THE TYPHOID EPIDEMIC AT PARIS.

763 well as means of health, and the outflow from them could gested above this separation could most readily be carried out. c. In order to prevent the arrest of the flow of sewage in be usefully applied for flushing purposes. 14. The great ashpit, to the working of which I paid con- the intercepting sewer during the rising of the tide, I should siderable attention, is not, I think, conducive to the health utilise still further the furnace at Roedean. I should make and welfare of Brighton. It ought, in my opinion, to be that furnace work a steam pumping engine, the pump of done away with altogether, and replaced by an arrangement which should be connected by a pipe from the Brighton side by which the refuse of the town would be regularly removed of the sewer beyond the flap which is used for shutting off each day altogether from it. If it were impossible to con- the back sewer air from Portobello. I should make the tract with any contractor to carry out this work, then I engine, so soon as ever the tide began to rise, empty the should suggest that after daily sorting of refuse, in order to sewer from the Brighton side, and pump the sewage, during retain what was useful, the residue should each morning be the whole rising of the tide and until the fall, into the sea, put on a steam barge, carried out a few miles to sea, and by a channel provided with a series of valves, which being buried in the sea. closed, one by one, as the tide rises, would still at the I would further strongly insist on an earlier and more highest tide leave an escape above the water surface. In this regular removal of the refuse of the town. I saw several way the intercepting sewer between Brighton and Roedean times dust-carts loaded with offensive refuse parading the need never be locked at all, while its ventilation would be streets of the town when they were filled with passengers, most effectively continued when the engine was in play. d. In addition to these works the authorities should, I and emptying dust from houses at the time when the butcher, baker, and other vendors of food were distributing think, more earnestly insist than they have yet done on the their produce. This is most unwholesome and utterly nu- importance to every householder, that he should separate his from the sewer by an open grating; that he should necessary. The general complaint of bad smells in the most distinctly connect his house with the sewer by a good town will never be removed until this reform is carried out. of his house should be freely open Bearing on this same subject the authorities might well trap ; that the soil enforce on all householders that everyone should have a above the house ; and that the present effete pan-closet movable dust-bin, so placed that the dustman can take it should be replaced by the valve or syphon system. It would, I think, also be worth while to indicate to the up at once, empty its contents into the cart, and replace it public the importance of catching, storing, and filtering the cleanly ready for the day’s use. 15. The next suggestion I have to make is, in some rain water which falls on the houses, and is now permitted respects, the most important of any. In many of the to flow into the sewers. By payment of a very small rate private schools of Brighton great benefit has been found to all this soft water might be collected, purified, and applied attach to the possession of a separate house, into which each to laundry and other purposes with the greatest advantage scholar who is seen to be ailing is conveyed, and retained and economy. In concluding this Report, Mr. Mayor and Gentlemen, I until the nature of the illness is declared. By this means the spread of infection is prevented in a very efficient way. have to express my deep obligations to your learned and I should urge the public adoption of this plan, with special excellent Medical Officer of Health, Dr. Taaffe ; to Mr. reference to those great possible centres of infection, the Lockwood; to the Resident Surgeons of the Medical Insti. board and, voluntary schools. A few small houses for the tutions, Messrs. Scott, Richardson, and Goode ; to the temporary reception and isolation of the poor children of Chairman and Secretary of the School Board ; and to Mr. these schools when they are falling into infectious disease, Hawes, the Chief Inspector of Nuisances, for the ready and would be the wisest means for stopping those calamities efficient aid they have rendered me in my inquiries. You requested me to report " completely and indewhich have lately caused so much public clamour, and which are so detrimental to the town, and so severe upon the sufferpendently" on your beautiful town. I have endeavoured to ing By plan 1 in the 1000 less of mortality the best of my ability to respond to that request, and Have the honour to be, Mr. Mayor and Gentlemen, would each yeareasily be saved to Brighton. Your faithful Servant, 16. I come finally to what some would think the allBENJAMIN WARD RICHARDSON, M.D., F.R.S. important question, the drainage and removal of sewage from Brighton. It will be gathered from what I have stated two or three times already, that I do not consider the THE TYPHOID EPIDEMIC AT PARIS. present sewerage system in Brighton responsible for the outbreaks of zymotic disease which, during the present and latter part of la;t year, caused the exceptional death-rates. THE rapid extension of the epidemic of typhoid fever in I should, nevertheless, in order to prevent in future the Paris is exciting considerable consternation, and well may suggestion of such cause, recommend certain modifications do so. The mortality has increased fivefold in the course in the present system, giving to them at the same time a of three weeks: from 57 in one week to 134 in the next, direction towards the separate system, and towards the and 250 in the third. The number of admissions into hosready utilisation of the sewage whenever a practical and pital has exhibited a corresponding increase, being 213 in profitable plan for so important a purpose has been discovered. the first, 536 in the second, and 1001 in the third, while on Oct. 19th the various hospitals contained no less than 2136 I place my suggestions under four heads :cases. Since then a slight fall in the number of fresh cases a. I should increase enormously the present surface ventilation. This, in my opinion, is much more efficient ventilation has occurred, which, it is hoped, indicates the comthan shaft ventilation, and I should extend it as follows :- ’ mencing decline in the epidemic. The epidemic is most I should instruct Mr. Lockwood, in at least twenty parts severe in the northern quarters of Paris, the mortality at of the town, and in such portions as he should see best, to La Villette being five times as high as at Montrouge. Of open a communication with the sewer between one manhole the 250 deaths in the last week, 42 were between the ages and another, each as wide as the manhole itself, and well of five and fifteen, and 167 were between fifteen and walled in on each side. I should cover over the entire twenty-five. It is conjectured that the extension of the length of each opening with grating, movable at certain disease may be connected with the return to Paris of many parts, so that the sewer men may be able to descend to the families, especially students and others, who have, during a open surface of the sewer beneath. At each end of these holiday spent in the country, lost some of their acelimatisalarger openings I should have doors that would close up tion ; but, on the other hand, it must be remembered that the space or chamber, and, when necessary, I should fill all the present season of the year is that in which typhoid most that space with water for flushing. The town might thus frequently assumes an epidemic form. The circumstances be speedily and regularly flushed from a limited number of of the outbreak, however, unquestionably deserve the most points, at which a special water service could be laid on for careful study, since its extent threatens to render it one of flushing freely and effectually by a weight of water which terrible proportions. It is remarkable as occurring in a could be made many numbers of proportions greater than is season of much and persistent rain, in which the chance of now possible. the contamination of drinking-water is usually regarded as b. To prevent all risk of the high town ever receiving small. But the household sanitary arrangements at Paris sewer air from the low town I should adapt the suggestion are notoriously of the most defective description-at any of Mr. Lloyd Roberts, of Denbigh, for disconnecting one rate, if judged by English standards,-and the authorities district from another. I should effect this by the intro- may well direct their attention to this subject. In other duction of large traps between one district and another, just respects the public arrangements seem to be ill-calculated to as we trap a house from a sewer, only on a proportionately cope with so formidable an epidemic, for we learn that but larger scale. By means of the large chambers I have sug- two hospitals possess an apparatus for disinfection.

house

pipe

population.

this