensive series of experiments on the influence of alcohol on susceptibility to infection,conducted by Dr. Taav. Laitinen (Zeitschri/tfiir Hygiene u~d In/eetionskra~kheiten,xxxiv., p. 206), lead to the conclusion that under all conditions alcohol eause~ s~ distinctly increased susceptibility to experimental infection,whether it is given before or after or both before and after the introduction of the infective material, and whether
it is given in a few large doses or in numerous small doses over a longer time, and whether with acute or chronic infections or pure intoxication. The animals (dogs, rabbits, guinea-pigs, fowls, and pigeons) employed received the diluted alcohol either by the mouth or injected under the skin. The favouring influence of alcohol on the different morbid processes showed itself in the fact that the affection terminated fatally in the aleoholized animals, the controls being unharmed, Or that at least the fatal result was appreciably hastened when both succumbed. With rabbits inoculated with anthrax bacilli of diminished virulence, the former was the case; with guinea-pigs treated with diphtheria toxin, the latter was observed. Alcohol was administered to a number of pregnant guinea-pigs for some days. Some aborted toward %he completion of term ; others gave birth to living young. The majority of the latter died before the tenth day, but those from mothers Which had received but small doses remained alive longer. The survivors when experimented upon with diphtheria tgxin showed a distinctly increased susceptibility in comparison with animals of equal age, the offspring of non-alcoholized mothers. Observationg of temperature showed no differences when the aleohotized animals had not been infected, excepting when such large amounts were given that the animal was almost in convulsions, when a decided fall was observed. After infection the aleoholized animals showed elevated temperature appreciably longer than the controls (averages, twenty-seven and twenty-four days respectively). The results of the research as a whoiehardly justify the employment of alcohol in the treatment of infectious diseases in nmn.--Amer. Journ. Med. Se. 4
S a n i t a r y A d m i n i s t r a t i o n in L o n d o n
tP,blicHeath
A REVIEW OF SANITARY ADMINISTRATION IN LONDON, 1856-99. IN a former issue we reviewed Dr. Allan's account of sanitary administration for close on half a century in the Strand district. We have now Dr. T. Orme Dudfield's valedictory supplement on the health, sanitary condition, etc., of Kensington during the years 1856-99. It wilt be noted that in the heading to this note we mention "London," and not "Kensington." No other heading would adequately describe the scope of Dr. Dudfield's report. Sanitary administration in Kensington has been an example to the rest of the l~fetropolis; and from Kensington have emanated some of the most influential stimuli which have resulted in reform of administrative methods. The present writer--and there must be many like him--when too busy with medical practice to pursue the investigation on his own account, has ofttimes in the past found Dr. Dudfield's monthly and annual reports an invaluable and lucid summary of everything that was being done, or ought to be, in the sanitary world. Before the appointment of a medical officer to the London County Council, Dr. Dudfield's work in these directions was shnply invaluable. We shall not attempt to summarize the statistics given in this report; they will be most useful for reference. The growth of administrative reforms is a more tempting subject. Foremost among these come improvements in hospital administration and control. The provision of a single hospital authority, free admission to hospital for all classes of the people, and depauperization of medical relief in the hospitals, are all reforms in which Kensington took a prominent and a pioneer's part. Dr. Dudfield's conclusion that of the two, isolation in hospital has had a greater influence than notification of infectious diseases in controlling infectious diseases, will probably be generally accepted, though the two are necessarily complementary. "Singly, I attach the greater value to hospitals, for means of isolation leads to disclosure of sickness, whilst without hospitals notification would be of minor influence." There is sound truth in the further remark, " F o r hospitals and notification alike we are largely indebted to the terror inspired by small-pox, and it is in respect to this loathsome disease that their combined effect has been most manifest." The paragraph as to licensed slaughter-houses deserves careful study. It might be entitled "Vested Interests v. the Interests of the Public." No sooner--as, for instance, i11 the recent strenuous attempt of the Public Health Committee of tb~ County Council to
Oc~ober,ZgOX] S a n i t a r y A d m i n i s t r a t i o n in L o n d o n
47
obtain the substitution of a limi%ed number of public for the private slaughter-houses--does %he Butchers' Trade Protection Society initiate its operations, than the question is shelved by the Council. As Dr. Dudfield pu£s iL " L o n d o n in sanitary matters generally lags behind the great provincial towns." Will the metropolitan boroughs improve on the record of their predecessors, or will overlapping between central and local administration and laxity in the latter continue to be prevailing features ? Dr. Dudfield's summary of work during the last forty years is a worthy record of much accomplished, which has had a wide influence in determining sanitary improvements throughout the Metropolis, and in shaping the course of such reforms as have been successfully initiated.
ALCOHOL AND SUSCEPTIBILITY TO [NFECTION.--The results of an extensive series of experiments on the influence of alcohol on susceptibility to infection,conducted by Dr. Taav. Laitinen (Zeitschri/tfiir Hygiene u~d In/eetionskra~kheiten,xxxiv., p. 206), lead to the conclusion that under all conditions alcohol eause~ s~ distinctly increased susceptibility to experimental infection,whether it is given before or after or both before and after the introduction of the infective material, and whether
it is given in a few large doses or in numerous small doses over a longer time, and whether with acute or chronic infections or pure intoxication. The animals (dogs, rabbits, guinea-pigs, fowls, and pigeons) employed received the diluted alcohol either by the mouth or injected under the skin. The favouring influence of alcohol on the different morbid processes showed itself in the fact that the affection terminated fatally in the aleoholized animals, the controls being unharmed, Or that at least the fatal result was appreciably hastened when both succumbed. With rabbits inoculated with anthrax bacilli of diminished virulence, the former was the case; with guinea-pigs treated with diphtheria toxin, the latter was observed. Alcohol was administered to a number of pregnant guinea-pigs for some days. Some aborted toward %he completion of term ; others gave birth to living young. The majority of the latter died before the tenth day, but those from mothers Which had received but small doses remained alive longer. The survivors when experimented upon with diphtheria tgxin showed a distinctly increased susceptibility in comparison with animals of equal age, the offspring of non-alcoholized mothers. Observationg of temperature showed no differences when the aleohotized animals had not been infected, excepting when such large amounts were given that the animal was almost in convulsions, when a decided fall was observed. After infection the aleoholized animals showed elevated temperature appreciably longer than the controls (averages, twenty-seven and twenty-four days respectively). The results of the research as a whoiehardly justify the employment of alcohol in the treatment of infectious diseases in nmn.--Amer. Journ. Med. Se. 4