- Email: [email protected]
THE MAIN-DRAINAGE SCHEMES EXAMINED FROM A MEDICAL POINT OF VIEW.
Mr. GRIFFIN said that no doubt the complaints arose from the immense districts men had to attend to. The Poor-law Board had laid it down as a rule that no man should have more than 15,000 acres; but if the President would look over the records of his own office, he would find that many men had three times that amount. Mr. ESTCOURT said that was certainly very grievous, and he would look into the matter. The next points urged were, that too great discretion was allowed to the relieving officers, that it should be transferred to the board of guardians, and that it should be at the discretion of the medical officer to attend to any cases he thought necessary, subject to confirmation by the board of guardians. The case, Mr. Griffin thought, might probably be met by giving power to overseers as well as relieving officers. It was also urged that persons having less than 10s. a week should be considered fit objects for relief, but that in cases of persons having large families, or under other special circumstances, that rule might be relaxed. The subject of competition was also spoken of Mr. ESTCOURT said that it had been for many years past the object of the Board to improve the condition of the Poor-law medical officers. He could not introduce any measure to Parliament this session with any chance of success, and he should like to be furnished during the recess with some arguments which would justify him in bringing in a bill. Taking the last twenty years, from 1838 to 1858, the amount paid by the to medical officers now is exactly double what it was public in the former period. In 1838, the salaries were £136,775; in 1858, they amounted to .6272,000. If he went before Parliament with a proposition of this kind, he should be asked what he wanted more than had already been obtained. Members would say, "You havedoubled in twenty years the amount paid to these gentlemen; and there can be no reason for any change, because whenever an opening takes place there are plenty of well-qualified candidates to fill it." He must request the gentlemen present to think over the matter, and supply him with answers to these objections. Mr. GRIFFIN reminded the right hon. gentleman that he had lumped together items which should not be combined with each other. In his estimate of 185S he had included the cost of vaccination. Mr. ESTCOURT said that increase would amount to about
THE MAIN-DRAINAGE SCHEMES EXAMINED FROM A MEDICAL POINT OF VIEW.
(From the Correspondent whose first communication subject we published on the 24th ult.)
on
the
WE are conscious that some of the views to be developed in the medical examination to which we propose to subject the principles of the Metropolitan Main-Drainage Schemes, are not in accordance with those generally entertained. We are also conscious that the opinions we have formed are the result of candid inquiry, and direct observation exercised under peculiar facilities. We, therefore, feel justified-considering the enormous interests, sanitary, commercial, and financial, involved-in inviting a deliberate re-examination into the fundamental propositions upon which all Main-Drainage schemes
repose. But first let us diverge for a moment to notice the substance of the remarkable Report upon the Sewage of Towns recently presented by the Royal Commission. The reporters may be presumed to comprise amongst them all the qualities fitted for the investigation. Medical knowledge is represented by Dr. Southwood Smith and Mr. Simon; chemistry, by Professor Way and Mr. Lawes; engineering science, by Mr. Rawlinson and Mr. Austin; and the judicial faculty, to weigh the evidence and pronounce a decision, by the Earl of Essex and Mr. Ker Seymer. They state that they are convinced, by the representations of Mr. Gurney-who had been, as we have previously shown, completely anticipated by Mr. Freebody and Dr. Barnes-that the mere diversion of the sewage will not purify the Thames from its present foul condition. They recommend the immediate execution of the Embankment-Scheme. Advanced terraces being constructed, continuous on the surface, but affording convenient entrances to inner basins for the wharves above Londonbridge, reservoirs are to be formed in the embankments adjacent to the mouths of the existing sewers, into which all the sewage is to be received and deodorized, and-from which the purified water being first allowed to flow into the river-the £10,000. A Gentleman said that he found he could not satisfactorily precipitated matter will be pumped into the country or to the discharge his duty for the small amount of pay he received, sea. The reservoirs and apparatus are to be beneath the surand it was impossible for him to keep a properly-qualified face, and consequently invisible, so that no nuisance whatever assistant. One result of this state of things was, that men can be apprehended. The cost of these works-of substantial could not go as assistants, and were obliged to go into practice and permanent utility and beauty is estimated at £3,250,000, for themselves within six or twelve months of passing their in lieu of the £9,000,000 or .611,000,000 which the Government examination. They could find no scope for their talent except engineers propose to sink in works of stupendous folly and hideous uselessness. by going into competition with other men. This Report is the final blow to the Main-Drainage delusion. Mr. ESTCOURT said he thought he saw clearly the nature of the grievances complained of, and what the members of the That such a delusion should ever have acquired so strong a hold deputation desired. It was no new subject to him, and he upon the scientific and popular mind as to dictate an Act of had not taken it up merely during the two months he had Parliament, dispensing with even the form of preliminary inbeen in office. He thought the present mode of paying salaries quiry, is a circumstance-with the utmost reverence be it was a very bad one, and he was of opinion that that portion spoken-which we owe to the influence of the press. The river which was paid by the Government should be paid entirely is observed by casual passengers to be in a foul and disgraceful out of the Consolidated Fund. It was very objectionable that condition: acres of hideous mud-banks, exposed at low water; one portion should be paid out of local rates and another out huge sewers disemboguing their black and fœtid streams by of the Consolidated Fund. With regard to the proposed in- open mouths, constitute a visible and elective nuisance, calling crease, he thought the amounts should from time to time be loudly for a remedy. The foremost chemist of the age makes made to correspond with the work done; and that their sug- a steam-b ’at voyage from London-bridge to Hungerford. As immortalised his Iter ad Brundusium, so did Faraday gestions were entitled to receivethe attentive consideration Horace of the Government. He freely admitted that the system commit the rapid impressions of his brief passage on the Thames of Poor-law medical relief required alteration, and if he could to the imagination and memories of his fellow-citizens. Every see his way to the adoption of a good measure he would at newspaper in the metropolis gave it a prominent place. It He was sure of this, that Parliament was reprinted by the Board of Health, and specially noticed by once introduce it. would have the greatest objection to interfere with the discre- the Houses of Parliament, who have a peculiar interest in the tion of boards of guardians. purity of the Thames. From the decision of a man so sagaMr. GRIFFIN, in the name of the deputation, thanked the cious, a philosopher so profound, there seemed no appeal. No ventured to examine critically what it was that right hon. gentleman for the courtesy with which they had one so much as condemnation of the Thames really meant; or Mr. Faraday’s been received. to inquire what was the true remedy indicated by his condemThe deputation then retired. nation. Professor Faraday’s voyage was made, and its history reHEALTH OF LONDON DURING THE WEEK ENDING corded in July, 1855. From that day to the present not one SATURDAY, MAY 8TH.-The deaths returned were 1056. Dis- tittle of evidence-that is, evidence springing from observation eases of the zymotic character produced last week 242 deaths. - has been advanced in support of the conclusions which the was fatal in 63 cases; measles in 45; scarlatinapress and the public drew from that graphic description. Ever Hooping-cough ’n 38; typhus (with common fever) in 30; diarrhaea in 9; small- eince, as Mr. Busk observes. "Very great and lamentable misox in 3; ague in 1. Two deaths resulted from cholera; and 5 conception has prevailed.’’ The attention of Professor Faraday - 4;al cases of diphtheria are returned. was arrested by the " opacity" of the stream. He tested this
Goldsworthy
489
quality by tearing up white cards, and dropping pieces into the water; he observed that " when the pieces fell edgeways, the I lower part was hidden from sight before the upper part was under water. Near the bridges the feculence rolled up in clouds, so dense that they were visible at the surface." As
Medical Societies. MEDICAL
nations
.
SOCIETY
OF
LONDON.
the Professor refers immediately afterwards to the offensive SATURDAY, MAY 1ST, 1858. smell, (it being low water, and the stream very shallow at river as a and use the the of the conclusion sewer, HUGHES DR. Hungerford,) WILLSHIRE, PRESIDENT, IN THE CHAIR. was universally adopted, that the "fec2clence rolling in clouds" was nothing more nor less than sewage matter. But Mr. Faraday did not say this, nor could he say it. " So far is this in- ; MR. BAKER BROWN referred to the use of the ference from being true," says Dr. Barnes in a Report printed SILVER WIRE SUTURE, in January, 1857, "those clouds of so calledfeculence’ aree recommended by Dr. Sims. Mr. Brown said that it had important agents in the purification of the Thames. Almost lately the of not cutting itself out, and in this respect great advantage that matter which the whole of renders the river turbid is invaluable in cases of operation for vesico-vaginal fistula earthy detritus--clay and silex, washed down from its banks was and water-shed, or raised from its bed, and suspended in the and ruptured perinæum. Dr. Sims had recommended its use This inorganic matter in cases of ovariotomy, and had suggested that the pedicle mass of flowing waters in fine particles. attracts and entangles the sewage substances as these mingle should be secured by a silver wire ligature. It might be used with the stream. It thus exerts a powerful disinfecting and also advantageously in cases of hare lip, flap operation of the Mr. Brown had never seen the silver wire affected decomposing action on the organic matter. A series of obser- thigh, &c. gases emanating from the wound. vations, as yet incomplete, which I have made upon the waters byI)r. BARRATT was about to perform ovariotomy, and would of the Thames, taken at different periods of the tide, from be to know if Mr. Brown endorsed the opinion of Dr. glad the acoualongside the Dreadnought, affords sufficient proof of Sims respecting the employment of the silver wire in that racy of these statements. The Thames is never so muddy, so Did Mr. Brown still advise injection in simple turbid, or so opaque, as during the flood and high-water, pre- operation. cases of ovarian dropsy ? when it of contains the minimum cisely sewage-matter;......at Mr. BROWN agreed with Dr. Sims respecting the employment low water, on the other hand, when there is the maximum of of silver wire sutures in ovariotomy. He still employed injec. the water is often almost sewage, bright, yielding cornparain simple unilocular non-malignant forms of ovarian dis. tively little earthy deposit.......rthink it has not been proved tions previous to attempting removal. by distinct evidence that the unconverted organic matter exists ease Dr. HEADLAND suggested that platinum wire would be more in a form which is capable of producing disease, so long, that is, than silver wire, inasmuch as it would not be advantageous it Near the as is not deposited on the banks." piers, where Mr. upon by the gases, which would affect the silver after a Faraday’s observations were made, the stream is very shallow acted at low water, and the paddle-wheels of the steam-boats of certain interval. Mr. BROWN had used the platinum wire, but it was too course churn up the earthy sediment from the bottom. Ridiculous as it may appear, it is still necessary to repeat that this pliable and flexible; it was not necessary to retain the silver wire long enough to be acted upon by gases. He might state, earthy detritus, which clouds the river, is not human excre- in reference to cases of vesico-vaginal fistula, that he had lately and that the diversion of the sewage will not purify the ment, operated upon a case successfully, the cure being effected in river from it. It requires something more than a steam-boat voyage on the ten days. A paper was afterwards read by Dr. Nelson, of New York, Thames to be able to pronounce magisterially upon the sources of its foulness, and its presumed deleterious influence upon on the Circulation ; but it offered no points of sufficient interest health. Mr. Faraday himself has not, that we are aware, de- for a report. At the previous meeting of the Society, Mr. ALFRED POLAND liberately enunciated the opinions or theories which others have drawn from his description of the river. read a paper Where our health is concerned, (we say nothing of money, ON THE ABUSE OF MERCURY IN OPHTHALMIC DISEASES. for pecuniary considerations are treated with such lofty contempt by those who advocate Main-Drainage schemes that we The author prefaced his remarks by stating that his chief aim dare not venture to interpose an objection on this score,) it is was to draw the attention of the profession generally to the at least worth while to inquire, What are the sanitary grounds above subject, and more especially when practised by those upon which the expediency of a Main-Drainage system rests ? not over-conversant with these affections. He was sorry to Obviously, the burden of proof lies upon those who affirm this say that the study of eye diseases had considerably declined, expediency. But they have limited their ingenuity and labour and that it was more and more becoming an isolated branch of the profession. In former years every hospital and general to the more attractive task of constructing Intercepting-plans. Let us recal to their attention what it is they are required surgeon undertook the treatment of this class of cases, and the lecturers on surgery at the several schools duly elucidated the to prove, and what it is they have assumed. 1. That the sewage, as it is now discharged into the Thames principles and practice thereof. Nowadays, on the contrary, by numerous natural outfalls, accumulates in the river, is with the exception of one or two leading medical schools, perfectly brought back or " ponded up" by every flood-tide, is the cause ophthalmic surgery had become isolated, and rendered of the foulness of the river, empoisons the air by putrefaction, distinct and separate; there were separate wards and separate and exerts a deleterious influence upon the health of the in- lectures, which were, moreover, unrecognised by the examining ’ boards. The author hoped that this state of affairs might be habitants of the metropolis. 2. That the appearance of the river will be improved, the remedied, and that persons before entering on practice should deposits of mud prevented, and the removal of offensive emana- show some evidence of having studied, and become practically effected, by diverting the sewage from that part of the acquainted with the treatment of diseases of the eye. With river which lies within the metropolitan boundary, and dis- these strictures the author cursorily surveyed the general dis. eases of the eye, pointing out that in the majority of them, charging it into the river lower down. 3. That the health of the metropolis generally will be raised mercury was not required. In the conjunctival inflammation, including also gonorrhceal ophthalmia, mercury was inadmisby this interception of the sewage. 4. That the facilities of sewerage-that is, of promptly and sible, inasmuch as they could be cured without its administraefficiently getting rid of the sewage and sewer-gases from our tion. So, also, in so-called strumous diseases, comprising habitations-will be increased by the construction of huge ophthalmia and corneitis, it was a remedy that did no good, as intercepting sewers, to supplant the existing natural and shorter attention to the secretions and excretions, with due regard to diet and the powers of the patient, sufficed to eradicate the outfalls into the river. It will be admitted that we have here a considerable body of complaint. It would hardly be credited that, in the year 1858, propositions of sufficient importance to engage a little attention mercury was administered for penetrating wounds of the eye, and research, before discussing the relative merits of rival yet he (Mr. Poland) was sorry to say such was the case; and, he remarked, what would be the results of operation for exMain-Drainage schemes. The been favoured with schemes without number. traction were this line of treatment to be adopted ? InadvertWe know not yet where to look for evidence of the truth of ing to sclerotitis and iritis, mercury came to our aid, more so the propositions, without establishing which these schemes are in the latter than in the former disease; yet even in these more attention ought to be paid to the condition an a logical anachronism, castles in the air, dreams unworthy to engage the thoughts of practical arca constitution of the patient than the nature of the disease.
public has
affections
o
490
THE MAIN-DRAINAGE SCHEMES EXAMINED FROM A MEDICAL POINT OF VIEW.
(From the Correspondent whose first communication subject we published on the 24th ult.)
on
the
WE are conscious that some of the views to be developed in the medical examination to which we propose to subject the principles of the Metropolitan Main-Drainage Schemes, are not in accordance with those generally entertained. We are also conscious that the opinions we have formed are the result of candid inquiry, and direct observation exercised under peculiar facilities. We, therefore, feel justified-considering the enormous interests, sanitary, commercial, and financial, involved-in inviting a deliberate re-examination into the fundamental propositions upon which all Main-Drainage schemes
repose. But first let us diverge for a moment to notice the substance of the remarkable Report upon the Sewage of Towns recently presented by the Royal Commission. The reporters may be presumed to comprise amongst them all the qualities fitted for the investigation. Medical knowledge is represented by Dr. Southwood Smith and Mr. Simon; chemistry, by Professor Way and Mr. Lawes; engineering science, by Mr. Rawlinson and Mr. Austin; and the judicial faculty, to weigh the evidence and pronounce a decision, by the Earl of Essex and Mr. Ker Seymer. They state that they are convinced, by the representations of Mr. Gurney-who had been, as we have previously shown, completely anticipated by Mr. Freebody and Dr. Barnes-that the mere diversion of the sewage will not purify the Thames from its present foul condition. They recommend the immediate execution of the Embankment-Scheme. Advanced terraces being constructed, continuous on the surface, but affording convenient entrances to inner basins for the wharves above Londonbridge, reservoirs are to be formed in the embankments adjacent to the mouths of the existing sewers, into which all the sewage is to be received and deodorized, and-from which the purified water being first allowed to flow into the river-the £10,000. A Gentleman said that he found he could not satisfactorily precipitated matter will be pumped into the country or to the discharge his duty for the small amount of pay he received, sea. The reservoirs and apparatus are to be beneath the surand it was impossible for him to keep a properly-qualified face, and consequently invisible, so that no nuisance whatever assistant. One result of this state of things was, that men can be apprehended. The cost of these works-of substantial could not go as assistants, and were obliged to go into practice and permanent utility and beauty is estimated at £3,250,000, for themselves within six or twelve months of passing their in lieu of the £9,000,000 or .611,000,000 which the Government examination. They could find no scope for their talent except engineers propose to sink in works of stupendous folly and hideous uselessness. by going into competition with other men. This Report is the final blow to the Main-Drainage delusion. Mr. ESTCOURT said he thought he saw clearly the nature of the grievances complained of, and what the members of the That such a delusion should ever have acquired so strong a hold deputation desired. It was no new subject to him, and he upon the scientific and popular mind as to dictate an Act of had not taken it up merely during the two months he had Parliament, dispensing with even the form of preliminary inbeen in office. He thought the present mode of paying salaries quiry, is a circumstance-with the utmost reverence be it was a very bad one, and he was of opinion that that portion spoken-which we owe to the influence of the press. The river which was paid by the Government should be paid entirely is observed by casual passengers to be in a foul and disgraceful out of the Consolidated Fund. It was very objectionable that condition: acres of hideous mud-banks, exposed at low water; one portion should be paid out of local rates and another out huge sewers disemboguing their black and fœtid streams by of the Consolidated Fund. With regard to the proposed in- open mouths, constitute a visible and elective nuisance, calling crease, he thought the amounts should from time to time be loudly for a remedy. The foremost chemist of the age makes made to correspond with the work done; and that their sug- a steam-b ’at voyage from London-bridge to Hungerford. As immortalised his Iter ad Brundusium, so did Faraday gestions were entitled to receivethe attentive consideration Horace of the Government. He freely admitted that the system commit the rapid impressions of his brief passage on the Thames of Poor-law medical relief required alteration, and if he could to the imagination and memories of his fellow-citizens. Every see his way to the adoption of a good measure he would at newspaper in the metropolis gave it a prominent place. It He was sure of this, that Parliament was reprinted by the Board of Health, and specially noticed by once introduce it. would have the greatest objection to interfere with the discre- the Houses of Parliament, who have a peculiar interest in the tion of boards of guardians. purity of the Thames. From the decision of a man so sagaMr. GRIFFIN, in the name of the deputation, thanked the cious, a philosopher so profound, there seemed no appeal. No ventured to examine critically what it was that right hon. gentleman for the courtesy with which they had one so much as condemnation of the Thames really meant; or Mr. Faraday’s been received. to inquire what was the true remedy indicated by his condemThe deputation then retired. nation. Professor Faraday’s voyage was made, and its history reHEALTH OF LONDON DURING THE WEEK ENDING corded in July, 1855. From that day to the present not one SATURDAY, MAY 8TH.-The deaths returned were 1056. Dis- tittle of evidence-that is, evidence springing from observation eases of the zymotic character produced last week 242 deaths. - has been advanced in support of the conclusions which the was fatal in 63 cases; measles in 45; scarlatinapress and the public drew from that graphic description. Ever Hooping-cough ’n 38; typhus (with common fever) in 30; diarrhaea in 9; small- eince, as Mr. Busk observes. "Very great and lamentable misox in 3; ague in 1. Two deaths resulted from cholera; and 5 conception has prevailed.’’ The attention of Professor Faraday - 4;al cases of diphtheria are returned. was arrested by the " opacity" of the stream. He tested this
Goldsworthy
489
quality by tearing up white cards, and dropping pieces into the water; he observed that " when the pieces fell edgeways, the I lower part was hidden from sight before the upper part was under water. Near the bridges the feculence rolled up in clouds, so dense that they were visible at the surface." As
Medical Societies. MEDICAL
nations
.
SOCIETY
OF
LONDON.
the Professor refers immediately afterwards to the offensive SATURDAY, MAY 1ST, 1858. smell, (it being low water, and the stream very shallow at river as a and use the the of the conclusion sewer, HUGHES DR. Hungerford,) WILLSHIRE, PRESIDENT, IN THE CHAIR. was universally adopted, that the "fec2clence rolling in clouds" was nothing more nor less than sewage matter. But Mr. Faraday did not say this, nor could he say it. " So far is this in- ; MR. BAKER BROWN referred to the use of the ference from being true," says Dr. Barnes in a Report printed SILVER WIRE SUTURE, in January, 1857, "those clouds of so calledfeculence’ aree recommended by Dr. Sims. Mr. Brown said that it had important agents in the purification of the Thames. Almost lately the of not cutting itself out, and in this respect great advantage that matter which the whole of renders the river turbid is invaluable in cases of operation for vesico-vaginal fistula earthy detritus--clay and silex, washed down from its banks was and water-shed, or raised from its bed, and suspended in the and ruptured perinæum. Dr. Sims had recommended its use This inorganic matter in cases of ovariotomy, and had suggested that the pedicle mass of flowing waters in fine particles. attracts and entangles the sewage substances as these mingle should be secured by a silver wire ligature. It might be used with the stream. It thus exerts a powerful disinfecting and also advantageously in cases of hare lip, flap operation of the Mr. Brown had never seen the silver wire affected decomposing action on the organic matter. A series of obser- thigh, &c. gases emanating from the wound. vations, as yet incomplete, which I have made upon the waters byI)r. BARRATT was about to perform ovariotomy, and would of the Thames, taken at different periods of the tide, from be to know if Mr. Brown endorsed the opinion of Dr. glad the acoualongside the Dreadnought, affords sufficient proof of Sims respecting the employment of the silver wire in that racy of these statements. The Thames is never so muddy, so Did Mr. Brown still advise injection in simple turbid, or so opaque, as during the flood and high-water, pre- operation. cases of ovarian dropsy ? when it of contains the minimum cisely sewage-matter;......at Mr. BROWN agreed with Dr. Sims respecting the employment low water, on the other hand, when there is the maximum of of silver wire sutures in ovariotomy. He still employed injec. the water is often almost sewage, bright, yielding cornparain simple unilocular non-malignant forms of ovarian dis. tively little earthy deposit.......rthink it has not been proved tions previous to attempting removal. by distinct evidence that the unconverted organic matter exists ease Dr. HEADLAND suggested that platinum wire would be more in a form which is capable of producing disease, so long, that is, than silver wire, inasmuch as it would not be advantageous it Near the as is not deposited on the banks." piers, where Mr. upon by the gases, which would affect the silver after a Faraday’s observations were made, the stream is very shallow acted at low water, and the paddle-wheels of the steam-boats of certain interval. Mr. BROWN had used the platinum wire, but it was too course churn up the earthy sediment from the bottom. Ridiculous as it may appear, it is still necessary to repeat that this pliable and flexible; it was not necessary to retain the silver wire long enough to be acted upon by gases. He might state, earthy detritus, which clouds the river, is not human excre- in reference to cases of vesico-vaginal fistula, that he had lately and that the diversion of the sewage will not purify the ment, operated upon a case successfully, the cure being effected in river from it. It requires something more than a steam-boat voyage on the ten days. A paper was afterwards read by Dr. Nelson, of New York, Thames to be able to pronounce magisterially upon the sources of its foulness, and its presumed deleterious influence upon on the Circulation ; but it offered no points of sufficient interest health. Mr. Faraday himself has not, that we are aware, de- for a report. At the previous meeting of the Society, Mr. ALFRED POLAND liberately enunciated the opinions or theories which others have drawn from his description of the river. read a paper Where our health is concerned, (we say nothing of money, ON THE ABUSE OF MERCURY IN OPHTHALMIC DISEASES. for pecuniary considerations are treated with such lofty contempt by those who advocate Main-Drainage schemes that we The author prefaced his remarks by stating that his chief aim dare not venture to interpose an objection on this score,) it is was to draw the attention of the profession generally to the at least worth while to inquire, What are the sanitary grounds above subject, and more especially when practised by those upon which the expediency of a Main-Drainage system rests ? not over-conversant with these affections. He was sorry to Obviously, the burden of proof lies upon those who affirm this say that the study of eye diseases had considerably declined, expediency. But they have limited their ingenuity and labour and that it was more and more becoming an isolated branch of the profession. In former years every hospital and general to the more attractive task of constructing Intercepting-plans. Let us recal to their attention what it is they are required surgeon undertook the treatment of this class of cases, and the lecturers on surgery at the several schools duly elucidated the to prove, and what it is they have assumed. 1. That the sewage, as it is now discharged into the Thames principles and practice thereof. Nowadays, on the contrary, by numerous natural outfalls, accumulates in the river, is with the exception of one or two leading medical schools, perfectly brought back or " ponded up" by every flood-tide, is the cause ophthalmic surgery had become isolated, and rendered of the foulness of the river, empoisons the air by putrefaction, distinct and separate; there were separate wards and separate and exerts a deleterious influence upon the health of the in- lectures, which were, moreover, unrecognised by the examining ’ boards. The author hoped that this state of affairs might be habitants of the metropolis. 2. That the appearance of the river will be improved, the remedied, and that persons before entering on practice should deposits of mud prevented, and the removal of offensive emana- show some evidence of having studied, and become practically effected, by diverting the sewage from that part of the acquainted with the treatment of diseases of the eye. With river which lies within the metropolitan boundary, and dis- these strictures the author cursorily surveyed the general dis. eases of the eye, pointing out that in the majority of them, charging it into the river lower down. 3. That the health of the metropolis generally will be raised mercury was not required. In the conjunctival inflammation, including also gonorrhceal ophthalmia, mercury was inadmisby this interception of the sewage. 4. That the facilities of sewerage-that is, of promptly and sible, inasmuch as they could be cured without its administraefficiently getting rid of the sewage and sewer-gases from our tion. So, also, in so-called strumous diseases, comprising habitations-will be increased by the construction of huge ophthalmia and corneitis, it was a remedy that did no good, as intercepting sewers, to supplant the existing natural and shorter attention to the secretions and excretions, with due regard to diet and the powers of the patient, sufficed to eradicate the outfalls into the river. It will be admitted that we have here a considerable body of complaint. It would hardly be credited that, in the year 1858, propositions of sufficient importance to engage a little attention mercury was administered for penetrating wounds of the eye, and research, before discussing the relative merits of rival yet he (Mr. Poland) was sorry to say such was the case; and, he remarked, what would be the results of operation for exMain-Drainage schemes. The been favoured with schemes without number. traction were this line of treatment to be adopted ? InadvertWe know not yet where to look for evidence of the truth of ing to sclerotitis and iritis, mercury came to our aid, more so the propositions, without establishing which these schemes are in the latter than in the former disease; yet even in these more attention ought to be paid to the condition an a logical anachronism, castles in the air, dreams unworthy to engage the thoughts of practical arca constitution of the patient than the nature of the disease.
public has
affections
o
490