M. LOUBET AS A SANITARY REFORMER.

1156 committees are attached to the Ministry of the Interior and represent in France what the Medical and Engineering Departments of the Local Government Board represent in England. Furtber, the scheme was also approved by a mixed committee representing the Ministries of War, of Marine, of Public Works, and of the Interior. Finally, and from the legislative and administrative point of view, the scheme was confirmed by the Council of State. But at this latter stage a most extraordinary event occurred. According to the law such schemes must be laid before the public of the town concerned and any inhabitant has the right to attend and to bear witness either against, or in favour of, the project. It was now found that the dossier containing this testimony had disappeared. It had been lost or stolen from the archives-an incident quite worthy of the Dreyfns case. The Government, tied down by the letter of the law, then insisted that, as a mere matter of form, another public inquiry should be held. This was done, but in the interval a new municipal council had come into power which in the preparing of the scheme bad bad no finger in the pie. The result of the public inquiry was the same as in the first instance. Out of a of 104,000, some 1400 persons, including women and servants whipped up for the occasion, had spoken against the proposal. M. LOUBET AS A SANITARY REFORMER. That the scheme is still approved by the great majority of SANITARY reformers have found a useful ally in M. Loubet, the inhabitants of the town is proved by the recent election President of the French Republic. With all the courtesy of M. Ferrera as representative of Toulon in the Parliament. necessary under the circumstances he has not hesitated to M. Ferrera was mayor of the town at the time the scheme administer a well-merited reproach to the municipality of was and at the recent parliamentary election the accepted, Toulon. Nothing can be more revolting and scandalous carrying out of the scheme was the first plank in his than the insalubrious condition of this town, which still serves Nevertheless, the present programme of local reforms. as an open door to all the epidemics that can be imported made a pretext of the second inquiry and municipality from abroad, while within its walls typhoid fever is in declared that, in the presence of the results of There are no sewers and no system this an endemic condition. inquiry, they would not carry out the project. of drainage; some houses have portable pails, some The contractors who had been engaged for the works have cesspools, but a great many houses, even in the are now suing the town. Nine years have been centre of the town, have nothing at all, and the inhabitants expended over this one scheme. It has received the highest are content to throw out their night-soil into the streets. governmental and technical sanction ; but because it did not On his return from visiting the Italian squadron M. Loubet originate with the present municipal majority, all this work, was entertained by the Municipal Council of Toulon. The the negotiations, technical reports, &c., which have ab. Mayor, in his speech of welcome, admitted that for 50 years sorbed so much time, money, and energy are to be destroyed the necessity of sanitary measures had been recognised, and and lost But for these party intrigues Toulon would to-day he asked that the President should use his influence so that have a suitable possessed system of drainage. The last two something might at last be done. The Mayor, however, did cholera epidemics first made their appearance at Toulon and not say anything about a drainage scheme which obviously Marseilles ; the latter town has now a general system of is the first of necessities. He only spoke of embellishdrainage. To-day Europe is more or less menaced with the ments and of building new and broader streets-schemes advent of plague, and Toulon is in as bad a condition as it that obviously lend themselves more readily to jobbery was during the last cholera epidemic. Well might M. Loubet than the creation of a drainage system. While pointurge the necessity of immediate action, but the bringing ing out that he had no constitutional right to take forward of a new scheme would mean years of delay. any initiative in such matters, M. Loubet said that on the strength of his white hair and his services rendered HÆMORRHAGIC TYPHOID FEVER. to France and to the Republic for more than a quarter of a HaeMORRHAGIC typhoid fever-that is, typhoid fever accomcentury he had authority enough to recommend to the - Government that the desire for sanitary reform should panied by generalised haemorrhages into the skin, mucous be realised and that the Ministers would not dishonour membranes, and serous cavities-is rare. The American his recommendation. He further urged that the town could Journal of the Medical Sciences for March contains an imporwell afford to make the effort; that too strict a policy of tant paper on this subject by Dr. A. E. Eshner and Dr. T. saving would only cause greater difficulties in the future; and H. Weisenberg. In hasmorrhagic typhoid fever haemorrhage that they ought to put their hands into their pockets and the first takes place from the nose and then from the gums. Next - Government would help them in carrying out a well-matured petecbias appear in the skin among the " spots," which scheme. By those who are unacquainted with the local become hsemorrhagic only in part, if at all. In history of Toulon the sting of these remarks will not severe cases extensive deep-seated extravasations take place be perceived, but those who are better informed will into the subcutaneous tissue. In some cases meningeal naturally inquire who is responsible for the present or cerebral haemorrhage occurs. There is usually melasna. insalubrious condition of Toulon if it is not the present which is sometimes fatal. Haemoptysis is the least common mayor and municipality. Many years ago a scheme form of haemorrhage. The earlier and the more extensive for the drainage of Toulon was prepared. This scheme was the haemorrhage the worse the prognosis. The writers report sanctioned by the Consultative Committee of Hygiene for the two following cases. A man, aged 39 years, a heavy France, of which Dr. Brouardel is president, and also by drinker, was admitted to hospital delirious on what appeared the General Council of the Fonts et Chaussees. These two to be the twenty-second day of his illness. He looked stupid,

should be composed of lawyers. :Moreover, every medicalman has daily in the exercise of his profession to weigh evidence received from his patients, from the patients’ friends, and from the witness of his own eyes and ears. The viewing of the body is a form when conducted by a lawyer, but when conducted by a medical man the appearance of the corpse may tell him much in support of or against the evidence which will shortly be given before him. To the medical coroner the evidence of friends, physicians, nurses, and eye-witnesses as to injuries or previous illnesses will have a very real meaning, and, in addition, its relation to any undisputed facts before the court will be clear to him in a way that it cannot .be clear to persons ignorant of medicine. In a coroner’s court the cause of death is not, as in other courts, one issue of a suit-it is the only issue, and the coroner should be a man able to weigh medical evidence and to direct the jury. The value of medical evidence is only completely clear to a man who has had a medical education. We therefore hope that the electors in whose hands the important appointment of the coronership of the City of London rests will appoint as coroner a member of the medical profession.

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