posal," which will more especially deal with the most modern methods of chemical precipitation, and descriptions (with illustrations) of the newest and best known forms of sewage precipitation tanks. The system named by our correspondent will be included.-Editor SAN. RECORD.] POSITION OF SANITARY INSPECTORS. SIR,-It is pitiful to read the letters lately addressed to you on the question of the relation of Chief Sanitary Inspectors and Medical Officers of Health. One is tempted to inquire who began this brawling and sprawling for precedence in command. It is, I opine, matter of regret that those who write text-books of Public Health should take upon them to urge each Medical Officer to subordinate the Sanitary Inspector. I have seen this in several text books, and I believe it is a pernicious course. Without a courteous and gentlemanly understanding between a Medical Officer of Health and the Chief Inspector of a Local Authority, no good sanitary work can be done. The sooner Medical Officers cease to thirst after supreme control, and Inspectors to refuse the assistance and support which is reasonable, the better it will be for both, and the cause of sanitation. Vacancies. GRIMEAU. CLERK OF WORKS (GUERNSEY, Dec. 31st).--For the surveyor's department of the States Office, Guernsey. Particulars, hours of duty, &c., from Mr. James Duquemin, States surveyor, States Surveyor's Office, Guernsey, N. Domaille, Esq., supervisor of the harbour and treasurer of the States of Guernsey. CLERK (AMPTHILL, BEDS, Dec. 18th).-For the Guardians. Salary £70 per annum, who will also be clerk to the Rural District Council, salary £35; the Assessment Committee, salary £20; and School Attendance Committee, salary £20. The salaries of the three last-named appointments are liable to variation, and voted annually. Mr. John Wright, clerk, Ampthill. CLERK (LONDON, E.C., Dec. 23rd).-For the St. Luke, Middlesex, Vestry. Salary £50 per annum. Mr. G. W. Preston, clerk, St. Luke's Vestry Hall, City-road, E.C., by 12 noon. INSPECTOR OF NUISANCES (WALTON-ON-NAZE, Dec. 16th).-For the Urban District Council, for the year 1896. Salary £30 per annum. Mr. T. A. Middleton, clerk, Walton-on-Naze. INSPECTOR OF Weights and Measures (BrightON, Dec. 17th). For the Town Council. Salary £150 per annum. Mr. Francis J. Tillstone, town clerk, Town Hall, Brighton. enced person to act as manager and toll-collector for the MANAGER, &C. (ABERDARE, Dec. 16th)-An experi Aberdare markets and slaughter-house. Salary 33 per week, with house, and a commission of £1 per cent. upon the gross annual receipts. Applications, with references, to Mr. H. P. Linton, 4, Canon-street, Aberdare. ROAD FOREMAN (LONDON, W., Dec. 17th).--Required, a working road foreman. Wages from 30s. to 365. per week. Apply, by letter only, to Mr. D. J. Ebbetts, 242, High-street, Acton, in sealed envelopes, endorsed "Road Foreman." Applications by 3 p.m. Must ROAD SURVEYOR (Wigtown, N.B., Dec. 21st).--For the Upper District of the county of Wigtown. provide and keep a horse at own expense. Must reside in Stranraer. Salary £200 per annum. Mr. C. A. M'Lean, clerk to Upper District Committee, Wigtown, N.B. SANITARY INSPECTOR (LONDON, S.E., Dec. 18th).For the Vestry of St. Mary, Newington. Salary to commence at 110 per annum, payable monthly, with an annual increment of £5 to a maximum salary of £150. Forms to be obtained from Mr. L. J. Dunham, clerk, Vestry Hall, Walworth, S. E. Urban District Council. Sanitary Contracts Open. The dates given below are the latest up to which tenders can be received. ASHTON-UPON-MERSEY.-December 14th.-Emptying ashpits. Mr. James Oddie Barrow, clerk, Council Office, Ashton-upon-Mersey. ABERDEEN.--December 16th.-Sewer, &c.-Mr. Wm. Dyack, burgh surveyor, Town House. WHITEFIELD (LANCS)-December 16th.-Sewering. CLERK (LONDON, S.W., Jan. 14th). -For the London County Council. Salary 2000 a year. Applications upon the printed forms. Clerk of the Council, Spring--Mr. T. Thorp, C. E., Knowsley-road, Whitefield. gardens, London, S. W., by 10 a m. ELECTRICIANS, &c. (LONDON, N., Dec. 16th).-For the Vestry of St. Mary, Islington, three electricians. Salary £2 per week. The Electrical Engineer, Electricity Department, 50, Eden-grove, Holloway, N., by 12 Mr. Wm. F. Dewey, Vestry clerk, Vestry Offices, Upper-street, N. noon. ENGINEER (EXMINSTER, Dec. 16th). -For the Devon County Asylumi, Exminster. Wages £2 2s. a week and cottage. Arthur E. Ward, 9, Bedford-circus, Exeter, clerk to the Visiting Committee. HARBOUR ENGINEER (CORK, Dec. 17th).-For the Cork Harbour Commissioners. Salary £500 per annum. The terms and the conditions of the appointment on application to Mr. William Donegan, secretary, 9 and 10, Lapp's-quay, Cork. Applications on printed forms, to be lodged at the Commissioners' Offices, 9 and 10, Lapp'squay, Cork, addressed to the Secretary. INSPECTOR OF NUISANCES (SOUTH SHIELDS, Dec. 18th). For the Town Council. The salary will commence at 35s. per week, and increase annually by Is. per week to a maximum of 40s. per week. Must possess the certificate of the Sanitary Institute. Mr. J. Moore Hayton, town clerk, Court-buildings, South Shields. WELLINGBOROUGH.-December 17th. Scavenging, &c.-Mr. J. T. Parker, clerk, 29, Church-street, Wellingborough. LONDON, S.W.-December 17th.-Sewers, &c. -Mr. G. Bruce Somes, surveyor to the Council, Council Offices, High-street, Mortlake, S.W. SOWERBY BRIDGE (YORKS). December 18th. Sanitary pipes.-Messrs. Utley and Gray, engineers, 10, Waterhouse-street, Halifax. HALIFAX. -December 19th. - Sewer.-Mr. Edward R. S. Escott, C.E., borough engineer, Town Hall, Halifax. DURHAM. December 20th.-Sewers, &c.-Mr. Wm. Lisle, clerk, 38, Saddler-street, Durham. DONCASTER.-December 20th.-Sewers.-Mr. F. E. Nicholson, clerk, Union Office, High-street, Doncaster. AYLESBURY.-December 21st.-Drains.-Mr. F. B. Parrott, clerk, Bourbon-street, Aylesbury. STEVENAGE (HERTS). -December 28th.-Sewers, &c. -Mr. Urban Smith, C.E., 41, Parliament-street, Westminster, S.W. DUBLIN. January 8th.--Drainage works.-Engineer's Offices, City Hall, Dublin. THE Sanitary Record, ... OF LA 497 498 ... 499 TREATMENT OF THE CHEMICAL AND BIOLOGICAL EXAMINATION ... ... REFUSE DISPOSAL AND OFFENSIVE TRADES ... ... ... 500 503 503 504 514 514 BURSTING BOILERS. MANY householders find the pleasure they should derive from a complete hot-water service, especially in the winter, considerably marred by the constant apprehension of explosions, especially when there happens to have been an unusual demand for hot water or some interference with any part of the system. It would conduce greatly to their peace of mind to understand that the sole cause of explosions is the formation of steam in a closed space. In all high-pressure systems, whether of steam or water, safety valves are provided which open and give exit to the steam whenever a pressure is reached below that which the pipes or plates would bear, but which, if long maintained, would ... 501 be scarcely consistent with safety. There is, however, no special danger in a high-pressure service so long as the pipes are clear and the valves in good working order, assuming, of course, that the pipes and plates are sound, though even the giving way of a weak or corroded part would 507 not give rise to a serious explosion, but rather 510 resemble the opening of a safety valve in an in512 convenient position. The greatest amount of 512 self-imposed suffering, mental and bodily, is 513 perhaps that endured by the families who, when the water supply is cut off, or the cisterns are frozen, deprive themselves of the common comfort of the kitchen fire. We would assure them that, if only they take the further precaution of shutting off the supply from the boiler, they have nothing whatever to fear from allowing the water in it to boil away entirely, nor from keeping up a fire under an empty boiler for a few days, not be long enough to cause any appreciable damage to the plates. Of course the boiler must be cold when the water is again run in, for if the metal were anything approaching to red heat, it might crack, an accident which, however, though necessitating the setting of a new boiler, could not be properly described as an explosion, any more than could the upsetting of a kettle on the fire. The one cause of all explosions in lowpressure systems, and, if we except those consequent on the failure of safety valves to act, the chief cause of those in the high-pressure, is the occurrence of a stoppage in some part of the pipes. The gradual accumulation of lime salts deposited on the inner surface of the pipes, and mainly at bends and angles, or the lowest levels, may at length completely obliterate the way; but this condition is not produced suddenly, and may be anticipated when increasing difficulty is found in heating the water in the cistern, and the parts of the pipes referred to as the chief seats of the crust. The other cause of obstruction is the freezing of the water in some distant part of the pipes, which can occur only when the fires have burnt out, and is the chief cause of acci NEXT WEEK being Christmas week, THE “THE SANITARY RECORD" is now published In consequence of some of our Readers not receiving their We propose to set apart for the benefit of our readers All communications should be addressed to the EDITOR, at 5, FETTER LANE, London, E. C., and Cheques and Postal Orders should be made payable to THE SANITARY PUBLISHING COMPANY, Ld. dents in churches and schools, which are often closed for several days. In private houses it ought not to be possible, and need not be feared if water in open vessels in rooms and passages has not frozen, but if the pipes be in part exposed to the risk of freezing, it would be prudent to make up the kitchen fire at night. The cause of the explosion is simple enough, the boiler itself has no outlet, but the vent pipe from the hot-water system affords an escape for the steam and prevents any appreciable rise of pressure so long as either the rising or return pipe is free throughout its course. When, and only when, both are blocked the steam generated in the closed space exerts an increasing pressure, until the boiler bursts with a force proportional to its strength. Stoppage of one pipe, at any rate of the lower, betrays itself by the continued recurrence of loud noises caused by the rise and collapse of bubbles of vapour in the cistern, and is not itself an indication of immediate danger. (All Rights Reserved.) THE NATURAL ARSENICAL WATERS OF LA BOURBOULE. Notes with reference to their Therapeutic Value in the Treatment of Diathetic Maladies and Cachexias in general. BY A. M. BROWN, M.D. VII. DIATHETIC maladies, particularly those we have already referred to, after a long duration inevitably lead to deterioration of the blood and other circulating fluids in consequence of certain organic morbid alterations gradually induced. In the present day it is generally admitted that the formation and maintenance of the blood are functions performed by the co-operation of certain organs. Pathology, better even than physiology, proves the hæmopoetic agency of these organs. We know, for example, that chronic affections of the liver and spleen produce serious consequences as regards the quan tity, quality, and composition of the blood; for whatever be the nature of these affections, they are followed by modifications in number, consistence, form, colour, and chemical constitution of the globules. Now, in the class of maladies we are considering, the origin of this tendency, irrespective of the structure implicated, may be traced to that morbid habit or disposition, be it hereditary, congenital, or acquired. sias, anæmia, chlorosis, &c., incidental to diathetic maladies. It is now generally admitted that anæmia and chlorosis cannot be regarded as the same diseases. Though often seen together or combined in the same subject, it by no means follows that the anæmic are chlorotic or the chlorotic anæmnic. If at source anæmia arises from a defect of blood constituents, chlorosis is a neurosis, and though often allied to the former, is rather the cause than the effect. It is to be feared in practice, the undue disregard paid to these facts has led to much confusion, and a too generalised specific mode of treatment; it is iron, iron in every form and everywhere. Trousseau has most pointedly exposed this error. The influence of ferruginous preparations on chlorotic subjects he maintains to be a matter of serious consideration, and insists that though, when prudently exhibited, they are generally well tolerated, should the object not be quickly gained, they ought not to be continued. In certain hereditary predisposition care must be taken not to push such an agent as iron too far, no matter how seductive the form of preparation, as from its power of functional stimulation. it may awaken gravest complications, which might otherwise have remained dormant. haps we ought to consider the use of iron with reference to these states much as we do mercury in syphilis or quinine in intermittents, valuable for enabling us to restore the normal state of things; and, be it observed, not because they furnish the economy with this or that constituent, metallic or alkaline, but rather because by affecting certain organs, they enable them to accomplish functions by virtue of which they assimilate those elements which food contains, as in the plenitude of health. Per In these obscure and indefinable pathological conditions characteristic of cachexias, whether diathetic or accidental in their nature, "I have obtained," says M. Trousseau, "under the influence of bitters, arsenic, and sea bathing, equally favourable results in those patients so affected, and escaped producing the general excitement, the prelude or cause cf, for instance, hypmotises in tuberculosis, and I am consequently constrained to impute to iron some of the worst effects which I have had to deplore." What stronger proof is necessary of the folly. of the excessive confidence in iron, and its manifold preparations, which medical routine of the day has vulgarised, or what higher testimony could be desired of the utility of arsenic when judiciously exhibited in this extensive field of human suffering? There is none I know of. VIII. Then how are we to explain the action of arsenical waters under such special conditions? Somewhat as we endeavour to explain the pharmaceutic agent, no doubt. Let us look more It is, therefore, the cachexias to which this closely into the pathological conditions, dyscra- agent curatively responds. It is in those Notes. deteriorations of the circulating fluids, whether which are so frequently the consequence of proceeding from nervous causes-as in certain chlorosis, lymphatic chlorosis, particularly in its skin affections or chlorosis or perversions infantile forms, as also those anæmias which accompanying or or consequent on diathetic accompany the chronic form of arthritism, and maladies, singly or combined, that arsenic shows arthritic dyscrasias. For the diabetic cachexias, best its virtues, tonic and restorative. Even by there is much to be said in favour of using those of anti-arsenical prejudices, this will not these waters, on condition that certain combe denied, at least as regards the mineral water plications do not present objection to their form, and with no sacrifice of their medico- employment. In fine, my opinion is that in all chemical ideas. On this point their conviction such cases enumerated there need be no hesitamay be fully gratified, as from their alkaline tion in advising, in a general manner, their use. classification the chloride of sodium and other They may even be extended to convalescents, associated salts, to which some would award the delicate, the debilitated, and those constituthe merit. However, in the opinion of those tionally or organically depraved, who with best entitled to decide, the arsenate, so far difficulty lingeringly undergo their normal defrom giving place to other salts, therapeutically velopment. In diathetic conditions, as well as dominates. Doubtless the arsenate alone is cachexias, these waters will be found suitable. not a direct thenoplastic, and the blood has nothing to demand of it, as in the case of iron and the chlorides. But, not to carry our consideration further, the essence of the action in these morbid conditions would appear to be that, in the case of the waters under consideration, it would seem to be largely a matter of dose and also the method of administration. Hot baths of Choussy-Perrière waters increase nutrition and accelerate the action of the secretory organs, and may be classed as stimulative. Taken internally, the arsenic moderates nutritive activity, minimising waste, especially of the phosphoric elements, lessening the secretion of urine, while profoundly influencing the character of the blood, the density of the serum being increased and the coagulation of fibrine diminished. But many clinicians have observed a marked difference of action according to the dose given. As applied to the waters of La Bourboule, I fully accept these facts, and maintain that it is owing to their complex action that we are indebted for their safety and success in practice. To enlarge farther on this subject seems almost unneccessary. CONCLUSION. We have already alluded to the opinion of M. Rotureau, who, in speaking of the curative action of the La Bourboule waters, holds that they are all the more remarkable as the maladies are deeper seated, constitutional, and for that reason graver in their nature. As for M. A. Nicolas, he places them in the first rank; they are for him the waters par excellence in the case of the diathesic, cachectic, delicate, convalescent, and valetudinarian. Relying upon the experience of those less interested, and as fully competent to judge, this claim is not without its weight. If the interpretation leaves anything to desire, the facts at least are beyond dispute Without entering more minutely into the subject, I would briefly recapitulate. Arsenic is better than iron in the paludal cachexias and neuralgias THE shipbuilding strike is likely to have farview to regard the men who are locked out as the reaching consequences. It is a very short-sighted only persons who are seriously affected. In its modern developments, society, notwithstanding all the differences of classes, is, after all, such a homogeneous whole, and the various portions of it are so mutually interdependent, that no one class can afford to be indifferent to the fortunes of another. We all hang together. And there is considerable reason for apprehension lest this engineer's dispute should have serious effects on the health of the community. It is all very well to say that the strikers, being members of a union, receive payment as long as they are out of work, as a result of combined action. But people who talk in this fashion forget that the payment made to the men the amount they have been accustomed to receive; is in many, if not in most, cases not above half of and income reduced by 50 per cent. in a working man's home means insufficient food for the family, and, consequently, inadequate nourishment, with the result that those who suffer in this way become too feeble to resist the attacks of disease. A SERIOUSLY reduced income in such a home means also, only too frequently, neglect of cleanliness, and inattention to ordinary sanitary requirements. A feeling of indifference is apt to grow upon the sufferers, which is certain to be fatal to the exercise of those habits which most conduce to the maintenance of health. And it is to be have to suffer from a diminution of income; the remembered that it is not the engineers alone who tradesmen among whom they usually spend their money are also affected by the strike, and these, in their turn, have, therefore, less money to spend, so that there is always a danger that such a sudden cessation of work as has been experienced in the shipbuilding industry may have a detrimental influence on the health of the community. It is to be hoped, even while we write, that wiser counsels may prevail, and that the strike may be regarded as virtually at an end. A VERY distinct service has been rendered to the community by the recent successful prosecution of certain persons who have given themselves out as qualified medical practitioners while possessing no bona fide professional qualification. It is most desirable that the public should be protected against adventurers or quacks, who pose as benefactors of the race, but who at the same time are exceedingly careful in the matter of feathering their own nests. No doubt there will always be found a considerable number of gullible people who will swallow any amount of stuff-in both senses of the word-with the unhesitating confidence that a cure is going to be effected in cases in which all the regular practitioners have failed. We are all acquainted with the interesting and pathetic testimonials in which Jenny Jones, or John Thomas, testifies that "all the doctors gave me up," but that one bottle of the Universal Elixir gave immediate relief, while half-a-dozen effected a complete and permanent cure. This is a very familiar form of literature; but the hope may be expressed that the cases that have recently been tried will have some influence in the way of infusing a little wholesome scepticism as to vaunted infallible cures. One of these was that of an unqualified practitioner who undertook to cure rupture without operation, and the evidence adduced in the course of the trial, while it showed a remarkable amount of gullibility on the part of the victim, should have the effect of opening the eyes of not a few, who might otherwise be tempted to throw away their money, to the desirableness of ensuring that their medical advisers have really some adequate equipment for the rôle they have chosen. The presiding judge pronounced the sensible dictum that "if a man set up a lot of lies to induce the public to part with large sums of money, then it became a case of fraud"; and those who are inclined to trust themselves to the care of unqualified men should take note of the natural effect of such a comprehensive judg. ment. A REPORT which has just been issued for the past year on work done by the Sick Poor and Private Nursing Institution of Manchester and Salford touches wisely on some of those points which ought ever to be kept in view in the management of such institutions. One of the special features referred to in the report is the maintaining of a special home in the country for the isolation and disinfection of those nurses who may have been attending patients suffering from infectious diseases; and we are not surprised to be assured that this feature is one that has been highly appreciated by the doctors and the families who had had occasion to employ the institution nurses, for nurses cannot claim immunity from infection any more than other people. Unfortunately, they have sometimes not only themselves been the victims of disease caught in attendance upon patients, but they have also conveyed, in their dresses or otherwise, the germs of infection to those who would otherwise, in all likelihood, have been exempt from the particular disease so carried. THE advantages, therefore, of a disinfecting home are too obvious to need much insisting on. In the course of their report the committee refer also to the difficulty they have had in keeping up their staff in point of numbers, on account of the profession of nursing being at present overrun by women whose training has been so short and incomplete as to afford no adequate guarantee of their fitness to discharge the responsible duties necessarily entrusted to them. It has been thought wiser, therefore, by the committee to increase their staff gradually, rather than to lower the present high standard of efficiency. In this course of action they will have the hearty approval of all who are anxious that nursing should take the place of a skilled profession, into which those only should be admitted who, by their education and training, have been duly fitted for the responsibilities which they undertake. The work effected by such insti tutions is of the very highest value for those who are directly benefited by them, and for the health of the community. THE SANITARY INSTITUTE. TREATMENT OF SEWAGE. SIR BENJAMIN BAKER, K.C.M.G., and President of the Institute of Civil Engineers, presided at a sessional meeting of the members of the Sanitary Institute, held on Wednesday evening last, at Parkes Museum, Margaret-street, W. There was a good attendance. An important paper was read by Sir DOUGLAS GALTON, K.C.B., Vice-President of the Institute, upon the lessons to be learnt from the experimental investigations by the State Board of Health of Massachusetts upon the purification of sewage. He said that the object of the paper was to give a brief account of the various experiments which had been made, and the conclusions arrived at in regard to the experimental treatment aud purification of sewage. Practically, it had only been in comparatively recent times that the growth of the population had compelled the public to recognise the necessity for the disinfection, purification, and destruction of refuse matter. A sparse population could afford to allow the refuse to purify itself gradually in the soil, ditches, streams, and rivers, but as the population and proximity of habitationsincreased, careful attention had to be given to methods of dealing with refuse to prevent the injurious effects which arise from decaying organic matter in the neighbourhood of dwellings, or from the use of polluted water in streams and wells. The problem rested with the engineer and the chemist, and various conclusions had been arrived at by experts, which conclusions might be summed up as follows: (1) The direct application of sewage to land is thoroughly effective as a means of purification. There is no sanitary objection whatever to the system of sewage disposal by agricultural irrigation, and no nuisance or offence can arise in connection with it, save as a result of gross neglect or mismanagement. But it entails difficulties in thickly settled districts, owing to the extent of land required. The chemical treatment of sewage produces an effluent harmless only after having been passed over land, or if turned into a large and rapid stream or into a tidal estuary, and it leaves behind a large amount of sludge to be dealt with. (2) Hence it was long contended that the simplest plan in favourable localities was to turn the sewage into the sea, and that the consequent loss to the land |