UPLAND VILLAGE WATER-SUPPLIES.

899

is, moreover, little analogy between the operation of extraction and that of discission with subsequent evacuation of the lens matter, which is the recognised proceeding for high myopia. It will seem to most who have seriously considered the subject that the chief question to be considered is that which has been excluded by Dr. Scott-namely, Does the operation render the eye more liable to detachment of the retina 2 The treatment has been extensively practised both on the continent and in this country and the results hitherto have been very satisfactory. It not merely enables many patients to dispense with glasses-in itself a great boon to individuals in some walks of life-but it gives them good vision without glasses in place of bad vision with them. It is, of course, possible that in after years eyes operated on in this manner may go wrong ; there does not, however, seem to be any reasonable ground for such an apprehension. Such an objection might be urged with equal force against any new proceeding, but we shall best consult the interests of our patients, not by refusing to adopt new methods on account of objections which are purely hypothetical, but by adopting them cautiously and selecting at first only the most promising cases. Although I am myself much impressed with the value of this treatment in suitable cases I think it prudent at present to confine it to one eye. I am, Sirs, yours faithfully, W. ADAMS FROST. Cavendish-square, W., Sept. 26th, 1898. EAST LONDON WATER. To the Editors

SIRS,-The following is

a

of

THE

report

on a

LANCET. series of

samples taken

at 6, Holly-road, Leytonstone. Five samples were taken: the first on Sept. 9th at 7.30 A.M. ; the second on Sept llth at 12 noon ; the third on Sept. 12th at 2 P.M.; the fourth on Sept. 14th at 8.30 A.M. ; and the fifth on Sept. 19th at 8.15 A.M. The samples were taken with the following precautions : six bucketfuls of water were drawn from the tap on the service pipe and a sample was then taken in a vessel sterilised at 160° C. for an hour. A given quantity was then measured off in a sterilised pipette and added to a tube of liquefied gelatin and plated ; the plates were incubated at from20°to22°C. The colonies were enumerated upon the second day. The gelatin used was 10 per cent. gelatin in nutrient broth (0’5 kilo. of meat per litre) and with an alkalinity of 3 c.c. normal NaOH per litre. The amount of water taken varied from 0’5 to 0’05 c.c. ,S’ample 1, taken on Sept. 9th at 7.30 A.s. 0’5 c.c., 0’2 c.c., and 0’1 c.c. were added to liquefied gelatin and plated; 0’5 c.c. of the sample was also treated by the method of Pakes for the detection of the coli group. On Sept. 10th 0’5 c.c. and 0’2 c.c. were entirely liquefied, and in 0’1 c.c. the colonies were so close as to be almost uncountable ; from enumerations of portions of the plate more than 15,000 were estimated to be present per c.c. The portion of the sample treated by Pakes’s method and subsequently plated gave flat, , thin, greyish-white colonies with irregular edges. The organism thus isolated is slightly motile, does not stain by ’i Gram’s method, gives a large quantity of gas, does not liquefy gelatin, and produces acid. It is therefore referable to the coli group. Sample 2, taken on Sept. llth at 12 noon. 0’1 c.c., 0’1 c.c., and 0’05 c.c. were added to liquefied gelatin and plated. On Sept. 13th 0’1 c.c. and 0’1 c.c. were liquefied. 0’05 c.c. = 100 colonies-i.e., an estimation of 2000 per c.c. Sample 3, taken on Sept. 12th at 2 P.M. 0’05 c.c., 0’01 c.c., and 0’1 c.c. were added to liquefied gelatin and plated. On Sept. 14th the colonies were enumerated as follows : 0-01 c.c., 4; 0-05 c.c., 20 ; and 0-1 c.c., 42; total 66 412 per c.c. Sample 4, taken on Sept. 14th at 8.30 A.M’ 0’1 c.c., 0’1 c.c., and 0’1 c.c. were added to liquefied gelatin and plated. On Sept. 16th the colonies were enumerated as follows : 0-1 c.c., 0-1 c.c., 23 ; and 0-1 c.c., 19 ; total 62 = 200 per c.c. Sample 5, taken on Sept. 19th, at 8.15 A.M. 0’2 c.c., 0’1 c.c., and 0’1 c.c. were added to liquefied gelatin and plated. On Sept. 21st the colonies were enumerated as follows : 0-2 c.c., 80 ; 0-1 c.c., 40 ; and 0-1 c.c., 50 ; total 170 475 per c.c. I therefore claim from the foregoing that (1) the number of organisms present per c.c. is a constantly variable quantity and may vary from 15,000 to 200 in a few days, a fact pointed out by other observers ; (2) that on one occasion at leaste.g., Sept. 9th-the numbers were abnormally high; and =

20 ;

=

(3) that on one occasion-Sept. 9th-organisms of the coli group were present in 0’5c.c. of water. I am, Sirs, yours truly, KENNETH W. GOADBY. Bacteriological Laboratory, Guy’s Hospital, Sept. 28th. " ITALY AND POLITICAL ASSASSINATION." To the Editors of THE LANCET. SiRS,—In your excellent leading article on the above= subject there is one statement which in fair criticism, and I am sure you do not object to such, I must protest

with all my heart and soul and strength and, mind, as it is contrary to fact, insulting (no doubt. unintentional) to every loyal Roman Catholic, and a..

against

libel upon his Church. These are the words I object, to : " Given the much-abused resource of the confessional,. which whitewashes crime and rehabilitates the criminal on. easy terms." This is one of the I I conditions " from which, you drew the inference that Italy is Senior Wrangler in, and is the nursery of, political assassination. To speak ofthe Sacrament of Penance whitewashing crime, &c., couldonly be a delusion on the part of those who had no know-ledge of it. I take it for granted, Sirs, that in the opinion of every unprejudiced English judge or gentleman your Catholic readers and subscribers can speak the truth and are as worthy of belief in matters of fact as are any of their Protestant. confreres, and I am sure they would repudiate your postulate as too absurd for Continental consumption and if’ uttered by an apostate of their own Church as blasphemousRoman Catholics are in a minority in this country, Sirs, but. minorities have rights, and when such a widely-read and excellent journal as THE LANCET traduces and insults. their holy religion, whilst in the next breath it blesses. and curses everything that they bless and curse, it is time for them to rub their eyes and protest against this want of proper accommodation and insular view of’ Peter and his keys. Sirs, if I have in any measurelifted the veil from your congenital myopia as regards theSacrament of Penance, against which the gates of’ anarchy have never prevailed and never will prevail, God bethanked. The first step to anarchy, and the final loss of the. Image of God and the gain of the stamp of hell, is due to" the abandonment of the Sacrament of Penance by the" anarchist. He has not even the remorse of Judas. Is he mad? Probably he is. Italy is reaping the whirlwind of’ her persecution of the Church and the Pope. Her anarchists. The right as well as those of Spain find refuge in England. of asylum, except it be a lunatic one, to such outlaws is not, fair to other nations. We may have to do penance for it yet.. I am, Sirs, yours faithfully, R. G. MCCALMAN, M.D., C.M. Aberd. Coldharbour-lane, S.E., Sept. 22nd, 1898. *** We print the above letter, but our correspondent. should understand that THE LANCET is a purely professional journal which does not interfere in questions of faith. or general politics. The reflection was intended to apply to, unworthy members of the Roman Catholic Church who abuse the rites of that communion.-ED. L. *

J

ROYAL MASONIC INSTITUTION FOR GIRLS. To the Editors

of

THE LANCET.

SIRS,-As candidates for the election of Oct. 13th notice the names of two daughters of deceased surgeons. and of one daughter of a deceased hospital steward. Many medical brethren would doubtless wish to support them. If’ any Masons care to send me their balloting papers dulysigned I shall be pleased to divide the votes equally between the three candidates in question and so avoid waste. I am, Sirs, yours faithfully, F. TAYLOR SIMSON, Past Master. Craven House, Northumberland-avenue, W.C., Sept. 26th, 1898. UPLAND VILLAGE WATER-SUPPLIES. To the Editors of THE LANCET. SIRS,—Will your readers who reside in our large towns. The parish of Southstoke-cumcredit the following2 Woodcote, with a population of about 700, is situated partly

900 the banks of the Thames and partly on the Chiltern Hills in Oxfordshire. The Woodcote division, with a population of between 200 and 300 souls, lies about 400 ft. above and 3 miles away from the river. The cottagers depend for water upon the drippings from their thatched or tiled roofs and upon roadside ponds filled in winter by the washings from the fields and from the highway. At the present time both ponds and tanks are absolutely dry and water has to be fetched from the river or from lowland wells, involving daily journeys of from six to eight miles. A deep well might be bored, from which an ample supply could be secured, but this has been opposed partly on the ground of expense and partly on the plea that the existing sources havebeen "satisfactory"" for many years and that no excessiveamount of disease has on

prevailed. The inhabitants can see no objection to the use of roadside pond water for drinking purposes, but now that the ponds are absolutely dry they are inclined to consider the matter. But they are by no means unanimous as to discarding their beloved ponds and substituting a deep well instead. In my opinion surface drainage from cultivated fields and high roads must always be a dangerous source from which to obtain drinking-water, but it would be of interest to hear the opinions of men who have given special attention to the question of water-supplies. It is stated that the medical officers of health in various districts similar in situation and water-supply to our own do not consider it imperative to condemn the roadside pond. Should you be able to insert this communication possibly some useful replies may be I am, Sirs, yours faithfully, forthcoming. CHARLES REINHARDT, M.D. Brux., L.S.A. Lond. Southstoke, Oxon., Sept. 27th, 1898.

NOTES FROM INDIA. (FROM OUR SPECIAL CORRESPONDENT.) of Restrictive Plague Measures.Comparative Mortality of the Diseases causing most Deaths.-Future Plague Policy.-Antitoxin Serum.-The Sanitary Commissioner’s Report.

Further Abandonment

THE station master at Poona has received orders, to date from Sept. 7th, not to issue a ticket to any person without the production of a pass from the plague authority. This edict is to apply without distinction to all, Europeans and natives alike. Considering that there is no indigenous plague in Poona such an indiscriminate rule must only raise opposition to plague measures and, like dozens of other hard and fast regulations, will have to be modified sooner or later. I made the above note two days ago and now it is announced that the Bombay Government have decided to abandon the system of passes as well as that of detention camps. The detention camps were costly and unsatisfactory and the system of passes was almost unworkable. This action may be criticised on strictly sanitary grounds, but under all the circumstances it has become not only justifiable but imperative. The prospect of plague being among us for a number of years compels the abandonment of quarantine except for a limited period. Theoretical sanitarians imagined that the system would prove completely efficacious, but practically it has not been so and we are now confronted not only with a rising plague mortality, but with a reappearance and spread of the disease in various districts of the Mofussil. At certain places a rigid medical inspection of travellers will be conducted. This will secure the obviously sick and the suspiciously sick and will doubtless deter all except the healthy from travelling. It is probable that the necessity for economy of expenses has determined this new policy. It was impossible that the previous rate of expenditure could last long. Every place was being ruined and the excessive inconvenience to which traders were subjected was more than desirable except for a temporary period. Now that plague has come among us-and apparently to stay-it is interesting to note some of the figures in the Sanitary Commissioner’s Report. What with plague, cholera, and famine the deaths in the Bombay Presidency for 1897 rose to 749,916, or 153,444 more than in 1896, giving a rate of 39-84 per mille, the decennial mean being 29-56. The birth-rate was low-33-46, there being 62,154 fewer births I than in the previous year. Cholera caused 57,109 deaths and plague 46,944. While deaths from plague in Bombay city are shown at only 10,237,

the

mortality

oi

Lne

year

exceeueu tiie

quiuqueuniai average

Part of this excess was doubtless due to plague. It is to be observed that even then plague would not The be shown to be more destructive than cholera. deaths from dysentery and diarrhoea show an increase of no less than 49,920 over those of the previous year. But in India we deal with large figures. From its first appearance to the present time a period of two years-plague has claimed over 100,000 victims, but cholera in 1896 alone caused 471,779 deaths, small-pox carried off 141,443 people, and "feversshowed the enormous mortality of 4,578’,944. Dysentery and diarrhoea are entered for 240,189 deaths, and while a separate return is not made for phthisis its prevalence and fatality are known to be extreme. The fear of plague may be over-estimated. Being strange to us and being attended with such a high mortality it created panic. We have come to regard cholera and consumption, fevers and dysentery, with such inevitableness that we fail to recognise that they are much more serious than plague. Then, again, there was the fear among sanitarians that plague would spread all over India. After two years it is still almost entirely confined to the Bombay Presidency. In the olden days, when nothing in the way of sanitation was in vogue, plague pursued its course unchecked ; and from a study of outbreaks we find that it moved slowly-it spread slowly and while it frequently repeated itself in several places it did not extend over very large areas. The western part of India has always been chiefly attacked. It is reported that Dr. Simond, working with serum prepared by Dr. Roux at the Pasteur Institute, Paris, has obtained 47 per cent. of cures. It is stated, however, that no results have been obtained in the so-called pneumonic cases or in those cases where the generalisation of the microbe either in the lymphatic system or in the blood took place before the treatment. Under these circumstances I do not consider the result satisfactory because in hospitals 50 per cent. die within forty-eight hours, and of those who live over three days 50 per cent. recover. I am unable to report any further progress in the treatment of plague from any other quarter. Prophylactic inoculation is practically at a standstill both in Bombay and Calcutta.

by 22,666.

Sept. 9th.

LIVERPOOL. (FROM

OUR OWN

CORRESPONDENT.)

Thompson- Yates Laboratories of Physiology and Pathology in University College, Liverpool. THE development of the Liverpool Medical School has steadily progressed since its establishment in 1834. On the foundation of University College, Liverpool, in 1881, the Royal Infirmary School of Medicine (as the medical school was then termed) was incorporated with that body, becoming its medical faculty. In 1884 University College became an integral part of the Victoria University as one of its affiliated colleges, and since that time the history of the medical faculty The New

has been one of continued success. The endowments of the chairs of anatomy, physiology, and pathology, were quickly followed by the gifts of the Tate Library, the Gossage chemical laboratories and Ashton Hall, the gift of the late Mr. George Holt, which that gentleman fully equipped for the use of the pathological department pending its removal to larger premises, and which in future will be known as the School of Hygiene, and, lastly, came the new laboratories of physiology and pathology, the noble gift of the Rev. S. A. Thompson-Yates, which are to be opened by Lord Lister on Oct. 8th. All these improvements show the great strides made in Liverpool in recent years in the direction of the advancement of medicine and its collateral sciences. The Thompson-Yates laboratories are located in a handsome building within the precincts of the grounds of University College. There is a spacious entrance-hall with tiled pillars extending all the way up the main staircase, a basement, ground floor, first and second floors and three mezzanines adjoining the main staircase. The ground floor is L-shaped, with the object ofadmitting a greater amount of window space than could be obtained by a rectangular form of building. This floor will be devoted to the department of pathology, and it contains the morbid histology classroom, 56 ft. in length by 26 ft. in breadth, to accommodate sixty students. ’This room opens at one end into. the