Dr. Buchanan has suggested that a temperature of 32°-40° is the worst, and this agrees with the winter rise of the deathrate in England, and its absence in many countries where the mean winter temperature is below freezing. Certainly this temperature is particularly unpleasant, and is usually in England combined with gloom and damp fog. Still what is unpleasant is not necessarily unhealthy; in fact, the rule seems to be the other way.

No one can deal with the Registrar-General's returns without noticing the steady decrease in the death-rate that has been brought about by improved sanitation. The average for the last five years is slightly above that for the preceding five in England, but on the Continent the decrease has been well maintained up to the present date. This is shown in Table III.

TABLE III.

Average death-rate of the European Capitals (except Madrid) and Lisbon) for recent years.

The increase in England has been caused by influenza and diseases of the respiratory organs, which seem always to accompany influenza. The important question for us all, and particularly for this Congress, is, Can the rate be further reduced? I have not the advantage of speaking as a medical man, but personally I believe that by increased attention to ventilation, as much may be done to prevent diseases of the respiratory organs, as has been done by improved drainage to check the deaths from zymotic disease. The ventilation, or rather absence of ventilation, of public buildings, such as churches and chapels, theatres, &c., may well be called disgraceful to a civilised people. It is no exaggeration to say that there is not one church in 100 lighted with gas, the air in which would bear analysis with a satisfactory result half an hour after the commencement of evening service. Commonly no ventilation is provided. Sometimes only inlets are placed, sometimes outlets only, and as a rule the cross section of the air passages is ludicrously small. Still the size does not make much difference, for brown paper and paste are cheap and easily obtained, and it is seldom long before the openings, if any, are closed.

The fact that the majority are content to sit in these buildings without protest shows clearly that they are not altogether unaccustomed to breathing impure air in their own homes; and if, by any means, a greater love of fresh air, and a greater dislike to air overcharged with carbonic acid and organic impurity, could be imparted to all classes in England, there would probably be a very great decrease of infectious diseases (for fresh air is admittedly the best disinfectant), of diseases of the respiratory organs, and in the death-rate generally.

EARL PERCY said, we have had a most interesting address, and I am quite sure you will wish to pass a hearty vote of thanks to Mr. Dines for his kindness in giving it to us. It is one that has covered a very large amount of ground, and if this was the time or the place, we might talk about it at some length. I will only make one remark, if I may be allowed to take advantage of my privilege in rising to move this vote of thanks. It is this. I should like to ask Mr. Dines, whether the rain-fall, as well as temperature, has not something to do with health. Mr. Dines has pointed out what is well known that the death-rate in Liverpool, and I believe it is true also of Manchester, and some other large towns, is much higher than that of London. How far is that owing to the rainfall which is very much larger on the West Coast than on the East? I think, probably, you will all have observed of two of the towns which stand highest in the list Mr. Dines has quoted they are towns on the East Coast where the rainfall is less, and not upon the West Coast where the fall is heavier. It is a curious fact, and one that has some bearing upon the question, that all convictions for drunkenness in England, follow almost exactly the line of the rainfall. That is to say if you draw a line diagonally across England, you can show that the rainfall is greater above that line than below it, and you can find also that the convictions for drunkenness are greater in the district above that line than in the district below it. You may follow that and find a great coincidence in the figures. The reason is plain, for when a man cannot take a walk in the streets because it is raining, he has nowhere else to go but to the public house, and the public house is not supposed to be always conducive to good health. So, perhaps, in that way also a rainy climate has a great deal to do with the deathrate. I will move that a very hearty vote of thanks be tendered to Mr. Dines for his valuable address.

The Hon. ROLLO RUSSELL (Haslemere): I have much pleasure in seconding the vote of thanks to Mr. Dines, which has been moved by Earl Percy, for his very interesting address. All who know anything of the work of Mr. Dines have reason for confidence in his use

of statistics, and in relation to this matter, I was glad to hear him speak in defence of figures, which it is a fashion to attack very unfairly; in fact, there is a saying that nothing is so untrustworthy as figures, except facts. Mr. Dines' figures, however, may be relied upon.

The motion was then carried with acclamation.

Mr. DINES (Leatherhead), said: I thank you very much for the kind way in which you have received my address. I may say that when I was first asked to hold the post of President of this Section, I thought there must be some mistake, for I did not feel in any way qualified to do so, hence I must thank you the more. With regard to Earl Percy's remark about the rainfall I have not considered the question, excepting that I did ascertain for the English quarterly death-rates, that a wet or dry summer did not make any difference. A wet hot summer, or a dry hot summer have high rates, and in England a cold summer is mostly a wet one, thus taking England as a whole most of the wet summers during the last thirty-five years have been healthy. There is more rain, and I believe a higher deathrate, in the West and South-West than in the East and South-East of England, but it does not follow that the quantities are connected.

CONFERENCE OF PORT SANITARY
AUTHORITIES.

ADDRESS

BY A. HOLT-BARBER, Chairman Port of London Sanitary

Authority,

PRESIDENT OF THE CONFERENCE.

I feel that I must, in the first place, acknowledge with grateful thanks the honour that has been conferred upon me, as Chairman of the Port of London Sanitary Committee, by my nomination as President of this important Conference of Port Sanitary Authorities; and I feel sure that good results will follow from this meeting of representatives from the various ports of the Kingdom. The first Conference of Port Sanitary Authorities was held in the Council Chamber of the Corporation of the City of London in 1893, and that meeting had a most beneficial effect in strengthening the hands of the medical officers of the different ports at a critical period, when the importation of cholera into this country was seriously threatened. It is therefore with very great pleasure that I now cordially welcome the attendance here to-day at this Conference of all representatives of different Port Sanitary Authorities, feeling sure that increased efficiency in the work to be carried out will result.

It must be universally acknowledged that a free and uninterrupted intercourse with foreign nations is the very life blood of this commercial country, with its teeming millions of working population, depending upon daily toil for daily food, and to whom any cessation of either imports of raw material or of exports of our manufactured products must mean a cessation of employment, and consequently a cessation of the daily wage necessary to their existence.

But on the other hand-although this free and uninterrupted intercourse with foreign nations is so essential to our wellbeing, and even to our very existence-there is a danger of another kind which confronts us, arising out of this very com

merce, namely, the introduction of dangerous diseases from countries which may be, and are, peculiarly liable to produce them.

In order therefore, to carry on our foreign trade, without danger on the one hand, and without delay on the other, the various Port Sanitary Authorities have been called into existence. It has been well said that "The gods help those that help themselves," and this is essentially a matter in which we are called upon to help ourselves by adopting the best known means that modern science has placed at our disposal. The work as now carried on by the Port Sanitary Authorities may be divided into two separate functions: first the very important duty of medical examination of all vessels arriving from over seas, and in cases of arrival from ports scheduled as being infected a medical examination of every person on board; then secondly the sanitary inspection of all vessels whether coastwise or otherwise, for the purpose of examining the accommodatoni provided for those living on board, whether crew or passengers and where this accommodation is found to be defective, pointing out the defects, and serving notices for alteration and correction.

This latter part of the duty now imposed upon the Port Sanitary Authorities is a very important, and at the same time a very difficult one to carry out, on account of the constantly moving character of the subjects of inspection and of the ever-varying conditions of life on board ship. When one considers the large number of vessels frequenting a port like London, the short stay that is now generally made, and the extent of the district to be worked, it will be seen that it is no inconsiderable task, to keep a watchful eye over such matters as ventilation, crew accommodation, water-supply, and the many details connected with life on board ship, where a large number of persons have to be accommodated in a small space. In the duty of medical inspection, of a ship arriving from a foreign port, scheduled as being an infected port, the medical officer boards at the point of arrival, and examines every person on board. Any case of infectious disease is at once removed to the proper hospital, the ship and contents as far as possible are chemically fumigated, and then allowed to proceed to her place of discharge.

This you will at once see imposes a large amount of responsibility on the medical officer, for in his hands is placed a very large discretionary power, and which he is constantly called upon to exercise. It has however been proved by

experience that the barrier thus raised by medical inspection is sufficient, and with the further growth of medical knowledge, we may fairly assume that the protection thus afforded will be good enough for the future.