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Salus populi suprema lex
SALUS POPULI
SUPREMA
ENTERIC
SAZ. US PO.PUZZ S U f i R E M A L•X. II. IN the course of our remarks under this title (published in our last issue) we commented on the need of the Government, on behalf of " t h e people," reserving to itself the power of intervention when a local authority persistently refuses to carry out the duties o f safeguarding public health imposed on it by law. Since writing to this effect we have had an opportunity- of examining the " P u b l i c Health Amendment Act, 1897," of the Cape Colony. There it is expressly provided that if a local authority make default in carrying out the Act, the Governor is empowered to call upon the authority to do its duty. If after an interval of four months from the date of such d e m a n d nothing has been done, the Governor can himself take such steps as may be necessary to give effect to the law. In this the right of the majority to intervene on its own behalf, with a view to nullifying the danger arising through the neglect of a minority, is fully recognised and made of good effect. I n the same article we suggested that it might be desirable under certain circumstances to transfer the sanitary supervision of a district to special commissioners. Rightly or wrongly, there is a prejudice to such form of administration in this country, but no such objection exists in the United States, or at all events in New York State. Dr. H e r m a n Biggs, in his Address before the British Medical Association, delivered at the meeting in Montreal, described the constitution of the Board of Health of New York City, which Board is practically autocratic and governed by medical experts. Dr. Biggs alluded to the prominent position of England as a pioneer in sanitatiori, but we may wellask whether that position has not been lost by us, in sanitary administration at least, if not in sanitation .9 A republic is generally deemed to be a form of govermnent which a/lows a more or less complete independence of action to the individual. Yet we see that the citizens of New York have surrendered themselves to the guidance and rule of the medical profession. We are curious to know how this has come about. The " p o l i t i c i a n " on the other side of the Atlantic is generally supposed to be more of a lobbyist than a legislator. NevertheJess, the constitution and powers of this Board of H e a l t h - - w h i c h will soon control the interests of some three millions of citizens--afford evidence of legislation far in advance of any existing in this country. T h e comparison between the sanitary control o f New York and that of London does not appear to us to be in favour of the latter city.
LEX. F E V E R AT
7
MAIDSTONE.
IN consequence of the announcements m a d e in the London Press as to the alarming outburst of enteric fever at Maidstone, we communicated with the Medical Officer of Health, and have received the foUowing particulars from his Deputy (Dr. Percy T. Adams) : On September i2th one notification of the disease was received--the first of the present outbreak. On the succeeding days, four, one, three, and one notifications were received, and on the i6th, 27. Careful inquiries were made as to food, water, and milk, and a comparison of the areas of incidence with those of the various water supplies indicated a very special incidence on one, viz., the Farleigh sources. There are four water supplies in the Borough, viz., Farleigh, Boarley, Cossington, and the Conduit, two being chalk waters. The Farleigh supply is derived from three separate sources~ viz., the Ewell Manor Springs, the Tutsham Manor Springs, and the South-Eastern Railway Springs, all derived from the Hythe beds of the Lower Greensand. The Tutsham Springs are gathered from grounds in close proximity to a fruit and hop pickers' camp. In the immediate neighbourhood a privy closet was found in an overflowing condition, the surrounding ground surface being much polluted with the excrement of the pickers. It is probable that the rain had washed this pollution into the springs. About 5oo yards away from the source there are eight cottages supplied from the main from these springs only. Here there have been (at each house) cases of diarrhoea. One of the cottages is a shop where the hop-pickers have appliea for diarrhoea medicine, from which disorder some of them appear to have suffered severely. One child died with symptoms indicating enteric fever, and cases of this disease have been reported (unofficially) to have occurred m the immediate neighbourhood. Dr. Adams concludes : " H a v i n g ascertained me origin of the water's pollution, this portion of the Farleigh supply was immediately cut off, the collecting tanks and reservoirs were emptied and scrubbed, and the filter-beds, which had previous to the outbreak been rarely used, were put into action as quickly as possible. Preventive measures had been already taken, as, although enteric fever had not been notified in Maidstone previous to the dates already given, nevertheless the diarrhoea rate had been too high, and, regarding the seasonal prevalence of that disorder, we thought fit to issue a notice of precautionary measures." We may remind our readers that Dr. M. A. Adams has twice saved Maidstone from danger of outbreaks of disease, by his careful and systematic examination of the " C o n d u i t " supply. O f late the Borough Council has refused to incur the expense of frequent and regular examination of the water supplies.
SUPREMA
ENTERIC
SAZ. US PO.PUZZ S U f i R E M A L•X. II. IN the course of our remarks under this title (published in our last issue) we commented on the need of the Government, on behalf of " t h e people," reserving to itself the power of intervention when a local authority persistently refuses to carry out the duties o f safeguarding public health imposed on it by law. Since writing to this effect we have had an opportunity- of examining the " P u b l i c Health Amendment Act, 1897," of the Cape Colony. There it is expressly provided that if a local authority make default in carrying out the Act, the Governor is empowered to call upon the authority to do its duty. If after an interval of four months from the date of such d e m a n d nothing has been done, the Governor can himself take such steps as may be necessary to give effect to the law. In this the right of the majority to intervene on its own behalf, with a view to nullifying the danger arising through the neglect of a minority, is fully recognised and made of good effect. I n the same article we suggested that it might be desirable under certain circumstances to transfer the sanitary supervision of a district to special commissioners. Rightly or wrongly, there is a prejudice to such form of administration in this country, but no such objection exists in the United States, or at all events in New York State. Dr. H e r m a n Biggs, in his Address before the British Medical Association, delivered at the meeting in Montreal, described the constitution of the Board of Health of New York City, which Board is practically autocratic and governed by medical experts. Dr. Biggs alluded to the prominent position of England as a pioneer in sanitatiori, but we may wellask whether that position has not been lost by us, in sanitary administration at least, if not in sanitation .9 A republic is generally deemed to be a form of govermnent which a/lows a more or less complete independence of action to the individual. Yet we see that the citizens of New York have surrendered themselves to the guidance and rule of the medical profession. We are curious to know how this has come about. The " p o l i t i c i a n " on the other side of the Atlantic is generally supposed to be more of a lobbyist than a legislator. NevertheJess, the constitution and powers of this Board of H e a l t h - - w h i c h will soon control the interests of some three millions of citizens--afford evidence of legislation far in advance of any existing in this country. T h e comparison between the sanitary control o f New York and that of London does not appear to us to be in favour of the latter city.
LEX. F E V E R AT
7
MAIDSTONE.
IN consequence of the announcements m a d e in the London Press as to the alarming outburst of enteric fever at Maidstone, we communicated with the Medical Officer of Health, and have received the foUowing particulars from his Deputy (Dr. Percy T. Adams) : On September i2th one notification of the disease was received--the first of the present outbreak. On the succeeding days, four, one, three, and one notifications were received, and on the i6th, 27. Careful inquiries were made as to food, water, and milk, and a comparison of the areas of incidence with those of the various water supplies indicated a very special incidence on one, viz., the Farleigh sources. There are four water supplies in the Borough, viz., Farleigh, Boarley, Cossington, and the Conduit, two being chalk waters. The Farleigh supply is derived from three separate sources~ viz., the Ewell Manor Springs, the Tutsham Manor Springs, and the South-Eastern Railway Springs, all derived from the Hythe beds of the Lower Greensand. The Tutsham Springs are gathered from grounds in close proximity to a fruit and hop pickers' camp. In the immediate neighbourhood a privy closet was found in an overflowing condition, the surrounding ground surface being much polluted with the excrement of the pickers. It is probable that the rain had washed this pollution into the springs. About 5oo yards away from the source there are eight cottages supplied from the main from these springs only. Here there have been (at each house) cases of diarrhoea. One of the cottages is a shop where the hop-pickers have appliea for diarrhoea medicine, from which disorder some of them appear to have suffered severely. One child died with symptoms indicating enteric fever, and cases of this disease have been reported (unofficially) to have occurred m the immediate neighbourhood. Dr. Adams concludes : " H a v i n g ascertained me origin of the water's pollution, this portion of the Farleigh supply was immediately cut off, the collecting tanks and reservoirs were emptied and scrubbed, and the filter-beds, which had previous to the outbreak been rarely used, were put into action as quickly as possible. Preventive measures had been already taken, as, although enteric fever had not been notified in Maidstone previous to the dates already given, nevertheless the diarrhoea rate had been too high, and, regarding the seasonal prevalence of that disorder, we thought fit to issue a notice of precautionary measures." We may remind our readers that Dr. M. A. Adams has twice saved Maidstone from danger of outbreaks of disease, by his careful and systematic examination of the " C o n d u i t " supply. O f late the Borough Council has refused to incur the expense of frequent and regular examination of the water supplies.