Dr. GARRETT (Cheltenham) asked Sir Charles Cameron whether they had any difficulty in Dublin as to the action of water on lead.

Sir CHARLES CAMERON replied that they use an alloy that he devised, and which had been found not to be acted upon. It was composed of 96 parts of lead and 3 parts of tin, and was the only metal that could be legally used in Dublin according to the waterworks by-laws. He devised it especially for the Dublin water after some experiments he had made, and they had never had a case of lead poisoning in Dublin since.

"Infantile Mortality of Large Towns," by H. O. PILKINGTON, M.R.C.S., L.S.A. Abstract.

IMPORTANCE of subject is shown by the fact that during the past ten years the infantile mortality (as estimated by the number of deaths under the age of twelve months to each thousand births), has been for the whole of England and Wales 142, for the large towns 169, and for Preston, always remarkable for its high infantile death-rate, not less than 232.

Some of the causes which bring about this loss of infantile life prevail in most of the large manufacturing towns, and it is because they are found in combination in Preston that this town has acquired its unfortunate reputation.

Since the causes are varied and numerous, no one remedy can be devised to meet them all, but each must be met and fought upon its own ground.

First amongst these causes is the employment of female labour in the mills. If an occupation, which requires a woman to stand during the greater part of the day, be followed up to within a few days or even hours of the time of parturition, it must act to the detriment of the offspring, and there is less chance of the latter coming into the world, fully grown, well formed, and in good health.

Many deaths taking place during the first month, and which are returned as due to premature birth, immaturity, congenital debility, convulsions, and the like, may safely be ascribed to this cause.

The return of the mother to her work within a very short period after confinement, thus depriving the infant of a mother's care, and of the sustenance which nature intended it should have, constitutes even a still greater evil. And with this is

connected the nursing out of infants, and their exposure to violent and sudden changes of temperature during their removal night and morning through the cold air of the streets.

But a third and more important cause consists in the very habits of the operative classes themselves, in their ignorance of the first laws of health, and in their blind adherence to customs which have long since been deservedly condemned. In the older manufacturing towns where there is little importation of fresh blood from without, there is a risk in the inter-marriages (often early marriages) amongst persons of the same class, and a danger of the progeny becoming more and more enfeebled.

There are few people with less knowledge or experience of household duties than the ordinary factory girl, and as a consequence she becomes a wife and a mother knowing little of the duties required of her, and content, as regards the management of her children, to follow the example of her parents and the customs of those amongst whom she lives. Accustomed to a heated atmosphere, the factory operative above all things fears a draught, and so the doors, windows, and fireplaces of the sleeping chamber are kept closed; its cubical capacity is often tested up to, and often above, the proper limit, and in this way the seeds of tubercular and scrofulous disease are engendered, and transmitted from one member of the family to another.

Unwholesome food and the want of cleanliness in its preparation and administration, are the direct causes of many infantile deaths. Bread and starchy preparations are substituted for milk, and where the latter is given, the feeding bottle from its dirty condition, frequently forms a source of danger to the infant's life. After the first week or two, proper and systematic ablution is less and less frequently used, fresh air and sunlight are not recognised as necessary requirements, and altogether there is a want of proper nursing, a word pregnant with meaning as applied to infantile life.

In the older manufacturing towns the houses of the poorer classes are crowded together, and the yards are small, badly paved, and largely taken up by the privy and ashpit.

To these conditions are due Infantile Summer Diarrhoea, which in certain parts of Preston at any rate, may with certainty be predicted after the ground temperature at a depth of four feet has reached to a height of 56 degrees.

Amongst other causes must be mentioned that of Insurance, by which the death of a child brings a monetary gain to the parents; the habit of allowing very young children to sleep in the same bed with their parents, resulting in deaths from suffocation, or "overlaying"; and the use of sleeping stuffs to quiet a fractious child, or to ensure a good night's sleep.

These, then, are the causes which sometimes separately, but more frequently in combination, lead to the heavy death-rate amongst infants in our large towns and cities.

As regards remedies, the Medical Officer of Health can close all houses or cellars unfit for habitation, enforce the removal of all nuisances from the neighbourhood of dwellings, and require the conversion of dangerous privies and ash-pits into some simple form of water-closet and ash-pail. He can keep the subject of Hygiene constantly before the public, and in times of special danger can issue short instructions to parents. Legislation might do something more to control female employment, but regulations too stringent or exacting would only be evaded or broken. Crêches or Day Nurseries in connection with the mill might do much good, but they must be self-supporting, without entailing much trouble or expense upon the mothers. Insurance, being a provident measure, deserves encouragement, but requires restrictions both as to amount, and the age at which a child becomes payable. A closer scrutiny should be made in cases of uncertified death, and this could be done by a Medical Adviser to each Coroner, whose duty would be to make enquiry into the circumstances of such deaths, and to decide whether or not a more searching investigation was required.

But Education, whether that given by the Medical Officer of Health, or that received by the rising generation in our Schools, is the remedy to which we must look. Year by year the working-man is taking more interest in matters connected with Public Health, and is beginning to see the loss involved by sickness and death, and to recognize the fact that an infant, like a plant, requires fresh air, pure water, and sunlight.

Dr. ALFRED HILL (Birmingham) said, with regard to the question of infantile mortality, that there were some towns which suffered very much more than others, and especially in the matter of deaths from diarrhoea. Preston had the unenviable reputation of having the largest death-rate of infants from this cause. He should be glad to hear from Dr. Pilkington if he could give any information as to the very high mortality from the disease in Preston.

The Hon. ROLLO RUSSELL (Haslemere) said he should like to ask Dr. Pilkington if he could account for the very large differences between the infant death-rates in certain Model Dwellings, and in the general population of a town. In the buildings of the Metropolitan Association, for instance, the infant death-rate was, per 1000

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births, 113 in 1893, 136 in 1894, 110 in 1895, compared with 164, 143, and 166 in the rest of London.

Dr. GARRETT (Cheltenham) mentioned the case of a small village fifteen miles up the Tyne, called Corbridge, where, as Dr. Armstrong stated some years ago, there had not been a death under one year for many years. The infantile death-rate of Cheltenham was between this extreme instance and that quoted by Dr. Pilkington. Dr. Pilkington had given some very interesting particulars in the resumé of his paper, but he had not told them why the infantile death-rate varied so much in towns of similar character. Why, for instance, was the infantile death-rate of Oldham and other mill places in Lancashire less than that of Preston?

Dr. PILKINGTON (Preston) said he thought it probable that had he read the whole of his paper the questions which had been put to him would have been answered. The reason why the infantile death-rate in Preston was so much higher than the infantile death-rate in Bolton, Blackburn and neighbouring towns, and why the diarrhoeal death-rate was so much heavier, was because all the causes work in combination in Preston. It was one of the oldest manufacturing towns in Lancashire. There were more females employed in the mills there than in other towns. The houses in the older part of the town had all the disadvantages, being crowded together, whilst the yards, lobbies, &c., were imperfectly paved. Until lately a great part of the town was provided only with the old-fashioned privies and midden ash-pits. These were now being gradually abolished. In many parts of the town they were entirely done away with, the ash-pits having been filled up, and the privies converted into water-closets, so that although the nuisance had not altogether been removed, the state of things was very much improved. But, he repeated, it was because in Preston all those causes of evil (present more or less in most manufacturing towns) had been working in combination that Preston until lately had occupied the unenviable position which it had amongst the large towns of the kingdom. There had been a great improvement lately, and when further contemplated alterations were carried out, a still greater improvement might be looked for in that town.

"The Bacterial Filtration of Public Water Supplies," by WOLF DEFRIES, B.A., M.I.Mech.E.

(MEMBER.)

THE term "bacterial filter" is used sometimes to denote a filter such as a sand filter, which delays the passage of organisms to a greater or less extent, varying with the nature and thickness

of the filtering medium, and the velocity of the water. Broadly the action of such filtration depends on the fact that the organisms pass less freely through the minute channels of the filter than does the water, and accordingly take a longer time to be washed through. During this time some, but not all, of them probably perish. The delay is to a large extent dependent on the formation of a film of slime on the surface. In practice such filters do not ever remove all the organisms contained in the water; but at their maximum efficiency they remove an extremely large percentage. The extent of their efficiency in this respect can only be tested by bacteriological examination of the filtrate itself; and the time and the nature of the attention. which they require to restore their efficiency, when from time to time it is decreased below what is regarded as satisfactory, involve both judgment and skill to obtain the best result of which the filter is capable. Filters of this type usually remove some part of the dissolved constituents of the water; but the filtrate may nevertheless remain as capable as the unfiltered water of permitting the growth of pathogenic micro-organisms. In this paper I do not propose to apply the term "bacterial filter" to such filters, but to reserve it for those which arrest the whole of the organisms contained in water on the surface of the filtering medium, irrespective of the thickness of the medium and of the velocity or pressure at which the water is delivered; and my purpose is mainly to suggest in general terms some conditions which are absolutely indispensable for such filters when applied to public water supplies.

The means at present available for bacterial filtration consist in the use of porous materials of definite composition which are empirically found to have the property of arresting organisms; something like a porous magnet would do with water containing little iron specks. It is necessary that the filtering bodies of this material should possess mechanical strength, seeing that pressure can be applied without detriment to their filtering capacity. At the same time it is desirable that these bodies should be as thin as possible, so as to offer the least obstruction to the passage of the water, and therefore to permit the greatest output for a given filtering area. The form which in practice gives the greatest mechanical strength is that of a cylinder. The smaller the diameter of that cylinder, the thinner its walls may be to stand a given pressure. As, therefore, the diameter of such cylinders is enlarged, and the filtering area, and consequently the output, increased, it becomes necessary in order to maintain the mechanical strength to increase the thickness of the tubes, and to that extent to diminish the advantage in point of .output which is obtained