the sanitary congress, dublin
TRANSCRIPT
658 THE SANITARY CONGRESS, DUBLIN.
THE SANITARY CONGRESS, DUBLIN.
IN the section of this Congress devoted to sanitary science on
and preventive medicine the following papers were read on ch
the lst inst. :- pliDr. Grimshaw, Registrar-General, read a paper on the L
Statistic Measure of the Health of Communities. After p,thanking the Council of the Sanitary Institute of Great en
Britain for the honour they had done him in selecting.him to preside over this section, the author stated that
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attempts have been made from time to time to esti- hEebmate what should be the death-rate of a healthy com- si,munity, but in his opinion all such efforts have been gffailures, and we are driven to depend upon comparisons of re
death-rates in various countries with one another, or to n(
comparisons of different portions of the same commnnitywith the whole or with one another, as the only test of the (3healthiness or unhealthiness of such communities. Thus fi]the average annual death-rate of the population of England r(and Wales for ten years, 1871-80, was 21’4 ; while in London ojit was 22’5. In Scotland it was 21’6 for the same period. ojIn Ireland for the same decade it was 18 3, and varied from t127’5 in Dublin to 14’1 in the rural districts of Conn aught. Now, do these varying rates truly represent the relative eJhealthiness of the different communities to which they n
refer ? Dr. Grimshaw stated unhesitatingly that they bdo not ; that in some of these districts the people are s,
less unhealthy, in other cases more unhealthy, than the t:rates represent them to be. It has long been known thata very general relation existed between the density of a
a population and its death-rate-in other words, wherepeople are packed closely together we expect to find a high r
death-rate. This at first sight appears to be a mere truism, r
but he was glad to say that the old sanitary or unsanitary tmaxim, " that a dense population has a high death-rate," iis becoming less true every day, though statistics show that (there is still a correspondence between high death-rates and tdensity of population. It is a matter of the utmost importance twhen applying death-rates as a test of health that the (relative numbers of the population belonging to each social ]
class should be known. The variations in the death-rate 1between the classes and the subclasses are remarkable. For ]example, in the " professional class" the death-rate is but <19’8 per 1000, while in the " general service class " it is 36’8, ]
or nearly double. Among domestic servants it is but 9’1, Iwhile among labourers it is 34’4, although both are drawn 1from the same stratum of society. Figures show that thedeath-rate steadily decreases as age increases, until the ageperiod of from ten to fifteen years is reached, when the ratereaches the maximum both in Ireland and England, being,3’7 in Ireland and 33 in England.
Dr. Edgar Flinn read a paper on the Administration of thePublic Health Act in Ireland with regard to the Duties ofOfficers of Health. He said the working of the PublicHealth Act in Ireland has, in a great majority of districts,well-nigh become a dead letter. One of the main causes ofthe slow progress of sanitary reform in Ireland is that thereare no local boards or combinations of districts. The boardsof guardians, the sanitary authorities for the rural districts,are not as a general rule opposed to sanitary reform, yetthey are never anxious to move in any measure of sanitarywork that will cause outlay. In lieu of having six or moremedical officers of health in each district, with a super-intendent medical officer of health, there should be one andonly one medical officer of health, who should be a manfree from the cares of practice, and whose pecuniary interestswould not be perpetually at war with a due and fearlessdischarge of his duties.
Mr. Edward Spencer, M,A., T.C.D., read a paper on theHomes of the Working Classes in Dublin, in which afternoticing the difficulties of dealing with the subject by generalas distinguished from local legislation, he pointed out thatDublin is, of all cities which have carried out improvementsfor the housing of the poor, most peculiarly situated.
Surgeon-Major Wycliffe Jones read a paper on the Insani-tary State of Small Irish Towns. ,
At the meeting of the Section on the 2nd inst. Dr. M’Caberead a paper on the Water-supply and Drainage of SmallTowns in Ireland ; Mr. R. 0. B. Furlong spoke of the Objectsand Work of the Ladies’ Sanitary Association; Mr. J. Byrne,M.B., of the Public Health of Kingsto wn; and Surgeon- General
A. C. C. de Renzy, C.B., discoursed on the Sanitary Con.ditions under which Cholera prevails in Northern India.The discussions in Section 2 of the Congress, which met
on the 2od inst. in the new buildings of Trinity College, werechiefly of a technical character, aud related to structuralplans and methods.Mr. C. Cotton, C.E., the Engineering Inspector to the
Local Government Board, delivered an address on thePublic Health (Ireland) Act of 1878, so far as it related toengineering.
Professor H. Robinson, C.E., read a paper entitled" Sewage Disposal." He said the general conclusions whichhe deduced from his observations were as follows :-(1) Thatchemical precipitation is not so necessary now as it was con.sidered to be a few years ago in cases where land for irri.gation is not procurable; (2) that the efforts to profitablyremove the manurial elements from sewage by chemicalsnot having been successful, the system should be adoptedper se only where filtration area cannot be obtained;(3) that the success which has attended the construction offiltration areas where the land is clayey, and the successfulresults which have been obtained from a combined strainingof sewage and of consequent filtration through small areasof artificial filters point to the adoption of one or other ofthese systems in many cases where chemical treatmentwould previously have been advised ; (4) that the injuriouseffects of passing untreated sewage into a river depend uponnot merely the relative volumes of the sewage and the river,but chiefly upon the power of the river to oxidise thesewage, which is in proportion to the extent of oxidisation of
: the river itself.. Mr. W. Eassie, C.E., read a paper on "The Collection. and Disposal of House Refuse."! Dr. Charles A. Cameron, on the 3rd inst., in Section 3,L read a paper on Micro-organisms and Alkaloids whichI render Food Poisonous. For the purposes of his address’ the author arranged diseased and otherwise unsound food’
into five classes : (1) Vegetable food infected by fungi andt other parasites, chiefly microscopic; (2) animal food con-1 taining entozoa or internal parasites ; (3) animal food con-s taining micro-organisms endowed with virulent properties;3 (4) animal and vegetable foods containing alkaloids gene.61 rated dming putrefaction ; (5) the flesh of animals affectede by specific diseases, the various materies morbi of whichr have not been isolated. Each of these divisions was dis-t cussed in detail, and the whole paper bore marks of careful3, research. Having already published some papers on the, subject of the fitness of the flesh of animals affected withtl contagious pleuro-pneumonia, rinderpest, foot-and-mouthe disease, and other maladies resulting from blood-poisoning,e Dr. Cameron did not in his paper consider it. He, however,;e strongly advocated the systematic and skilful examinationg of food prepared or being exposed for sale.
On the 3rd inst. the business of the Congress was con.le cluded by a lecture from Dr. Carpenter, the Chairman of theof Council. He urged that stringent legislative measures shouldic be passed to present the overcrowding of houses in the3, poorer parts of cities, and further recommended that in placeof of sewage being thrown into the sea and wasted it should’e be used for manuring. If the present system of sewage inIs London was continued a state of things would gradually beS) produced which would make the future sanitary history ofet the Thames somewhat similar to that which belongs to the’Y Pontine marshes or the deltas of the great rivers of India.re The 100,000,000 gallons of water fouled by the filth ofr- London ought to be returned to the land whence the waterid came, and ought to be again filtered through the chalkLll hills, the Woking and other sand beds, or the barren acrests of Surrey, Hants, Berks, and Oxfordshire, by which tens ofss thousands of cattle might be nourished, and millions of
gallons of milk provided for the teeming population of thele great metropolis of the empire.er
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.at SCHOLARSHIPS. - At the Middlesex Hospitalits Medical School, the science scholarship of the value of 30
has been awarded to Mr. J. Gordon; the entrance scholar-ni- ship of £25, tenable for two years, to Mr. E A. Falkner; the
entrance scholarship of 220, tenable for two years, to Mr.be H. B. Shepherd ; and the exhibition of 20 to Mr. Alfredall Clark.-At St. Mary’s Hospital Medical Shoot, Mr, R. T.ets Graveley and Mr. F. Lewis divided the scholarship inile, natural science of jE105 open to students of Epsom Collegeral who are sons of medical men.
659OVER-PRESSURE IN SCHOOLS.
INTERNATIONAL MEDICAL CONGRESS.PHYSIOLOGICAL SECTION.
Cheyne-Stokes’ Breathing.PROFESSOR Mosso (Turin) has constructed an apparatus
for registering respiratory movements in the healthy subject.This consists of a respirator applied over the mouth andnose connected with a delicate gasometer, and which can beworn by many persons during sleep without producing muchinconvenience. An examination of the tracings which canbe obtained showed a rhythmic variation of the same
character as those seen in Cheyne-Stokes’ respiration.These consisted of rhythmic variations, both in time and in
quantity of air respired. Professor Mosso maintained thatthis condition, about which so much had been written, wasa normal one, and could not be considered a pathologicalphenomenon at all. I.Professor HAYCRAFT remarked that the experiment was
not conducted under normal conditions, and that the resist-ance produced by the gasometer exhausting the nerve-centresof the respiratory muscles would, as in other cases of suchdepression, produce rhythmic variations of activity. A
pathological condition may be a quantitative deviation fromthe normal; and if rhythmic variations should eventually beproved in normal breathing, the exaggeration of this seen, say,in a case of apoplexy might well be considered pathological.Professor CHEVEAU suggested an improvement which
might be made in the instrument of Professor Mosso, whichwould simplify it and diminish the resistance.On the Action of a Secretion obtained from the Medicinal
Leech on the Coagulation of the Blood.Professor HAYCRAFT found that the leech secretes from its
sucker and gullet a juice which prevents the coagulationof the blood, which therefore remains fluid within its body,and is difficult to stop when exuding from the wound afterthe animal is withdrawn. This may be extracted from theanterior part of the creature with water after dehydration inalcohol. The juice destroys the blood-coagulating fermentwithout killing the corpuscles. On invertebrate blood wherethe clotting is due to the welding together of the corpusclesit has no action. When injected into the veins of dogs orrabbits, the animals are thrown into a condition resemblinghasmorrhagic diathesis ; the blood withdrawn from theanimal remaining fluid, and the smallest wound bleeding con.tinuously on this account. It was suggested that in the caseof transfusion of blood any chance of clotting could be pre-vented by injecting small quantities of the substance intothe body of the person from whom the blood was afterwardsto be taken,
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THE INTERNATIONAL COLLECTIVE INVES-TIGATION OF DISEASE.
A STATEMENT has been submitted by Dr. Isambard Owen,general secretary, in which the main object of the Inter-national Committee formed at the Copenhagen Medical
Congress for the Collective Investigation of Disease isdefined as follows. To widen the basis of medical science, togather and store the mass of information that at present goesto waste, to verify or correct existing opinions, to discoverlaws where now only irregularity is perceived, to amplify ourknowledge of rare affections, and to ascertain such points asthe geographical distribution of diseases and their modifica-tions in different districts. It will be its endeavour toplace clearly before the whole profession the limits anddefects of existing knowledge, as well as to stimulateobservation and to give it a definite direction. Thefollowing is the proposed method. A subject having beenselected, a person or persons of acknowledged authoritywill be asked to write a memorandum, in the form of ashort essay, upon it. The memorandum will succinctly givethe present state of our knowledge. It will also point outthe directions in which further research may best be made;and, with this view, will suggest a few simple and definitequestions upon the subject selected. The questions willrelate to matters of fact, to be elicited by observation ofcases, rather than to matters of opinion. The contemplatedorganisation will, it is hoped, in time enable the Committee
to ask and collect answers to these questions from the pro.fession at large wherever scientific medicine is studied orpractised. It will be a further duty to examine, arrange,tabulate, and deduce results from the mass of observationsthus collected, due credit being given to each contributor forthe information he has furnished; and reports on the resultsof the several investigations will be laid before the Inter.national Congress at its next meeting at Washington.
OVER-PRESSURE IN SCHOOLS.
THAT the views which we have thought it our duty toenforce in connexion with the subject of over-pressure inelementary schools are accepted by those who, next tomedical men, are best entitled to express an opinion on thepoint-viz., the school teachers-may be gathered from thefollowing resolutions adopted at a meeting of the ExecutiveCouncil of the National Union of Elementary Teachers onSaturday, the 4th instant.Resolved :-" That this Executive Council, consisting of
men practically engaged for years in the work of elementaryeducation, and representing 13,000 elementary teachers inall parts of the country, endorses the general conclusionsarrived at in Dr. Crichton Browne’s report with respectto over-pressure in schools, and thanks him for themasterly way in which he haa presented the facts ofthe case as known to teachers, and as established bycommunications received from teachers, managers, andparents of pupils in all classes of elementary schools in allparts of England and Wales. That this Executive Councilhas read with the greatest surprise the memorandum ofMr. Fitch on Dr. Crichton Browne’s report, and distinctlyaffirms : 1. That teachers in Mr. Fitch’s district and through-out the country declare that they find detention after schoolhours absolutely necessary to meet the requirements of theinspectors and secure a sufficient number of passes. 2. Thatexaminations, instead of being tests of school work, havebecome, to a great extent, its one aim and guiding principle.3. That the power to withhold children from examinations.isnot, and cannot be, effective to remove the over-pressure solong as the inspector is the sole judge, on the day of exami-nation, of the reasonableness on which children are with-held."
In the face of testimony of this kind, what becomes ofthe charge of exaggeration brought against Dr. CrichtonBrowne by interested or ill-informed critics ?
THE PROGRESS OF CHOLERA.
WITH the advent of cooler weather the number of freshcholera cases in Italy is showing a decided diminution ; theabatement being especially marked in Naples, Genoa, andSpezia, where the force of the epidemic had principallyshown itself. There are still fluctuations ; thus the latestnews from the province of Cuneo relates to a notable increasein the number of attacks ; and notwithstanding the generalabatement which has taken place, the epidemic is stillcausing about 120 deaths a day in the localities concerningwhich statistics are officially published. The accounts fromVenice are contradictory, but even if any cases of truecholera have occurred there, they have been but isolatedones. Rome still remains free from the epidemic.In France, a few cases still occur daily at Toulon and
Marseilles, and a new outbreak is reported from Oran ; butelsewhere the epidemic still maintains signs of subsidence.In Spain, the provinces of Alicante, Lerida, and Tarragonacontinue to be the only ones whence cholera news comes ;and in view of the late season, it may now be confidentlyhoped that the Peninsula will escape any such prevalence aahas occurred in France and in Italy.
QUARANTINE AND INFECTED PORTS.All arrivals in Algeria from Portugal are subjected to a
quarantine of five days ; the quarantine on arrivals fromFrance has been reduced from five to three days.The port and shore of the whole " Circondario" of Genoa