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The Sewerage of Sea Coast Towns
PUBLIC HEALTH.
1912. REVIEWS.
OBSERVATIONS UPON THE NATURAL HISTORY OF
EPID~.~Ic DIARRH(JdA. By O. H. Peters, M.D., D . P . H . Cambridge : The University Press, ~9II, pp. I77. Price, 7s. net. This treatise originally appeared in the Journal of Hygiene, and in it Dr. Peters has embodied the results of a careful enquiry into a number of cases of diarrhcea in the Borough of Mansfield. After reading the book no other conclusion can be come to than that the writer has done well to publish it as a separate monograph. There is always a possibility that contributions to a periodical journal may be overlooked by those to whom they are important, and this work of Dr. Peters is so useful that no one interested in the prevention of infantile mortality can afford to overlook it. In book form the contents are divided into nine sections; the first containing an introduction setting forth the various facts in connection with the Mansfield investigation, and the last a general summary of conclusions, while the remaining sections deal fully with such subjects as social relations, sanitation, epidemiological features, prevention and treatment, etc. In connection with sanitation, the points which were investigated were household dirtiness, paving and drainage of yards, sanitary conveniences and disposal of refuse, and stables and manure pits and the fly nuisance. Into each of these Dr. Peters goes very exhaustively, and generally speaking he seems to regard spread of infection as largely a matter of contact, and the badly kept house as having an important influence on the incidence of diarrhcea. Since, though there may be water-closet accommodation in or in connection with the house, young children do not always use it, and the floors of living rooms are often soiled with infected motions, the type of sanitary convenience provided he found to make little or no difference. Equally, he found little to support the view that paving of yards was of importance, though he did find reason to object to the provision of yards common to two or more houses. His observations with regard to the fly nuisance are particularly interesting, and his observations that flies do not bring infection with them from the manure heaps where they were bred, but only act as carriers when they visit an infected household where they can obtain infected matter to carry, are noteworthy. In connection with food it is worth mentioning that he found that the percentage incidence of the disease upon the first year of life when breast milk was given was 32, and 9° per cent, in the case of cows' milk,
193
H e does not consider that either milk or fruit, which are so often regarded as potent factors in the causation of the disease, do much more than act as carriers of infection. ~In the section on epidemiological features, tile various theories as to causation are discugsed in reIation to the observations made, the data obtained at Mansfield, the effect of temperature and the.part played by flies being most fully gone into. In considering prevention and treatment, not unnaturally the former receives the greatest amount of attention. Throughout the investigations the question of notification of diarrhoea sickness Was kept in view, and though he found that only some 12 per cent. of the cases observed sought medical advice, Dr. Peters still thinks that if notification of cases was required a considerable amount of good would result. Education of the public he regards as most necessary, and his summary of the points regarding which instruction should be given should prove useful. Taken altogether the b o o k is a most valuable one. W o r k of this kind is not too readily taken up and Dr. Peters deserves a great amount of credit for what he hasdone. THE
SE'~VERAGE OP SEA COAST TOWNS. By H e n r y C. Adams, Assoc. M. Inst. C.E., M.I. Mech. IL., etc., L o n d o n : Crosby, Lockwood & Son, I 9 I I , pp. I3~. Price, 5 s. net.
Mr. Adams' object in preparing this work was to save others the trouble he himself had to go through, in order to collect .information on various points, when he was first called upon to prepare a sewerage scheme for a seaport. It may safely be said that he has not spared himself in doing so, and has indeed provided a manual likely to prove of the greatest service to any engineer who has to perform a similar piece of work. Every aspect of the subject is treated of in the fifteen chapters of which the book is made up, and the engineer is enlightened as to the formation of tides and currents, as to the taking of various observations, as to diving, as to trigonometrical and hydrographical surveying and so on. Though the majority of the chapters are chiefly of interest to the engineer, there are some which, to some extent, concern also the medical officer of health, such as, for example, that on the selection of a site for a sewage outfall, and that on the discharge of sea outfall sewers. These seem to be of importance in connection with the prevention of nuisance on the foreshore
194
~EBRUAR¥,
P U B L I C HE.dZTI-].
The author evidently knows his subject and the book is pleasantly written. It is clearly printed and there are several useful diagrams. SCHOOL LIFE. Edited by T. N. Kelynack, M.D., M.R.C.P. London: Charles H. Kelly, I 9 i i , pp. 16o. Price, IS. net. This is the third volume of the series of National Health Manuals of which Dr. Kelynack is editor, and contains some twelve articles on a variety of topics relating to the health of children of school age, contributed by a number of writers, each an authority o n the branch with which he deals. T h e object of this volume, like the others in the series, is to provide information which shall be useful to all interested in health work, whether professionally or as voluntary health workers, members of school care committees, etc. Some of the subjects considered are : " Characteristics of School Children," by Dr. A. S. Arkle ; " Medical Inspection of the School Child," by Dr. Bridge ; " The School Child W o r k e r , " by Dr. Taylor ; and " Physical Education," by Dr. Lambert. Dr. Myra Mackenzie and Dr. Symes deal with the personal hygiene of the school-girl and schoolboy respectively, and both touch upon the sex question with great skill and delicacy. Dr. Wallis' chapter on " Dental Condition in School Children" is an interesting contribution on a subject of great importance, and " The School Child and Citizenship," by Dr. Edwards, makes a most readable essay. An important feature of the book is the appendix, which contains references to publications which m a y be consulted if the reader desires to go more fully into any of the subjects dealt with in the pages of the manual. ARCHITECTURAL HYGIENE. By Banister F. " Fletcher, F.R.I.B.A., and H. Phillips Fletcher, F.R.I.B.A. Fourth Edition, revised. London: W h i t t a k e r & Co., 1911. Price, 5 s. net. In preparing the fourth edition of this excellent text-book, the authors have subjected it to a thorough revision and have brought it up to date. The whole subject of the application of sanitary science to the dwelling-house is treated comprehensively from the foundation of the house to its fitting and furnishing. Throughout, the authors have the requirements of the student in mind, and the book is clearly written and provided with numerous illustrations. There is a very helpful chapter on sanitary surveys and reports, in which m o d e l reports are given on the sanitary condition of various types of houses. T h e chapters on drainage are well done, but the authors are surely over-stating the case when they say most architects preter pipes of glazed stone-ware to iron pipes.
Our experience is that there is a g e , e r a l preference for iron pipes wheice the additional initial expense can be well borne. The book contains a good deal of information that is not to be found in the ordinary text-book on sanitation, and it will be helpful to the student and to the sanitary officer. HEALTH POSTERS.
W e have received from the National League for Physical Education and Improvement the firstof a series of health posters. These are of a size and style adapted for hanging on the walls of schools for mothers, infant consultation centres, day nurseries, the out-patients' halls of hospitals,mothers' meetings--in fact, wherever mothers congregate. T h e y are also very suitable for use by lecturers on hygiene, etc., the corners being re-inforced with linen to allow of frequent pinning up and taking down. T h e first poster deals with good and bad feeding bottles. T h e price of this wall-chart is 1/6, post free, and it can be had on application to the Secretary of the League, at 4 Tavistock Square, W.C. The next two posters will show the dangers arising from unguarded fire-places and from clothing made of inflammable kinds of flannelette, and the evils of push-carts when used for very young children. W e congratulate the National League on these excellent publications. TUBERCULOSIS CONFERENCE IN GLASGOW.--A
conference of local authorities in Scotland and of associations interested in the treatment of tuberculosis, convened by the Lord Provost of Glasgow onbehalf of the Corporation, to discuss the question of a memorial to the late King Edward, having for its object the alleviation of suffering, was held in Glasgow on J a n u a r y I2th. Delegates were present from seventeen county councils, thirtysix town councils, and from several parish councils, associations, and the Royal Faculty of Physicians and Surgeons, Glasgow, It was intimated that several of the burghs and counties invited had not seen their way to appoint representatives, but that they had expressed themselves in s y m p a t h y with the movement. It was decided to raise a fund to be called the " King Edward Memorial F u n d , " which should be applied, inter alia, to the establishment and maintenance of a " King Edward Memorial Institute of Preventive Medicine," the Institute to be dedicated primarily to research and the dissemination of knowledge relating to tuberculosis and to be available for the whole of Scotland. An executive committee was appointed to carry out the resolutions of the conference and to consider the question of the provision of sanatoria.
1912. REVIEWS.
OBSERVATIONS UPON THE NATURAL HISTORY OF
EPID~.~Ic DIARRH(JdA. By O. H. Peters, M.D., D . P . H . Cambridge : The University Press, ~9II, pp. I77. Price, 7s. net. This treatise originally appeared in the Journal of Hygiene, and in it Dr. Peters has embodied the results of a careful enquiry into a number of cases of diarrhcea in the Borough of Mansfield. After reading the book no other conclusion can be come to than that the writer has done well to publish it as a separate monograph. There is always a possibility that contributions to a periodical journal may be overlooked by those to whom they are important, and this work of Dr. Peters is so useful that no one interested in the prevention of infantile mortality can afford to overlook it. In book form the contents are divided into nine sections; the first containing an introduction setting forth the various facts in connection with the Mansfield investigation, and the last a general summary of conclusions, while the remaining sections deal fully with such subjects as social relations, sanitation, epidemiological features, prevention and treatment, etc. In connection with sanitation, the points which were investigated were household dirtiness, paving and drainage of yards, sanitary conveniences and disposal of refuse, and stables and manure pits and the fly nuisance. Into each of these Dr. Peters goes very exhaustively, and generally speaking he seems to regard spread of infection as largely a matter of contact, and the badly kept house as having an important influence on the incidence of diarrhcea. Since, though there may be water-closet accommodation in or in connection with the house, young children do not always use it, and the floors of living rooms are often soiled with infected motions, the type of sanitary convenience provided he found to make little or no difference. Equally, he found little to support the view that paving of yards was of importance, though he did find reason to object to the provision of yards common to two or more houses. His observations with regard to the fly nuisance are particularly interesting, and his observations that flies do not bring infection with them from the manure heaps where they were bred, but only act as carriers when they visit an infected household where they can obtain infected matter to carry, are noteworthy. In connection with food it is worth mentioning that he found that the percentage incidence of the disease upon the first year of life when breast milk was given was 32, and 9° per cent, in the case of cows' milk,
193
H e does not consider that either milk or fruit, which are so often regarded as potent factors in the causation of the disease, do much more than act as carriers of infection. ~In the section on epidemiological features, tile various theories as to causation are discugsed in reIation to the observations made, the data obtained at Mansfield, the effect of temperature and the.part played by flies being most fully gone into. In considering prevention and treatment, not unnaturally the former receives the greatest amount of attention. Throughout the investigations the question of notification of diarrhoea sickness Was kept in view, and though he found that only some 12 per cent. of the cases observed sought medical advice, Dr. Peters still thinks that if notification of cases was required a considerable amount of good would result. Education of the public he regards as most necessary, and his summary of the points regarding which instruction should be given should prove useful. Taken altogether the b o o k is a most valuable one. W o r k of this kind is not too readily taken up and Dr. Peters deserves a great amount of credit for what he hasdone. THE
SE'~VERAGE OP SEA COAST TOWNS. By H e n r y C. Adams, Assoc. M. Inst. C.E., M.I. Mech. IL., etc., L o n d o n : Crosby, Lockwood & Son, I 9 I I , pp. I3~. Price, 5 s. net.
Mr. Adams' object in preparing this work was to save others the trouble he himself had to go through, in order to collect .information on various points, when he was first called upon to prepare a sewerage scheme for a seaport. It may safely be said that he has not spared himself in doing so, and has indeed provided a manual likely to prove of the greatest service to any engineer who has to perform a similar piece of work. Every aspect of the subject is treated of in the fifteen chapters of which the book is made up, and the engineer is enlightened as to the formation of tides and currents, as to the taking of various observations, as to diving, as to trigonometrical and hydrographical surveying and so on. Though the majority of the chapters are chiefly of interest to the engineer, there are some which, to some extent, concern also the medical officer of health, such as, for example, that on the selection of a site for a sewage outfall, and that on the discharge of sea outfall sewers. These seem to be of importance in connection with the prevention of nuisance on the foreshore
194
~EBRUAR¥,
P U B L I C HE.dZTI-].
The author evidently knows his subject and the book is pleasantly written. It is clearly printed and there are several useful diagrams. SCHOOL LIFE. Edited by T. N. Kelynack, M.D., M.R.C.P. London: Charles H. Kelly, I 9 i i , pp. 16o. Price, IS. net. This is the third volume of the series of National Health Manuals of which Dr. Kelynack is editor, and contains some twelve articles on a variety of topics relating to the health of children of school age, contributed by a number of writers, each an authority o n the branch with which he deals. T h e object of this volume, like the others in the series, is to provide information which shall be useful to all interested in health work, whether professionally or as voluntary health workers, members of school care committees, etc. Some of the subjects considered are : " Characteristics of School Children," by Dr. A. S. Arkle ; " Medical Inspection of the School Child," by Dr. Bridge ; " The School Child W o r k e r , " by Dr. Taylor ; and " Physical Education," by Dr. Lambert. Dr. Myra Mackenzie and Dr. Symes deal with the personal hygiene of the school-girl and schoolboy respectively, and both touch upon the sex question with great skill and delicacy. Dr. Wallis' chapter on " Dental Condition in School Children" is an interesting contribution on a subject of great importance, and " The School Child and Citizenship," by Dr. Edwards, makes a most readable essay. An important feature of the book is the appendix, which contains references to publications which m a y be consulted if the reader desires to go more fully into any of the subjects dealt with in the pages of the manual. ARCHITECTURAL HYGIENE. By Banister F. " Fletcher, F.R.I.B.A., and H. Phillips Fletcher, F.R.I.B.A. Fourth Edition, revised. London: W h i t t a k e r & Co., 1911. Price, 5 s. net. In preparing the fourth edition of this excellent text-book, the authors have subjected it to a thorough revision and have brought it up to date. The whole subject of the application of sanitary science to the dwelling-house is treated comprehensively from the foundation of the house to its fitting and furnishing. Throughout, the authors have the requirements of the student in mind, and the book is clearly written and provided with numerous illustrations. There is a very helpful chapter on sanitary surveys and reports, in which m o d e l reports are given on the sanitary condition of various types of houses. T h e chapters on drainage are well done, but the authors are surely over-stating the case when they say most architects preter pipes of glazed stone-ware to iron pipes.
Our experience is that there is a g e , e r a l preference for iron pipes wheice the additional initial expense can be well borne. The book contains a good deal of information that is not to be found in the ordinary text-book on sanitation, and it will be helpful to the student and to the sanitary officer. HEALTH POSTERS.
W e have received from the National League for Physical Education and Improvement the firstof a series of health posters. These are of a size and style adapted for hanging on the walls of schools for mothers, infant consultation centres, day nurseries, the out-patients' halls of hospitals,mothers' meetings--in fact, wherever mothers congregate. T h e y are also very suitable for use by lecturers on hygiene, etc., the corners being re-inforced with linen to allow of frequent pinning up and taking down. T h e first poster deals with good and bad feeding bottles. T h e price of this wall-chart is 1/6, post free, and it can be had on application to the Secretary of the League, at 4 Tavistock Square, W.C. The next two posters will show the dangers arising from unguarded fire-places and from clothing made of inflammable kinds of flannelette, and the evils of push-carts when used for very young children. W e congratulate the National League on these excellent publications. TUBERCULOSIS CONFERENCE IN GLASGOW.--A
conference of local authorities in Scotland and of associations interested in the treatment of tuberculosis, convened by the Lord Provost of Glasgow onbehalf of the Corporation, to discuss the question of a memorial to the late King Edward, having for its object the alleviation of suffering, was held in Glasgow on J a n u a r y I2th. Delegates were present from seventeen county councils, thirtysix town councils, and from several parish councils, associations, and the Royal Faculty of Physicians and Surgeons, Glasgow, It was intimated that several of the burghs and counties invited had not seen their way to appoint representatives, but that they had expressed themselves in s y m p a t h y with the movement. It was decided to raise a fund to be called the " King Edward Memorial F u n d , " which should be applied, inter alia, to the establishment and maintenance of a " King Edward Memorial Institute of Preventive Medicine," the Institute to be dedicated primarily to research and the dissemination of knowledge relating to tuberculosis and to be available for the whole of Scotland. An executive committee was appointed to carry out the resolutions of the conference and to consider the question of the provision of sanatoria.