for extras, they will seize it. If the ratepayers wish to keep their water rates down, they must watch them carefully, and without rushing into litigation must be ready in case of any fresh encroachment to protect their rights. The attempt to make war on the companies by means of confiscatory legislation has failed, for this session at any rate, but the companies are desirous, and from their point of view properly so, of making good their position as far as possible. Both parties are now inclined to stand on their strict rights, and neither can expect any concession from the other.

THE MANUFACTURE OF SMALL-POX.

A REPORT has just reached us of one of those extraordinary cases of recklessness in spreading disease of the most loathsome type, which we are at a loss whether to attribute to ignorance, cupidity, or utter indifference to the due consequences of such indefensible conduct. Mabel Wilson, a cowkeeper and milk retailer, has been fined 40s. and costs at the Newcastle Police-court for an offence which should have entailed a reasonably long term of imprisonment with hard labour. It seems that the woman is the owner of a house, in one room of which she lives with her daughter. In this room, 12 feet by 10 feet in dimensions, where her daughter's child had been suffering from small-pox for six or seven weeks, Mabel Wilson kept her stores of milk, and, with the assistance of the mother of the afflicted child, sold it without compunction to whoever was unlucky enough to want any of it. Eventually a neighbour found the matter out, and expostulated with Wilson, telling her that she should report the case to the medical officer. She, however, simply stated that she had had the services of a very experienced man, the said very experienced man being a chemist from whom she had bought some physic, but who had never seen the child. The neighbourhood at last revolted. Mr. Armstrong, the Medical Officer of Health, visited the place and found that the child was suffering from small-pox. The woman was summoned before the magistrates at the instance of the Corporation, the summons stating that on March 11, 1884, the defendant, then being the occupier of a house used for a human habitation, at Factory Yard, Gallowgate, wherein a certain inmate named Jane Ann Kitchen was suffering from small-pox, unlawfully did not, so soon as she became aware of the existence of the infectious disease, forthwith give notice thereof to the medical officer of health at his office, contrary to section 40 of the Newcastle Improvement Act, October 1882. The magistrates could not inflict a more severe penalty than 40s. with costs; but is it possible to imagine a more effective and repulsive factory of small-pox?

POISONING FROM SALMON IN A
BULGED TIN.

PARTICULARS of the two fatal cases of poisoning from tinned salmon, which occurred lately at Wolverhampton, will serve to enforce the warning the public has already received as to the risk of using food of this kind unless thoroughly assured of its soundness. It appears that Sarah Dewen (51), her son, Frederick William Dewen (20), a cabinet maker, and her daughter, Agnes Dewen (18), purchased a tin of salmon for 74d., of which they all par

took at supper on May 21, the younger woman eating but sparingly. The man was first taken ill, suffering from abdominal pain, vomiting, coldness of surface, &c., and died the next morning. Then his mother and sister were attacked in the same way; and the mother, in whom the symptoms were from the first the most severe, died on the 24th. A younger sister, who just tasted the salmon, thought it bitter, and ate none. The medical man called in was of opinion that the symptoms observed might be caused by some animal poison being absorbed and affecting the nervous system, though he knew of no poison which would produce precisely the same results. The inquest on the bodies of the deceased was adjourned to permit of an analysis being made of the contents of the stomachs, &c., the small quantity of salmon left in the tin, and a tin of salmon having the same brand and procured from the same shop. At the adjourned inquiry the coroner read the report of the borough analyst for Wolverhampton. The examination by chemical means of the contents of the nearly empty tin yielded no evidence of poison, but on some tame mice being fed with small portions, one died in five hours, and another in six hours and twenty-five minutes. An infusion of tea, partaken of at the fatal meal, and portions of bread and bacon, were examined and found free from poison. The analysis of the viscera of the deceased man and woman gave the same negative results. No recognised poison demonstrable by chemical tests was present. It was noticed that the tin had the appearance of having been bulged by pressure from within, which would indicate that the fish had undergone some decomposition before the opening of the tin. The coroner said that it would be well the public should know the danger of bulged tins, and only purchase those with the ends depressed, showing properly sustained exhaustion. It would be well that all tins should be examined by some competent person before being exposed for sale. There was no law on the subject, but it would be much to the interest of vendors that they should themselves make a careful examination of all such goods received; they were well able to form an opinion as to the soundness or otherwise of the contents. While the jury were considering their verdict the coroner asked after Agnes Dewen. was stated to be better, but not quite recovered. The verdict was that both the deceased persons 'died from the effects of poison contained in the salmon tin, arising from decomposition.'

She

METROPOLITAN AND PROVINCIAL SANITARY

PROGRESS.

DURING the recent debate in the House of Commons on the London Government Bill, Sir Charles Dilke pointed out the apparently small improvement in the health of London as compared with that of other large English towns. He stated that while the death-rate in the past ten years in nineteen of the largest English towns had declined as much as 5:1 per 1,000 persons living therein, the London deathrate during the same period had declined only I' per 1,000. He quoted these figures as giving in his opinion a very fair test of the effect of the Government of London upon the health of London as compared with the improvement of the health of other large English towns since the passing of the Public Health Acts of 1872 and 1875. Taking the three

years 1870-71-72, and the three years 1880-81-82, it is found that the annual death-rate in the former period in London was 23.4 per 1,000, and in the latter period it was 214. In the large provincial towns the rates were 27.2 and 23'0 respectively. The London deathrate, therefore, showed a decline of 20, and the large towns of 42 per 1,000 during the ten years. It will, of course, be noticed at once that, notwithstanding the greater decline in the death-rate of the large provincial towns, the rate of mortality in London, which has not shown so rapid a decline, is still below it. It will probably take a much longer period than another ten years to reduce the death-rate in these provincial towns another 4.2 per 1,000. Some exception was taken by members present to the assumption of Sir Charles Dilke that the death-rates he quoted were a test of the relative sanitary conditions of the metropolis and of the large provincial towns; and he is reported to have stated that the test of the death-rate in London must be altogether fallacious, unless a correction were made by including all the deaths of London residents which occur outside Registration London. It is difficult to see how this would greatly affect the argument that Sir Charles Dilke urged, for the proportion of deaths that occur outside the metropolis of London residents has probably not varied materially in the space of ten years, and the necessary correction applied to each of the London death-rates would hardly alter the amount of the decline which has taken place. It can scarcely be doubted, however, that the health of London would show a further marked improvement by the simplification and centralisation of sanitary authority. The present system, under which there are, according to Sir Charles Dilke, no less than seventy authorities dealing with infectious diseases, seems eminently suited to hinder that general metropolitan co-operation, especially in cases of epidemics, which alone can secure the success of efforts in the direction of further sanitary progress in the metropolis.

THE ADULTERATION OF FOOD AND DRUGS. AN attempt has been made by the Local Government Board to secure a more general adoption of the Food and Drugs Act. In many districts, including large and populous cities, this useful measure is practically inoperative, while in others it receives but scant recognition from the local authorities. And perhaps but little progress can be expected until the constitution of these bodies is materially altered, for with a large proportion of small shopkeepers ruling their counsels it is hopeless to expect any radical improvement. It has often been pointed out that the Act of 1875 protects alike the buyer and the seller, and the central board, in issuing a circular letter to almost every sanitary authority in the country, has indirectly again drawn attention to this provision. The chief object of the letter is, however, to point out that Gany medical officer of health, inspector of nuisances, or inspector of weights and measures, or any inspector of a market, or any police constable under the direction and at the cost of the local authority appointing such officer, inspector, or constable, or charged with the execution of this Act,' may procure any sample of food or drugs, and if he suspect the same to have been sold contrary to the Act, shall submit the same for analysis. The task of collecting samples is one specifically laid upon inspectors

or

of nuisances by the Board's General Order of March 1880 prescribing the duties; but it rests entirely with the local authority whether not they will instruct their officer to this effect. The circular is accompanied with extracts setting out the salient features of the Act, together with some useful instructions. A notable instance of the manner in which some local authorities carry out their important duties in this respect has recently occurred at Newington. In this district the Act has remained a dead letter, notwithstanding that the Local Government Board have made several efforts to bring about a better state of things. At a meeting of the Vestry, held a week or so ago, a member, in an outspoken speech, proposed that an inspector be appointed to carry out the provisions of the Act. He showed that at present a tradesman living on one side of a road could sell an adulterated article for which on the other side he would be prosecuted. He contended that this was a reproach to the local authorities of Newington, and should no longer be permitted to exist. This was followed by a discussion which reflected but little credit upon the majority of the members, who finally negatived the motion by a majority of 29 to 13.

UNCERTIFIED DEATHS.

DR. MACLAGAN, who has long complained of the imperfect and unreliable system of death registration carried out at Hexham, again calls attention in his last report to the lax manner in which investigations into the 'causes of uncertified deaths are conducted. Of thirty-eight deaths so returned in 1883, some were returned as the verdict of an inquest; some, as dictated by the coroner, from 'information received,' without any inquest having been held; and others were not certified at all. Even in cases where inquests have been held, frequently no medical evidence has been given. Dr. Maclagan thinks that were all cases of sudden death, or of deaths resulting from accident, or the subjects of suspicion, investigated by the health-officer, few of the causes of such deaths would remain undetected; but, unfortunately, no such cases came to his knowledge, except through the death register, and that frequently many days after the occurrence. Apart from this, it seems of the first importance that in all cases of suspicious death, and more especially amongst infants, the circumstances should receive a careful sifting at the hands of the coroner. The fear of publicity which attends these inquiries is known to exercise a wholesome effect on the minds of parents, and it might be well if the practice of holding them was adopted pretty extensively at Hexham.

CUTTING OFF WATER SUPPLIES.

IT is much to be deplored that the Bill introduced by the Earl of Camperdown for the better regulation of the powers of metropolitan water companies should have fallen through, because the standing orders of the House of Lords had not been complied with. The Bill proposed that 'from and after the passing of this Act no supply of water shall be cut off unless the company shall have obtained an order granted on a summons to show cause why the supply of water shall not be cut off, and the order shall state when the cutting off may take place, as well as the reason for putting the power in force.' It is about this time of the year that the arbitrary and

often unjust manner in which the existing companies proceed to deprive houses of their water-supply becomes severely felt. In many cases it happens that the fault lies not with the tenant, but with the non-resident landlord. Thus, as Dr. Bristowe observes in a recent report on the circumstances of the poor in his district, not only are dwellings left for weeks without one of the first necessaries of life, owing, it may be, to no default of the tenant, but the company coolly give the sanitary authority intimation of their proceedings, so that the vestry (acting in the interests of health) may take legal measures to compel landlords to have the water supply reinstated, and thus act as the company's cat's-paw. This practice obtains in almost every metropolitan and suburban district, and at Tottenham it is carried out very extensively. In the majority of instances the houses which are treated in this manner are occupied by the poorer class of people, who are not over-scrupulous in their habits. There is general uncleanliness, and the lack of water leads to imperfect removal of excreta and consequent contamination of the air. As Dr. Watson, the local health officer, remarks: It is not difficult to see how an epidemic would spread with rapidity amongst the inhabitants of such houses, and it is fortunate that the illness which recently prevailed there was measles, and not one of the more dangerous and fatal of the zymotic diseases.

THE STATISTICAL WORKS OF DR. FARR. It has long been the source of much regret amongst students of vital statistics, as well as among those practically interested in this branch of sanitary science, that the valuable statistical work of the late Dr. Farr is, from the form and manner of its publication, not generally available. The Sanitary Institute of Great Britain propose, in these circumstances, to publish a selection fom Dr. Farr's official reports, papers, and addresses, and have confided the selection and editing of this memorial of his labours to the capable hands of Mr. Noel A. Humphreys, of the Registrar-General's Office. It is proposed that the volume should consist of not less than 450 pages 8vo., and that it be published at the price of 30s., or, to subscribers, one guinea, provided that the number of subscribers warrants the Institute in incurring the expense of publication. Intending subscribers are requested, therefore, to send in their names without delay to the Secretary of the Institute, in order that this Council may be able to determine whether they will obtain sufficient support to justify them in publishing the book.

PRECAUTIONS AGAINST CHOLERA IN
THE TYNE.

AT the last meeting of the Newcastle City Council Alderman Wilson, Chairman of the Tyne Port Sanitary Authority, stated it would be satisfactory to the inhabitants of both banks of the River Tyne to learn that the most vigilant precautions were adopted at the present time to prevent the importation of infectious disease from abroad. They had two inspectors who boarded every vessel that arrived in the Tyne from abroad, and, in addition to that, the Local Government Board had sent down a special inspector to assist in that duty. He trusted that this statement might allay any apprehensions that might be felt on the matter.

DISINFECTION AND CHOLERA IN PARIS. ACCORDING to a Paris correspondent, writing to the Times on July 3, 'since Tuesday last a system of disinfection has been in operation at the Lyons Station, in Paris, for all passengers arriving there from Toulon and Marseilles or other infected places. Special carriages are reserved for such passengers and their luggage. On arrival in Paris the former are conducted into a waiting-room, the interior surface of which is covered with sawdust impregnated with lime and salts of copper. In this waiting-room there are vases containing a mixture which gives off enough nitrous acid to effect disinfection without impeding respiration. The passengers pass half an hour in this place. Meanwhile the luggage is conveyed to another room, opened, and the contents spread out. The room is then closed, and everything is submitted for a quarter of an hour to intense nitrous vapour. This measure is enforced by virtue of an order of the Prefect of Police, which has been issued pursuant to a law of 1790 and to an order of the Consuls of the 12th Messidor, year VIII.'

What useful purpose this mode of disinfecting may serve, unless to allay the fears of nervous persons, we do not know, and having regard to the nature of the disease, we do not see the value of the application of intense nitrous vapour to the respiratory mucous membrane. It may, moreover, be attended with no little danger to persons who had been wintering abroad on account of weak lungs. It would, we thing, be more useful to examine the clothing of the passengers, particularly their underclothing, and in certain circumstances to see that these were destroyed and the passengers previously bathed and supplied with new clothing, or previously sent to a hospital, where they might be under medical supervision. We would suggest that all persons arriving in Paris from cholera districts be medically examined, that such as are not in a satisfactory state of health be placed under medical supervision, that such as may be suffering from diarrhoea be sent to hospital and their clothing destroyed, and that the names and addresses of those who appear to be in good health be sent to the sanitary authority of their respective places of abode, so that, in the event of their becoming subjects of diarrhoea, they might be promptly dealt with.

DR. BROUARDEL, member of the Academy of Medicine and professor of Medical Jurisprudence at the Paris Faculty of Medicine, has been elected to replace the late Professor Würtz as president of the Comité Consultatif of Public Health.

THE NATIONAL HEALTH SOCIETY'S PUBLICATIONS.We spoke last month of an excellent little pamphlet about vaccination, which the National Health Society was suggesting for house-to-house distribution in the metropolis by the officers of the several Boards of Guardians. We are glad to find that the pamphlet has since been virtually adopted by the Local Government Board, who have officially recommended its circulation in a letter which subject of the present epidemic of small-pox. they have addressed to the Metropolitan Guardians on the Many thousands of copies of the pamphlet-not far short of 150,000 in fact-have been distributed during the last few weeks, and the demand still continues. Encouraged by this success, and always with the view of doing useful public work, the society has prepared a similar leaflet about cholera, the issue of which may be expected immediately.

THE PUBLIC HEALTH
DURING JUNE 1884.

THE mean temperature at the Royal Observatory, Greenwich, during the month of June was 580; it was below the average June temperature in one hundred years, and was 10 below that recorded in the corresponding month of last year. An excess of temperature prevailed on ten days during the month, while on eighteen days it was below the average. The warmest day of the month was the 27th, when the mean was 66°·6, and 4°.6 above the average; the coolest day was the 6th, when the mean did not exceed 49°5, and was 8°.8 below the average. Rain was measured at Greenwich on eight days during the month, to the aggregate amount of 2.2 inches, which exceeded by the fifth of an inch the average June rainfall in sixty-one years. During the first six months of this year the rainfall amounted to 8.9 inches, which was as much as 19 inches below the average rainfall in the same period of sixty-one years. The sun was above the horizon during 494 5 hours during June, but only 134 3 hours of bright sunshine were recorded at Greenwich; this amount was below the average of the corresponding month of the five preceding years 1879-83. The wind was very variable during the month, except from the 12th to the 22nd, when north-easterly winds prevailed.

In the twenty-eight large English towns dealt with by the Registrar-General in his Weekly Return, which have an estimated population of nearly eight millions and three-quarters, 23,243 births and 12,976 deaths were registered during the four weeks ending the 28th ult. The birth-rate, which had been 348 and 35.5 per 1,000 in the two preceding months, declined to 34 6 during June, and was slightly below that recorded in the corresponding month of either of the two previous years, 1882-83. The lowest birth rates last month in these twenty-eight towns were 28.3 in Brighton, 29.2 in Halifax, and 30 2 in Huddersfield; the rates ranged upwards in the other towns to 40°2 in Nottingham, 40'5 in Cardiff, 442 in Preston, and 451 in Sunderland. In London the birth-rate last month was 331, while it averaged 35.8 per 1,000 in the twenty-seven provincial towns.

The annual death-rate in the twenty-eight towns, which had been 22.1 and 20.7 per 1,000 in the two preceding months, further declined to 19.3 during the four weeks of June, but slightly exceeded the rate recorded in these towns in the corresponding period of 1882 and 1883, when it was 19'0 and 19.1 per 1,000 respectively. The lowest rate of mortality last month in these towns was 12.9 in Brighton. The rates in the other towns, ranged in order from the lowest, were as follow:-Brighton, 12.9; Norwich, 149; Bristol, 15.3; Derby, 15.8; Leicester, 160; Hull, 16.3; Birkenhead, 17.2; Bradford, 17:4; Nottingham, 175; Salford, 181; Newcastle-uponTyne, 184; Sheffield, 18.6; London, 187; Birmingham, 187; Cardiff, 190; Hudderfield, 19:4; Plymouth, 201; Bolton, 2015; Preston, 208; Blackburn, 214; Sunderland, 216; Leeds, 22'1; Halifax, 22'7; Manchester, 231, Oldham, 236; Wolverhampton, 238; and the highest rate during the month, 25.6 in Liverpool. While the death-rate in London during June, as above stated, was 18.7 per 1,000, it averaged 19.9 in the twentyseven provincial towns. The 12,976 deaths from all causes in the twenty-eight towns during the four weeks of June included 2,026 which were referred to the principal zymotic diseases, of which 618 resulted from measles, 490 from whooping-cough, 250 from diarrhoeal diseases, 238 from scarlet fever, 180 from small-pox, 152 from 'fever' (principally enteric), and 98 from diphtheria. These 2,026 deaths were equal to 15.6 per cent. of the total deaths, and to an annual rate of 3'02 per 1,000. This zymotic rate showed a slight further decline from the rates in the two preceding months, but exceeded that recorded in the corresponding month of either of the two previous years. The death-rate in London during June from the principal

zymotic diseases was equal to 3.6, and exceeded by as much as 10 per 1,000 the average rate in the twentyseven provincial towns, among which this zymotic rate ranged from o'I in Brighton, o'3 in Derby, 11 in Bristol, and 13 in Hull, to 36 in London and in Cardiff, 3.8 in Oldham, 46 in Liverpool, and 47 in Wolverhampton. Measles caused the high zymotic death rates in London, Oldham, and Wolverhampton, and scarlet fever in Cardiff.

Measles was the most fatal zymotic disease in the twenty-eight towns during June. The death-rate from this disease, which in the two preceding months had been o'96 and o'94, further declined to o'92 during June, although it considerably exceeded the rate in the corresponding period of either 1882 or 1883. In London the rate of mortality from this disease was equal to 103 per 1,000, and showed a very slight decline from the high rate in the preceding month; in the provincial towns the measles death-rate averaged 0.83, but was equal to 1.89 in Liverpool, 212 in Blackburn, 2·55 in Oldham, and 399 in Wolverhampton. The rate of mortality from whooping-cough, which had been 110 and 0.96 per 1,000 in the two preceding months, further declined during June to 073, which, however, considerably exceeded the rate in the corresponding period of last year. The fatality of whooping-cough in London was again almost twice as great as in the provincial towns, among which it was excessive in Sunderland and Liverpool. The death-rate from diarrhoeal diseases was considerably below the average of corresponding months in recent years. The rate of mortality from scarlet fever, which had steadily declined in the seven preceding months from 0.84 to 0.40 per 1,000, further fell to 0.35 during June, and was lower than in any month on record. In London the scarlet fever death-rate was equal to 0.33, while it averaged 0.38 in the twenty-seven provincial towns, and was equal to o 80 in Leeds, 1.30 in Sheffield, and 140 in Cardiff. The death-rate from 'fever' (principally enteric or typhoid) showed a slight increase upon the rate in the preceding month; the highest rates of mortality from this disease last month were 0.52 in New. castle-upon-Tyne, 0.53 in Salford, and o'98 in Portsmouth. The death-rate from diphtheria almost corresponded with the rates in recent months; the prevalence of this disease was almost entirely confined to London, Portsmouth, and Cardiff. During the four weeks of June 180 fatal cases of small-pox were registered in the twenty-eight towns; showing a considerable further increase upon the numbers in the four preceding months; of these, 137 occurred in London, 24 in Liverpool, 6 in Sheffield, 4 in Sunderland, 3 in Hull, 3 in Cardiff, 2 in Manchester, and I in Birmingham. Judged by the returns of the Metropolitan Asylum Hospitals, the prevalence of small-pox in London showed a further considerable increase during June. The number of small-pox patients under treatment in these hospitals, which in the eight preceding months had increased from 41 to 1,057, further rose to 1,290 at the end of June, and exceeded the number at any period since June 1881. The average weekly number of new patients admitted to these hospitals, which had been 52, 84, and 246 in the three previous months, further rose during June to 275.

The rate of infant mortality in the twenty-eight towns, measured by the proportion of deaths under one year of age to births registered, was equal to 126 per 1,000 during June, which differed but little from the rates recorded in the corresponding months of recent years. The rate of infant mortality in London was 126, and in the twentyseven provincial towns it averaged 127, ranging from 57 in Brighton, 91 in Birkenhead, and 93 in Bristol, to 154 in Leeds, 161 in Liverpool, and 195 in Wolverhampton.

The death-rate from diseases of the respiratory organs, judged by the metropolitan returns, slightly exceeded the average during June. The weekly number of deaths referred to these diseases in London averaged 235, and the annual death-rate was equal to 31 per 1,000. In