tion be found necessary. Boards of railway directors always profess great readiness to examine, try, and perhaps adopt any plans for increasing the comfort and safety of the travelling public, but when various plans are submitted to them, they easily evade their professions by replying that the plan is not adapted to their system.' The unguarded space between the carriages is an ever-present cause of railway accidents, which can be very easily prevented by hanging a strong net perpendicularly on the near side between the carriages, one corner of the upper side of the net being looped on to a hook fixed to the side of each carriage at about 4 feet above the level of the floor of the carriage, and the lower side of the net, being armed by a stout iron rod, which acts as a stretcher, and which resting in two clips, one fastened to each carriage at the level of the floor of the carriage, by its weight keeps the net in its place. If these two plans were universally adopted on our railways, these too constantly recurring railway accidents would be entirely done away with, for the space between the platform and the side of the carriages would be too small to admit of any person falling into it, and the net would certainly prevent any person from falling in the space between the carriages; and with the floor of the carriages and the surface of the platform on the same level, and only about 6 inches apart, all travellers would be able to enter or leave a railway carriage nearly as easily, and with about as little danger, as when leaving one room in a house for another. I sent my plans to the Board of Trade, and the board submitted them to Captain Tyler, one of the inspectors, and his report was favourable, but I was at the same time informed that the board had no power to oblige railway companies to adopt any plans for the comfort and safety of railway travellers, however much they may approve of them. I think the British travelling public are beginning to be of opinion that it is time to say: Quousque tandem abutere?' GODFREY SINCLAIR.

Conservative Club.

RAILWAY PLATFORMS AND FOOT-BOARDS. (To the Editor of the SANITARY Record.) SIR,-The following bears upon your leader of Dec. 30, last, on railway platforms and foot-boards.

Having descended from a Midland carriage at Ampthill the other day, it occurred to me I had left something in the carriage, and I stepped back to look in just as the train was moving off, but before the door had been closed. The kerb of the platform was of vitrified brick a foot or fifteen inches wide, and sloping steeply towards the line; and having on shooting boots at the time, the nails thereof slipped on the sloping surface and nearly threw me against or under the carriage, the steps of which being disjointed would very soon have disjointed me, if I had not had, as I consider, a very narrow escape.

I mentioned the matter to the officials on the platform at the time, calling attention to its dangerous condition. DEVONIENSIS.

Lower Musgrave House, Exeter.

Jan. 5, 1877.

WATER ANALYSIS.

(To the Editor of the SANITARY RECORD.) SIR,-Allow me to thank Professor Wanklyn and Dr. Cornelius Fox for their letters, and at the same time to assure Dr. Fox that while modesty forbids me to laud my own skill, I am not very captious but a bona fide inquirer, anxious to become au fait with all reliable processes of water analysis. I also expect Dr. Fox to come to my rescue where Professor Wanklyn ridicules subjecting small quantities of water to analysis, for if I am not mistaken, Dr. Fox, in his little book,' strongly advocates a similar proceeding. In contradistinction to Dr. Fox, I do indeed think that, so far as regards a medical officer of health, the amount of filth' in a water is the all important point to ascertain. I do not believe the Public Health Act, 1875,

contemplates the closing of any well or other source of water-supply save on 'filth' grounds. The Public Health Act most certainly does not contemplate interference with natural mineral, chalybeate or such like springs. In short, 'filth,' and 'filth' alone, is the only ground on which a source of water-supply can be interfered with, legally or equitably.

Dr. Fox evidently holds the ammonia process in very subsidiary esteem, merely as an aid to the formation of an opinion.' Here I leave him to the tender mercies of his past master, Professor Wanklyn.

Now for Professor Wanklyn. Truly I fail to see that he has replied to one of my difficulties, and I would ask him to inform me the precise value he attaches to the presence of free ammonia' and 'albumenoid ammonia,' both singly and together. Also as to nitrates and nitrites, whether they are not often sewage or filth' products, as well as natural constituents of water? If so, how, when, and where, in the ammonia process, are they accounted for and estimated? Also, whether the 'free' and the 'albumenoid' ammonias are not affected in relative quantity, according to the time that elapses between taking and analysing the sample? It is self-evident that if each ammonia, according to its quantity, has its own definite and distinctive pro or con value, if this relative quantity is liable to variation owing to time or circumstance, our verdicts from analysis will be all at sea. Here I may point out that Dr. Fox, in his little book,' does not hold the same opinions as to the value of the two ammonias as does Professor Wanklyn.

Now, as to the much vaunted 'silicated carbon filter,' perhaps Professor Wanklyn will tell me, if it effectually removes nitrogenous organic matter from drinking water, where it places it, and how he reconciles this statement with a previous one, in which he says the silicated carbon performs the same office as the potash solution in his ammonia process'?

I am glad to find that at length the Government has given its official recognition to Professor Wanklyn's process, for in the last report of the medical officer to the Local Government Board the Wanklyn process is the only one-re the Croydon fever epidemic-used. Dr. Dupré was employed to make the analyses, and he never once uses or refers to the Frankland method. On the other hand, if your readers will refer to the British Medical Journal of Dec. 16, they will find a paper by Dr. W. L. Lindsay, on the Estimation of the Quality of Potable Water,' in which, on Dr. Frankland's authority, it is stated that the albumenoid ammonia process of analysing water is quite useless for dietetic purposes,' and Dr. Mills, the Young professor of technical chemistry at Glasgow, says that with the Wanklyn method he cannot agree on chemical grounds,

and therefore never uses it.' So it will be seen that with Dr. Fox and Professor Wanklyn, both ammonia-ites at variance as to the value and indications of their pet process, and with the direct condemnations above quoted, there is some little excuse for trying to clear up this vexed question of water analysis.

In conclusion, I should like to call Professor Wanklyn's attention to the curious fact, in support of my nitrate and nitrite difficulties, that in America his own disciples estimate ammonia in three columns, viz. Free,' 'Albumenoid,' and 'From Nitr'tes' (sic).

GAUDENS IN PROLIO.

A PROBLEM.

(To the Editor of the SANITARY RECORD.) SIR, Has it been estimated what proportion of the water supplied to a town flows into the sewers? This town has been supplied, during the past twelve months, with 1,006,963 gallons of water, over 30 gallons per head per day. I may say in parenthesis, it is one of the purest waters in the kingdom, and is procured from deep wells in the new red sandstone, about six miles from the town. There being gardens at the back and

front of almost every house, a great quantity is used for watering, consequently does not pass into the sewers. From a comparison of the quantities used in different months and seasons, I estimate this at about one eighth of the whole, leaving say 881,093 gallons for domestic and trade purposes; the problem I want solved is, what proportion of this goes into the sewers? The number of houses in connection with this supply is 4,847 (average for the year). The object I set before me in this inquiry is a very important one. We are laying a new system of main sewers which will have only a slight fall-an average of 3 feet per mile, for a length of 43 miles; find the quantity of water flowing from the houses, and add a proportion of the known rainfall, it will then be possible to calculate if the volume is sufficient to flow with a velocity quicker than the minimum time necessary for decomposition, and the formation of gas to take place. CHARLES HY. BROWN. Southport, Jan. 9, 1876.

Sanitary Invention.

CLARK'S PATENT PYRAMID NIGHT LIGHTS AND FOOD WARMERS.

THESE useful inventions have been for some years before the public, who have patronised them to such an extent as to necessitate an extension of the factories where they are produced. Notwithstanding this unmistakable evidence of public favour, Mr. Clark has not been satisfied even with success, but has introduced improvements in the manufacture of the night lights, which ensure even burning, and the power of relighting the lights after they have been extinguished, as well as a considerable amount of light and heat. He has also made a change in the usual form of night lights by constructing these pyramid lights to burn under a glass shade. This shade serves a twofold purpose; in the first instance, it lessens the danger of fire from sparks when the lamp is carried about, and also of the accidental ignition of the garments of the nurse or attendant using it for warming purposes; in the second place, it serves to concentrate the heat on the tin jacket which holds the panakin of the food warmer above it. This tin jacket is filled with water, which is kept at a boiling-point if the pyramid lights be used, so that food placed in the interior vessel is easily warmed, and kept warm for as long a time as required. It will be obvious that these facilities are of great value in the sick room; the night-light stand being also available as a light for passages and rooms.

Notice of Meeting.

NORTHERN COUNTIES ASSOCIATION OF MEDICAL OFFICERS OF HEALTH.

The Winter General Meeting of the Association will, by permission, be held in the Board Room of the Guardians, Morpeth, on Tuesday, January 16, at 2 P.M. Prior to the General Meeting, a Meeting for the transaction of private business will be held at 1'IO P.M.

Business.

Private Meeting.-1. The following are proposed for election :-As members: Philip Brown, M.D., Blaydonon-Tyne; Robert Clement Pritchard, L.F.P.S, Aspatria. As associates: J. C. Murray, M.D., Newcastle-on-Tyne ; Jos. Gordon, C.E., Frankfort-on-the-Maine. 2. Consideration of resolution of committee passed on 12th ult., viz., That it be a recommendation of the committee to the members to support the memorial of the North-Western Association of Medical Officers of Health as to the tenure of office by medical officers of health.' 3. Arrangement of places for Spring and Summer (Annual) Meetings.

General Meeting.-Papers to be read. 1. The Isolation of Cases of Infectious Disease,' by R. Elliott, M.D.; 2. Damp Houses,' by W. Clarkson, M.R.C.S.; 3. The Predominant Causes of Infant Mortality,' by J. C. Reid, M. D.; 4. House Air and Towns' Water,' by R. Elliot, M.D. HENRY E. ARMSTRONG, Hon. Sec.

Dinner will be provided at the Queen's Head' Hotel, at 4 P.M. Tickets (not including wine), 6s. each. Notice of intention to dine with the Association must reach Mr. Clarkson, Morpeth, not later than the 13th inst.

Trains.-Arrive at Morpeth from North at 11.24 A.M. and 1.8 P.M.; from the South at 12.35 P.M. (by N.E.R.) and 1.5 P.M. (by B.T.R.); and leave Morpeth for North at 5.55, 7.5, and 9.25 P.M.; for South at 6.5, 7.43, and 9.10 (N.E.R.), 6.15 and 9.15 (B.T.R.).

APPOINTMENTS OF HEALTH OFFICERS, INSPECTORS OF NUISANCES, ETC.

annum.

BULL, Mr. Frederick, has been appointed Town Clerk and Clerk to the Urban Sanitary Authority, Bury, Lancashire, at 400l. per COGAN, Philip E., M.D.. C.M., Qu. Univ. Irel., has been re-appointed Medical Officer of Health for the Allerton, Heaton, and Wilsden Urban Sanitary Districts, Yorkshire.

DALLENGER, Mr. John, has been appointed Inspector of Nuisances for the Woodbridge Rural Sanitary District at 407. per annum. DAVIE, William B., Esq., has been appointed Treasurer to the Bideford Guardians and Rural Sanitary Authority, vice Simpkins, resigned.

GARLIKE, James Percie, L. R.C. P. Edin. and L. M., M.R.C.S. Eng.. has been appointed Medical Officer of Health for the SuttonBenger Sub-District of the Chippenham Rural Sanitary District, vice Little deceased.

GOWAN, Mr. Charles, has been appointed Inspector of Nuisances for the Cleator-Moor Urban Sanitary District.

HILL, Mr. John Edward, has been appointed Clerk to the Hipperholme Local Board and Urban Sanitary Authority, Yorkshire, vice Walker, resigned.

JENKINS, John, M. R.C.S. Eng., L.S.A. Lond., has been appointed Medical Officer of Health for No. 3 Sub-District of the Bridgend and Cowbridge Rural Sanitary District, vice Allen, deceased. JENNINGS, Mr. John, has been appointed Clerk to the Llanelly Local Board and Urban Sanitary Authority, vice Johnson, deceased.

KNOWLES, Mr. Eli, has been appointed Surveyor to the Local Board and Urban Sanitary Authority, Accrington, Lancashire, vice Hardie, resigned.

MASON, Charles L., Esq., has been appointed Treasurer to the Bramley Guardians and Rural Sanitary Authority, Yorkshire, vice Meggeson, resigned.

SUTTON, Frederick, M.R.C.S. Eng., L.S.A. Lond., has been appointed Medical Officer of Health for the Gainsborough Rural Sanitary District, vice Eminson, whose term of office has expired.

VACANCIES.

ARBROATH, FORFARSHIRE. Medical Officer of Health. Certifying
Factory Surgeon.
BATTLE, EASTBOURNE, EAST GRINSTEAD, HAILSHAM, NEWHAVEN,
TICEHURST, AND UCKFIELD, RURAL, AND THE CUCKFIELD,
EASTBOURNE, LINDFIELD, ST. WILFRID'S, AND UCKFIELD
URBAN SANITARY DISTRICTS, combined. Medical Officer of
Health.
CARLISLE, BOROUGH OF, AND URBAN SANITARY AUTHORITY.
Surveyor and Inspector of Nuisances.

CERNE RURAL SANITARY DISTRICT. Medical Officer of Health for the Western District. Application, 15th instant, to William Beach, Clerk to the Authority.

DARTFORD LOCAL BOARD AND URBAN SANITARY AUTHORITY, Collector.

NEW SARUM (or Salisbury) URBAN SANITARY DISTRICT. Medical Officer of Health. 60l. for one year. Application, 13th instant, to Charles Marsh Lee, Town Clerk.

NOTICE.

THE SANITARY RECORD is published every Saturday morning, and may be ordered direct from the Publishers. Annual Subscription, 175. 4d.; free by post, 195. 6d.

Reading Covers to hold 12 numbers of THE SANITARY RECORD have been prepared, and may be had direct from the Publishers or through any Bookseller, price 3s. each.

Original Paper.

ON THE LEGISLATIVE ENACTMENTS WHICH ARE NECESSARY TO ARREST THE SPREAD OF INFECTIOUS FEVERS.*

BY FRANCIS T. BOND M.D., B.A., LONDON, Medical Officer of Health, Gloucestershire Combined Sanitary District.

The question I have here to discuss is, what further legal enactments, if any, are required with a view to arrest the spread of infectious fever, and how far national and municipal registration is desirable as a means thereto? and, if so, what should be the nature of such registration?

In discussing this question it will be here assumed that the term 'infectious fever' includes all those diseases which are liable to be communicated

from one person to another, and thus to spread throughout the community, by any means except direct personal contact. No one can, I apprehend, deny that the subject embraced by this question is one of the most important with which this section can be called upon to deal. It involves the yearly sacrifice of a number of lives so prodigious that the losses incurred in such a war as that which has of late desolated Eastern Europe are but a trifle to it. But this is by no means its most serious aspect; for each actual death which thus occurs may be looked upon as a centre around which is aggregated an amount of shattered health, blighted prospects, entailed poverty, and misery, and trouble of all kinds, that are out of all proportion to the mere numerical mortality from these diseases.

Whilst this subject is, therefore, one whose importance to the happiness of the community can scarcely be overstated, it must at the same time be observed that it is one of very considerable difficulty. In many respects, our knowledge with regard to it is very incomplete. To legislate upon it with any real effect involves an interference with some of the most private social relations, and a restriction of that 'liberty of the subject,' to which so vague and mysterious a veneration is popularly attached.

That the present state of the law in regard to these diseases is satisfactory no one who has had any practical experience of its working will for a moment assert. It is greatly lacking in precision; it makes a great show of activity whilst giving little or no real power to enforce the precautions at which it aims; it allows injuries of the most grievous kind to be inflicted by one citizen upon another without providing any effectual remedy for such wrongs; and it leaves the poorer classes of the community at the mercy of their richer neighbours in matters in which the general selfishness of human nature is too often intensified by the influence of ignorance, prejudice, and cowardice combined.

In discussing this question in its legislative aspects it will be impossible here to do so in any but a most fragmentary and imperfect manner. Scarcely any single proposition can be made in connection with it that is not open to serious debate, or upon which as much might not be written as will be here devoted to the entire subject. I shall, therefore, only

Read before the Health Section of the Social Science Association, at the Annual Meeting at Liverpool, 1876.

attempt to sketch in very rough outline some of the more important matters with which any legislation in regard to it that is intended to be effective must deal, and if in so doing I should appear to be more dogmatic than is fitting, I trust that it will be attributed to a desire to be concise, rather than to a want of appreciation of the many-sidedness of the question which is at issue.

The suggestions which I shall venture to make will be founded on certain preliminary assumptions, some of the most important of which it may be as well to enunciate. I assume then, firstly, that it is in the interest of the community at large that the spread of infectious disease should be arrested as speedily and as effectually as possible, and that society has the same right to interfere with the liberty of the subject in seeking to carry out this object, which it is admitted to have in repressing murder, robbery, and other acts which are confessedly prejudicial to its welfare.

Secondly, that as the attainment of this object is moreover, the visitations of infectious disease in in a large degree a mere question of cost, and as, most cases fall heaviest upon those who are least able to bear them, and who are exposed to them from no fault of their own, it is both expedient and just that the expense of arresting such disease should be looked on as an investment for the benefit of the community at large, and that it should, so far as is practicable, be borne by the same body. Thirdly, that inasmuch, and in so far, as the steps which are necessary for this purpose, can be most effectively and economically taken by a public representative body, such as the law has provided in the sanitary authority, it is both expedient and just that such bodies should not only be empowered but compelled by law to adopt all such measures as can be shown to be effectual for this purpose, and that in case of their neglecting to discharge their public duty in this respect, those who suffer from their neglect should be authorised to supply their default, so far as it is possible so to do, and to recover from them in a summary manner any cost or damage to which they are put in so doing.

If there should be any person present to whom these propositions should appear to be so self-evident that it is superfluous to formally state them, I can only observe in apology that there are a large number of public bodies who, if they are to be judged by their actions, seem to be of a very different opinion; and that in so far as the present state of sanitary law represents the views of the public on the matter; it is very far from recognising these propositions as evident at all.

Before proceeding to state in general terms some of the chief legislative enactments which are required to arrest the spread of infectious disease, if sanitary law is to be a reality, instead of a sham as it is in a great measure at present, it may not be out of place to say a few words on one or two points which are of more especial importance.

Unquestionably the first step in the direction in which we are endeavouring to move, is the notification of the cases of infectious disease, since it is obvious that in order to enable a sanitary authority, as the representative of the public, to arrest the spread of disease, it is an essential condition that it shall be informed of its existence at as early a period as possible. It is also equally clear that as, for very intelligible reasons, the public generally are for the most part very anxious to prevent the existence of

such disease in their houses from being known, some special provision must be made to enable the sanitary authority to become acquainted with the existence of cases when they occur.

I think that there can be no doubt that if the sanitary authority is to be furnished with this information, the occupier of the infected house is the proper person to make responsible for giving it. But in order to make this provision operative, it is essential to couple with it an enactment providing that every medical practitioner who shall, when in attendance on a sick person, recognise that such sickness is of an infectious nature, shall be required to immediately notify the fact, in a written form, to the occupier of the house, who shall in his turn be required to transmit such notification without delay to the sanitary authority or its officers.

It may be said that it is easy to make such an enactment, but how is it to be enforced? There are two or three ways in which this may be done. The first is by providing a pecuniary penalty in case of default. For my own part, I can see no valid objection against this course. If it be once admitted that society in its own interests has a right to demand this information, it follows that it has an equal right to enforce it by any measures which it may consider most effective for the purpose.

But there are other means which probably would be quite as efficacious as direct penalties in procuring this information. One of these is to make a medical man who should fail to notify to the occupier of a house the infectious nature of any disease which might occur within it, directly responsible either to such occupier, or to anyone else, for any damage or expense which might accrue from the concealment of this fact, and to enforce the same responsibility upon the occupier, in his turn, in case he should neglect to convey to the sanitary authority the information so given to him.

If we know anything certain about infectious diseases, we know this, that by adopting proper precautions they can with almost infallible certainty be prevented from spreading. If, therefore, those who know that these diseases exist conceal that knowledge, and thereby render it impossible for such precautions to be adopted, it is only equitable that they should be made directly responsible for all the consequences which can be shown to flow from the secrecy which they have practised.

In this, as in other further aspects of this question, it seems appropriate to refer to a most serious defect in the law on this matter, and that is that it provides no simple and summary process by which a person who has been damaged by another, in respect of failure to adopt proper precautions to prevent the spread of infectious disease, can be indemnified for such damage. Take, for instance, the case of a parent who sends an infected child to a school without any medical certificate to justify him in so doing, and who thereby leads to an outbreak of the disease in the school; to its being broken up, thereby seriously damaging the keeper of the school; and, possibly, to the illness and death of many of the scholars, thereby entailing further expense, to say nothing of anxiety and suffering. Or, take the case of an employer, who sends from his house a servant labouring under infectious disease, in a cab to her crowded home in the country, leading, possibly, to the diffusion of disease through the medium of the cab, and almost certainly to the outbreak of it in the servant's family at home. Or, again, take the case

of a well-to-do householder, who sends infected clothes to a poor laundress to wash, without giving her any notification of the fact, thereby leading to an outbreak of disease in her house. Or, the converse case of a milliner or tailor, who allows clothes to be made up in infected houses, and sent thence to those of well-to-do customers, therein to spread the seeds of disease and death.

But it is useless to multiply such instances; they must be familiar to everyone. What is wanted in order to put a stop to such practices, is not only a simple and summary process, by which persons who are so damaged can seek to indemnify themselves, but one which shall be so open and accessible and well known, that it can be held in terrorem, as a means to compel people to take precautions in their own personal interests, which in many cases they would not adopt out of any regard to the interests of their neighbours.

The Public Health Act does, indeed, recognise in a feeble and imperfect way, the impropriety of some of the acts quoted, and provides penalties on those who are guilty of them. I believe, also, though from want of special legal knowledge I speak with some doubt on the matter, that an action for damages would lie at common law in such cases; but the whole subject is at present enveloped in such doubt and obscurity, and there are such difficulties in the way of enforcing any remedy, that those who perpetrate these improprieties do so for the most part with impunity, and will continue to do so until the law lays down in so many words their direct responsibility for the consequences of their proceedings, and gives those who suffer through their neglect a precise and easily available remedy against them. I hold that this is the only effectual way to deal with this aspect of the question of how to arrest infectious disease, either as regards individuals or public bodies, viz., to say to such people, there are certain precautions which sanitary science has shown to be sufficient to prevent the spread of these diseases; if you can show that you have adopted such precautions, so far as it is practicable for you to do so, you shall be exonerated from any consequences which may flow from the spread of the disease from your premises, for which you cannot, under the circumstances, be held equitably to be accountable; but, if you choose to neglect such precautions, you must be prepared to take the consequences, and to indemnify anyone who can show that he has suffered through your neglect.

From the principle which I have thus laid down, it follows, also, that any householder who communicates to the sanitary authority the existence of infectious disease on his premises, and who adopts, so far as is in his power, the instructions given to him by competent authority for preventing the spread of the disease, should be entitled to claim from the sanitary authority a certificate to that effect, which should be, if not an absolute bar to legal proceedings against him, at any rate prima facie evidence that there is no ground for such proceedings.

It also follows from the same principle, that where a sanitary authority neglects to discharge its obvious duties to the public in respect of these discases, e.g., by failing to provide proper accommodation for the isolation and treatment of cases of infectious disease, or proper appliances for disinfection, or in any other way, those who suffer from its default should be authorised either to require its

officers to act on its behalf, or to take such steps in supplying its default as circumstances may allow, and to recover from it in a summary manner the cost of so doing.

to condemn them to be admitted only to the latter, is practically to give them no alternative except to remain in their own wretched homes, there to spread disease which may be said, in the language of Horace, to disregard equally pauperum tabernas regumque turres. Poverty may, in most cases, be, if not a crime, at least a well-deserved penalty for neglected opportunities and wasted resources; but it has yet to be shown that for a man to be visited by infectious disease is otherwise than a pure and unmerited calamity, which should challenge all possible sympathy and assistance, rather than provoke, as it so often does, repulsion and neglect.

A large number of other illustrations might be quoted to show the absolute necessity of recognising this principle of direct responsibility on the part both of public bodies and private individuals to do all that can be shown to be necessary and reasonably practicable in the way of precautions against the spread of infectious disease. For my own part I am quite satisfied that until this is done, and the whole superstructure of law in regard to these diseases is erected upon it as a foundation, any legislation in the matter will be inoperative and worthless.

There are two other matters to which I should wish specially to refer before summarising the suggestions which I have to offer on the subject of specific legislative enactments. The first of these is the necessity of prohibiting sanitary authorities from making any charge for admission to infectious hospitals, except when special accommodation is provided at the request of the patient or his friends. I feel assured that until this is done it will be useless, in the greater number of cases, to attempt to compel authorities to provide such hospitals. They will, if driven to do something by force of law or of public opinion, put up some place or other, probably only of a temporary character, and then, as the authorities of a town have down within my own knowledge, they will charge a fee for admission which is prohibitory to the great mass of those for whose benefit the hospital should have been intended; and when, as is only to be expected, the building remains untenanted, though there may be plenty of cases to fill it, they will triumphantly point to its empty wards as a proof of the freedom of their district from infectious disease, or of the folly of those who had advocated its erection, and will probably, as in the case referred to, dismiss the staff, and practically close it altogether.

If it is necessary in the public interest that such hospitals should be provided, it is equally essential that admission to them should be perfectly free, for the simple reason that it is in the public interest to induce all who will to avail themselves of their aid. As all ratepayers contribute to their maintenance in proportion to their means, they have all an equal right to claim admission to them; and as to those who are too poor to be ratepayers, it makes little or no difference in point of expense, whether they are treated in such hospitals or in workhouses, whereas

There is another recommendation in favour of making admission to infectious hospitals free by law, and that is, that it would effectually remove a constant source of disagreement between boards of guardians and sanitary authorities in places where ther the consideration of pauperism as an element of the question. There would then be no necessity of debating the subject whether a patient labouring under small-pox is a pauper or not; and if he is not actually in the receipt of relief, but too poor to pay for admission to the infectious hospital, discussing what is to be done with him, during the course of which dispute the poor wretch has probably solved the problem himself by dying, or, if not dead, has infected half the neighbourhood, as was the case at a town in the south of England not long since.

Another most urgently needed enactment is the legal definition for sanitary purposes of what persons are in the charge' of others. For want of such a definition, the 2nd clause of the 126th section of the Public Health Act is practically of little or no value. The following persons should be held to be 'in charge,' for sanitary purposes, of the occupier of any premises on which they may happen to be sleeping at the time when they are discovered to be suffering from infectious disease, namely, all minors, domestic servants, and trade-assistants, and persons who, from physical or mental incapacity, are unable to take care of themselves. In all such cases, the occupier of the premises should be held to be legally responsible for taking proper steps, so far as it may be in his power to do so, for the isolation and treatment of the sick person, and he should, as has been before suggested, be invested with full power to make any practicable arrangement for the attainment of this object, wherever the local authority might have neglected to provide a special place for the purpose, and to recover the cost of so doing from the authority. By this means local authorities would be more effectually induced to provide hospitals than by any direct legal enactments that they shall do so; for directly they found that it would be cheaper to provide hospitals, and to maintain them in efficient condition, than to pay a number of stiff bills for lodging infected persons in private houses, they would at once proceed to do so, with an alacrity which would be as great as the reluctance they now exhibit.

The third point upon which it is desirable to make some special remarks is the necessity of giving the sanitary authority, through the medical officer of health, the same power of visiting and inspecting a house in which infectious disease exists, or is suspected to exist, as it now possesses in the case of an ordinary nuisance. Such a power would be a very effective check against neglect of notification of such cases, since people would be rather slow to incur the