old existing difficulties. The workers were advancing from one condition to a higher; and the improvement in the Laws would help forward that progress. All this should encourage them to struggle on. Much might be done by legislation, but much more would be accomplished by mutual confidence between employer and employés. Let them improve the laws as circumstances showed it to be advisable to do so; but however perfect Acts might be in the eyes of the Legislator, it was only by the willing co-operation of the worker that they could be successfully carried out.

In replying to several points in the discussion, Dr. SYKES said that they felt very thankful to Professor Corfield for his pronouncement on the question of gully openings in bakehouses, as an opinion from so eminent an authority must have considerable value. With regard to the remarks of Mr. Mackie in reference to cards affixed in workrooms by Sanitary Authorities being illegal he hardly grasped the reason why, for there were many points in the Act which might be regarded as illegal from a given standpoint, yet perfectly legal if permitted by the only person possible to aggrieve. The difficulty of finding out workshops was the initial one, and equally so for the Sanitary Inspector and the Factory Inspector alike. With reference to the supervision of out-workers the Sanitary Inspector can enter any premises, his power being covered by the Entry Sections of the Public Health Acts. As Brigade-Surgeon Pringle observed, the real basis of the whole question is health.

REVIEWS OF BOOKS.

PUBLIC HEALTH IN EUROPEAN CAPITALS (BERLIN, PARIS, BRUSSELS, CHRISTIANIA, STOCKHOLM, AND

COPENHAGEN.)*

This Volume, the bulk of which has already appeared in various periodical publications, contains a very interesting comparative study of Public Health Administration in the European Capitals mentioned in the title. Dr. Legge is an impartial critic, but the British reader will be continually making for himself contrasts and comparisons with our own arrangements to the advantage sometimes of the foreigner, sometimes of ourselves. They do not manage all things better in France, and the picture which Dr. Legge draws of the confusion of administration and the utter want of central control in France, the home of centralisation, may make the Local Government Board hug itself with satisfaction, if the frivolity of the simile may be excused.

Among the most interesting passages in the book are those which describe the great sewage-farm system of Berlin, and the great scheme for disposing of the sewage of Paris on the same principle. Berlin was much favoured by its situation, unlimited opportunity being afforded by the sandy wastes by which it was surrounded; these, or certain parts of them, have been now transformed into fertile fields. Among the products of the farms are wheat, oats, barley, rape, mangolds, potatoes, fruit, and even attar of roses! Convalescent Homes, Consumption Hospitals, and labour colonies have been established on the farms; and so complete has been the success of the management, that as a rule the working expenses have been covered by the sale of the produce. Paris however is much less fortunate, but the difficulty has been grappled with. One farm 1,850 acres is already in use, and an area of 20,000 acres will be available in 1900. Meanwhile London may be expected to continue its present extravagant and irrational system well into the coming century. The practical application of bacteriological examination to the control of the efficiency of filtration of water supplies is in full force in connection with the Berlin water, and also at Stockholm, where Ekendahl however lays more stress on the number of varieties in the filtrate than on the actual number of bacteria, on the ground that certain harmless bacteria have a peculiar faculty of developing in the filter beds.

The description which Dr. Legge gives of the public slaughterhouses of Berlin and Paris, and the very elaborate control exercised by the public authority, is a proof of the great importance attached to meat inspection abroad. In Berlin especially the arrangements are remarkably thoroughgoing. The fact that trichinosis is so prevalent in pigs in Germany that one out of every 2,000 carcasses contains the parasites, taken with the German habit of eating pig's

* By Thomas Morison Legge, M.A., M.D.(Oxon), D.P.H.(Cantab). 201 pp., 8vo. Swan Sonnenschein & Co. London, 1896. Price 3s. 6d.

flesh in various forms either uncooked or very imperfectly cooked, accounts for the fact that in Berlin no less than 184 microscopists are engaged daily in making examinations of pig's-flesh for trichinæ, the rule being to examine twenty-four specimens from each animal. The description of the routine of meat inspection in Berlin and Copenhagen will be found very instructive by Medical Officers of Health who may be called upon to organise a system in boroughs in this country, where as yet not very much practical experience exists.

Many other points have been noted for comment, but enough has been written to make it plain that Dr. Legge's small book is well worthy of perusal by those who are engaged in health administration in this country, whether as officers or members of sanitary authorities. If another edition is called for, the author would do well to revise certain looseness of style, which sometimes obscure his meaning, and to compile a more complete index, that with which the book is now provided being far too meagre for a work so full of detail as this.

If the expression of a general impression from a careful perusal of the book may be permitted, it would be that in the matter of the control of food supplies generally, but especially of meat, we in this country are so far behind others that comparison is impossible; that in house sanitation and in the collection of sewage we are in a better position, while in its disposal we are in a worse, at least in London; and finally, that in adininistrative arrangements we are distinctly more fortunate than other countries.

REPORT OF THE ROYAL COMMISSION APPOINTED TO ENQUIRE INTO THE EFFECT OF FOOD DERIVED FROM TUBERCULOUS ANIMALS ON HUMAN HEALTH.*

Without disparagement to the eminent men whose evidence is reported in the first part of this volume, it may be said without fear of contradiction that the most valuable part of the volume is contained in the Appendix, or Part III., in which are printed the reports of the special enquiries made for the Commission by Dr. Sydney Martin, Dr. Sims Woodhead, and Professor MacFadyean. Dr. Sydney Martin's investigation is of special value, owing to the very positive results which he obtained with regard to the infectivity of milk from tuberculous cows, and the definite opinions which he found himself justified in expressing. He says "the milk of cows with tuberculosis of the udder possesses a virulence which can only be described as extraordinary"; and the conclusion naturally follows that the milk of such cows ought not to be allowed to be consumed. As a practical measure, he recommends that the milk obtained from all

* Report of the Royal Commission Appointed to Enquire into the Effect of Food Derived from Tuberculous Animals on Human health. Part II.: List of Witnesses, Minutes of Evidence, and Index. Part III.: Appendix, Special Inquiries. London: Eyre & Spottiswoode; Edinburgh and Glasgow: John Menzies & Co.; Dublin: Hodges, Figgis & Co. Price 7s. 3d.

cows in which (a) one or more quarters of the udder are enlarged or nodular, or (b) in which the milk from one or more quarters fails either in quantity or quality, should be at once excluded, and the cow examined by an expert. Further, he points out that every tuberculous cow must be looked upon with suspicion for although the presence of tuberculosis of the internal organs does not confer infectivity on the milk, yet tuberculosis may develop in the udder at any stage of the general disease. Dr. Woodhead's experiments show that for the effectual destruction of the tuberculous virus in milk mere "scalding" is quite inadequate. He gives minute directions (page 177) for sterilising milk on a water-bath as follows:

"The indications then for sterilizing milk by this method are:

(1.) That the quantity of milk should never be more than the quantity of cold water by which it is surrounded; it is an advantage in fact to have a somewhat larger bulk of water than of milk to allow for evaporation.

(2.) The milk should not be covered in and should be stirred from time to time, but the water may with advantage be covered in order to prevent evaporation; this of course is arranged for in the special milk sterilizing pans. (3.) The water should be boiled over a good brisk flame in order that the best results may be obtained, and the heating process should be continued until the temperature throughout the milk has risen to from 88° C. to 92°C., in most cases this takes place at the end of about twenty-five minutes, but in order to be perfectly safe it may be recommended that every quart of milk treated in this fashion should be heated for half-an-hour, that is for about twenty minutes after the water in the outer pan has begun to boil. One great advantage of this method of sterilisation is that after the pan is placed on the fire or gas stove, it needs little attention beyond an occasional stirring until the end of the half-hour.

Milk treated in this manner may be looked upon as "sterilised" and as perfectly innocuous even though it should contain the bodies of a considerable number of tubercle bacilli."

It needs no argument, however, to convince those who have experience in such matters that the only real safeguard is to exclude from a public supply milk which may by any possibility be contaminated by tuberculous virus. In an article published in the Lancet of October 27th, 1894, Dr. Woodhead has advanced cogent reasons for accepting the view that, in children at least, general tuberculous infection is, in very many cases, to be traced to the ingestion of infected milk, and that it is not necessary that a local lesion of the alimentary canal should be produced. The tubercle bacillus may run the gauntlet of the lymphoid tissue of the intestines and pharynx to establish itself in the mesenteric or the cervical, and finally the tracheobronchial glands, from which by a process of extension or secondary infection tuberculosis of the peritoneum, of the lungs, or a generalised acute tuberculosis may ensue. Professor MacFadyean's report deals with the means of recognising tuberculosis in animals during life. With regard to tuberculin, he is led to the opinion that to obtain trustworthy results it would be necessary to resort to a double inoculation with an interval between the injections. D. W.

VOL. XVII. PART II.

K

PUBLIC HEALTH LABORATORY WORK.*

This is the second edition of a small manual intended mainly for the use of students desirous of taking the Diploma of Public Health. A large part, about a third, is devoted to water analysis. Other parts of the work deal with the chemical examination of soil, of air, and of foods. A chapter on bacteriological methods is contributed by Dr. Childs. There are a good many illustrations and the work is of a convenient size. The subjects are all well treated, the descriptions clear and the matter generally well up to date. It is without doubt a most useful laboratory text book.

A. W. B.

THE LAW RELATING TO FACTORIES AND WORKSHOPS.+

This work is divided into two parts.

The first Part brings together under their several heads the substance of the provisions of the various Acts bearing upon factories and workshops, describing them in a consecutive and coherent manner. This is necessitated by the numerous cross references in the Acts that otherwise are most confusing. Here the law is presented in a readable and comprehensible form that is highly creditable to the collaborators, and will materially facilitate the labours of any Minister who may contemplate a recodification of the Acts. Exception, however, must be taken to the statement that mechanical means of ventilation are never required in a workshop. It also appears doubtful whether Section 78 of the Act of 1878 requiring an Abstract of the Act and certain notices to be affixed can be enforced "in every factory and workshop," as the last paragraph but one of Section 93 of the same Act excludes from the Act "such workshops other than bakehouses as are conducted on the system of not employing any child, young person, or woman therein," that is to say, where adult male labour only is employed. There are in this Part several very useful tables as to Abstracts and notices required to be aflixed, registers to be kept, notices to be sent, exemptions, fees, special obligations, offences, and penalties. In an Appendix is also a full list of the Special Rules and Requirements for dangerous occupations.

Part two consists of the various Acts of Parliament set out in

extenso, with copious notes. The sections of the Acts are complete, and not mutilated for the purpose of adapting them to later amendments, nor are the sections of one Act interpolated into another, but the amendments are shown by italics and by notes. This is a more satisfactory method than the irritating system, sometimes

* Public Health Laboratory Work, by Henry R. Kenwood, M.B., D.P.H. 8vo., 453 pp. H. K. Lewis, 1896. Price 10s. 6d.

+ The Law Relating to Factories and Workshops, by May E. Abraham and Arthur Llewellyn Davies. 8vo., 283 pp. Eyre and Spottiswoode. 5s.