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becomes the first floor on the High-street, and here there arewindows both back and front. The council has decided thatthese upper floors alone shall be inhabited. The floors belowthe level of the High-street must in future be used only asstorehouses. In dealing with the vexed question of the

housing of the poor the council has refused to entertain

any vast scheme for sweeping away an insanitary area. Itmaintains that as Exeter is but a small town it is easier todeal with the worst houses and remove them one by one.Further, what appears to be one of the worst slums of Exeteris, in reality, one of the most picturesque, interesting, and-comparatively speaking-healthy parts of the town. This,the western quarter, is on the steep slope of a rocky hill-sosteep, indeed, that the principal street is divided into broadsteps. On each side are numerous mediaeval houses, withupper floors that project over the street, pointed roofs,gables, odd windows, and picturesque irregularities. Insteadof treasuring these old buildings and doing all that was Ipossible to preserve their original beauty, this historical Iportion of the town has been allowed to decay and is nowinhabited by some of the dirtiest and poorest sections ofthe population. Nature has been kinder than man, for,in spite of the poverty and the overcrowding, this partwas especially exempt from cholera in 1832, and has eversince been exceptionally free from infectious diseases.The fact is that the same phenomena obtain here as at theAltona district of Hamburg, which has always, in 1832 asin 1892, been free from cholera. The hill faces south andwest. There are a natural ventilation, a full exposure to thepurifying effects of the sun’s rays, a prompt and completenatural drainage of surface waters, and a rocky soil whichprevents infiltration. Hence this old quarter of Exeterescapes epidemics just as Altona, likewise built on a

rock, escaped cholera during not one but all of the great- epidemics. Under these exceptionally favonrable circum-stances there is no sufficient reason for pulling down old,historical and beautiful houses. Too many of these havealready been ruthlessly destroyed and can never be replaced.Some modern jerry-built houses might with advantage beswept away, but houses that are several centuries old willgenerally be found in a more solid and durable conditionthan the flimsy structures of the modern speculative builder.It is only necessary to introduce modern sanitary appliancesand drains into these old dwellings, and, by reason of theirstouter walls, better construction, and greater freedom fromdamp, they will become more wholesome dwellings than

many which have been erected quite recently. The interestsof history and art need not be sacrificed to the exigencies ofsanitation. On the contrary, the sanitary reformer would wishmodern builders to revert to the honest, sound, substantialwork of older days. It is, therefore, with some satisfactionthat I record the fact that the town council is not desirousof sweeping away this old district with its antique dwellings,so that it may be replaced by so-called model-but what arein reality too often jerry-built and intensely ugly-artisandwellings. A company did build at Exeter a block ofindustrial dwellings containing ninety-eight separate-tenements let out at from six shillings to one shillingper week, but the class of tenants for whom this blockwas intended did not go there, consequently the buildingis not fully inhabited. The fact is that rents are

very low at Exeter and the town is so small that itis no great inconvenience for the poorer classes to live inthe outskirts. There is no urgent necessity, therefore, to

pull down the mediaeval houses that still remain in the centreof the town. Five-roomed houses with a bathroom can beobtained for f,12 a year. In the vicinity new four-roomedhouses with outbuildings can be leased for ;S9 a year. Theseall have properly flushed closets, and the Exeter woiking manexpects to have a bathroom in the house he rents. Bybuilding extensively on the outskirts the congestion in thecentre of the town has been relieved to some extent, thoughthe process is certainly very slow. Thus according tothe census of 1861 there were at that time 6’26 inhabitantsfor every house. In 1871 the proportion was 5 88, in 1881 itwas 5 69, and in 1891 the average was 5 33. The reduction,therefore, in the thirty years is equal to nearly one-sixth.There is still need of considerable improvement, but the

building of new streets and houses continues, and it rests’with the sanitary authorities by constant interference andsupervision to reduce the population of the old houses.

The Exeter town council claims that it exercises a

better control over the poor of the town by combiningthe functions of Poor-law medical officer with those of

medical officer of health. The chief medical officer ofthe workhouse is also the medical officer of health.The three assistant Poor-law medical officers are alsoassistant medical officers of health. By combining thesalaries paid the services of a better class of medical mencan be obtained, and as the parish medical officer must goamong the extreme poor he is able to detect the first out-break of epidemic disease or other insanitary conditions withwhich as medical officer of health he can deal promptly.The four medical men attached to the Poor-law and sani-tary services take it in turn to attend for one month atthe fever hospital. The theory is that by dividing the workconnected with the three public services between fourmedical officers it leaves to each time enough to attend toprivate practice. They are also supposed to acquire morethan usual experience in the treatment of infectious diseasebecause they have to attend for one month out of four at theisolation hospital. Such, in any cafe, is the theory and itseems to work, at least to the satisfaction of the town council.Nevertheless, the old arguments against the mixing up of theinterests of private practice with those of the maintenanceof public health still hold good. Exeter is a town of suffi-cient size and importance to engage the services of a medicalofficer of health whose time should be exclusively devoted tothe fulfilment of his public duties.That there is still much sanitary work to do is set forth

by the fact that the death-rate is high. Last year, it istrue, it amounted to only 17’47 per 1000, but then the death-rate for England and Wales was 187, and for the thirty-three large towns 20 7; or, what is more to the point, itwas equal to an average of 18’6 for the sixty-seven largetowns in which Exeter is included. But this was an

altogether exceptional year. In 1894 the death-rate atExeter was equal to 20’63, though the death-rate for Englandand Wales was only 16 6. The average death-rate for the

previous ten years was 21’3 per 1000, which is certainly toohigh for a small town like Exeter, where so many of theadvantages of a country life can be enjoyed.

BIRMINGHAM.(FROM OUR OWN CORRESPONDENT.)

Hospital Sltnday.THE proceeds of the annual collections at the places of

worship in the city this year go to the Queen’s Hospital. Upto the time of writing the amount received reaches the totalof L4809 13s. 10d., a sum which will materially help thefunds of this deserving institution.

Food Adulteration.

The Health Committee have directed their attention withlaudable zeal to the question of the adulteration of food withboracic acid. Some recent prosecutions against the use ofthis ingredient in milk have shown that it cannot be legallyused for the purpose of preservation of milk. The cityanalyst, Dr. Hill, has shown that the amount of boracicacid in butter was from fifteen to twenty grains in the pound.The whole question of the use of boracic acid and salicylicacid as preservatives of food is one of much importance-they are largely med in many articles of diet, such as ham,bacon, fish, milk, butter, wines, &c., and no doubt with the

consumption of such foods an amount may be taken dailywhich may be productive of injury to health and digestion.Any attempt to interfere with the purity of, or to disguise,these common articles of everyday use is an infringement ofthe law and deserves all the consideration which the HealthCommittee can bring to bear upon the matter. On thesubject of the adulteration of sweetmeats with paraffinwax four wholesale manufacturers interviewed the magis-trates recently. Two were fined <&5 and costs, one costsalone, and the fourth 40s. and costs. Some protection isthus afforded to the stomachs of the young and informationelicited for the guidance of the public as to the deleteriousnature of such attractive morsels.

Midland Medical Society.At the inaugural meeting of this society on Oct. 29th an

address was delivered by Sir William Broadbent entitled" Clinical Obiter Dicta." There was a large gathering ofmedical men, who listened with much interest to the outcome

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of the practical experience of the lecturer, to whom a

cordial vote of thanks was passed.The 11 eed of Education.

The appalling ignorance and indifference occasionallymet with in the matter of feeding the young points to somewant of instruction in the matter of diet. An example ofrecklessness in this particular was lately the subject of aninquiry by the coroner. A boy aged ten years having beento an afternoon performance at a local theatre was put into atram to go home. A glass of port wine was given to him whenhe started by his father. On his way the boy purchased acocoanut and some chestnuts, of which he ate freely. Histea on arriving home consisted of cocoa, bread and butter,and tinned lobster and he finished up with more cocoanut andchestiauts. The result was constipation, twisting of theintestine, and death-a climax not to be wondered at.

Nov. 3rd.

LIVERPOOL.(FROM OUR OWN CORRESPONDENT.)

De2nolition of -T.*sanitary Property and Improvement at CityBat3ts.

MR. R. WALTON, Local Government Board inspector, heldan inquiry on the 30th ult. at the municipal offices relativeto the application by the Corporation to borrow .650,000 forthe purchase and demolition of insanitary property, and.S18,675 for the purpose of public baths and washhouses.Dr. Hope, the medical officer of health, said that the pro-perty as scheduled was not only that which was in the mostruinous state of dilapidation and of the worst and mostvicious construction, but was also that in which the highestdeath-rate occurred and the greatest amount of certain formsof infectious sickness was found to exist. The property in-cluded in the present application was situated in seven

different districts, comprising the north, south, and centre ofthe city. The death-rates for the last three years based upona special census to secure accuracy varied from 30 per 1000in the district of the south end, where there was someshockingly bad property, up to as high as 79’6 per 1000 inthe north end. Besides these circumstances they wouldhave to record what too often happens-a frequent recurrenceof typhus fever was constantly taking place in these dis-tricts. There were no fewer than forty-seven cases of thisdisease within the current year taken out of the streetsincluded in the present report. The mischief, of course, didnot end in these streets. It spread from there to better ones.It had been traced into a number of other streets. The

general health of the inhabitants was naturally very low, asthe high death-rate would indicate. The sanitary conditionof the houses was very defective and the people had nochance of leading a wholesome life. Some of the 1500houses vacant in these districts were little better than those

proposed to be demolished. It was very remarkable that,considering the constant process of demolishing insanitaryproperty and displacing large populations, overcrowding wasnot on the increase. It was, in fact, diminishing, and thenumber of convictions for overcrowding was lessening yearby year. At the same time inspection was much more closeand the conditions more exacting, as a greater cubic spacewas now required in sub-let houses. The property proposedto be demolished was neglected by the owners and wasdefective in every particular. In reference to the applicationto borrow money for the purpose of public baths it is pro-posed to supply Westminster- road baths and Burlington-street open-air baths with hot salt water brought througha main from the Liverpool Cold Storage Company’s premises,where the hot salt water would be pumped by a pump whichthe corporation intended to erect there. The companycould supply about 200,000 gallons of hot salt water pertwenty-four hours. The water would not be transmitteddirectly, but first of all lodged in suitable tanks in Bevington-hill, whence it would flow to the baths by gravitation. Thisscheme would cost about 6500. In connexion with further

applications for power to borrow money to improve the sani-tary arrangements of two other public baths and wash-houses, it appears that the system of washing clothes atthese washhouses was said to be very antiquated, the dryingapparatus generating such a high temperatnre-180&deg; F.-that Ithe women engaged there frequently fainted. The idea was

to re-arrange the whole system and to improve the sanitarycondition of the baths.

Nem Hospital for Phthisis.A public meeting was held at the town hall on the-

2nd inst., under the presidency of the Lord Mayor, in supportof the scheme for building a new hospital for phthisis.The building which has done duty as a hospital for some-years consisted originally of two dwelling houses providingforty beds. This institution is now found to be too small for-its requirements. The committee have had a plan beforethem, devised by their architect, of rebuilding the hospitalon its present site in Mount Pleasant, the wards beingso arranged as to receive the full benefit of the sunshine.The new hospital is estimated to cost .E.50,000, and will con-tain seventy-six beds. It is proposed that the cost of buildingshall not exceed &pound; 22,800, the remaining &pound; 27,200 to be-

expended on furnishing the hospital and endowing twenty-fivebeds. It is to be sincerely desired that the committee will see-their way to build the new hospital in a more salubriousatmosphere than can be had in its present situation. Thatthere is a prospect of attaining this desirable end is indicatedby the speeches of the Lord Mayor and of Mr. WilliamRathbone (the president of the hospital), both of whom laidstress on the importance of fresh country air as an absolute-necessity in the treatment of phthisis. It is interestingto see that of E16,774 already promised towards the required50,000 no less than 11,000 had been contributed by thecommittee themselves.

"Health of Lazerpool and Corporation Hospital’ Accom7)todatioit.

In a memorandum submitted to the City Council by thechairman of the Port Sanitary and Hospitals Committee itwill be seen that the total number of beds available in theCorporation hospitals amounts to 540. This number is to

provide for the requirements of a city containing 650,000-inhabitants, in addition to which is a large emigration popu-lation of 200,000. some of whom are not unfrequentlyunable to proceed on their journey owing to infectious-diseases, and, in consequence, require removal to the

Corporation hospitals. The Local Government Board advisethe provision of one bed per 1000 of the population,exclusively of accommodation for cases of small-pox ; so thatif it be assumed that 100 beds are set aside for small-

pox there only remain 450 for general requirements. ,

An additional fifty beds will shortly be available at Nether-field-road. At the present time all the available accommo-dation for scarlet fever is taken up, and, what is still moreserious, almost every available bed for typhus fever is alsooccupied, and accommodation for some of these cases hasonly been found by encroaching upon wards which oughtproperly to be set aside for small-pox. At the present timethe trade of the port is liable to be influenced by the presenceto any considerable extent of the more serious forms ofzymotic disease. Some of the consuls receive every week astatement on the matter, and the increase of any one of themore serious forms of infectious sickness is at once the subjectof inquiry and correspondence. The following shows thenumber of cases reported and the number of cases removedto hospital during each of the last three years :-1894 :6232 cases ; 2766 removed to hospital. 1895 : 4641 cases ;2128 removed to hospital. 1896 (to Sept. 30th) : 3895 cases ;1820 removed to hospital. The chairman of the health com-mittee, in his review of the city during the past year, alsosays that the gradual improvement in recent years in thehealth of the city has been well maintained during the firstnine months of the present year, the general death-rate forthe whole city during that period being 22-5 per 1000, as.compared with 25’4 per 1000 during 1895. This improvementwas apparent in each of the wards of the city, and advertingfirst to the former city area, exclusively of the recently incor-porated districts, it was gratifying to notice a decrease in the’general death-rate to 245, as against 25-6 per 1000, the

average of the previous ten years. The city during theperiod referred to had been free from small-pox with the-

exception of 2 cases, 1 being introduced into the city overlandand the other arriving by sea from Constantinople. Bothcases were isolated in hospital, and the precautions adoptedprevented any extension of the disease. The number ofcases of typhoid fever reported were 867, and represent adiminution of 73 on the number of cases reported duringthe same period of last year. Scarlet fever had shownsome increase during the past two or three months,.but the type, fortunately, had been a mild one, and