The Congress of the sanitary institute at Leeds, September, 1897

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to secure a n intelligent a p p r e c i a t i o n t h e r e o f in all classes of t h e people. I n a s m u c h as the foregoing p r o p o s a l s d e m a n d a large n m n b e r of specially-trained instructors, it is essential that a sufficient n u m b e r o f chairs of state m e d i c i n e s h o u l d b e p r o v i d e d in m e d i c a l schools, universities, elc. THE CONGRESS OF THE SANITARY INS T I T U T E A T L E E D S , SEPTEMBER, 1897. T o give t h e salient points a n d to b r i n g o u t in relief the new facts, or new m e t h o d s o f s t a t e m e n t of fact, t h a t m a y b e f o u n d in t h e P r o c e e d i n g s of a Congress h a v i n g t h r e e sections as well as six special conferences, is a task of no small difficulty. W i t h such a large mass of available m a t e r i a l one must necessarily m a k e a selection, t h e c h a r a c t e r of which is d e t e r m i n e d largely by the i n d i v i d u a l bias of t h e writer. PRESIDENTIAL ADDRESSES. W e m a y first discuss a n d criticise t h e various P r e s i d e n t i a l Addresses. T h e s e were, with o n e or two exceptions, long, too long. C o u n c i l l o r Womersley, the P r e s i d e n t of the C o n f e r e n c e o f M u n i c i p a l R e p r e s e n t a t i v e s , gave a s u m m a r y o f t h e history o f sanitary a d m i n i s t r a t i o n in Leeds. Dr. S e a t , n , t h e P r e s i d e n t - E l e c t o f the I n c o r p o r a t e d Society of M e d i c a l Officers o f Health, p r e s i d e d over a c r o w d e d m e e t i n g of M e d i c a l Officers, a n d delivered a n interesting a n d t h o u g h t f u l A d d r e s s u p o n " Sanitation a n d Sanitary Organiz a t i o n : t h e i r Significance a n d V a l u e in Public H e a l t h A d m i n i s t r a t i o n . " I t will r e p a y careful perusal w h e n it appears in its c o m p l e t e form. M a j o r L a m o r o c k Flower's P r e s i d e n t i a l A d d r e s s to the C o n f e r e n c e on R i v e r P o l l u t i o n was largely historical in its subject. Mr. P r i d g i n Teale's A d d r e s s to Sec. I. ( P r e v e n tivo M e d i c i n e a n d Sanitary Science), unfortunately, we d i d n o t hear. I n Sec. I I . ( E n g i n e e r i n g a n d A r c h i t e c t u r e ) Mr. Lewis A n g e l l read a n encyclopaedic A d d r e s s , w h i c h was not without points r e d e e m i n g it from total dreariness. T h u s : - -

vestrydom. Autocracy, however wise and" benevolent, is repugnant to English instincts. Local Government is grand principle--in theory--but the procedures of some o~ our governors, reported in local papers, as '* personalitles~" "disgraceful scenes," "scandals," "rowdyism," not to mention occasionally a '* free fight," lead cynics to inquire whether, after all~ Local Government, in practiced is not a fraud ? There is no reason why it should be so if representative men of intelligence, business capacity, and disinterested motives, selected from and by all classes of the people~ constituted the governing body Unfortunately, excepting in Our great cities~ local affairs'are not only too frequently avoided by those most fitted to take part therein, but a very large portion of the population take no interest whatever in matters affecting their welfare, as evidenced by

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the scanty polling at local elections, but when an epidemic scare occurs, people who at other times are utterly careless of their local institutions or representation, break out in hysterical denunciations of local management. In the hands of ignorant and interested persons Local Government may degenerate into littleness, for, as the Royal Sanitary Commission said: " N o code of laws, however complete in theory, upon a matter of such importance and complexity as the health of the community, can be expected to attain its object, unless men of superior education and intelligence throughout the country feel it their duty to come forward and take part in its working." A f t e r this, Mr. A n g e l l ' s o p t i m i s t forecast is pleasant reading :-" W e shall enter the twentieth century, late although it be, .with full hygienic knowledge of the sound principles of samtary work and the practical experience of the engineer ano the architect. Every vital question has been discussed and, for the most part~ legislated upon. We have the knowledge and we have the power, and require only the will. The will lies with the people, and can only be called into action by their education ; it was neccssary~ as wa~ said by Robert Lowe, that we should " educate our masters." Amid all the agitations and unrest of this ]7n-de-si~cZe there are no conditions which would contribute more to the comfort and welfare of the community than sanitation, education, and thrift." T h e P r e s i d e n t i a l A d d r e s s o f iV~r. W. W h i t a k e r , F.R.S., in Sec. I I I . ( C h e m i s t r y , Meteorology, a n d Geology) was chatty a n d interesting b u t i n o r d i n a t e l y long. A m o n g n u m e r o u s o t h e r i n t e r e s t i n g s u b j e c t s h e d i s c u s s e d t h e i m p o r t a n t p r o b l e m s as to u n d e r g r o u n d water c o n t a i n e d in t h e P a r l i a m e n t a r y Bills p r o m o t e d by t h e c o r p o r a t i o n s of N o t t i n g h a m a n d N e w a r k last session. As b e a r i n g o n t h e i m p o r t a n c e of k e e p i n g free from c o n t a m i n a t i o n t h e subsoil from which d e e p wells a n d borings receive t h e i r water t h e following m a y b e q u o t e d : - " I t has been legally settled, by the case of Bal[ard v. To~linson, that no man has a right to pollute the water in another man's well, where communication between the work of the polluter and the well of the polluted can be proved. But this does not go far enough for sanitary purposes. We want to stop the pollution before it is proved. The sanitary requirement is that no pollution shall t)e allowed on a waterbearing bed where such pollution is likely to affect a neighbouring waterworks or well. I do not see that at present we can go beyond the bounds of probability ; but that is a wide range, quite enough to stop many doubtful practices. Whether we shall ever be able to go to the extent of possibility is another question." R e f e r r i n g to c o m b i n a t i o n s of w a t e r c o m p a n i e s over large districts, Mr, W h i t a k e r m a k e s t h e following remarks, which will scarcely m e e t with t h e approval of t h e L o n d o n C o u n t y C o u n c i l . "Perhaps the most peculiar case in the kingdom, as showing the need of combination, is that of the chief city, wherein eight companies hold divided, but often concurrent, sway, their districts overlapping in a most elaborate way . . . . From the point of view of those who prefer that the watersupply should be in the hands of a company rather, than under the control of a corporation~ it would surely not be held that in the multitude of companies there is wisdom. I have long wondered whlr the London companies have not strengthened their position by some amount of combination. A federation for the northern side of the Thames, and another for the southern, would be of great advantage, and is as much division as there should be. ,r Of course, the suggestion of federation in the matter of

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water-supply will be met with the plea that there are many and great difficulties to be overcome ; but difficulties may be defined as things that have to be overcome. W e have a good stock of engineers, financiers, znd such like, whose chief object is the getting over difficulties, and who are useless if they can't effect that object. I was about to include lawyers, but abstain, in deference to the opinion of many, that their function is to create difficulties, a view which I don't altogether hold myself." Of the conferences of Municipal and County Engineers, Sanitary Inspectors, and on Domestic H y g i e n e w e a r e u n a b l e to g i v e p a r t i c u l a r s . We may next pass on to special subjects, selecting t h e s e f r o m t h e v a r i o u s s e c t i o n s a n d c o n f e r e n c e s in something approaching order. T H E VACCINATION COMMISSION'S R E P O R T . A p a p e r f r o m Dr. B o n d , o f G l o u c e s t e r , w a s followed by a useful discussion, in which the feeling of the meeting was evidently strongly against too g r e a t r e l a x a t i o n o f t h e p r e s e n t law. Dr. Bond's recommendations were summarised in the following propositions :-~' i. That it is expedient to give efffect to the unanimous recommendations of the Royal Commission on Vaccination, that repeated penalties for default in the vaccination of infants should no longer be enforced, and that parents who persistently object to the vaccination of their children should not be fined for non-compliance with the law when sufficient grounds for exempting them from it exist. " 2 . That the object of the Commissioners can be attained with least risk to the community, with least disturbance of the present law, and with reasonable consideration to those who are affected by it, by the magistrates exercising more largely than they have hitherto done the discretion with regard to the enforcement of vaccination which the law already gives them ; by an extension of that discretion, so far as may be necessary, and of the principle o[ temporary suspension of vaccination, which is already recognized by the law, in cases where it may appear expedient ; and also by providing for the distinction between defaulters through negligence or indifference and ob/ectors who urge sufficient grounds for their objection, by giving the latter an opportunity of applying voluntarily to a court of summary jurisdiction for an order for the suspension of the vaccination of their children instead of their being required to be summoned as at present. *' 3" That it is expedient injustice to objectors no less than in the interests of the community generally, that in any case in which objection to the vaccination of a child is made on the ground that injury from vaccination has been experienced in the family of the objector or that there is special reason for fearing danger therefrom to the child, competent inquiry should be made into such allegations, and a report thereon presented to the justices for their information as well as for that of the public. "4. qthat it is desirable that the recommendation of the Royal Commission as to the extension of the vaccination age of infants should be accepted, with the view of obviating disadvantages to which the vaccination of young infants is exposed, and that the age might be extended even to twelve months without serious risk, and with advantage,.' w h i c h would do much to compensate for such risk. 't 5. That it is expedient, in order to diminish as much as possible the danger to the community of a number of unvaccinated children, growing up in it under such an arrangement as the foregoing~ that the vaccination of a child should not be suspended for a longer period than four years from its birth ; that at the end of that period or upon its being received into any school or other place for its education or maintenance, its liability to vaccination should revive, and that further exemption from liability should only be obtained by a further order for suspension, as in infancy.

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" 6 . That it is expedient in view of the fact that outbreaks of small-pox so frequently occur amongst those who have been vaccinated in infancy but have not renewed their protection in after years, and of the evidence contained in the Report of the Royal Commission as to the protection which re-vaccination confers and as to the desirabilty of such renewal at the end of childhood, that re-vaccination should be systematically offered to all children at public elementary or other schools about the age of twelve years, in the same way as primary vaccination would be in early childhood under the arrangement suggested above. " 7. That it is expedient that there should be more effort than has been hitherto made, both by official and other means, to inform the public as to the evidence on which the belief as to the efficacy of vaccination as a preventative of small-pox rests ; to,inquire locally into allegations of mischief produced by vaccination, and to expose in every practicable way the misrepresentations and fallacies by which the confidence of the public in vaccination has been shaken. " 8 . That it is only just that in all matters connected with vaccination procedure there should be as little distinction as possible between rich and poor, and that in the language of the Commissioners, " No consideration of cost ought to be allowed to stand in the way of any improvement, which would render the operation less burdensome or diminish its risk. It is only fair to demand this if vaccination is to remain. compulsory." " T h e order of procedure involved would be as follows : - " (ct) The parents of all infants would be required to have them vaccinated, and would be formally notified to that effectp as at present, but the period within which this would be required to be done should be extended to twelve months, or even as in Germany, to the first calendar year after that in which the child had been born, for the reasbns previously given. " ( b ) Any parent who might wish to be relieved from this requirement should be at liberty to make an application to that effect to a court of Petty Sessions, at some time before the expiration of the statutory period, accompanied by a formal statement of the grounds of his objection, and should be granted an order suspending the vaccination of the child until four years of age, on payment of a small registration fee and with or without payment of costs at the discretion of the Court, regard being had to the nature of the objection alleged, and subject to the right of the Vaccinating Authority to make an application at any time for the supersession of the order on showing cause for so doing. "(c) If any parent made default in having his child vaccinated within the statutory period, without having obtained a medical certificate of unfitness, or an order of suspension, he would be summoned. After hearing any grounds of objection which he might allege for being relieved for the time from compliance with the law, an order for suspending the vaccination of the child would be made, subject, as before, to the right of the Vaccinating Authority to apply at any subsequent date for an order to vaccinate, on showing cause for so doing. T h e defendant in this case to be liable to pay a penaltyas well as court costs and the registration fee. " ( d ) In case of failure to appear, the magistrate would make an order for vaccination, the disregard of which would be followed by the same consequences as at present. "(e) On joining a school, whether public or privatej or on attaining the age of four years, a child would become liable to be inspected by the appointed official, and, if not found to be efficiently vaccinated, the parent would receive notice that the child must be vaccSnated, unless a medical certificate of unfitness, or an order for suspension, were obtained by him. Such order to be obtained in the same way as in the case of infant vaccination. " ( f ) Every child attending a school, whether public or private, or on attaining the age of ten years, to be liable to be re-vaccinated, or to be vaccinated, as the case may be~ subject to exemption under the conditions prescribed previously. "(g') The medical officer of health to act as general referee

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in all questions connected with vaccination, and to be empowered to visit all schools or other places lot the maintenance and education of children, for the purpose of requiring into their condltlon m regard to vaccination." METI-IODS OF DISlNrEC'rrON. Dr. Spottiswoode C a m e r o n i n t r o d u c e d this discussion in a n interesting a n d suggestive speech. T h e n followed Professor D616pine, a n d after a paper by Dr; K e n w o o d o n t h e " D i s i n f e c t i o n of R o o m s by F o r m i c A l d e h y d e V a p o u r s , " Dr. Sims W o o d h e a d , Dr. R i d e a l a n d o t h e r s m a d e critical c o n t r i b u t i o n s to t h e discussion. T h e k e y n o t e of Dr. K e n w o o d ' s p a p e r is c o n tained in t h e following extract : - - T h e r e can be no gainsaying that the infection of the infectious diseases which we have commonly to deal with is wry easily destroyed under the ordinary circumstances of its existence apart from the human body ; and that this ma~ter of disinfection has been made to appear a much more difficult task than it actually is, from the circumstance that, in experiments, disinfectants are asked to accomplish a great deal more than they would ever have to do in actual practice. In ordinary practice we probably have to deal with non-spore bearing bacteria, of comparatively easy destructibility, and these bacteria do not find at their site of lodgment anything approaching the fostering and protective properties of the nutrient media in which they are planted in experiments. " B y experiments with the more resistant organisms~ which, by the way, are not sought to be destroyed in the ordinary practice of room-disinfection--it canbe shown that surface disinfection by sulphurous acid gas is not so reliable as that by chlorine, vapourised phenol, or a spray of perchloride of mercury. In my paper, last year, I ~ave some reasons why I considered the adoption of the spray method undesirable and likely to prove in practice less satisfactory than the use of SO2 ; since then my opinion has received some justification from the work of Lemaire, who has experi.mentally demonstrated how micro-organisms may and do escape destruction by this method." T h u s h e takes t h e less resistant m i c r o b e s as his s t a n d a r d of c o m p a r i s o n in treatin~ of t h e efficiency of formic a l d e h y d e as a disinfectant. T h i s point was seized u p o n by Mr., Wolf Defries, w h o u r g e d the i m p o r t a n c e of a h i g h ideal. So long as the m i c r o b e of small-pox was u n d i s c o v e r e d , a n d in view of t h e fact t h a t the a n t h r a x bacillus is m o s t difficult to kill, it was, he urged, m o s t i m p o r t a n t t h a t we s h o u l d n o t c o n t e n t ourselves with m e a n s which suffice for so feebly resistant a m i c r o b e as t h e Kebs-L6ftter bacillus. A c c e p t i n g , however, for the nonce, Dr. K e n w o o d ' s s t a n d a r d , it appears to be certain '* (i) That when the atmosphere is saturated with, or charged with from {--2 per cent. of the vapour (of formic aldehyde), the disinfection of all surfaces is complete and rapid, and that this holds good under the ordinary conditions of temperature and moisture obtaining in liviu~ rooms ( ) That the vapours possess a certain and variableamount of penetrating power into loose fabrics, especially when these are dry. This penetration is largely due to the circumstance that when pro'anted in a warm state the vapour is of a low specific gravity and mixes well with the air. " (3). That the vapours do not affect the colonrs of textile materials, &c.j or (with the exception of iron or steel) metallic surfaces. " 14). That the room, and articles exposed, can be cleared of the vapours readily by sufficient a~ration, and the vapou~ are not so irritating but one can always enter the room a

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unseat at the first attempt (an advantage over S02 and el). gr:'a~eS~-t:hatthtohsed~s~;e:toirngproperties of the aldehyde are "(6). That there is no danger in entering the room,, ither from the aldehyde, or from the CO which is formed at the same time. This is proved from the fact that the men employed in the works and exposed to considerable quantities enjoy good healthm and also from many experiments with animals in atmospheres heavily charged with the vapours generated as in room disinfection. . . . " A 4o per cent. soloution of formic aldehyde in water is known as "Formalin," but when this solution is heated the aldehyde becomes largely polymerised into a whitish amor. phons substance known as "paraform" which gives off slowly a little aldehyde." T h i s p o l y m e r i s e d formalin has b e e n cast into tabloids by t h e F o r m a l i n H y g i e n i c C o m p a n y , who sell with t h e m a l a m p for b u r n i n g m e t h y l a t e d spirits. T h e products, rich in moisture, passing o v e r the t a b l o i d s of paraform, r e c o n v e r t t h e m taro a l d e h y d e , w h i c h volatilises into t h e r o o m . In Trillat's a p p a r a t u s a different m e t h o d is a d o p t e d . " T h e 40 per cent. solution of formic aldehyde is hea,ed under pressure in an autoclave provided with a pressure gauge and a thermometer. & little chloride of calcium is placed in the solution, and as the boiling point of the calcium chloride solution is well above IOO~' C., and the gas comes away below mo q C., practically the whole of the aldehyde (fairly pure and dry) is given off before the water comes away as steam. The apparatus needs attention, and so it is placed outside the room. The solution is heated in the autoclave by means of a Swedish petroleum lamp, and when the pressure registers 4o lbs. the vapours are allowed to escape through a long, thin, copper tube, which is placed through the keyhole into the compartment. " T h e apparatus costs about ~18, ~nd the disinfection of an ordinary-sized room would cost about 2s. 6d. Half-anhour is required to get up the necessary pressure, and then the vapours must be allowed to escape into an ordinarysized room for half-an-hour, and for an hour in a very large room. '~

T h e bacteriological tests m a d e by Messrs. K e n w o o d a n d Curtis s h o w e d that a l d e h y d e vapour, as used by t h e m , was sufficient in d e z t r o y i n g t h e Klebs-LSffler bacillus. I n t h e discussion w h i c h followed this paper, Dr. Sims W o o d h e a d q u o t e d u n p u b l i s h e d bacteriological tests w h i c h h e h a d m a d e , i n d i c a t i n g the insufficiency o f f o r m a l i n disinfection, w h i l e Dr. R i d e a l i n d e p e n d e n t l y c o n f i r m e d from bacterioiogical d a t a t h e efficiency of f o r m a l i n [ When doctors disagree, we m u s t a s k t h a t e a c h wilt p u b lish in a c c u r a t e d e t a i l t h e i r m e t h o d s of investigation. Messrs. K e n w o o d a n d Curtis h a v e d o n e this. THE C O N S T R U C T I O N OF ISOLATION H O S P I T A L S . Mr. E. J. H a l l , F . R . I . B . A . , r e a d a m o s t e x h a u s t i v e p a p e r o n this subject, d e a l i n g with it historically, a n d t h e n giving a d e t a i l e d d e s c r i p t i o n o f t h e n e w P a r k H o s p i t a l of t h e M e t r o p o l i t a n A s y l u m s B o a r d , of w h i c h Mr. H a l l is t h e architect. I t a p p e a r s t h a t w h e n t h e b u i l d i n g s n o w in progress a r e c o m p l e t e d t h e total a c c o m m o d a t i o n for a c u t e fever a n d d i p h t h e r i a in t h e m e t r o p o l i s will b e 4,642 b e d s , or say i in i , o o % n o t i n c l u d i n g

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1,38o beds for convalescent patients, which brings up thetotal to one bed for 775 or 800 of population. Small pox accommodation is not included in these figures. The acreage in proportion to beds varies greatly. Thus at Glasgow the Belvedere Hospital has i7 beds per acre, at Liverpool, the Graffon Street Hospital has 34. In London, the Eastern has 4o, the Western 36 , the South Western 47, the South Eastern 42, the North Eastern 22, the Fountain Temporary 4% the Brook 16, the Park 28, and the Grove 19" This will evidently be determined by exigencies of site and by the necessity of allowing at least 4 ° feet between all buildings and the boundary wall. T h e Asylums Board in all recent hospitals fix " a b o u t ioo feet." The 4o-feet limit applies in the regulations of the Local Government Board also to the distance between hospital blocks ; but the Asylums Board have fixed as between parallel twostoried infected buildings a distance equal to twice tt~e height of the building. Mr. Hall has a good word to say for two-storied hospital blocks, although they necessitate staircases, lifts for coal, food, etc. " M e d i c a l l y the ideal is doubtless the one-storied hospital, but the practical suggests and permits the two-storied " The Park Zlos2MtaLqThis is the largest hospital for acute cases of fever and diphtheria in the United Kingdom providing as it does for 548 patients. The immediately preceding Brook Hospital of the Metropolitan Asylums Board had 488 beds. The Park Hospital contains 42 buildings, has 6 miles of drains within the curtilage, 29 miles of water and steam pipes, 42 miles of electric wires, and 3 miles of eaves guttering. Mr. Hall advocates covered ways connecting all wards with the administrative building. We regret to have to agree with the Local Government Board on this poim, as covered ways are in our opinion inadvisable. Goloshes for nurses meet all the necessary requirements, and the danger of carriage of infection is minimised by a blow in the open air. Mr. Hall recommends teak floors for the wards in long narrow boards laid in bitumen, and edgenailed directly to the concrete. This floor, wax polished, is hard, warm, and impervious. Objection is taken to terrazzo flooring for wards, because of its multitudinous joints, and '" it is hard and unsympathetic to the f e e t " We believe these objections do not hold good in fact, terrazzo flooring having been adopted at the new Derbyshire Infirmary, the new block of the London Fever Hospital, and the isolation block of the Poplar Hospital, with satisfaction to all concerned. For scarlet fever patients the Asylums Board have fixed twenty patients for each ward. The height of each ward should be thirteen feet, 2,ooo cubic feet being allowed for each patient, and twelve feet of lineal wall space per bed. For diphtheria, 2,5oo cubic feet are required per bed, and a

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wall length of fifteen feet. The ward in each case should be twenty-six feet wide. We are glad to note that Mr. Ward agrees that " a nurse's duty room, as distinct from the ward kitchen, is not necessary, except in cases where there is a sister in charge of a pavilion. A nurse's place when on duty is in the wards, when off duty better accommodation and recreation for her are provided in the nurse's home." The system of heating adopted is by low pressure hot water radiators beneath windows, the coils being enclosed in if on cases with hit-and-miss covers. Horizontal pipes around tiae walls of a ward are deprecated. I n addition, central fireplaces are provided, one fire for every thirty feet of length in a ward. Mr. Hall has adopted a central stack, as preferable to a stove with horizontal flues carried to the external walls. T h e central stack, we think, is decidedly objectionable. It prevents the charge nurse commanding a fullview of the whole ward. Mr. Hall's objection to horizontal flues, that they are harbours for germs, is fanciful. Such germs would be rapidly smoke-dried. The numerous other points raised in Mr. Hall's paper cannot be given here, but the whole paper should be perused by all who have to advise as to practical details in the construction of a fever hospital. Small 7solation Z-Zospitals.- Dr. Meredith Young's paper contains many useful practical hints. Thus, mattresses should each contain twenty-one pounds of good curled horse-hair. All mattresses should have covers of strong unbleached linen to

s a v e wear.

Dr. Young describes a special patient's locker. A special low table, twenty inches high, is very advisable for children in a scarlet fever ward. Cocoa-fibre mats for doors are preferable to wire mats. Small baths (economical of hot water) should be provided for children, raised on a concrete foundation some six to eight inches from the floor. Twvford's patent slop-sink is strongly recommended. Mr. Hall is equally satisfied with a special one designed by him, and made by Messrs. Dent and Hellyer. Like all others who have had experience of them, Dr. Young objects to the " man and wife" system of resident control. T H E HOUSING OF THE WORKING CLASSES.

Naturally at a Leeds meeting the Scheme of the Leeds Corporation, under Part I. of the Housing of the Working Classes Act, formed the subject of a paper. This was contributed by Mr. G. F. Carter. T h e area in question, concerning which Dr. Cameron made an official representation on April 3rd, 1895, is 75 acres in extent, with a population of about 15,ooo. It had an average deathrate in 1893-4- 5 of 3g'I6 per Ioo% that for the whole city being 2o'26. It is proposed to deal first with 16} acres, containing a working-class population of 3 , I I 9 , of

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DUTIES

w h o m 755 occupy 35 registered c o m m o n lodging houses. T h i s section has been d i v i d e d into four parts, each to be demolished in turn, a n d replaced by houses for 500 persons before the next is similarly demolished and rebuilt. Tlaus 2,0o0 will be provided for. It is probable that a municipal lodging house for 5oo, and t e n e m e n t dwellings for the remaining I , c o o will complete the a c c o m m o dation in this section. Mr. l a m e s M u n c e read a paper on " W o r k m e n ' s Dwellings in Belfast." T h e Belfast workman appears to be provided with the cheapest houses in the U n i t e d K i n g d o m , in part due to the exceptional facilities for the purchase of materials cheaply in Belfast. T h u s a very high proportion of the householders live in single houses, This is clearly seen from the census figures for I 8 9 I , which show that at that time there w e r e ~ *' 42, 240 houses occupied by one family each. 3,745 do. do. two families each. 275 do. do. three families each. 86 do. do. four families each. I6 do. do. five families each. 9 do. do. six families each. 2 do. do. seven families each. I Barrack occupied by sixteen families. z Workhouse occupied by eighty families. I Military Barrack occupied by one hundred and thirteen families." T h e n u m b e r of persons owning their own house is increasing year by year : a very general custom being to pay , ~ i 5 or more at once, a n d so m u c h per m o n t h for ten years, the monthly subscription being just a little in excess of the usual rent. T h e density of population in the newer por.tions of the City, may be taken as fi.fty houses per acre. This has been actually measured, and as the population is 4"8 per house, this gives 240 persons per acre. But the most interesting information on this subject was furnished in a lecture to the Congress by Mr. Boulnois, the City E n g i n e e r of Liverpool, who has m a d e a thorough and practical study of it, and has been able to prove the correctness of his views in actual practice. H e points out that the natural laws o f supply of d e m a n d will, as a rule, enable the arfizan to obtain d e c e n t and appropriate housing without any municipal interv e n t i o n . But the unskilled town labourer, who does not earn more than ~5 s. a week cannot thus be housed without overcrowding and its attendant evils. T h e few attempts that have been made to m e e t the requirements of the unskilled labourer have failed because they have attempted to provide something too " g o o d . " T h e ideal is to have whatever is necessary for decent, healthy living, but not to provide m o r e than this, which can only be given by dipping into the pockets of the ratepayer. T h e unit Mr. Boulnois proposes is that the rent shall be a shilling a week a room, as a maximum, and he has been able to carry this into actual practice, only e x c e e d i n g his unit slightly, the rent o f the t e n e m e n t s erected by him

ON

INHABITED

HOUSES.

15

for the Liverpool City Council being TS. x]d. per week per room. T h e t e n e m e n t houses in question are three-storied. O n the ground floor is a four-roomed tenement, and on each of the next two floors two separate t e n e m e n t s of two or three rooms each. T h e land on which these were built was valued at ~2s. a square yard. T h e houses were substantially built of the plainest materials. T h e floors are all fire-proof. T h e walls are distempered. T h e sanitary arrangements of each t e n e m e n t are distinct and separate. A caretaker lives in each block of tenements, rent free, and is responsible for maintaining order and cleanliness, especially for seeing that each tenant takes his weekly turn in keeping c o m m o n staircases clean. Allowing 33½ per cent. for leakages (voids, repairs, rent) the i n c o m e derived from these t e n e m e n t houses by the Corporation is 4½--5 per cent. T h e experim e n t i s one of profound interest, and its further history will be watched with mingled anxiety and hopefulness by all who are conerned in this vital problem. TENEMENT BUILDINGS AND DUTIES ON INHABITED HOUSES. Dr. J. F. ]. Sykes has m a d e h i m s e l f master of this subject, on which he read an exhaustive paper. T h e historical study o f the subject was novel a n d interesting. T h u s " I t was not until the third century that glass appears to have been used in windows in Europe. " It was not until the end of the twelfth century that glass was used to any extent in the windows of private houses in England. " T h e glass had to be imported then, and it appears to have been regarded as a luxury. " In Britain a window-tax was first imposed in 1695, was several times increased, and in I8~Oproduced ~I,832,684. "The effect of this wlndow-tax must undoubtedly have been to exclude much light and air from dwellings, and knowing as we do the value of light and air, it is surprising how litde notice is taken in most works upon public health ol the imposition of this tax, and of its repeal. And yet its repeal must have largely contributed to the improvement of the public health. ~' For the purpose of more strictly assessing this windowtax, in the year I8O8 the following provision became law :-48 GEORGE III., c. 5 5 . - - S C H E D U L E B. Rules for charging Duties payable on Inhabited Dwelli~zg f:louseSp ~,~C.~

T h e following points as to the present state of the law are taken from Dr. Syke's paper : - " B y the Customs and Inland Revenue Acts, x89o and I891 , artizans' dwellings, so well constructed and arranged as to be worthy of certificates, may be exempted from the payment of inhabited house duty. In the case of future new artizans' dwellings, if the plans of drainage have not been previously submitted to and approved by the Medical Officer of Health, owners run the risk of not ~btaining certificates. '*A Medical Officer of Health may protect himself in the future against the attacks of the dissatisfied by (in writing) officially requesting his Vestry or Board to add or attach such a paragraph as 1he preceding to the drainage or building form, in order to make it known. *' In future new houses the following additional requirements may also be exp:cted : ~ ~' That the house is provided, on each floor, with at least

16

THE

CONGRESS

OF

THE

SANITARY

one sufficient space or lobby open to the air, accessible to and for the use of the occupants of the dwellings on each floor. " T h a t the house is so constructed and arranged that perflation of the dwelling rooms is uot obstructed. " T h a t accommodation for bathing is provided sufficient for the number of persons inhabiting the house. " T h a t there is an outer door or gate locked at night, or a resident caretaker. ", The constructors of this class of buildings have, therefore, to consider whether they shall build them with balconies or staircases open to the air, and so escape both inhabited house duty and certificate of the Medical Officer of Health ; or whether they shall build them with inside staircases aid become liable to inhabited house duty, and to the requirements of the Medical Officer of Health in order to obtain hi~ certificate. In any case. it is quite evident that it is very simple to avoid the Acts, and to defeat the very object with which they were passed."

POISONING FROM CANNED [~OODS. A paper on this subject was read by Dr. J. Brown, M e d i c a l Officer o f H e a l t h o f B a c u p : - " T h e canned foods trade was," he said, " an enormous one. Over 58o,ooo Ibm. of such food, it was estimated, were consumed daily in this couf, try. Tinned salmon was so popular that two mildon people ate it every day. One private firm in Liverpool had a turn-over of more than twenty million cans per year. The American Bureau of Statistics showed tbat the exports from that country alone from June, 1895, to 1896, were 63,698,I8O lbs., and during the following year 54,or9,7:z2 lhs. In passing through the streets of our cities and towns we saw the windows decorated with high piles of canned goods. Indeed, this might be called the ' Canned Food Age.' Dr. Brown proceeded to give particulars of a number of eases of poisoning {including six deaths) flora eating canned meats--beef, mutton, rabbits, and tongues--and six from canned fish. In canned meats, whmh included beef, mutton, 'rabbits, and tongues, the poison was probably due to one of the ptomaines which were of bacterial origin, and might have been produced (1) before the meat was canned, (2) after canning, or (3) after being opened. In the first case the toxic properties were probably rendered inert by the steaming process, but the nutritive value of the meat was lessened. In the second case the can was usually in the condition technically known as ' blown,' the gases produced by putrefaction causing so great an internal pressure that the ends were convex insteaa of concave. There was little danger of anyone consuming these, as the putrid condition and bad smell were manifest. After being opened under certain conditions of the atmosphere, foods were rapidly acted upon by bacteria, which formed toxines, some of which were more dangerous than the mineral poisons. This was particularly so in fish, salmon being the worst. It was only just to say that the wholesale and retail traders were most careful in examining all cans, and rejecting those which were blown or pierced. Thiswas, in all probability~ the reason why the cases of poisoning were not more frequent. I n canned fish ptomaines were the chief poison, salmon being the kind of fish which in nearly all eases had been associated with poisoning. From what one had read in the daily Press, and from the physical condition of some cans of salmon, it was probable that a good deal of it unde, went putrefactive changes before being canned. The great canning firms wouhJ do well to take all necessary steps Io ensure that all meats and fish were prepared and canned under the strictest hygienic conditions. In canned fruits the salts of tin and zinc had been the poisons. He was not aware of any case having ended fatally. The symptoms had been those usually associated with metallic poisons. From the analyses which he had made, he found that cans in which lead was used in tinning or soldering, lead was present in the fruit and syrup, due, firstly, to the action ot natural acids, and, secondly~ to galvanic action. The amount of lead in some

INSTITUTE

AT

LEEDS.

p e a r s and apricots was such that in time it would produce

plumbism, with its manifold symptoms. The amount of metal was sufficient to give the fruit a metallle taste, and at least one case had proved fatal. In meats the metal was chiefly found where i( was in contact with the soldering and plating. In iruits it was present in the syrup, and also throughout the substance of the fruit In the syrups, with but one or two exceptions~ a certain amount of tin and lead, when terne plating had been used, had been present. Mr. Winter Blyth examined over twenty cases of fruits, and found tin in every one, the amount being from i '58 to I I'd 5 grains per lb. AIt canned foods were better for being used soon after canning. In Lancashire there was a general practice of opening the can of meat or fish, and then pouting vinegar into the tin, and taking out just as much food as was necessary for the occasiorl. How long foods hermetically sealed would keep was not definitely known. Having had canned foods, including meats, soups, rabbits, giblets, oysters, &c., of from twenty to thirty years old, he found that the tins, though rusty outside, were perfectly good inside; ~onewere blown. The meats were sound, though not so fresh and tempting to the eye as recently canned foods. One family, consisting of seven persons, consumed over twenty cans, and another lot of thirteen canned rabbits were partaken of by a club. In no case was anyone made ill. In canned frnlts the effect of age w a s of greater importance, as the acids of the fruits dissolved by chemical and galvanic action the plating and solder. A~ to prevention, all the eanmng stations for meats, fish, and fruit should be under the control of such bye-laws ot the sanitary authorities as would ensure that all the conditions necessary to the purity and soundness of the goods were enforced. In canned traits it was very rarely one could detect any decayed fruit. The plating of the tins should be of pure tin, unless a satisfactory substitute could be dis. covered. In recent times the plat,ng had seriously deteriorated, an alloy of tin and lead being used containing two parts of tin to one of lead, and in some instances even two parts of lead to one of tin. Severe competition had, no doubt, brought about this serious deterioration, since plating tin cost ~62 per ton, whilst lead cost only ~I4. All canned goods should be kept in a cool and dry place. Shop windows should not be filled to such an extent that the cans become heated. This was especially harmful in regard to tinned fruits, as alcoholic fermentation was set up. Fruits should be whole and unskinned, so that any metallic salt in the syrup would not saturate the fruit. Semi-lead or " t e r n e " plating ought not to be permitted. Consumers should avoid cheap brands of canned foods. When opened the contents should at once be poured into a jar or other vessel. In regard to canned fruits, pears and apricots had shown the largest amount of dissolved lead and tin, probably due to the largo amount of acid in the juice of these fruits. Pineapples were the safest fruit to buy in cans. Fish in a yellowish, soft, and friable condition--especially salmon--ought to be avoided. If the plating in the can was corroded, the contents of the tin should De thrown away. If it had a bluish slate eolour and eoutained frmt, it was also risky. He believed there should be u non-metallic coating for cans. Probably a light, cheap, and durable substance could be discovered in this connection. Aluminium seemed to offer a field for future research, as it could not be dissolved by the ordinary organic acids, but it should not be used in the soldering. AsKing what the Government should do in the matter, he urged that they should forbid the importation of canned foods in which the tin used for tin-plating contained more than I per cent. of lead r,r more than Io per cent. of solder. This law had been in force in Germany since 1889. They should also provide thatthe soldering should be on the outside of the can. This regulation was enforced in France and Germany. In one recent can, Dr. Brown added parenthetically, he found over 40 grains of solder among the fruit. The Government should also enact that the date of canning should be l~gibly stamped on each can. This was very important in regard to fru,ts. -It had been proved by Professor Gautier, od Pads, that the amount of metal dissolved increased with keeping."

THE

REDUCTION

OF

MEASLES

T H E REDUCTION OF ~/~EASLES AND DIARRH(EA. A f t e r d i s c u s s i n g t h e c o m p a r a t i v e failure h i t h e r t o e x p e r i e n c e d in r e s p e c t o f t h e r e d u c t i o n o f t h e s e two diseases, D r . Priestley suggests as p r a c t t c a b l e m e a s u r e s t h e following : - " ( a ) Measles. 7"h~vretically, nothing could besimpler, but practically nothing could be more difficult, than adding measles to the list ofnotifiable diseases under the Act, with a view to benefit resulting from such a course . . . . What i~ wanted is some sort of "partial " notification as between the Health Departments and the' School Authorities. Measles affects chiefly infants and young children, and is undoubtedly spread direcNy through the agency of schools, so that if we find the inmates of any school becoming strickened down with this disease iu such increasing numbers as to interfere with the attendance, the greatest good will be derived from the closure of that particular school or the particular class involved--more especially as we know that this d,sease spreads rapidly amongst scholars io an overcrowded, ill-ventilated, or insanitary school. The quickest and easiest wag to obtain the necessary information preparatory to closing a school is by this system of notification between the Head Teachers or Attendance Officers, and the Health Departments. The cost would be slight and the information exactly in the form best suited for the purpose." " (b) Diarr~wa. Dr. Priestly recommends : - " ( I ) Cleanliness in ks widest sense - - municipal, domestiC, and otherwise. "(2) The importance of teaching the laws of health to the young. " (3) The subject of illegitimacy and the proper care of illegitimate children, the treatment of the question of uncertified deaths, and those of infant protection, and the infant insurance, call for attention by Parliament, Who (at a not far di,tant date, I hope) will give us amended Infant Life Protection and Insurance Acts, a sensible Midwife's Registration Actj medical advisers to coroners and special investigators into all uncertified deathsj &c." OUGtiT MANURE AND STABLE AND COWSHED LITTER TO BE COLLECTED AT PUBLIC OR P R I VATE EXPENSE ?

Dr. Sykes in discussing this important question, makes the following among other remarks :-" Dividing the refuse produced by the community into soiled waters, excreta, road sweepings, domestic refuse, manure~ and trade refuse, the first four--which the whole community help to produce more or less equally--are collected and removed at public ex0ense, and in the benefits of this the whole community would share. But with regard to manu~e and trade refuse the whole community are not producers, and it is a question of policy for the whole community to express its opinion at election time as to whether it will be willing to bear the burden and expense of removing the manure, and perhaps also the trade refuse, of those memhers of the community who produce them and derive profit or pleasure from their production." WATER SUPPLY FROM WELLS. Dr. M i t c h e l l W i l s o n p o i n t e d o u t t h a t : - " T h e Public Health (Water) Act, I878, by its limitation of theamount which a District Council can enforce for a better supply through the construction of wells, prevents wells being made of a class which would secure a purer water from the strata at greater depth. Such improved wells had, however, been adopted by the sanitary authorities and voluntarily by private individuals with highly satisfactory results. "Specially designed well tubes consisting of glazed sanitary tubes from 30 inches to 3 feet in diameter, have been largely adopted in the rural districts to the east and south of

AND

DIARRH(EA.

I7

Leeds. As the socket is fixed on the inner side of the pipe the outer surface is smooth and offers little hindrance to the tube sinking ; three or four tubes are Usually required. It is believed that a well made with these is more secure against impurities reaching the water than when bricks are used." WATER SuPPLIEs IN" RURAL DISTRICTS.

I n a paper on this subject Dr. Thresh states

that :--

"Apart from its sanitary importance, if we wish to prevent the exodus from our villages, or attract the town dweller to the country, we must provide better Water supplies, and do all in our power to remove the stigma which at present causes all intelligent people to look with suspicion upon all water supplies in rural districts."

H e draws attention to the fact that subsoil water m a y o f t e n b e safely u t i l i z e d at a m u c h s m a l l e r e x p e n s e t h a n is i n v o l v e d in t h e d i g g i n g o f d e e p wells. ~LUMBo-SOLVENT WATER.

Dr. Tattersall, M.O.H. Oldham, read a naner on " T h e Action of Moorland Water -~ r__.¢- " - . . . Prevention of the same." v . ~ c ~ u , ann me After discussing the origin of the plumbo-solvent properties of moorland water he suggests that the best means of preventing lead poisoning by moorland water are : - '* (x) That the water be got off the peaty gathering grounds as quickly as possible. " (2) That as much time as possible be given for subsidence and bleaching. ~'(3) And, most important, that the water be filtered through ordinary sand filters, or failing this be passed over ,, Paris W h i t e " as at Sheffield. ,, (4) That blocked tin-llned lead piping of good quality be used for water service pipes instead of ordinary lead piping." T H E SANITARy ASPECTS OF ~VOOD PAVING. T H E p a p e r o n this s u b j e c t b y M r . C. M a s o n , t h e S u r v e y o r to t h e S t r a n d District, gives a u s e f u l s u m m a r y o f this s u b j e c t , b a s e d o n a w i d e e x p e r i e n c e . A s p h a l t e is u n d o u b t e d l y t h e best, b u t its g e n e r a l a d o p t i o n m u s t b e p o s t p o n e d until h o r s e s a r e r e p l a c e d b y m o t o r cars a n d c a b s . N e x t to this c o m e s w o o d , t h e h a r d w o o d s f r o m t h e A n t i - , p o d e s b e i n g p r e f e r a b l e to t h e p i n e s o f N o r t h E u r o p e so c o m m o n l y e m p l o y e d . T h e life o f a w o o d p a v e m e n t varies f r o m 5 t o 12 years, a c c o r d i n g t o t h e a m o u n t o f traffic, q u a l i t y o f w o o d , a n d m e t h o d o f laying. A p a r t f r o m a faulty s y s t e m o f scavenging, which can easily b e r e m e d i e d , M r . M a s o n laid stress o n t h e fact t h a t t h e c o m plaints as to t h e i n s a n i t a r y c o n d i t i o n o f w o o d p a v e m e n t s w e r e d u e to i m p e r f e c t m e t h o d s o f laying a n d m a i n t a i n i n g , c o u p l e d w i t h insufficiently frequent renewals. " W o o d pavements are condemned on sanitary grounds because : ~ " I. Too little attention has been given in the past to the contour of the road toallow for a natural fall to the galUes. " 2 . The wood used has in many cases not been carefully selected, and properly treated with a preservative. " 3 - The exv~ansion joint in each channel is allowed to become a source of nuisance. " 4 . Repairs have not been carefully executed, and renewals have not been nmde at frequent intervals. C

I8

THE

CONGRESS

OF

THE

SANITARY

" 5 . An inefficient system of scavenging has been allowed exist." T h e h a r d w o o d s k n o w n as " K a r r i " a n d " J a r r a h " '* are generally laid close jointed, and grouted with pitch and tar, and form an excellent sanitary pavement ; their liability to contraction, however, has proved a drawback, as the spaces left between the blocks when contraction takes place become filled with horse clung and road detritus, which it is impossible to get out. It is to be hoped this wood will soon be supplied in such a condition that this, its only fault from a sanitary point of view, will soon be a thin K of the past." A c c o r d i n g to M r . M a s o n w o o d is s u i t e d for t o w n p a v e m e n t s , b e i n g less n o i s y a n d less s l i p p e r y t h a n a n y o t h e r k i n d o f p a v e m e n t w h i c h is s u i t a b l e for h e a v y traffic. Soft wood should be properly c r e o s o t e d , t h e b l o c k s laid " c l o s e - j o i n t e d " t o a contour transversely and longitudinally, and grouted with b i t u m i n o u s c o m p o s i t i o n . "Wood blocks t h u s laid a n d c l e a n s e d b y p e r i o d i c a l w a s h i n g , f o r m as p e r f e c t a p a v e m e n t for c a r r i a g e w a y s as zt is p o s s i b l e to o b t a i n . "

to

T H E TREATMENT OF DOMESTIC SLoP-WATER IN ISOLATED HOUSES. D r . P o o r e in a p a p e r o n this s u b j e c t p o i n t s o u t that :-" L Slop-water is as foul as sewage composed of excrement and slops. " 2 . A system of sewerage is necessary for the slop-water, and it is not easier to treat slop-water alone than it is to treat a mixture of slops and excrement.'* He adds :-" T h e fact that the total solid and suspended matters are less by 3~ grains in the water-closet towns than in the midden towns, can only be accounted for by the enormous dilutions of the excremental matters in the sewage. Notwithstanding this dilution we find that the water-closet town sewage contaius 20 per cent. more combined nitrogen than midden town sewage, 23 per cent. more ammonia, and, what is very remarkable, 35 per cent. more suspended mineral matter. " T h i s excess of mineral matter in suspension could only be caused by the precipitation of mineral matters by the ammonia and sulphuretted hydrogen formed by decomposition of the albuminous and other organic matter. This exce~s of mineral matter in susponsion must therefore be taken as a measure of the enormously increased putrefaction in water-closet sewage, a putrefaction probably to a great extent brought about by the millions of microbes which are provided from the human intestines with the excrement, and we must therefore assume that the increase of mineral matter in suspension is an indication that a large quantity of foul putrefactive gases has been given off into the streets and houses of,~ater-closet towns." D r . P o o r e t h e n p r o c e e d s to e n u n c i a t e a n d e n f o r c e t h e following p r o p o s i t i o n s : ~ " i . All waste pipes should terminate well above the level of the ground. " 2 . No stagnation must anywhere be permitted along the line of slop-drainage. ** 3. Slop-water should run in open guttersp and when it has reached a certain distance from the house~ it should be allowed to soak away as it runs. and take the line of natural drainage of the locality. This is effected by means of filtration-gutters. " 4 . When it is feasible, it is advisable to allow different varieties of slops to flow in separate gutters." T H E TREATMENT OF SEWAGE. T h i s s u b j e c t was d e a l t with in t h e E n g i n e e r i n g

INSTITUTE

AT

LEEDS.

Section in three important papers, followed by an animated discussion. Messrs. Dibdin and Thudichum read a paper on "The Scientific Basis of Sewage Treatment." They pointed out that" I n the recognition of the fact that all processes of sewage purification must be made subservient to the requirements of the various micro-organisms, lles the whole secret of success. All sterilizing or antiseptic agents must be strictly excluded ; a condition of neutrality or slight alkalinity must be maintaiued; oxygen, anyhow in the final stages, must be freely supplied ; the temperature must be kept above the freezing point of water ; and the amount of food must be proportioned to the powers of the organisms. " I n the process of completely oxidizing effete matters two stages may be recognized in which distinct classes of organisms play their respective parts. The actual identification of these organisms may be left for future discussion, it being sufficient for the present purpose to divide them into those that are able to break down and liquefy solid organic matter, and those that deal with it when in solution. It is not pretended that a clear line of demarcation can be established, although between the extremes of either class there are very distinct and clearly defined functional differences. The first-mentioned class may again be divided into two, viz : those that do their work in the presence of air, and those that thrive in its absence. Both of these are always present in ordinary sewage, and the predominence of one or the other is entirely in the hands of the sewag.e operator. If~ as at Sutton, the first be employed, care xs taken that oxygen shall have free access to every part of the culture medium ; the beds are frequently entirely emptied to admit the air to every crevice ; and the most successful work, hitherto~ has been by working and resting intermittently. When, however mthe ana~robians are employed, air is rigidly excluded ; a fermentative action of a putrefactive character is encouraged, and the process is necessarily continuous. This is the method which has been adopted with such satisfactory results at Exeter. Into the relative merits of these two systems, aErobian and ana~robian, the authors do not propose to inquire ; both are based upon scientific principles, both have been highly satisfactory in practice, and both remove, once and for all, the troubles of sludge disposal." I t is p o s s i b l e t h a t t h e a u t h o r s o f this p a p e r a r e t o o s a n g u i n e in t h e i r s t a t e m e n t s q u o t e d a b o v e . I t will b e b e t t e r to wait a n o t h e r y e a r or t w o b e f o r e c o m m i t t i n g o n e ' s self to t h e c o n c l u s i o n t h a t t h e sewage disposal problem has been solved, T h e following useful s u m m a r y o f t h e c o n d i t i o n s t h a t a n effluent o u g h t to fulfil m a y b e q u o t e d : m " f i) It must contain, practically, no solids in suspension. " (2) It must not contain in solution a quantity of organic matter sufficient to seriously rob the stream, into which it is discharged, of its oxygen. *' (3) The organic matter it contains must be in such a con. dition as to yield readily t~o the natural purifying influences exerted upon it. " (4) It must not be liable to putrefaction or secan6'ary decomposition. " (5) It must contain nothing inimical to microbial growth and activity ; in other words, it must not be sterilized or treated with antiseptics. "(6) It must not contain pathogenic organisms." Profession Bostock Hill read a paper on "The Filtratign of Sewage through Coal." This method has been adopted successfully at Lichfieldl under difficult c i r c u m s t a n c e s , i n c l u d i n g t h e p r e s e n c e o f a large q u a n t i t y o f b r e w e r y r e f u s e in t h e sewage. T h e c o n c l u s i o n s , as s t a t e d by D r . Hill, a r e t h a t : ~

HEALTH

EXHIBITION

OF THE

" It would appear that in many places where laud of a suitable character cannot be obtained, that in coal we have a medium cheap and effective which will produce an effluent as good or better than that which may be obtained from land, while in those districts which have hitherto relied on land purification it would appear also that by the putting down of coal filters far greater purification can be obtained, and in a growing community it seems possible by this method of treatment to do away with that constant increase in the area of land required which is such an incubus on the rates of our urban communities." Mr. Donald Cameron, the city surveyor of Exeter, read a paper on " A Year's Experience of the Septic T a n k System of Sewage Disposal at E x e t e r . " T h e method pursued can be seen in the beautiful m o d e l shown by Mr. Cameron at the L e e d s H e a l t h Exhibition. Mr. C a m e r o n states in his paper that : - " The Exeter installationm during its twelve months' work, has been subjected to the severest conditions that sewage works have to contend with, and has proved thoroughly reliable in all respects. The trial has been on a sufficiently large scale to give practical results, .and is the outcome ot experiment, step by step, leading from smaller to larger plants. It has been shown that sewage-disposal works can be designed so as practically to take care of themselves, requiring no more attention than a visit two or three days a week to change or alternate the filters, the work ot a few minutes, and a day's work every month or six weeks in tidying the filters. Once a year it may be desirable to remove the deposit from the tank ; by proper arrangements this can be done by the one man who acts as caretaker. To Local Authorities the saving in ~nnual expenditure thus effected is even more important than a corresponding reduction in the first cost of works. At the same time the initial cost of such works as are herein described, is very moderate, being often less than is often spent in laying out a sewage farm to serve an equal popuIation." T h e process is a promising one, but it is distinctiy as yet upon its trial, and it would be premature to r e c o m m e n d its adoption in o t h e r localities on the basis of results hitherto attained. The analytical results as hitherto published are somewhat conflicting and puzzling, and we must wait for further experience and for further analytical resalts before a definite and final opinion can be g~ven. 2"ke C a n a d i a n P r a c t i t i o n e r for July last gives a section showing the general arrangement of house .plumbing and drainage from the " M o d e l P l u m b mg Bye.laws" of the' Provincial B o a r d o f H e a l t h of Ontario. T h e section shows all wastepipes from baths, lavatories, sinks, etc., connected to the soilpipe in exactly the same manner asthose of the w.c.s, each waste having antisyphonage pipe. T h e soil-pipe appears to be situated in the m i d d l e of the house, and the intercepting trap is within the main wall. No inspection c h a m b e r is provided, but it is i n t e n d e d that the drain-pipes are to be uncovered, and numerous clearing eyes are provided. Close to the intercepting syphon, a sewer ventilator is provided, carried up to the roof. ~ T h e fresh air inlet is a curved pipe (like an inverted d - - [ TM)without mica flap. T h e extreme cold of winter has probably had much to do with the designing o f the system sketched here.

SANITARY

INSTITUTE

AT

LEEDS.

29

THE HEALTH EXHIBITION OF THE SANITARY INSTITUTE AT LEEDS. A HEALTH EXHIBITION mus'G necessarily be a mixture of things new and old, and though it may present few new features, it does not follow that the chief value of an e x h i b i t i o n - - t h e education of the general public through the e y e - - i s the less on this account. The L e e d s Exhibition is the largest ever held in connection with the Sanitary Institute, and we propose briefly to n o t e the most important exhibits, especially the f e w presenting novel features bearing on t h e work of sanitary administration. Our notes will follow the order adopted in the official catalogue. SCIENCE IN P~ELATION TO HYGIENE.

Messrs. Reynolds and Branson, of Leeds, showed three excellent series of lantern s l i d e s " D a n g e r s to H e a l t h , " by T. P. Teale, F . R . S . ; " Is my H o u s e H e a l t h y , " by Dr. Spottiswoode C a m e r o n ; and " Slipshod Sanitation," by Dr. W. L. H u n t e r . I t will be useful to m a n y medical officers of health to know where these slides can be obtained.

PREVENTION OF FIRES. Messrs. Jas. Milne and Son (Limited), of 4 8, Wellington Street,Leeds, showed fire-hosefittings in aluminium which deserve special attention. They are lighterbut quiteas strong as the heavy gunmetal fittings of the past. A further advantage is the " I n s t a n t e r " grip, by which an instantaneous joint is m a d e without screwing. Messrs. Noble, Brown and Co., of F r i t h Street, Leeds, showed portable fire pumps worked by the feet, thus leaving the hands free to direct the jet of water. T h e i r segment tank pedestals are also m u c h superior to the pails o f water as ordinarily k e p t hanging. T h e i r window cleanser, in which a current o f water is directed throHgh the handle of the soft brush, c o m b i n i n g the operations o f swilling and brushing, is most ingenious. APPARATUS FOR W A T E R

SUPPLY.

The "Eureka" water pipe of Messrs. B. Clarke and Co. is composed of an inner tube of pure block tin, an outer case of lead, and an intervening section of non-conducting material. T h e weak point in such an arrangement is obviously the joints, but it is claimed for the Eureka pipe t h a t t h e danger of melting the tin lining when m a k i n g joints is entirely obviated by the non-conducting section. It is further claimed that the pipe is less liable to burst from frost than ordinary lead pipes. Messrs. E. Walker and Co. showed their paterit block tin lined iron p i p e ; also samples o f Walker's aluminium lined pipes. T h e s e require further testing before one can give a satisfactory opinion. C

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