Current public health literature

62

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PUBLIC HEALTH

sterilize the silk threads or paper slips when they were exposed in the centre of the room on the same level as the lamp, but the /7. azl/zracis exposed on a linen slip near the wall was found to be sterile. ( f ) On repeating this experiment, using 20 grammes per i , o o o cubic feet as before, I found that silk threads infected with .~. an#zracis, and exposed ( i ) s i x feet over the lamp and (2) near the wall, were sterilized. A dry paper slip similarly infected near the wall, gave growth s on subculture, but those from a wet slip were much attenuated and did not appear until the fourth day. A fold of dry linen infected with an anthrax culture similarly placed was not sterilized, but the organisms in another fold wetted and then infected were killed. (g) Further experimentsin August last were started to determine whether it was necessary to remove infected linen, etc., from the room when formaldehyde was employed in this way, in other words, to ascertain its penetrating power. I found that with i o grammes per i,ooo cubic feet, pieces of damp linen infected with SlapS. 2yog. aureus culture and placed in test tubes plugged with cotton wool, were not sterilized when they had been exposed within eight folds of a heavy blanket and when buried in the centre of a feather pillow; on the other hand, when 2o grammes per 1,5co cubic feet were tried, infected linen sealed in a sterile paper envelope exposed on a table in the room was sterile, and the infected linen from similar envelopes placed inside the pillow and between eight folds of the blanket did not give any growth of the staphylococcus after subculture, although in the last two cases the broth of the subculture became turbid from some other adventitious organism. It will be seen from the above experiments that I have obtained sufficient good results with i o grammes per i,o0o cubic feet to warrant this quantity being used in all cases of ordinary disinfection, and if in special cases the walls and floors are in additioff'sprayed with a 0"5 per cent. Formalin solution before using the lamp, I believe that the best practical means of disinfection would be in this way ensured.

SLAUGHTER-HOUSES IN BATH.--At a meeting of the Bath Sanitary Committee, held on October 4th, the sub-committee recommended that if a person or a private company would submit plans for the erection of slaughter-houses on an improved site they should be favourably entertained. This recommendation was adopted, and a resolution g,as passed urging the Corporate Property Committee, who own the slaughter-houses in Pa,son's Yard, to treat for the surrender of the lease in order to dose t h e m . - - B . 2If. yr.

LITERATURE.

CURRENT

PUBLIC LITERATURE.

HEALTH

IVIORTALITY FROM CERTAIN CAUSES IN LONDON, PARIS, BERLIN, AND VIENNA, AND IN SEVERAL OF THE STATES OF EUROPE, by Dr. NAHTS~ of

the Imp. Statist. Office.

(Alrb. a. d. I~. Ges. ~d. xiv. k. 3.) THE populations of London and Berlin (the former on the whole better housed, the latter with the better sewerage and water supply) are almost identical in every respect save infant mortality, which is higher in Berlin, perhaps through overerowdihg. The enormous difference in age constitution between the populations of these cities and of Paris shows the necessity of appropriate correction before comparing the recorded deathrates. Illegitimacy and still-births (?) are fearfully prevalent in Paris, suggesting the association of the two. While children form z 5 per mille of the population of London and of Berlin, and a x per rail. of that of Vienna, they constitute only r 2"4 per mil. of the population of Paris. To x,ooo live births there are in France r79 illegitimate, in Prussia 77, and in Italy 72 . [These figures apply to the entire nations, and cannot, therefore, be explained away by the social conditions of Paris itsel£--REv.] T h e still births to each i,ooo live births are 3 x in Berlin and 71 in Paris. I n England these are not registered. F o r ro,ooo births the mothers dying in childbed were 4o in :Berlin, 43 (?)in London, and 53 in Paris. T h e London figures are probably misleading, from the fact that there would be no registered birth in the case of death following premature delivery, or when the death of the mother was associated with a still birth at full term. In infant mortality alone does Paris show to advantage, viz., x38 as against 240 in Berlin per i,oeo born alive. [But as x38 per i,ooo is lower than that of France as a whole, and indeed of any great town or country in Europe with the single exception of Norway, it cannot represent the truth, but must be explained by the practice of sending infants out to nurse in the provinces.--REP.] T h e probability at birth of reaching the age of 2o years, and at eo of reaching that of 6o years, is greater in London and Berlin than in Vienna or Paris, the mean annual deathrate per io,ooo living in the former period being in Berlin io7, London I r o , Paris I39 , and Vienna i6o, and in the second, Berlin, I o 4 ; London, x28; Vienna, t36 ; and Paris, i42. The annual mortality per io, obo of the population from tuberculosis and respiratory diseases is in Berlin, 4 5 ; London, 54; Vienna, 69; and Paris, 7o; and from scarlatina, Berlin and London, 28; Paris, 34 ; Vienna, 44. [ I f these rates for scarlatina were calculated on the age period to which the disease is almost restricted, viz., o-I5 years, P a r i s would come out worst, for the child element

CURRENT

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HEALTH

(o-lo years) is but half what it is in London and Berlin.--REv.] ARTIFICIAL MOTHER'S MILK. (MT/cTa. Zeit., i896. l~e~rinled in C/zem. Zeit., xx.) A new method for preparing this is described by Backhaus. Fresh milk is centrifugalised, and to the skim milk, previously raised to the temperature of 4 o deg. C. (lO4 deg. F.) a n d rendered slightly alkaline, rennet is added to coagulate the casein ; after the milk has been kept at 4 o deg. C. for thirty minutes it contains 1"25 per cent. of soluble albumen. It is then heated to 80 deg. C. (176 deg. F.) to arrest the action of the enzyme, and the coagulated casein is removed by straining or centrifugalising. Sufficient cream is then a d d e d to raise the fat to 3"5 per cent. and the casein to o'5 per cent., and lastly, I per cent. of milk sugar. The mixture is then bottled and sterilised. T h e process is easy, and the apparatus required is simply such as is found in all large dairies. INFANT FEEDING.

(Arch. fl ttyg..gd, xxx., _/~f. 2.) Dr. Magnus Blauberg discusses the composition and probable value of certain foods sold in Germany under the name of F o o d Salts (W~/zrs~//ze), intended to supplement other artificial foods by supplying the salts in which they are deficient. I n a subsequent paper he treats of the bacteriology of the infants' foods in general use here as well as on the Continent. Both reports~ especially the latter, seem to be preliminary to more exhaustive investigations yet to come. TINNED VEGETABLES.

(A~ot~. Zeit., 1897 , /3d. xi.,2. 584 . C/~. Zt. xx.,2. 228). H. peas, which grams

Re2rinted ba

Beckurtz describes his analyses of tinned beans, celery, asparagus, truffles, e t c . , in he detected tin to the amounts of o'2 to o'6 per kilo. VEGETABLE (CONDENSED) MILK.

( C/z. Zt., xx.

Reflrfnted in t/ze Pharm. Cent. BI. New Se,ies, Bd., xvii.)

Spaeth gives the results of an analysis of a preparation sold under this name, as follows : Water . . . . . . . . . . . . . . . . 2 7 " 1 7 per cent. Albuminolds :Fat . . . .

lO"58 24"6

,, ,~

Sugar . . . . . . . . . . . . . . . 28"7.3 Othernon-nitrogenous constituents... 9"4I

,, ,,

. . . . . . . . . . . . . . . . . . . . . . . .

KEMMERICH'S PEPTON, LIEBIG'S Co.

(Miinc/~. .afed. FUock., i896 , No. 45. in ~.lg., Oct., I897 ).

Abstracted

W. Zinn describes researches on the metabolism and the clinical value of this preparation, which he considers useful in anaemia, chlorosis, phthisis, and convalescence from exhausting diseases, as con-

LITERATURE.

63

taining a pepton (?) which supplies the place of albumen. H e recommends its administration in small doses (e.g., 20 grams) to whet the appetite rather than as a food. BUTTER--MARGARI NE.

The Arb. a. d. K. Ges. Amt. J3d. xii. contains a report by Dr. Windisch which should be read by all interested in the burning question of the control of this important industry and great field for fraudulent practices. H e discusses it at length from the technical, legal, and analytical aspects, and, though the statute law is that of Germany, its study will be the more suggestive. The report is divided into the following p a r t s : I. Margarine. ( i ) Preparation of margarine; (2) sanitary considerations; (3) detection and estimation of margarine in butter and of butter in margarine. I I . Butter schmaltz and margarine schmaltz. I I I . On the estimation of water, salt, and fat in butter. IV. Margarine ( " f i l l e d " ) cheese. V. Lard and other animal and vegetable fats. [NOTE. - ' c Schmaltz " is the name given in Germany to butter which, having been melted to the state o fan oil, is then drawn off into casks, entirely freed from the traces of casein,

sugar, water, etc., in the butter milk, which rise as a scum or sink to the bottom of the vat. It is an absolutely pure and dry fat, and, with a very small addition of salt, remains free from rancidity for many months. It is much used for provisioning ships, and in contracts for public institutions.-REP.] ON THE PRESENCE OF C¥STICERCI (MEASLES) IN THE FLESH OF CATTLE AND SWINE. (Vollers, Zts. fi fffefsc/z m Mifc/z ffyg., ]a/zrg. v i , 7 / i 2 ; Noach, do. ; Zschokke, do. ; Glage, do. ; Foth, J3erlin T/derdrz. l/Voc,rzemch, 1896 , No. 37). Noach detected an unsuspected presence of cysticerci even in the prime joints, which are usually considered free, by cutting them up into small pieces. Zschokke admits that they are killed by a temperature of 45 deg. C. ( ~ I I 3 deg. F.) H e found that he passed tape-worms after eating meat that had been kept in an ice-house for 14 days, but not when it had been frozen for 40 days or longer. Glage states that weak acids, as 2 per cent. of acetic, suffice to kill the C. ceZIz~/os~, but that C. tenndcoffis is more resistant. Pieces of meat, weighing 3 to 4 kilos (7 to 9 Ibs.) and io cms. (4 inches) thick, were " c u r e d " by a few days ~ steeping in 5 per cent. acetic acid. ON THE I N J U R Y TO I~EALTH, INCIDENT TO THE MANUFACTURE OF CHROMATES AND TO THE INDUSTRIES IN WHICH THEY ARE EMPLOYED.

(Dr. [4Zulzdorff, Arb. a. A 7C Ges. X777.) The author inspected, on behalf of the Imperial Board of Health, 27 factories in different provinces of the Empire, employing from six to 300 workpeople. T h e total number of workers was about 92o, of whom I i only were women. I n x5 of the

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works no case of injury to health had occurred for five years or more, but in eight there was clear evidence of illness. It was doubtful whether the solitary instances of disease reported from the reinaining four factories had originated in the works or elsewhere, or, on the other hand, whether they were not due rather to lead than to chromium poisoning. The possibility of preventing all injury to employ6s was demonstrated by the robust health of the employSs in certain factories where the work was of the more dangerous character. Dr. Wutzdorff reviews the literature of the subject issued in Germany, England, France, and Belgium for the last forty years, including the most recent reports of our factory inspectors. H e describes the principal processes in their relation to health, giving determinations of the amount of Cr~ 03 present in samples of air, and the nature of the injuries observed, both general and local. In discussing preventive measures he insists on the practical objections to all kinds of respirators for men engaged in laborious or hot work, as also to medicinal drinks or lotions. H e would prefer to rely on improved ventilation, removal of dust by fans, the conduct of the more dangerous processes in closed chambers wherever possible, the regular use of baths, gargles, etc., and change of clothing. VACCINATION.

Reports on the institutions for the production of calf lymph in Germany for the year x896, and the success attending primary and secondary vaccinations, public and private, as regards operations and insertions, will be found in Arb. a. d. Ges., xiv. 3. TRANSPORT OF ANIMAL (VAccINE) LYMPH TO THE TROPICS.

Dr. 13ecker, Pr. Med. Officer to the German Colonial troops in East Africa, considering the transport of lymph in tubes through the Red Sea, especially in the hot season, to be beset with insuperable difficulties, recommended the establishment of a local institute for its production, as at Rio, Havana, Batavia, etc. But Dr. Plehn, feeling that this was at present impracticable, has endeavoured to improve on the method of transport. H e finds that if the tubes be packed in cotton wool, enclosed in strong wooden boxes, and kept in the coolest part of the vessel, the results, though uncertain, are often very satisfactory, and would, he believes, be all that could be desired if the boxes were stored in the ice-room. H e insists on each sample being marked with its source and date of collection. He gives (Arb. a. d. IC. Ges. Bd., xiii.) elaborate tables of the results of vaccinations, primary, secondary, and after small-pox, on numbers of persons of different races and ages, showing great uncertainty in the results (from o per cent. to ioo per cent. of successes), and is inclined to the belief that among black races or in

HEALTH

LITERATURE.

equatorial regions the immuuity acquired by previous vaccination or by small-pox tends to wear off sooner than in temperate climates. PRODUCTS OF THE

13ACTERIAL DECOMPOSITION

OF MIL~. ( Firdz. drc~. Bd., cxlvi., p. 65. ) 131umenthal long ago showed that the souring of milk by the action of the bacillus coli, whether " spontaneous" or induced by the addition of cultures, was due to the formation of succinnic not of lactic acid. He has since confirmed this by a long series of experiments on normal and on alkalised milk with the 13. eoli, Oidium lactis, B. of typhoid, and of cholera, Diplococci, etc. As a rule none of the products of the decomposition of albumens, as indol, phenol, hydrogen sulphide, mercaptan, etc., appear, and the casein is little if at all acted on. Succinnic acid might be formed from albumen, but is, as well as the volatile acids, probably derived from the sugar. In 26 experiments succinnic acid was formed alone in ~7, lactic in 3, and both in 6. Along with the succinnie acid were alcohol, aldehyde, and volatile acids, all doubtless derived from the milk sugar. No difference could be observed in the action of the B. coli and 13. typhosus. Those of cholera, tetanus, and diphtheria formed little toxin in normal but much in alkaline milk. PHYSIOLOGY

OF

LABOUR.

Wolpert (Arc,~. f. Hyg. Bd., xxvi. h. I) reports researches, conducted on the lines of those of Pettenkofer and Voit, on the elimination of carbon dioxide and aqueous vapour during work and rest, with the influence o f high temperature on hard labour. H e operated on persons engaged in actual useful work, as shoemakers, tailors, needlewomen, female sewing machinists, clerks, draughtsmen, lithographers, and mechanics employed for three to five hours at a time. THE

IMPORTANCE A N D THE

MEANS

FOR

THE

PREVENTION (Bedeutunff und J~e~dmj~fung) OF TUBERCULOSIS AMONG CATTLE AND SWINE.

This subject is clearly and concisely dealt with in a report of the Prussian Board of Agriculture (duflr. d. K. Pr. 3linist. f. Lan&virtksc/O, since published as a pamphlet by P. Parey, Berlin, t896 , and abstracted in (f/..8., Sept. i5th , I897 , vii. i8). R E P O R T FOR 1895 OF THE INSPECTORS OF iTACTORIES AND MINES rN THE KINGDOM OF PRUSSIA,

An abstract of these highly important and interesting reports appeared in the C/z. Zdt.) xx., p. 69~. REPORT ON LEPROSY IN RUSSIA.

(.4rb. a. d. K. G., xiii.) Drs. Kiibler and Kirchner, with maps.

ANNUAL REPORT

OF T H E

LOCAL GOVERNMENT

CLI~MATE AND METEOROLOGY OF GERMAN EAST AFRICA.

( A t & a. d. ](. Ges. JRd. xiii.) Dr. Plehn, Government Surg. These observations, made at Tanga, would be valuable to anyone proceeding to the British Protectorate, which is extensively conterminous with the German. MICROBE

OF TYPHUS.

(Arck. des Sciences JRiol., iv., 4). Levaschew describes a coccus 0"2 # to o"3 diameter, whieh he believes to be specific and pathogenic.

B O A R D FOR ~896-97

A N N U A L R E P O R T OF T H E L O C A L GOVERNMENT BOARD FOR 1896-97. THE bulk of this report is naturally financial and administrative , and it deals but slightly wilh matters coming under the jurisdiction of health officers. As the year dealt with ended on March 3ISt last, there has ]peen commendable dispatch in publishing the report. We could wish that the reports of the medical department of the board were published with even an approximate promptitude. With reference to finance, the most interesting item of information is the cort, parison instituted between local indebtedness and the National Debt. The following are the figures : -

DIFFERENTIATION OF B. TYPH. AND VIB. CHOL,

National Debt of the

(Mort. f. Ges. 2bfl., 1896 , 2Vo. 6, and Z-Z. R., vii. I8, Sept. I5, 1:897). Gruber discusses their diagnostic reactions.

United Kingdom.

MALLEIN.

(72r.. R. vii., 18). Foth describes a new method of preparing a very stable mullein, and discusses its diagnostic employment in a pamphlet published by R. Schoetz, Berlin, Louisien Strasse No. 36, 1896. BACTERIA OF DENITRIFICATION.

(Arck. i In. JRd. xxx., 3). These recently-discovered organisms, which break up the nitrates and nitrites with an evolution of nitrogen and nascent oxygen (?), are discussed in an important contribution by Dr. Weissenburg. The fungi of muguet or thrush are described by Teissier (Arch. de Yf~d. Ex2b. et d'Anat._Path., r897 , .No. 3)" Reaction of Culture Fluids as InfluenciDg the Growth of Bacteria" is the subject of a report by Dr. Marinus Deelemann, of the Saxon GrenGuards (L4r3. a. d. I~. Ges. ~d. xiii.) A remarkable branching or " s t a g s h o r n " bacillus is deseribed (Arc/z.f It-. JR. xxx., If.. 2) by Dr. Albert Stoltz, with remarks on the case whence it was obtained.

TI~E Standard of October 26th, reports that the Local Government Board have addressed a letter of inquiry to the Lynn Sanitary Authority as to the cause of the i2o cases of enteric fever reported in the district: I f the allegation as to the water supply, contained in the Standard's report be true, there is little difficulty in giving a plausible explanatio~ for the cases.

65

Local Debt of England & WaleF.

x874"75 . . . . . . L768,945,757 ... ~92,82O,lOO I894-95 . . . . . . 656,998,94I ... 235,335,o49 The figures for the remainder of the United Kingdom for 1874-75 are not available, those for 1894.95 are, Scotland, .£32,746,589, and for Irdand, .£9,542,960, making a grand total for the United Kingdom of .£277,624,598. The local debt for England and Wales in the last period was equivalent to an average o f . £ 8 2s. 3d. per person, ranging from .£IO r3s. 2d. in the metropolis to 5 s. 8d. in the purely rural districts. The ratable value of England and Wales was .£16I,I39,575, the debt being equivalent to .£1 9 s. 3 d. per pound of ratable value. From a perusal of two separate tables we gather that at the end of the financial year 637 rural authorities (out of a total of 66I) claimed half the salaries paid to medical officers of health, whilst of urban authorities, excluding metropolitan, 871 out of I,O22 made similar claims. In London half the salaries of all medical officers appointed subsequent to the beginning of 1892 are paid by the County Council. The officers so appointed number 42 . On March 3Ist, I897, the Notification Act of 1889 was in force in 1,527 districts, excluding the metropolis, viz., 9o3 urban and 624 rural, having a total population, at the census of ~891, of I9,654,42o inhabitants. In London notification is compulsory under the Public Health Act of ~891, and in 49 towns is provided for under private Acts. The Act of ~889 is also in force in 40 port districts. Of the total population of England and Wales, 29,002,525 at the census of I89I, 27,761,82 + are protected by notification. The board receives weekly returns of notifications from 217 urban authorities, with an aggregate population ( I 8 9 I ) of I5,446,68o. The total notifications received by these authorities during the year 1896 , were as follows: Small-pox, 2,820; scarlet fever, 88,713 ; diphtheria, 25,498 ; membranous croup, 1,365 ; and enteric fever, I7,616. The percentage proportion of deaths from these F