THE PUBLIC HEALTH AND THE PARIS FLOODS.

534

THE PUBLIC HEALTH AND THE PARIS FLOODS.

pass under the river by a railway tube and come bubbling HEALTH AND THE PARIS up the steps ot a railway station a mile away on the other and northern side of the river. Yet this is the explanation FLOODS. given of the inundations in front of the Gare St. Lazare, which is so familiar to the English visitors who come to Paris by (FROM OUR SPECIAL SANITARY COMMISSIONER.) the Dieppe or Havre routes. The proximity of tubes and main collecting sewers has brought about a new danger to Paris, Feb. 13th, 1910. health and life. At any moment a tube or an underground de Ville AT the Hotel the authorities are so busy that it is railway may be converted into a sewer. A flood, an earthno easy matter to find anyone who is free to talk quietly over the recent events, but I managed to obtain a good deal of quake, or simply a little jerry-building may produce such a catastrophe. Then, though we know how to clean and disinteresting information. In the various offices occupied by infect a room or a hospital ward, what experience have we in functionaries who are responsible for some of the sanitary services the rush, the noise, and the crowds are immense. In the purification of several miles of underground tunnelling ? Considering the new problems that arise it is perhaps the large courtyard of the Prefecture of Police there is an fortunate the floods are subsiding slowly. Indeed, for the interesting confusion of strange objects. Here are rows of moment, they are not subsiding at all but rising again. This collapsible boats and carts with high wheels that rendered will more time to plan proper measures. The need of give good service in maintaining communications in the streets time is all the greater, as there is no one supreme authority, when these were converted into canals, and barrels of all sorts of stores. The character of the crowd is also very but a multiplicity of departments, possessing different jurisdifferent from what one usually sees, while the ordinary dictions which have not even a common chief. Thus, if a is inundated, the Prefect of the Seine is political police and the numerous detectives who keep private house for the condition of the streets or But

THE PUBLIC

order in the streets or endeavour to hold the criminal section of the community in check seem to have been brushed aside to make room for a totally different order of service. Broughams and motor cars arrive out of which jump men in frock coats, often with decorations in their button-holes. These are members of the professions concerned most directly in fighting the ravages of the floodsmedical men, engineers, and architects. They all turn sharp to the left on entering, pass the municipal laboratory, and are lost in the stairs which at that corner of the vast building lead to the various offices devoted to the multiple sanitary services that depend on the Prefecture of Police. Whether at the Hotel de Ville or at the Prefecture of Police the floods have set much administrative machinery in motion which has been rusting in idleness for many a long year. Medical men who have never in their lives had occasion to go to either of these two great centres of local government have suddenly, and by reason of new and heavy responsibilities now thrown upon them, found it indispensable to see one or the other of certain functionaries able to give instructions or issue the materials needed in (arrying relief to the victims of the floods. Everyone is working with a will, but the direction ,of the work seems sometimes a little vague, for to tell the truth everyone is a little in the dark what to do. So vast and far-reaching a flood is an unprecedented eventthere are no lessons acquired in the past which can be utilised to-day. The flood of 1658, it is true, was as great a flood as that of to-day ; but the one single practical lesson to be derived from it is that the preceding flood was quite as bad and yet it occurred only seven years previously. Consequently it would be extremely imprudent to imagine that we shall have to wait two and a half centuries before ! another flood of the same magnitude will occur again. On the contrary, past experience indicates that there may be i, another equally bad flood in a few years. Then, and besides the two great Paris floods of 1651 and 1658, there have been minor but very disastrous floods in 1740, 1802, 1807, and 1876. But the experience acquired during all these floods is of little or no use to us to-day, because the science of bacteriology has now taught us to combat dangers the existence of which was ignored when the previous g--eat floods took place ; besides, the complexities of civilisation hare so increased that many more things in our daily life can now be put out of gear by a flood than could possibly be the case even in 1876. It is now felt that mere cleansing and drying do not suffice, but in many places rigorous disinfection is indispensable. Formerly Paris was a town almost exclusively of cesspools. There were but few sewers and they only drained away slop-water and rain-water. Now there are numerous sewers. Many of the houses have suppressed their cesspools and drain direct into these sewers which convey the sewage a long way into the country to various irrigation fields and sewage farms. A vast underground Paris has come into existence within the last half century and no one seems to have thought what would happen in this network of far-reaching subterranean thoroughfares if one of the greater floods recorded in history was to recur. No one could have believed that because a sewer burst on the southern side of the river, near the Chamber of Deputies, the escaped sewage would

responsible

dwellings.

if in that house there are tenants occupying furnished rooms then the matter falls under the jurisdiction of the Prefect of Police. If in the house there is a workshop or a restaurant, if a pastrycook, for example, or a baker works there, then the dwelling comes under the heading of an industrial building, for which there are special provisions according as the industries are wholesome or unwholesome. But supposing none of these conditions exist, and therefore the house is solely under the jurisdiction of the Prefect of the Seine, it suffices that one of the inhabitants should refuse to be vaccinated or should suffer from an infectious or contagious disease to bring the Prefect of Police on to the scene. The Prefect of the Seine performs many of the functions that would be the attributes of a mayor in a large English town, and he attends to the more purely local concerns of Paris or the small Department of the Seine, in which Paris is situated. The Prefect of Police, on the contrary, sees to the enforcement in Paris of the laws and regulations that apply not merely to Paris but to the entire country. As each prefecture is divided into numerous sub-departments, with their chiefs and sub-chiefs, many complications arise and much time may be lost in dealing with any situation. Thus, when a street is inundated, at the Prefecture of the Seine the Public Works Office and the Technical Service of Public Roads have to decide if the street is safe, and when the ordinary traffic may be resumed. The Sewers and Water-supply Departments see to the drains and mains in the streets, but it is the Direction of Architectural Works which deals by architectural inspectors with all that occurs within the houses, and is responsible for domestic hygiene. The Sewers Department sees to the soil-pipe within the house, the architect to the connexion outside between the house and the sewer; and as in many cases both are damaged by the floods the risk of confusion is great. Though it is the Prefect of Police who disinfects in case of transmissible disease, it is the Prefect of the Seine who disinfects if this is only desired from motives of cleanliness. Thus a child has a sore-throat. It may be merely a cold due to the dampness of the inundated house, but it may be the commencement of diphtheria. Therefore application must be made at the laboratory of Montsouris under the Prefecture of the Seine for a bacteriological diagnosis. If the result is negative, then the house remains under the Prefecture of the Seine, which has to disinfect, to provide any medical service or ambulance that may be thought necessary, because, though there may be illness, it is not an epidemic disease. But if the laboratory reports that it is a case of diphtheria then it is the Prefecture of Police which has to disinfect and provide medical services and ambulances. Thus two totally different and rival administrations are doing almost identically the same work side by side in the same streets, if not in the same houses. Obviously this must occasion unnecessary delay and work. In the course of a week no less than 14,000 houses in Paris have been affected by the floods. In many cases it is only the cellars that have been invaded by the waters. In other localities the ground floors as well as the cellars have been completely under water. Never has there been so sudden, so widespread a catastrophe. But the worst feature of all

535

BRISTOL AND THE WESTERN COUNTIES.

scarcely been noticed. The dépotoire at Billancourt is flooded and inaccessible. Here it is that the contents of the

has

and the

of the floods having penetrated many these need to be emptied at once. Thus from Sunday to Monday this week no less than 215 fresh applications were received from householders urgently demanding that their cesspools should be emptied. In that interval 295 cesspools were partially this, then, is a gain of 80 on the demand. But there remain 595 cesspools that have been neglected, and it will require another week to make up for these arrears. The state of affairs in the suburbs just outside Paris is far worse. Of the 14,000 houses which have been affected by the floods, presumably rather less than half have cesspools. Even when these were watertight the flood waters entered from above through the small hole made to lift the stone that constitutes the lid or entrance to the cesspool. These cesspools therefore are overflowing, and the great difficulty at present is to prevent the sewage contamination of the basement and cellars of the houses. waters

cesspools

cesspools, the moveable tubs, and the metallic pails which retained the solids while allowing the liquid contents to escape to the sewer are taken and emptied, treated chemically, a.nd converted into manure. Thus the disposal of the night soil of thousands of houses is suddenly rendered impossible. Many cesspools are full to overflowing, must be emptied immediately, and yet what is to be done with their contents now that the main sewage works are inaccessible ? As a matter of fact, some of the great tanks on wheels that are loaded with the crude, concentrated sewage extracted from the cesspools had to be emptied straight into the river. Everybody agrees that this is a most abominable thing to do, no one would be personally responsible for such an act ; every person concerned loudly denounced the bare suggestion of such a proceeding, yet they all had to tacitly admit that there was no other way out of the difficulty. With the tubs or pails, especially now that the waters have partially subsided, the matter was easy to manage. Sewage was conveyed to a neighbouring sewer mouth BRISTOL AND THE WESTERN COUNTIES. and there emptied. But soon the people who lived close (FROM OUR OWN CORRESPONDENTS.) by clamoured against the horrible odour arising from this operation, though it had been proposed that a sewer mouth Bristol Eye Hospital. separated by the Tuileries Gardens from inhabited houses should be selected for this purpose. As for the remainder, ON Feb. 3rd the Lord Mayor presided at the annual probably some of it will be emptied in the Seine, meeting of the Eye Hospital, held at the institution. but lower down the river. It is this somewhat extensive During 1909 the in-patients numbered 441, and the outmixing of sewage with the waters of the floods that con- patients 8628. The annual report, presented by Mr. Edmund stitutes one of the principal dangers of the situation. King, showed that a balance of Z1100 was due to the treasurer. Perhaps, after all, what is thrown into the swollen river and The Lord Mayor called attention to the fact that a large in mid-current will not do any harm. It will be carried along number of outlying towns and villages sent patients to the with such rapidity and diluted with such enormous volumes of hospital, and said that it would be well to ask for more conwater that the process of natural purification should be both tributions to the Hospital Sunday Fund from such places. rapid and effective. But the water that enters the cellar Mr. F. Richardson Cross, in moving a vote of thanks to the The walls prevent its racing Lord Mayor, remarked that ever since the hospital was of a house remains there. forward to the sea and exclude the purifying wind and founded the mayor or lord mayor had been a member of the light. At best this water can only escape by slowly per- committee, and spoke of the large number of former colating into the soil beneath, and then it leaves a residents who were now acting as hospital ophthalmic deposit of slime in the walls and floor-slime which may be surgeons in London and the large provincial towns. In June mixed with fsecal matter due to broken soil-pipes or over- the hospital centenary is to be celebrated by a fete at the flowing cesspools. It has been suggested that such water Zoological Gardens. when in cellars should be mixed with a disinfectant, so that The .Lord Mayor’s Hospital Sunday Fund. as it sinks into the soil or penetrates the porous walls it On Jan. 30th collections were made at the places of would take the purifying chemical with it. But who is to see to all this? Imagine 14,000 houses simultaneously in need of worship in Bristol and neighbourhood on behalf of the The accounts received up to last week aid or at least of surveillance, for it would be most imprudent Hospital Fund. to trust to private individuals to do all the work without reached a total of .6582, about .E28 more than at the corresome experts to watch that it is properly done. One of sponding date last year. The service at the cathedral on the first questions I asked was how the disinfecting staff had Sunday morning was attended by the Lord Mayor and Lady been increased, but I was met with the disconcerting reply Mayoress, the Sheriff and Mrs. Riseley, four ex-lord mayors, that it had not been increased. How could it be increased ? and other members of the city council. be could not employed, not merely because they Strangers The Q1teen Victoria Jubilee Convalescent Home, Durdham were lacking in the technical knowledge of the work that had Downs. to be done, but more particularly because they could not be The annual meeting of the subscribers to this institution The first comer cannot be introduced under the was held on Feb. 3rd. The medical trusted. report stated that during responsibility of the public authorities into private houses, 1909 1847 patients had been admitted (1016 males and 831 where he might steal many things, unless he was known to females). Of these 1847 patients 611 were sent from the be trustworthy. Royal Infirmary, while the General Hospital sent 652 ; 334 were Paris, Feb. 15th. free patients, 148 paying patients, and 68 came from the The position is improving because it has been decided Bristol Dispensary, 17 from the Clifton Dispensary, and 17 that for the moment no attempt shall be made to empty the from the Eye Hospital. The average daily number was 79, cesspools thoroughly, but that only two to three cubic metres and the average stay 15 days. The financial statement shall be withdrawn. Then permission is given to empty a showed the total income for the year was .E3174, and the certain portion of the contents of the cesspools into the expenditure amounted to .62839. sewers within Paris instead of taking them all to the sewage The Bristol Naturalists’ Society. works outside the city. The only sewage works accessible are At the annual meeting of the Bristol Naturalists’ Society at Aubervilliers, as these can be reached by, the tank barges of the St. Martin canal. On the other hand, the sewage works which was recently held Mr. G. Munro Smith, L.R.C.P. Lond., M.R.C.S. Eng., was elected president for the ensuing on the island of Billancourt are inaccessible because the barges cannot pass under the bridges of the swollen river. year. The -Royal United Hospital, Bath. The position is as follows. There are 80,000 houses in Paris and of these 45,000 drain direct into the sewers. For the The annual meeting of the subscribers of the Royal United remaining 35,000 houses there are 29,200 cesspools, 11,800 Hospital, Bath, was held on Jan. 26th under the presidency metallic tanettes or pails that only retain the solids, and of the mayor. The medical report stated that during 1909 8300 tubs or pails that retain everything. The tubs and the in-patients numbered 1385, against 1298 in 1908. 14,155 tinettes are removed, on an average, once a week. This out-patients were treated, compared with 13,765 in the is done in the daytime by carts and causes little or previous year. 279 patients were visited at their homes, an no nuisance. The cesspools are emptied into huge tanks increase of 36 over the preceding 12 months. The financial by pneumatic suction, produced by a portable steam statement showed that the income amounted to £6248 and that engine. In normal times about 150 cesspools are emptied a deficit of .E634 remained at the close of the year. T.The D. Mr. every night. But the floods have disorganised this service, committee in the report state that " in October last

emptied ;

.