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Bacteriology
BACTERIOLOGY.
printed and circulated it in their district. The Infectious Disease Notification Act not being in force in the district, D r . Liston's information on certain points is necessarily defective, and it has been impossible to exercise complete control in preventing the spread of disease. It appears that Southwick has no health committee, and that very fear sanitary notices of any kind are served. T h e following remarks on water supply are made by Dr. Liston: " I have reported to the Sanitary Authority on several occasions the want of water supply to houses, and have been told (verbally) that this arises from people stealing the brass taps. The Sanitary Authority must either be ignorant or misinformed, as I can point out houses close to the offices in Dean Terrace where there is neither water nor backyard accommodation tor the tenants, and I know of another house in the township which has four tenants, and which has had no water supply since i888." ASTON MANOR. Dr. H. May gives in his annual report for i89z a table of the age distribution of the population of Aston Manor in ~88~ and ~89I respectively, which strikingly illustrates the effect of the lowered birthrate in i.ncreasing the average age of the population. Building Regulations.--" The nature and suitability of the sites for new houses have been specially referred to me on two occasions, and I have inspected and reported on them to the surveyor. Although one was on an old tip, the ground had become so consolidated and innocuous that I had no hesitation in approving of it with the additional precaution of a layer of concrete Over the building site. In the other case, the ground was part of a recent tip still containing undecomposed animal and vegetable matter, and unfit for building, atthough a street had been made there. The site in question was the oldest part of it, and though I objected to its being used for building at present, I said a complete layer of concrete would be absolutely necessary if so used. I am informed that the plans were not approved, but the houses were proceeded with without concrete, and the matter is under your consideration with a view to proceedings for breach of bye-laws and violation of section 25 of Public Health Acts Amendment Act. I have referred fully in previous reports to the importance, from a sanitary point of view, of the supervision of small houses during construetion, and I am glad to note that you have taken legal proceedings on several occasions during the year against builders for breaches of the building bye-laws." BACUP. Dr. J. Brown says : "Whooping-cough was more or less present all through x892 in Bacup. As a rule, no precautions are taken to prevent the spread of the disease ; it is treated as a trivial ailment. Some of the cases were of a severe type, and seven
~ 83
proved fatal. I have advocated for several years the use of carbolic acid. When sprinkled on the floor, or clothes hung in the room saturated with it, the carbolised atmosphere lessens the severity of the spasms ; besides which, the fact that carbolic acid is about educates the people to the fact that whooping-cough is a highly infectious disease, and that precautions should be taken that it is not wantonly or carelessly disseminated.' BACTERIOLOGY. By RUBERTBOIrCE,1V[.B.,Assistant Professor of Pathology, University College, London. A LARGEnumber of interesting and important experiments have been carried out recently Upon the already well-known subject of disinfection. Some of the most interesting have been made upon the disinfectant action of direct sunlight. Thus Buchner, Centrlb. f. Bakt., i892, B. xi. and xii., exposed a beaker of water, containing about roo, ooo germs of bacterium coli commune to the cubic centimetre, to the direct action of sunlight for one hour. After this exposure inoculations of the water upon gelatine gave no result. The temperature of the water was scarcely higher than that in the control' vessel, in which the number of germs had, if anything, increased. Exposure to direct sunlight for ten minutes of the typhoid bacillus produced considerable diminution of the culture. One to one and a-half hours caused com. plete arrest of development ; the same was obtained by five hours exposure to diffuse light. Professor Marshall Ward has also been experimenting upon the same lines, and has found that an exposure to a December sun for five hours prevented the growth of anthrax. According to the Oesterreich. Sanit~ts Wesen, i892 , carbolic acid is disinfectant in much smaller quantity than is usually thought. It is also important to find that the addition of hydrochloric or sulphuric acid greatly increases the activity of the carbolic acid, but especially in the case of the crude productions as creosote ; in these cases the carbolic acid which is the active agent is liberated. The warming also of the disinfectant greatly increases its value. The internal administration of carbolic acid is, however, not so effective, according to Albu and Wegl. Thus, in the case of a phthisical patient, who from November, i 8 9 i , to October, i89z , had taken as many as 43 ° grammes of creosote in 9,6oo capsules, the sputum still contained living bacilli. Kholer has a long article ~ upon the action of acids, alkalies, and the aniline colours upon typhoid bacilli. H e sums up by saying that they possess a relatively high resisting power against acids and dyes; that the mineral acids are much more po~¢erful than the organic, and that the resistance of the bacilli against the alkalies is less than against the acids. * Zeitschrift f. Hyg., I893'-:[:I r.- ...................
I84
QUERY
Numerous experiments have also been carried out upon the efficacy of the various porous earth filters, and perhaps the most useful results are those of Lacour. ~" Thus the porcelain Chamberland filter is very good, if (1) the pressure at which the water is forced through does not much exceed that of the atmosphere; and ('2) if the bougie is thoroughly sterilised every third day. M. Morot~ makes out a very strong ease for more effective meat inspection in France. H e has collected a m a s s or information upon the meat frauds which are practised in France, not only as regards the substitution of bad horse and dog flesh, but even of that of the various animals which died at the Jardin des Plantes. Galtier~_ has confirmed former experiments as to the degree of infectivity of the flesh of tubercular animals when given as food. In fourteen cases where he fed swine and calves with minced raw meat and meal no infection resulted. T h e meat juice in two of the above experiments produced tuberculosis in the rabbit after subcutaneous inoculation. H e believes there is very little danger in the meat if it is properly cooked. As is well known, cooking upon an extensive scale has been adopted in Germany in the case of infected meat, and with apparently very great advantage ; and a paper by Dr. Hertwig,~ Director of the Thierschau in Berlin, gives numerous interesting results, the forms of apparatus used, and the time necessary to thoroughly cook the meat. In " I n den gewerblichen Betrieben vorkommonde Staubarten in W o r t u Bild, Wien, i892," will be found photographs of all the most important dusts met with in the various industries. T h e relative danger of the various groups is also pointed out.
COUNTY NOTIFICATION RETURNs.--We have received a statement of returns received by Dr. Thresh from the medical officers of health of the number of infectious diseases notified in each district of the administrative C o u n t y of Essex during the month of January. This statement is of value, not only to the local medical officers of health for whom it is primarily intended, but for comparison with other counties. Similar returns have for some time been circulated by the county medical officers of Lancaster, Stafford, and the West R i d i n g ; and it may be hoped that ere long the organisation will be complete for a universal adoption of this system and an interchange of returns similar to that already undertaken by the Local Government Board for the great towns, and, originally started by Dr. Tatham. Hyg. Rundsehau, Feb., 1893. t Ann. d' Hygiene publique, Feb, I893.] $ Journal de Med. V6t.~ i892. Schmidt's Jahrb, 1893.
COLUMN. QUERY COLUMN. A. B. inquires whether an order of abatement of a smoke nuisance having been obtained, signed by the justices, this order stands good for any length of time or only for six months ? Answer.~The original notice to abate signed by the town clerk only stands good for six months, but the six months' limit of time is not applicable to the justices' order. Rural M.O.H. asks: Can a rural S.A., after receiving a certificate from their M.O,H. under sec. i2o, P.H. Act, 1875, that cleansing and disinfecting is necessary to prevent the spread of an infectious disease, order the occupier or owner (inter alia) to strip the paper off the walls and whitewash the ceiling of the house ? Answer.~Stripping the paper off the walls in our opinion comes under the head of the necessary cleansing and disinfecting, and we think that the notice to this effect could be sustained. Whitewashing certainly forms a necessary part of the process of cleansing. S. I. inquires whether, after the occupier of a house has refused to allow an insFector to enter and examine the premises under the powers of the P.H. Act, 1875, and an order for entry has been obtained from a justice and served upon the occupier, forcible entry can now b e m a d e against the occupier's wish, or what other procedure must be adopted ? Answer.-Where the order of a justice to enter has been obtained under see. lO2, P.H. Act, the only remedy in ease of continued refusal of admission is to apply for a penalty under see. lO3. An order to enter the premises under see. 305. P.tL Act, I875, would justify a forcible entry on the premises. Rural M.O.FL asks: I have a case of acute peritonitis with vomiting, which has come on rather suddenly in the case of Mrs. A - - - - , confined about a fortnight ago. Does this case come under the heading of puerperal fever, and should it be notified? I t may be due in some degree to bad dieting and unintentional carelessness of those in charge. Answer.--We think the ca~e should be notified, and few words of explanation sent to the medical officer of health with the certificate. R. N. writes : T h e managers of a public elementary school close the same on account of an epidemic without consulting me, the medical officer of health. Afterwards they d e m a n d a certificate, saying that they were justified in closing the school. As I was never consulted, am I bound to give such a certificate ? AnmJer.--Certainly not, The school managers must accept the responsibility. Under Article 83 (a) Education Code, any competent medical man may certify, and the local doctor may therefore be prepared to give the certificate. A HIGH DIPHTHERIA DEATH-RATE.--Dr. Snell, in his report to the Grays Local B~ard, Essex, in December last, stated that during the precedin~ four months 48 cases of diphtheria were notified, 2o of them being fatal, giving a d e a t h r a t e from this cauoe alone equal to 6'5 per annum.
printed and circulated it in their district. The Infectious Disease Notification Act not being in force in the district, D r . Liston's information on certain points is necessarily defective, and it has been impossible to exercise complete control in preventing the spread of disease. It appears that Southwick has no health committee, and that very fear sanitary notices of any kind are served. T h e following remarks on water supply are made by Dr. Liston: " I have reported to the Sanitary Authority on several occasions the want of water supply to houses, and have been told (verbally) that this arises from people stealing the brass taps. The Sanitary Authority must either be ignorant or misinformed, as I can point out houses close to the offices in Dean Terrace where there is neither water nor backyard accommodation tor the tenants, and I know of another house in the township which has four tenants, and which has had no water supply since i888." ASTON MANOR. Dr. H. May gives in his annual report for i89z a table of the age distribution of the population of Aston Manor in ~88~ and ~89I respectively, which strikingly illustrates the effect of the lowered birthrate in i.ncreasing the average age of the population. Building Regulations.--" The nature and suitability of the sites for new houses have been specially referred to me on two occasions, and I have inspected and reported on them to the surveyor. Although one was on an old tip, the ground had become so consolidated and innocuous that I had no hesitation in approving of it with the additional precaution of a layer of concrete Over the building site. In the other case, the ground was part of a recent tip still containing undecomposed animal and vegetable matter, and unfit for building, atthough a street had been made there. The site in question was the oldest part of it, and though I objected to its being used for building at present, I said a complete layer of concrete would be absolutely necessary if so used. I am informed that the plans were not approved, but the houses were proceeded with without concrete, and the matter is under your consideration with a view to proceedings for breach of bye-laws and violation of section 25 of Public Health Acts Amendment Act. I have referred fully in previous reports to the importance, from a sanitary point of view, of the supervision of small houses during construetion, and I am glad to note that you have taken legal proceedings on several occasions during the year against builders for breaches of the building bye-laws." BACUP. Dr. J. Brown says : "Whooping-cough was more or less present all through x892 in Bacup. As a rule, no precautions are taken to prevent the spread of the disease ; it is treated as a trivial ailment. Some of the cases were of a severe type, and seven
~ 83
proved fatal. I have advocated for several years the use of carbolic acid. When sprinkled on the floor, or clothes hung in the room saturated with it, the carbolised atmosphere lessens the severity of the spasms ; besides which, the fact that carbolic acid is about educates the people to the fact that whooping-cough is a highly infectious disease, and that precautions should be taken that it is not wantonly or carelessly disseminated.' BACTERIOLOGY. By RUBERTBOIrCE,1V[.B.,Assistant Professor of Pathology, University College, London. A LARGEnumber of interesting and important experiments have been carried out recently Upon the already well-known subject of disinfection. Some of the most interesting have been made upon the disinfectant action of direct sunlight. Thus Buchner, Centrlb. f. Bakt., i892, B. xi. and xii., exposed a beaker of water, containing about roo, ooo germs of bacterium coli commune to the cubic centimetre, to the direct action of sunlight for one hour. After this exposure inoculations of the water upon gelatine gave no result. The temperature of the water was scarcely higher than that in the control' vessel, in which the number of germs had, if anything, increased. Exposure to direct sunlight for ten minutes of the typhoid bacillus produced considerable diminution of the culture. One to one and a-half hours caused com. plete arrest of development ; the same was obtained by five hours exposure to diffuse light. Professor Marshall Ward has also been experimenting upon the same lines, and has found that an exposure to a December sun for five hours prevented the growth of anthrax. According to the Oesterreich. Sanit~ts Wesen, i892 , carbolic acid is disinfectant in much smaller quantity than is usually thought. It is also important to find that the addition of hydrochloric or sulphuric acid greatly increases the activity of the carbolic acid, but especially in the case of the crude productions as creosote ; in these cases the carbolic acid which is the active agent is liberated. The warming also of the disinfectant greatly increases its value. The internal administration of carbolic acid is, however, not so effective, according to Albu and Wegl. Thus, in the case of a phthisical patient, who from November, i 8 9 i , to October, i89z , had taken as many as 43 ° grammes of creosote in 9,6oo capsules, the sputum still contained living bacilli. Kholer has a long article ~ upon the action of acids, alkalies, and the aniline colours upon typhoid bacilli. H e sums up by saying that they possess a relatively high resisting power against acids and dyes; that the mineral acids are much more po~¢erful than the organic, and that the resistance of the bacilli against the alkalies is less than against the acids. * Zeitschrift f. Hyg., I893'-:[:I r.- ...................
I84
QUERY
Numerous experiments have also been carried out upon the efficacy of the various porous earth filters, and perhaps the most useful results are those of Lacour. ~" Thus the porcelain Chamberland filter is very good, if (1) the pressure at which the water is forced through does not much exceed that of the atmosphere; and ('2) if the bougie is thoroughly sterilised every third day. M. Morot~ makes out a very strong ease for more effective meat inspection in France. H e has collected a m a s s or information upon the meat frauds which are practised in France, not only as regards the substitution of bad horse and dog flesh, but even of that of the various animals which died at the Jardin des Plantes. Galtier~_ has confirmed former experiments as to the degree of infectivity of the flesh of tubercular animals when given as food. In fourteen cases where he fed swine and calves with minced raw meat and meal no infection resulted. T h e meat juice in two of the above experiments produced tuberculosis in the rabbit after subcutaneous inoculation. H e believes there is very little danger in the meat if it is properly cooked. As is well known, cooking upon an extensive scale has been adopted in Germany in the case of infected meat, and with apparently very great advantage ; and a paper by Dr. Hertwig,~ Director of the Thierschau in Berlin, gives numerous interesting results, the forms of apparatus used, and the time necessary to thoroughly cook the meat. In " I n den gewerblichen Betrieben vorkommonde Staubarten in W o r t u Bild, Wien, i892," will be found photographs of all the most important dusts met with in the various industries. T h e relative danger of the various groups is also pointed out.
COUNTY NOTIFICATION RETURNs.--We have received a statement of returns received by Dr. Thresh from the medical officers of health of the number of infectious diseases notified in each district of the administrative C o u n t y of Essex during the month of January. This statement is of value, not only to the local medical officers of health for whom it is primarily intended, but for comparison with other counties. Similar returns have for some time been circulated by the county medical officers of Lancaster, Stafford, and the West R i d i n g ; and it may be hoped that ere long the organisation will be complete for a universal adoption of this system and an interchange of returns similar to that already undertaken by the Local Government Board for the great towns, and, originally started by Dr. Tatham. Hyg. Rundsehau, Feb., 1893. t Ann. d' Hygiene publique, Feb, I893.] $ Journal de Med. V6t.~ i892. Schmidt's Jahrb, 1893.
COLUMN. QUERY COLUMN. A. B. inquires whether an order of abatement of a smoke nuisance having been obtained, signed by the justices, this order stands good for any length of time or only for six months ? Answer.~The original notice to abate signed by the town clerk only stands good for six months, but the six months' limit of time is not applicable to the justices' order. Rural M.O.H. asks: Can a rural S.A., after receiving a certificate from their M.O,H. under sec. i2o, P.H. Act, 1875, that cleansing and disinfecting is necessary to prevent the spread of an infectious disease, order the occupier or owner (inter alia) to strip the paper off the walls and whitewash the ceiling of the house ? Answer.~Stripping the paper off the walls in our opinion comes under the head of the necessary cleansing and disinfecting, and we think that the notice to this effect could be sustained. Whitewashing certainly forms a necessary part of the process of cleansing. S. I. inquires whether, after the occupier of a house has refused to allow an insFector to enter and examine the premises under the powers of the P.H. Act, 1875, and an order for entry has been obtained from a justice and served upon the occupier, forcible entry can now b e m a d e against the occupier's wish, or what other procedure must be adopted ? Answer.-Where the order of a justice to enter has been obtained under see. lO2, P.H. Act, the only remedy in ease of continued refusal of admission is to apply for a penalty under see. lO3. An order to enter the premises under see. 305. P.tL Act, I875, would justify a forcible entry on the premises. Rural M.O.FL asks: I have a case of acute peritonitis with vomiting, which has come on rather suddenly in the case of Mrs. A - - - - , confined about a fortnight ago. Does this case come under the heading of puerperal fever, and should it be notified? I t may be due in some degree to bad dieting and unintentional carelessness of those in charge. Answer.--We think the ca~e should be notified, and few words of explanation sent to the medical officer of health with the certificate. R. N. writes : T h e managers of a public elementary school close the same on account of an epidemic without consulting me, the medical officer of health. Afterwards they d e m a n d a certificate, saying that they were justified in closing the school. As I was never consulted, am I bound to give such a certificate ? AnmJer.--Certainly not, The school managers must accept the responsibility. Under Article 83 (a) Education Code, any competent medical man may certify, and the local doctor may therefore be prepared to give the certificate. A HIGH DIPHTHERIA DEATH-RATE.--Dr. Snell, in his report to the Grays Local B~ard, Essex, in December last, stated that during the precedin~ four months 48 cases of diphtheria were notified, 2o of them being fatal, giving a d e a t h r a t e from this cauoe alone equal to 6'5 per annum.