The Maidstone inquiry

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The

Maidstone Inquiry

t~bac Health

and the question arises, How far would the "liberty of the subject" and the "conscientious objector" be allowed to stand in the way ? Having regard to the recent display of weakness on the part of the Government q~td vaccination, we do not feel much confidence on this matter. If this doubt be right, we should have to fall back on the improvement of general hygiene, which matter cannot be left until the disease reaches our shores. It therefore behoves the Government to see that the local authorities in all parts of the country are fully alive to their responsibilities and carry out their duties promptly and thoroughly. THE MAIDSTONE INQUIRY. THE Inspectors who on behalf of the Local Government Board held the recent inquiry at Maidstone rejected Prof. Corfield's "defective sewerage and drainage" theory, and concluded that the pollution of the Farleigh springs was the prime cause of last year's epidemic of enteric fever. The evidence in support of that conclusion is too strong to be upset by the singular immunity enjoyed by the children attending the East Farleigh Schools, which were supplied with the water from the polluted springs. In the soil-pollution, due to defective sewerage and drainage and to the almost universal system of hand-flushed (?) closets, the Inspectors found a sufficient explanation for the secondary cases. In regard to these matters, the Corporation is charged with a grave dereliction of duty, which, coupled with their notorious refusal to avail themselves of a sufficiently frequent analysis of the town's water-supply, has crippled the municipal funds with a debt of £18,000, to say nothing of the losses incurred by the individual inhabitants. To meet this indebtedness, the Corporation have applied to the Local Government Board for permission to raise a loan of £15,000, ~o be repaid in twenty years. The Board have, however, intimated that they can sanction such loan for three years only. It is said that these terms would require a special rate of one shilling in the pound, and the Corporation are naturally anxious to secure better terms from the Board. There is probably no better method of bringing home to the minds of the Corporation and the townsfolk the utter folly of their past neglect and parsimony than that of making them meet their liabilities within the shorter period, and we venture to hope that the Local Government Board will not give way. In the course of the inquiry attention was called ~o Mr. M. A. Adams' remarks on the value of a "local chemical standard" for water-supplies. Similar suggestions have been made with regard to bacteriological investigations by Profs. Del6pine and MzWeeny.

I~ovember, 1898]

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Such standards undoubtedly invest the results of our present methods with a significance and value hitherto imperfectly appreciated. This is exemplified by the fact that one analyst of undoubted ability characterized as " e x c e l l e n t " and " o f very high organic p u r i t y " water from the Farleigh sources which contained nitrates from 71 to 97 per cent. in excess of the local standard. Dr. Woodhead's employment of inoculations of broth-cultures of the organisms in water, for the determination of the liability of such water to "surface relations "--i.e., pollution with organisms from the surface of the ground--is a new feature in such inquiries as this, in this country, at least. Mr. Adams' views on the relations of enteric fever and diarrhoea with rainfall and level of sub-soil water are of great interest, and will, we hope, be further examined. Lastly, the Inspectors insist that the chemical and bacteriological examinations of a water-supply should be supplemented " b y skilled inspections of the actual conditions, geological, topographical, and sanitary, of the gathering grounds," a view which all health officers will not only endorse, but devoutly hope that Par.liament will adopt and bring into actual operation at an early date. INTRA-UTERINE TYPttOlD.--In the Scottish Medical and Surgical Journal, 1898, vol. iii., No. 1, Fordyce reports a very interesting ease in which typhoid was demonstrated in a five-months' foetus. The mother aborted and died soon after. No autopsy could be obtained, but there was no doubt about the diagnosis. Externally and internally nothing abnormal could be seen by the naked eye in the foetus or its appendages. There was a small quantity of serous fluid in the abdomen. The intestines seemed quite healthy; the liver and spleen were not enlarged. Tubes inoculated from the kidney, spleen, and intestinal contents gave pure cultures of the typhoid bacillus; the blood was sterile. Care was taken to make tests, which showed the absence of the Bacillus cell communis. It was impossible to demonstrate bacilli in the tissues by microscopic examination. The Widal test was very successful in this case.--Am. Joker. Med. Sci. THE NEW ISOLATION HOSPITAL AT LEEDB.--On t h e let ult. the Lord Mayor of Leeds opened a new Hospital for Infectious Diseases at Mansion. The site is some three miles distant from the centre of the City, and has an area of nearly ninety-eight acres. The accommodation to be provided at once includes sixty-six beds for scarlet-fever, fifty-eight for small-pox, and six for isolation. The staff, normally to include forty-four persons, will be housed in the mansion purchased with the estate. The scarlet-fever wards are 400 feet distant from the administrative block, and the small-pox wards a little over 800 feet. The site allows for ample increase of the hospital for emergencies or for permanent enlargement. We are somewhat surprised at the proximity of the small-pox wards to the rest of the hospital, having regard to the popularly accepted theory of a~rial transmission of that disease, a theory which we do not endorse, but which is accepted by the Local Government Board. 6--2