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BEWAGE ORGANISMS AND DISEASE.
356
SEWAGE ORGANISMS AND DISEASE.
favourable circumstances to
It is results it is concluded that sewage, even in the absence of not the fault of medical men that such an arrangement as is the normal micro-organisms which it contains, is clearly an medium for the growth of the typhoid germ, said to obtain at Margate is not in much more extensive use, unfavourable whereas the colon bacillus can grow and multiply freely in where medical men-and druggists are under mutual obligait. It might be anticipated, it is pointed out, that in com. tion-within reasonable limits of course-the former not to petition with other organisms, able to grow well in sewage, dispense and the latter not to prescribe. If druggists would the typhoid bacillus would die out even more speedily. show less disposition to prescribe and to make secondary These experiments are only preliminary and are necessarily but they give a distinct indication of the prouses of medical prescriptions, and if they would contrive incomplete, bable fate of typhoid bacilli which gain access in a living better to adapt their charges to the means of patients as condition to sewage, while it seems " clear that sewage does medical men have to do, they would do much to hasten this not form a medium in which much, if any, growth is possible division of labour. It is no part of this argument to dis- for them under natural conditions, and their death is probably parage the legitimate business of druggists, which is a only a matter of a few days, or at most one or two weeks." dignified and worthy one ; but we’deny entirely their right Obviously, this resistance to growth may be overcome by to prescribe. The General Medical Council at every meeting attenuation, as when sewage has access to the drinking supply or to milk. It would appear, then, that so far as bacteriological removes from the Register medical men for allowing unanalysis goes there is no ground for believing that sewer qualified practitioners to act as if they were qualified. This air plays any part in the conveyance of typhoid fever; but are is what many druggists do, even in grave cases, often with the conditions under which the bacteriological examinations grave results ; and it hinders that cooperation and con- of sewage and of sewer air are made such as to give ns absolute assurance on these and other points ? In spite of fidence of medical men which we all desiderate. its apparent bacteriological innocuousness no one entertains the least doubt that sewer air is a constant source of disease, and if this is not to be referred to micro-organisms to what may it be ascribed2 There is undoubtedly a poisonous agency at work when sewer air is inhaled, which, though it " Ne quid nimis." may not directly act, yet so prepares the soil that the system is unable to resist the invading organism when it comes. In some well-known experiments recorded in THE LANCET2 SEWAGE ORGANISMS AND DISEASE. it was shown that when rats, amongst other animals, IN previous reports1 presented to the London County were inoculated with a weak growth of typhoid culture, after Council Mr. J. Parry Laws, F.I.C., made the important to sewer emanations, they nearly observation that the micro-organisms contained in sewer air previously being exposed all succumbed. On the other hand, rats treated to the same were not only less in number than the micro-organisms in dose of typhoid culture, but exposed to fresh air after inocufresh air in the vicinity at the same time, but that they were showed little sign of illness and eventually recovered. lation, also apparently related to and derived from those of fresh air is this poisonous constituent of sewer air which then, What, rather than sewage, while there was no evidence forthcoming leaves the system defenceless against the attacks of the that sewage was able to give off micro-organisms to the air microbes which it may encounter ? An investigation on this in contact with it. Acting on the instructions of the Main would form, we suggest, an excellent and fitting sequel Drainage Committee of the Council this investigation has point to the above valuable contribution. been extended by Mr. Laws, with the assistance of Dr. Andrewes, to a study of the organisms existent in SNOW SALT, AND SLUSH. sewage. From a copy of the valuable report which has been and which a contains careful series EVERYONE will agree that the severe and bitter cold we issued, recently of well-chosen and laborious experiments, we gather the are experiencing just now hardly requires accentuating. following materials. The most striking difference in the Eight degrees of frost all day in London, with probacteriology of sewage and sewer air appears to be the bably twice that number registered in the suburbs, absence of moulds from the latter, while in the former require no ordinary amount of endurance on the part moulds were found to be a predominant feature. The bacillus of pedestrians, but to reduce this to zero by artificial coli communis was found, with one exception, in each means on the pavements of our streets is intolerable sample of sewage examined, but neither it nor its allies were and unnecessary. Yet the sprinkling of salt in the streets The bacteria of sewage rapidly appears to be the only means which has occurred to the ever found in sewer air. while organisms possessing this pro- street authorities for removing the fallen snow. It is a liquefy nutrient gelatine, in sewer air. This evidence matter of common knowledge that such a mixture produces absent perty were practically that there is no relationship instant liquefaction and consequent great absorption of heat, would seem to be conclusive air and sewage, and the and the temperature of the resulting mixture, pro tempore, between the organisms of sewer writers are thereby led to think that some of the ill-effects sinks to zero. But this is not all ; the mixture, being which have been erroneously (?) ascribed to sewer air saline, remains wet at a temperature considerably below may be due to subsoil air derived from soil polluted by freezing point, so that the pavements are made much more constant infiltration of excremental matter, but suggest that uncomfortable and cold than they would be if nothing at it is not until the outer margin of the permeated soil has all was done. There is little doubt also that the salt solution, become dry that the air is infected with organisms. In a finding its way into the soles of boots, renders them persearch for the typhoid bacillus in sewers, where it might be manently damp and therefore permanently cold. The roads expected to be present in large proportion, such as in the (for we must bear in mind our four-footed friends) and the drains of the Eastern Hospital at Homerton, they were suc- pavements should be swept immediately after a fall of cessful in demonstrating the actual presence of the bacillus snow, or, if salting must be done, the saline slush could be typhosus ; but in a sample taken about a quarter of a mile "squeegeed off " the moment it is formed so that we may away no single colony developing on culture could be referred have at least a dry footway. The street sanitary authorities to the bacillus of typhoid fever. In the light of this and other should surely use their powers and, if unable to do the work one
specially devoted to it.
Annotations.
1
THE LANCET, March 24th, 1894.
2
THE LANCET,
Sept. 29th, 1894.
SEWAGE ORGANISMS AND DISEASE.
favourable circumstances to
It is results it is concluded that sewage, even in the absence of not the fault of medical men that such an arrangement as is the normal micro-organisms which it contains, is clearly an medium for the growth of the typhoid germ, said to obtain at Margate is not in much more extensive use, unfavourable whereas the colon bacillus can grow and multiply freely in where medical men-and druggists are under mutual obligait. It might be anticipated, it is pointed out, that in com. tion-within reasonable limits of course-the former not to petition with other organisms, able to grow well in sewage, dispense and the latter not to prescribe. If druggists would the typhoid bacillus would die out even more speedily. show less disposition to prescribe and to make secondary These experiments are only preliminary and are necessarily but they give a distinct indication of the prouses of medical prescriptions, and if they would contrive incomplete, bable fate of typhoid bacilli which gain access in a living better to adapt their charges to the means of patients as condition to sewage, while it seems " clear that sewage does medical men have to do, they would do much to hasten this not form a medium in which much, if any, growth is possible division of labour. It is no part of this argument to dis- for them under natural conditions, and their death is probably parage the legitimate business of druggists, which is a only a matter of a few days, or at most one or two weeks." dignified and worthy one ; but we’deny entirely their right Obviously, this resistance to growth may be overcome by to prescribe. The General Medical Council at every meeting attenuation, as when sewage has access to the drinking supply or to milk. It would appear, then, that so far as bacteriological removes from the Register medical men for allowing unanalysis goes there is no ground for believing that sewer qualified practitioners to act as if they were qualified. This air plays any part in the conveyance of typhoid fever; but are is what many druggists do, even in grave cases, often with the conditions under which the bacteriological examinations grave results ; and it hinders that cooperation and con- of sewage and of sewer air are made such as to give ns absolute assurance on these and other points ? In spite of fidence of medical men which we all desiderate. its apparent bacteriological innocuousness no one entertains the least doubt that sewer air is a constant source of disease, and if this is not to be referred to micro-organisms to what may it be ascribed2 There is undoubtedly a poisonous agency at work when sewer air is inhaled, which, though it " Ne quid nimis." may not directly act, yet so prepares the soil that the system is unable to resist the invading organism when it comes. In some well-known experiments recorded in THE LANCET2 SEWAGE ORGANISMS AND DISEASE. it was shown that when rats, amongst other animals, IN previous reports1 presented to the London County were inoculated with a weak growth of typhoid culture, after Council Mr. J. Parry Laws, F.I.C., made the important to sewer emanations, they nearly observation that the micro-organisms contained in sewer air previously being exposed all succumbed. On the other hand, rats treated to the same were not only less in number than the micro-organisms in dose of typhoid culture, but exposed to fresh air after inocufresh air in the vicinity at the same time, but that they were showed little sign of illness and eventually recovered. lation, also apparently related to and derived from those of fresh air is this poisonous constituent of sewer air which then, What, rather than sewage, while there was no evidence forthcoming leaves the system defenceless against the attacks of the that sewage was able to give off micro-organisms to the air microbes which it may encounter ? An investigation on this in contact with it. Acting on the instructions of the Main would form, we suggest, an excellent and fitting sequel Drainage Committee of the Council this investigation has point to the above valuable contribution. been extended by Mr. Laws, with the assistance of Dr. Andrewes, to a study of the organisms existent in SNOW SALT, AND SLUSH. sewage. From a copy of the valuable report which has been and which a contains careful series EVERYONE will agree that the severe and bitter cold we issued, recently of well-chosen and laborious experiments, we gather the are experiencing just now hardly requires accentuating. following materials. The most striking difference in the Eight degrees of frost all day in London, with probacteriology of sewage and sewer air appears to be the bably twice that number registered in the suburbs, absence of moulds from the latter, while in the former require no ordinary amount of endurance on the part moulds were found to be a predominant feature. The bacillus of pedestrians, but to reduce this to zero by artificial coli communis was found, with one exception, in each means on the pavements of our streets is intolerable sample of sewage examined, but neither it nor its allies were and unnecessary. Yet the sprinkling of salt in the streets The bacteria of sewage rapidly appears to be the only means which has occurred to the ever found in sewer air. while organisms possessing this pro- street authorities for removing the fallen snow. It is a liquefy nutrient gelatine, in sewer air. This evidence matter of common knowledge that such a mixture produces absent perty were practically that there is no relationship instant liquefaction and consequent great absorption of heat, would seem to be conclusive air and sewage, and the and the temperature of the resulting mixture, pro tempore, between the organisms of sewer writers are thereby led to think that some of the ill-effects sinks to zero. But this is not all ; the mixture, being which have been erroneously (?) ascribed to sewer air saline, remains wet at a temperature considerably below may be due to subsoil air derived from soil polluted by freezing point, so that the pavements are made much more constant infiltration of excremental matter, but suggest that uncomfortable and cold than they would be if nothing at it is not until the outer margin of the permeated soil has all was done. There is little doubt also that the salt solution, become dry that the air is infected with organisms. In a finding its way into the soles of boots, renders them persearch for the typhoid bacillus in sewers, where it might be manently damp and therefore permanently cold. The roads expected to be present in large proportion, such as in the (for we must bear in mind our four-footed friends) and the drains of the Eastern Hospital at Homerton, they were suc- pavements should be swept immediately after a fall of cessful in demonstrating the actual presence of the bacillus snow, or, if salting must be done, the saline slush could be typhosus ; but in a sample taken about a quarter of a mile "squeegeed off " the moment it is formed so that we may away no single colony developing on culture could be referred have at least a dry footway. The street sanitary authorities to the bacillus of typhoid fever. In the light of this and other should surely use their powers and, if unable to do the work one
specially devoted to it.
Annotations.
1
THE LANCET, March 24th, 1894.
2
THE LANCET,
Sept. 29th, 1894.