« EelmineJätka »
would be confined to the flue, and would find its Huddleston delicately styles 'very serious conseexit in the ordinary way. If we mistake not, this quences' will follow for themselves. system has to a limited extent been carried out at Gloucester, under the direction of the city surveyor, POISONED BY CANNED TOMATOES.-DANGER but in London especially there would be many
OF USING A CHLORIDE OF ZINC FLUX. difficulties in construction and other points, which must for some time to come prevent its adoption An interesting case, in which a whole family were from becoming general, how desirable soever it poisoned (fortunately not fatally) by eating canned
tomatoes, is reported by Dr. J. G. Johnson, of
Brooklyn. A lady, her son and nephew, and three HOW TO PREVENT AND OPPOSE THE
daughters, partook of bread and butter and boiled CHOLERA.
tomatoes for lunch. About two hours after they were
all taken ill with burning pain in the pit of the The National Health Society have issued a circular stomach, intense thirst, dryness of the throat, retchletter to sanitary authorities, stating that in view of ing and tenesmus. On the symptoms increasing the spread of cholera in France, and of the possi- the mother administered a purge, and the boys, after bility that the disease may be imported into this some hours, were able to throw off the contents of country, it appears to be very important that house their stomachs, and improved. The mother and holders generally should understand the precautions daughters grew worse, and by the fourth day the which they must individually adopt if the progress eldest daughter had all the symptoms of severe of the disease—when it has once gained a footing gastro-enteritis, the abdomen being intensely tender, here-is to be checked. In these circumstances the and she was beginning to sink into a state of coma. society has prepared a memorandum, couched in The mother and second daughter suffered in the plain and simple language, explaining - How to Pre- same way, the latter having, in addition, a fiery red vent and Oppose the Cholera.' The society suggests eruption from head to foot, accompanied with inthat this pamphlet might very usefully be distributed tolerable itching. The eldest daughter passed into from house to house in each district by the officers
a state of profound coma, from which she could not of the sanitary staff. With the object of encouraging be aroused, and on the evening of the eighth day as far as possible the taking of precautions against she was seized with epileptiform convulsions, which the invasion of cholera the society are prepared to continued with considerable severity till the tenth supply copies at the cost of printing—viz., il. 15. day, when the bowels began to act, and the patient per 1,000, and will on request give instructions for improved. By this time the other patients were the filling in of certain blanks on the last page, with also convalescent. That they were suffering from the names of the local medical officer of health and
some irritant poison was evident from the fact that inspector of nuisances, without further charge, pro- they all sat down to lunch in health, and that all vided that no less than 5,000 copies are ordered. who partook of the lunch were affected. That the The memorandum contains a variety of useful poisoning was not caused by the bread and butter instructions as to the precautions to be observed to was proved by the lady's husband having eaten of it keep the cholera away, and to prevent its spread if for breakfast and supper with impunity. Dr. Johnson it should come. Its universal distribution through- concluded the symptoms were not those which might out the country would therefore be a great advan- be expected from the ingestion of over-ripe or tage, and it is to be hoped that local authorities may spoiled tomatoes, and that if there had been a fersee fit to incur the small expense which the purchase ment or poisonous mould present it would have been of a few thousand copies would entail. It should be rendered innocuous, as the tomatoes had been well added in this connection that the pamphlet, being a boiled just before being eaten. Could the vessel copyright publication, cannot be reprinted without used in cooking have introduced a mineral poison ? the assent of the society.
No; the vessel was made of fire-clay with a salt
glaze, and had been in use by the family for over a VACCINATION v. VACILLATION.
month. The spoon used in stirring was also care
fully examined—it was triple plated and unworn. The Guardians of Dewsbury appear to be sincerely | The poison must have been a soluble one, and condesirous of emulating the doughty deeds of the tained in the tomato juice, for the eldest daughter Keighley guardians of happy memory, and of spend (who suffered most severely) had not eaten of the ing a period of seclusion at York Castle in the sacred solid part, but soaked bread in the juice. Unforcause of anti-vaccination, to be welcomed back at tunately the dishes had been washed, and none of its termination with banners and bands of music. the fruit or juice remained for analysis. It is perfectly idle for the guardians to pretend that ptoms corresponded closely with those of verdigris they are anxious to carry out the vaccination laws poisoning, and Dr. Johnson was at first inclined to under proper safeguards. Their whole action shows attribute them to this, as in canning establishments them to be possessed with the demon of incurable large copper kettles are used, and verdigris frequently wrong-headedness. They have trifled with the law forms in them when acid fruits are stewed and and the Local Government Board long enough. With allowed to stand. However, on showing a their specious pleas of lack of proper candidates, and similar to that used for the tomatoes to a tinsmith a of desire that the vaccinator shall give a guarantee flood of light was thrown upon the case.
This man against ill-effects arising from vaccination, they have pointed out to Dr. Johnson that the cap was not frittered away something like twelve months of time, fastened to the head of the can by a resin amalgam, during which the distriot has remained unprotected as the sides were, but that the amalgam was made from small-pox. It is to be hoped that the guardians of muriate of zinc-i.e. pieces of zinc were placed will now recognise that, whether they like it or not, in muriatic acid and dissolved till the acid would no the law is more powerful than they, and that if they longer attack the zinc, and this liquid was painted do not do as the law tells them, what Mr. Baron into the groove at the head of the can.
was then placed on and held with a clamp, and the that cholera is not communicable from person to soldering iron passed round. Of course the solder person. That the disease cannot be ascribed to held the acid in, and if there happened to be too somebody else'; that is, that the sick do not manumuch acid applied to the groove, then, as the tin facture a special poison’ which causes the disease. expanded with the heat, it would be forced into the That cholera is a local disease--an epidemic affecting
This appeared to Dr. Johnson to offer a rea- localities, and there depending upon pollution of sonable solution to the problem he had set himself | earth, air, and water and buildings. That the isolato master-the source and nature of the poison in tion of the sick cannot stop the disease, nor quarancanned tomatoes, the ingestion of which had so tine, nor cordons, nor the like. These, indeed, may nearly proved fatal. That chloride of zinc was the tend fatally to aggravate the disease, directly and poisonous agent in these cans is not absolutely indirectly, by turning away our attention from the proved, but so nearly that Dr. Johnson is more than only measures which can stop it. That the only justified in warning the profession and the public preventive is to put the earth, air, and water and against this new danger, and cautioning purchasers buildings into a healthy state by scavenging, limeto reject every article of canned food that does not washing, and every kind of sanitary work, and, if show the line of resin around the edge of the solder cholera does come, to move the people from the of the cap, the same as is seen on the seams at the places where the disease has broken out and then to side of the can.'
cleanse. Persons about cholera patients do not
'catch' the disease from the sick any more than LAMB AT THREEPENCE A POUND.
cases of poisoning 'infect' others. If a number of
persons have been poisoned, say by arsenic put by A MAN named Clark, living at Turnham Green, mistake into food, it is because they have each swalwas lately prosecuted by the Fulham Board of lowed the arsenic. It is not because they have taken Works for exposing for sale in King Street West, 'it,' the mysterious influence,' of one another. Hammersmith, the carcase of a lamb unfit for food In looking sadly at Egypt–Egypt, where cholera of man. Dr. Collier, the medical officer of health did
not begin anywhere along the route from India for the district, stated that on the evening of the to Europe, but at Damietta, where no ship and no 21st. ult his attention was drawn to the defendant's passenger ever stops, and where the dreadful insanistall by a man calling out 'Lamb, 3d. a pound.' He tary condition of the place fully accounts for any went up to the stall and noticed a carcase of lamb, outbreak of cholera-in sorrowfully looking at Egypt the flesh of which was spotted. He was of opinion and at Europe now, one might almost say that it is that the animal had died of fever, and the meat had this doctrine of a special poison emanating from the been brought before a magistrate and an order to sick and which it is thought can be carried in a destroy it obtained. Mr. Kisch, who appeared for package that has (mentally) ‘poisoned’us. People the defendant, said the meat was Australian, and will soon believe that you can take cholera by taking was so late in the market, through delays in transit, a railway ticket. They speak as if the only reason that the defendant had been able to purchase it at against enforcing quarantine were, not that it is an an exceptionally cheap rate. It was passed by the impossibility and an absurdity to stop disease in this port sanitary authority and by the chief inspector way, but that it is impossible to enforce quarantine. of the meat market. Mr. William Wild, Chief •If only we could,' they say, 'all would be well.' inspector of the market, was called, and confirmed Vigorously enforce sanitary measures, but with judgMr. Kisch's statement. The defendant was fined ment—e.g. scavenge, scavenge, scavenge; wash, 10l. and 31. 55. costs; the magistrate remarking cleanse, and limewash ; remove all putrid human that if it had appeared to him that the defendant refuse from privies and cesspits, and cesspools and knew the meat was bad he would have sent him to dustbins ; look to stables and cowsheds and pigsties; prison.
look to common lodging-houses and crowded places, This case affords a good illustration of the dirty houses and yards. 'Set your house in order unsatisfactory way in which meat is inspected. All in all ways sanitary and hygienic according to the meat intended for food of man should be subjected conditions of the place, and all will be well.'. The to a careful examination to ascertain if it be sound real danger to be feared is in blaming somebody else and free from disease, and the examiner should and not our own selves for such an epidemic visitapossess the necessary skill and knowledge. One tion. As a matter of fact, if the disease attacks inspection is sufficient provided it be thorough. As ourselves we ourselves are already liable to it. To matters are, however, it would appear that meat trust for protection to stopping intercourse would be may run the gauntlet of two inspections and yet be just as rational as to try to sweep back an incoming so bad as to be pronounced unsound directly it is food instead of getting out of its way. seen by a medical officer of health. We are pleased to notice that the inspection of meat markets was MR. CHARLES WINGATE, of New York, points out in one of the special subjects discussed at the Public the Medico-Legal Journal, published in that city, that Medicine Section of the Belfast meeting of the sanitary legislation in England dates from a very early British Medical Association. Few topics are more
period. For instance, Edward II. decreed that a butcher deserving of attention.
who sold measled pork should be fined for the first offence, pilloried for the second, imprisoned and fined for the third,
and expelled the town for the fourth. Richard II. took MISS FLORENCE NIGHTINGALE ON THE
measures against the pollution of rivers. Henry VII. pro. CHOLERA.
hibited cattle-slaying within walled towns with three ex
ceptions. Elizabeth enacted that only one family might In a letter appearing in the New York Herald Miss
dwell in a cottage. The plague, in the time of Charles II., Florence Nightingale gives the following practical led to many health enactments. More than two centuries advice concerning the cholera :-That our whole ago we read that Shakespeare's father was repeatedly fined experience in India, where cholera is never wholly by the authorities of Stratford-on-Avon for throwing absent, tends to prove-nay, actually does prove- | garbage into the streets in front of his cottage.
THE PUBLIC HEALTH
as much as 7'03 per 1,000 (of which 4.52 was due to DURING JULY 1884.
diarrhoea), whereas it did not exceed 5 or in the provincial
towns, among which the diarrhoea rate was 2-95 per 1,000. The mean temperature during the month of July at the The zymotic rates in the provincial towns ranged from l'I Royal Observatory, Greenwich, was 63°:4 ; it exceeded by and 1:8 in Huddersfield and Bristol, to 7.5 in Liverpool, 10:8 the average July temperature in one hundred years, 7-8 in Nottingham, 9.o in Preston, and 10:4 in Leicester. and was as much as 30.6 above that recorded in the corre- Diarrhoea was by far the most fatal zymotic disease in sponding month of 1883. An excess of temperature pre- the twenty-eight towns during July. The rate of morvailed on fifteen days of the month, while on the other six. | tality from this disease in these towns, which had been teen days it was below the average. The warmest day of but 0.37, in June, rose to 3:67 during July, and exceeded the month was the 4th, when the mean was 72°4, and that recorded in the corresponding month of 1883, when showed an excess of no less than 11°.0; the coolest day it did not exceed 2.40 per 1,000. The diarrhoea deathwas the 26th, when the mean was only 54°2, and 80.5 rate last month did not exceed 0-49 in Huddersfield, 1.07 below the average.
Rain was measured at Greenwich on in Wolverhampton, and 1'09 in Halifax ; while it ranged sixteen days during the month, to the aggregate amount of upwards in the other towns to 4:53 in Leeds, 6.00 in 18 icches, which was o:8 of an inch below the average Nottingham, 7.34 in Preston, and 8.80 in Leicester. July rainfall in sixty-one years. During the first seven While the rate of mortality from diarrhoea was 4.52 in months of this year the rainfall amounted to 10°7 inches, London, it did not average more than 2.95 in the twentywhich was nearly three inches below the average rainfall in seven provincial towns. The death-rate from measles, the same period of sixty-one years.
The sun was above which had been 0.94 and 0.92 per 1,000 in the two the horizon during 496.8 hours in July, but only 126.5 preceding months, further declined during July to 0.64. hours of bright sunshine were recorded at Greenwich; In London the rate from this disease was 0.60, and the this amount was considerably below that registered in the highest rates among the provincial towns were 1'98 in corresponding period of any year since 1879. South- Liverpool, and 2.08 in Blackburn. The rate of mortality Westerly winds prevailed almost throughout the month. from whooping-cough was 0.63 per 1,000, and showed a In the twenty-eight large English towns dealt further decline from
the rates in recent months, although it with by the Registrar-General in his Weekly Returns, considerably exceeded the rate recorded in the corresponding which have an estimated population of nearly eight period of last year. In London the rate from this disease millions and three-quarters, 28,589 births and 19,121 was 0.73 per 1,000, and among the provincial towns deaths were registered during the five weeks ending the the highest whooping.cough rates were 1'02 in Leicester, and inst. The birth-rate, which had been 35.5 and l'11 in Liverpool, and 2.37 in Sunderland. The death 34'6 in the two preceding months, further declined to te from scarlet fever, which in the eight preceding 340 during July, and almost corresponded with the rates months had steadily declined from 0.84 to 0:35 per 1,000, recorded in the same month of the two preceding years, rose again during July to 0:44. In London the rate of 1882-83. In these twenty-eight towns the lowest birth mortality from scarlet fever was equal to 0:38 per 1,000. rates last month were 28.1 in Bradford, 28.2 in Brighton, while in the twenty-seven provincial towns it averaged and 29'2 in Huddersfield and in Halifax ; in the other 0:48, and showed the highest proportional fatality in towns the rates ranged upwards to 40:8 in Nottingham, Wolverhampton, Sheffield, and Cardiff. The death-rate 42'I in Cardiff, and 42:4 in Sunderland. The birth-rate from 'fever '(principally enteric or typhoid) showed a last month in London was 32.9, while it averaged 35:1 slight increase upon recent monthly rates, and was in the twenty-seven provincial towns,
considerably higher in London than in the aggreThe annual death-rate in the twenty-eight towns, gate of the provincial towns. The rate of mortality which in the two preceding months had been 20°7 and from diphtheria corresponded with the rate in the 19-3, rose to 22.8 during July, principally owing to the preceding month ; this disease showed some prevagreatly increased fatality of diarrheal diseases. This rate lence in London, but very few fatal cases considerably exceeded those recorded in the corresponding corded in the provincial towns. During the five weeks of months of 1882 and 1883, which were 19.1 and 20:7 per July 132 fatal cases of small-pox were registered in the 1,000 respectively. The lowest rate of mortality last twenty-eight towns, showing a marked decline from the month in these towns was 14'5 in Bristol. The rates in number during June ; of these, 102 were returned in the other towns, ranged in order from the lowest, were as London, 13 in Liverpool, 6 in Sheffield, 5 in Hull, 5 in follow :-Brighton, 14:6 ; Portsmouth, 15.8; Huddersfield, Sunderland, and 1 in Cardiff. Judged by the returns of 175; Derby, 18:1 ; Plymouth, 18:2; Hull, 18.4 ; Birken- the Metropolitan Asylum Hospitals, the prevalence of head, 1806, Birmingham, 19'1; Bradford, 19:3; Old-small-pox in London showed a further considerable deham, 20-5; Blackburn, 20:8; Wolverhampton, 20:9; cline throughout July. The number of small-pox patients Salford, 21:4; Norwich, 21.4 : Halifax, 21-6; Sunder under treatment in these hospitals, which in the nine preland, 22:4; Bolton, 22.7 ; Cardiff, 23:1 ; London, 2367; vious months had steadily increased from 41 to 1,290, Newcastle-upon-Tyne, 23'9; Sheffield,' 24.0; Leeds, declined to 892 at the end of July. The average weekly 24.5; Manchester, 25'0; Nottingham, 25:6; Liverpool, number of new patients admitted to these hospitals, which 267; Preston, 26.8'; and the highest rate during the had risen frorn 18 to 275 in the six previous months, fell month, 27'3 in Leicester. While the death-rate in London during July to 151. during July, as above stated, was as much as 23:7 per
The rate of infant mortality in the twenty-eight towns, 1,000, it did not average more than 22'o in the twenty- measured by the proportion of deaths under one year of seven provincial towns. The 19,121 deaths from all causes age to births registered, was equal to 246 per 1,000 during in the twenty-eight towns during the five weeks of July July, against 163 and 195 in the corresponding periods of included 4,986 which were referred to the principal zy- the two preceding years, 1882-83. This increase was motic diseases, of which 3,012 resulted from diarrheal entirely due to the excessive fatality of summer diarrhoea, diseases, 540 from measles, 529 from whooping-cough, which caused very high rates of infant mortality in many 366 from scarlet fever, 214 from “fever ' '(principally of the towns. While the infant mortality did not exceed enteric), 132 from small-pox, and 123 from diphtheria. 131 per 1,000 in Brighton and Bristol, where but little These 4,986 deaths were equal to 26 per cent. of the total diarrhoea existed, it was equal to 303 in Nottingham, 326 deaths, and to an annual rate of 5.94 per 1,000.
This in Preston, and 453 in Leicester, where the highest deathzymotic rate, owing to the prevalence of summer diarrhea, rates from diarrhea were recorded. considerably exceeded that recorded in recent months, The death-rate from diseases of the respiratory organs, and also was above the rate from the same diseases in the judged by the metropolitan returns, differed but slightly Corresponding months of either of the two preceding from the average during July. The weekly number of years. The zymotic death-rate in London during July was I deaths referred to these diseases in London averaged
194, and the annual death-rate was equal to 2.52 per
NOTIFICATION OF INFECTIOUS 1,000. In Liverpool the annual rate of mortality from these diseases was last month equal to 3.80 per 1,000.
DISEASE. The causes of 390 of the 19,121 deaths registered in the The question of the compulsory notification of infectious twenty-eight towns during the five weeks of July were disease, and especially of the person by whom such notifinot certified, either by medical practitioners or by coro- cation is to be made, appears to have now taken firm root ners. These uncertified deaths were equal to 2.04 per cent. as one of the most pressing sanitary problems of the day. of the total deaths, which was below the average in recent It was hardly to be expected, perhaps, that there should months. In London the proportion of uncertified deaths be absolute unanimity with regard to it on the part of the did not exceed 1:07 per cent., while it averaged 2.92 in medical profession; but one was scarcely prepared for the the twenty.seven provincial towns ; and ranged from 0.00 complete opposition of opinion which has been revealed and 0'76 in Portsmouth and Plymouth, to 5.00 in Hull, by recent discussions at the International Health Exhibi5.81 in Oldham, and 7:41 in Birkenhead.
tion and elsewhere. We publish to-day two admirable Among the population living in the outer ring of papers on the subject by two acknowledged leaders of the suburban districts around London, estimated at rather more sanitary world. The one argues strongly in favour of notifthan a million persons, the annual death-rate during July cation by the medical man ; the other argues just as strongly from all causes was equal to 18:9 per 1,000, against in opposition to it. The one treats as of no importance ob14:6 and 16'7 in the corresponding periods of 1882 and jections which seem to the other to be of paramount weight. 1883. During the five weeks ending the 2nd instant, If we could print the opinions of these two authorities in 313 fatal cases of diarrhea, 69 of whooping-cough, 29 of parallel columns, such of our readers as do not possess measles, 24 of small-pox, 22 of diphtheria, 19 of • fever,' an abnormal development of the critical faculty might well and 12 of scarlet fever were recorded in the outer ring. stand aghast, and wonder how with views so divergent as These 488 deaths were equal to an annual rate of 4.74 | these, there could be any hope of the system of compul. per 1,000, which considerably exceeded the rate recorded sory notification making progress at all.
The answer is to in the same month of the two previous years. The be found in the words of Goethe : •More light': and it is fatality of measles and scarlet fever showed a decline, with the view of shedding more refulgence upon the but that of each of the other zymotic diseases showed an question that we inaugurated the system of returns to increase. The 24 deaths from small-pox registered in the which we refer more at length below. After all, a system outer ring included 15 in West Ham, 3 in Croydon, and of whatever kind must be judged by its results; and the 2 in Hornsey. Six fatal cases of diphtheria occurred in outward and visible sign of those results is, in the case Tottenham sub-district, and 6 of measles in the sub- before us, a diminution of the prevalence of fatality of district of Bromley.
zymotic disease. We have before pointed the futility of merely collecting together for dry statistical purposes a
record of the zymotic sickness in this or that district. The The use of tube or Abyssinian wells for obtaining water notification return, though useful of course for reference in rural districts has often been resorted to, and almost and table-making, should be regarded primarily as a invariably with success. This plan, which possesses many danger signal, upon which the local authorities, if they are obvious advantages over the ordinary open well, has been wise, will lose no time in acting. tried with excellent results at Watford. In referring to the There are rcasons for belief that before very long a subject in a recent report, Dr. Saunders suggests that the general inquiry into notification and its results, actual and sanitary authority should obtain the necessary tackle and proposed, will be undertaken by the Government. Such lend it to persons whose means are small. At this time of an inquiry has been recommended by the Special Comthe year, when the usual supplies of water in many mittee which was appointed this session to deal with the districts are getting scanty, the suggestion is well worthy various Corporation Bills containing sanitary clauses, and of a trial.
it is apparently coming to be generally recognised that the M. HYADES has written a memoir on the hygiene of the present haphazard method of dealing with the matter can
be endured no longer. Meanwhile, we think it useful and Fuegians which he studied during his visit to Terra del Fuego. His memoir contains also considerable informa
instructive to place upon record each month the numerical
results of disease-notification, as obligingly furnished to us tion on affections peculiar to the Fuegians. It might by the various medical officers of health. Later on it may have been reasonably expected that the hygiene of the Fuegians would have been open to the celebrated descrip: Registrar General's figures about towns not included in the
be possible, from a study of the returns and of the tion by the schoolboy of the habits and manners of the
tables, to form some sort of statistical judgment as to the Romans !
propriety of extending the system of compulsory notification The Sanitary Authorities of St. Pancras have resorted throughout the country. At present the materials for such to a special organisation of their staff to make a house-to- a judgment do not exist; and it is especially with the house call weekly, not only for the purpose of looking object of helping towards a calm and impartial consideraafter the water-supply and drainage, but to see that the tion of the question that our returns of infectious sickness dustbins are clear of animal and vegetable refuse.
A have been organised. number of men are employed in following the carts, sup: The following table contains uniform statistics for sickplied with carbolic acid, and as soon as the bins are clearedness and mortality in twenty-eight of the thirty-eight urban commence their work of disinfecting. It is a most remark- sanitary districts in England and Scotland in which the notiable fact that four-fifths of the inhabitants exhibit annoy.
fication of infectious disease is compulsory. We hasten to ance at the weekly visits, and in the majority of cases will take this opportunity gratefully to acknowledge the very not allow the dustbins to be emptied until they are over. general response of the medical officers of health whose flowing with refuse. This circumstance, however, only co-operation we invited in this matter. We are pleased to puts in a stronger light the urgent necessity, especially be able to state that the health officers of a very large during hot weather, of removing all the multifarious de. majority of the thirty-eight towns in which notification is composing matter of which the so-called dustbin is the compulsory have most readily responded to our appeal, receptacle in all neighbourhoods, rich as well as poor. and we are glad to be enabled to publish our first monthly The Vestry of St. Pancras have shown practical common
table so nearly complete. We have every reason to hope sense in the step which they have taken, which should be that the number of contributors will increase. We would imitated by every parish. Very forcible and stringent specially thank the medical officers of health for the measures are required to prevent many of the inhabitants prompt dispatch of their cards. While we are fully aware of this vast metropolis from becoming piggishly indifferent of the difficulty which is often experienced in furnishing to dirt and bad smells.
the required information immediately after the close of the
Table Showing Sickness and Mortality in Large Towns of England and Scotland During the Month of July 1884.