1146

a very severe outbreak occurred in a lunatic asylum nearScutari, together with a few cases in the vicinity ofthe Bosphorus ; still, comparatively, the epidemic has

spared Constantinople, which has been, and still is, healthy.While the belief on the part of the Porte in the

efficacy of quarantine to keep out cholera is so strong,and urgent representations are made to the sanitary board atConstantinople to exercise an increased vigilance in this

respect, the European Powers may fairly point to what hasrecently taken place at Mecca in connexion with the late

pilgrimage. It seems amazing that such a condition of

affairs, such a hotbed for the breeding of cholera, should con-tinue to exist in this part of the Turkish dominions. The

disease was most probably imported, as has been alleged, bypilgrims into Constantinople, if recently imported at all. But

why, it may be asked as a matter of common sense, put astop to trade and commerce in the Bosphorus and expendlarge sums of money in vainly trying to guard against theimportation of cholera, instead of seeking to remove the

cause, so that there should not be any cholera to import ? It

is in the direction of Mecca and the holy pilgrimages that theTurkish authorities should turn.With regard to the work performed by Professor Koch and

the commission despatched by the German Government in1883 to Egypt and India, and to the inquiry instituted by theIndian Government which followed it, we are reminded thatProfessor Klein strenuously opposed, at that time and subse-quently, the views put forward by the German savant andbacteriologist. He apparently held that, whatever might be theultimate conclusion as to the comma bacillus, it would be anoutrage on common sense to advocate measures against choleraepidemics based on the assumption that this organism causesthem ; and that, although it was possible that this particularorganism, of all those observed in the human body, is thecause of cholera, Professor Koch had not proved it to be

so, nor even rendered it highly probable that it is so. At thattime Professor Klein also appeared to hold the opinion thatno micro-organism present in the body of a person affectedwith cholera was the cause of that disease, but that this causemust be something produced altogether outside and inde-pendently of the body of a cholera patient The cholera

evacuations alone, it was held, did not contain the virus

either potentially or actually, and that, assuming the causeof cholera to be a self-multiplying living organism, it never-theless did not necessarily require cholera evacuations for itsmultiplication or for the creation of the virus. What weare all keenly interested, however, at the present time inascertaining is-what are Professor Klein’s views in regardto these matters now ?

There is, happily, not much to be chronicled this week inregard to the progress of cholera. Everywhere the epidemicseems to be declining, although it cannot be said to have dis-appeared.From St. Petersburg we learn that the epidemic is de-

creasing both there and at Moscow, and in the provincesgenerally. An improvement is also shown in the returns fromthose governments in which the disease had prevailed withthe greatest severity, such as Podolia. The prevalence of thedisease is stated, however, to have recently increased in theCrimea, and a number of medical officers and sisters have leftOdessa for that place.The Imperial Health Office, Berlin, announced on the

29th ult. twelve fresh cases in Germany. In Schleswig fiveattacks took place among the navvies engaged on the worksof the canal between the North Sea and the Baltic, some ofwhich have since proved fatal. There are cases also at Zer-

penscbleuse, Tilsit, Stendal, Potsdam, and Havelberg. Since

Sept. 23rd 79 cases and 41 deaths have been registered atStettin. The latest accounts show that sporadic cases arestill occurring at some of these places. Up to the presenttime there have been 33 cases and 12 deaths at Havelberg.

Reports from Bucharest show that during the last fort-night of October 42 cholera deaths had been registered inthirteen centres classed as infected.From Vienna we learn merely of the death from cholera of

a boatman from Pesth, and we may therefore conclude thatif the epidemic has not altogether disappeared in Austro-Hungary it has greatly diminished.

Intelligence from Tunis at the end of last month reportedthat cholera had broken out at Susa and caused a considerable

panic and mortality-twenty-eight deaths were reported onthe 28th ult.-together with the exodus of 4000 of the inhabi-tants, the majority of whom fled to Tunis.As regards Italy, reports from Rome show that the disease

is gradually dying out. It still lingers, however, at Palermo,where 9 fresh cases and 4 deaths were registered on the lastday of October. At Leghorn and Messina the disease hasapparently ceased.From Teheran we learn that cholera is practically extinct

in the city. The disease still prevails to a slight extent,and in a milder form, in the province of Khorassan. Thetotal cholera mortality in Teheran since Sept. 21st has beenabout 700.As regards this country the report is satisfactory. Grimsby

has been free from cholera since the 14th ult., and the hospitalship has been docked and the shore hospital closed. Theexact nature and cause of the outbreak of diarrhcea, at Green-wich Workhouse have not yet been determined. All the

patients at present under treatment there are doing well.The disease is not considered to have been cholera, and, apartfrom other things, the relatively small percentage of mortalityto attacks corroborates the correctness of that view.

CHOLERA IN ITALY.(FROM OUR OWN CORRESPONDENT IN ITALY.)

" RECRUDESCENCE all round might have summed up thereport from the various cholera-visited centres in Italy untilthe close of last week. For this there were sundry causes toaccount, differing, no doubt, according to locality and cir-cumstances, but all of them traceable, in the last resort, tothe relaxation of existing precautions, the discovery of freshsources of infection, or failure of some kind in grapplingwith the conditions that favour the disease. Steady,systematic, organised effort is not a characteristic of Italianpolicy or procedure in any sphere, least of all in dealingwith an insanitary force that has its origin in traditionallybad regulations, that appears suddenly and unannouncedwhere least expected, and that provokingly (to use thecolloquial phrase) " never seems to know when it is beaten."To take Leghorn first. Only now, after more than two

months of conflict with the disease, are we beginning torealise the extent to which that seaport literally invited theunwelcome guest. The infected quarters are-(1) the Viadella Venezia; (2) the Via San Giovanni; and (3) theVia Sant’ Antonio. The first of these is not a really poorquarter. It is occupied by seafaring people, or such asmake their living by the sea-fisherfolk, lightermen, bargees,pilots, and such like. Under these, however, there is alower class, the members of which in good times are fairlywell off, but in the late and still continuing depressionof trade and the industries that feed it, they are main-tained in circumstances unfavourable to health, which, intheir case emphatically, means "resisting power." Atthe best of times, moreover, the houses they inhabit com-bine every conceivable defect. Externally there is little toremark, except their great height, their very small windows,and their steep stairs. But let us enter one of them.We are at once in a labyrinth to which only years offamiliarity can give the Ariadne’s thread. Here, forinstance, there is a hole in the wall through which you getfrom the first floor of the house you are in to the landingbetween the first and second floors of an adjoining one;there, on the other hand, the roofs of a detached pair

1147

of tenements are so close together that you step fromone to the other with ease ; whole blocks being so

ui’uerpenetrated with passages and communications, somemade expressly, others produced by disrepair, that the walls’7 i.uch should separate then really unite them, till you find’tiur way out as best you can from a sort of human "rabbitvarren," lighted in the oddest, most haphazard fashion,which seems built for "evil communications " of all kinds,equally defiant of sanitary inspection or of police surveillance.A malefactor, it is said, who is I wanted " may, the moment’1e sets foot in the Via della Venezia, ’consider himself free, "...nd. so far as experience goes, epidemic disease may say thetjme. When to this poison preserve be added a water-

;pply notoriously foul, it may be realised how cholera throveend is still thriving within its precincts, and how the patientsTreated "at home " in it died, while those who were accom-modated in the lazaretto recovered.

Let us leave the Via della Venezia and explore the Via San(,iovani3i and the Via Sant’ Antonio. Every sense, outraged’.’ready in the first quarter, becomes literally overwhelmed in’: 1,e second and third. The interiors of the houses are drippingvith damp (particularly in sirocco weather), they are mal-ouorous with the reek of human excreta, and a universal, atickiness " on floor, wall, and roof seems to present theappropriate nidits, or rather matrix for bacteria of everyind ; foul linen hangs about everywhere, and in your hasteto descend the steep, slippery stairs and get out into the openAir you are reminded, to your horror, that every landing is ainline. The inmates, moreover, are in keeping with theCouses. Sallow, squalid, clothed in rags, living on black,’read or ill-cooked polenta (a sort of Indian-meal porridge),(ad on tripe or fritto-that is, offal fried in oil--as a raretreat; they breed like the rabbits-multiplying and replenish-ing the graveyard. The babies are the pets of the household ;after four years of age they become the scapegoats for the ill-humour of the parents ; after fifteen they have grown, ifara.tes, to be masters or privilege " men ; if females at, andeven before, that age to be mothers and not always wives.If I seem to exaggerate I can but appeal to the Nazione ofthe 18th inst., where such details as I have given and othersalmost too horrible for publication are set forth by its specialcommissioner. "I have seen," says this gentleman, "entirefamilies sleeping in an attic, in one room, on the bareSoor; I have seen a stabile (tenement), Via San Giovanni,No. 8, where 500 (yes, five hundred !) human beings areLnddled together-a tenement called with grim humour’il palazza.ccio.’ Pity of the profoundest kind-all the moreprofound that it feels so helpless-wells up from the heartat such spectacles; while everywhere the ear is assailed withthe cries or screams of babes or children, the moan or lachry-mose whine of women, ragged, gaunt, despairing. 11-Fare,fare,te," exclaims the Nazione. "Act, act, act." Demolish,dismantle the rookeries, give air, give light, give work oremployment, give life. This is Italy’s present duty in all herhives of suffering, pining humanity. Nor are these poor1Jr.tcas1cs unreclaimable. As I can testify, their gratitudef:-’ the smallest help, for a kind word or even look, goescèraight to the heart. They pulsate with like emotions toourselves, and have but to be put in the way of well-doing toi[l,y a honest part in the world. But it is sheer mockery to’preach at them or preach to them when their whole lives are’one long disease, prompting every instinct of escape fromi:; thrall. And yet ’’ Society " turns its back on them untilthe Nemesis of a cholera visitation reminds it of its neglectedcities, and its tardy intervention tides over the crisis-tilltLe next one.In the Abruzzi there was also a recrudescence of the

crease, or rather its appearance in quarters where theconditions favouring it had been characteristically unsus-pested. In that province, however, as in Leghorn, probably: confirmation of Professor Tommasi-Crudeli’s doctrine that’the candidates " for it having been all picked off the’epidemic tends spontaneously to die out, there is a markeddecline in the number and the severity of the cases. FromA’l11na, for instance, for the twenty-four hours ending’Oct. 20th no case was reported to the authorities. The othermral centres showed equally clean bills of health, with theexception of Pescina (Avezzano), where there was one patient1l.nounced. Further south, from Catanzaro, a town of some21,000 inhabitants and the capital of a populous agriculturalprovince, we hear of an epidemic of another kind, which hasfor the last seven weeks been prevalent. Scarlet fever and- aiphtheria, both of them due to the mediaeval sanitary::,-,-angements still doing duty in this so-called enlightened

century, have, in Cotrone alone, carried off 400 victims,mostly children. The population is coster nata, as we read,and no wonder, seeing that the mezzi sanitari sorso insuffieiento(the sanitary means are inadequate).Palermo would of itself require a letter, furnishing, as it

does, an instructive object-lesson in the causation anddiffusion of cholera. Its water-supply, as far as natureis concerned, could not be better, the basin in whichthe city lies being surrounded by hills of magnesianand calcareous limestone, which lower down is succeededby masses of volcanic tufa. From these heights flow downstreams of the purest quality to Palermo ; but here themischief intervenes. Side by side with the argillaceousconduits that distribute this water throughout the city runearthenware pipes for the conveyance of dejecta and waste ofevery kind, pipes the porosity and disrepair of which lendthemselves to the active infiltration of the soil with the deadlymatter. Hence the frequency and the virulence of choleravisitations in Palermo. Add to this the failure of the citizensto cooperate with the sanitary authorities-nay, the practicalmeasures they take to thwart the latter. Scarcely is theindividual attacked with cholera when the first thoughtof his family, even before calling in the physician, isto save the bulk of his furniture, efeects and wearingapparel, all of which are sent "for safety" to thehouse of some friend. On his arrival the physicianfinds only the articles which it has been found too difficultto remove, and the patient in bed, stripped of everygarment. Can cholera help diffusing itself with such’’ friends at court " ? 1 No doubt the law can punish suchcontraventions of its spirit and letter ; but in the lessfavoured classes, where the furniture, including the ward-robe, is almost their sole movable property, the impoundingand destruction of these constitute a disaster to be evaded byevery subterfuge available. Until the authorities replacethe articles they seize the poor householder is not likely tolet them work their will on the furniture and the apparelwhich constitute his domestic all. Accordingly, it is pro-posed that, in every case-where such confiscation and destruc-tion of private property are necessitated by the MM.scpMK,the authorities should give a fair equivalent in ready money orin kind for what they remove-an act of indemnity which wouldput an effective stop to the underhand smuggling away ofinfected clothes or bedlinen and, with it, to the spread ofcholera. " Ma come si fa?" (What is to be done ?)exclaims the magistrate or town councillor, already at hiswits’ end to provide funds for disinfection and the multi-farious needs of a municipality in a state of cholera-siege." Where am I to find the money or its equivalent in goods ?"The answer is difficult in the present financial straits of theItalian kingdom. Meanwhile, it is so far satisfactory to notethat Palermo, like her sister seaports of the Mediterranean,is marking a diminution in the number and the severity ofthe cases-probably, as I said before, in illustration ofDr. Tommasi-Crudeli’s observation that there are fewer’’ candidates to glean from.Oct. 22nd.

_______________

THE MANCHESTER SHIP CANAL.(FROM OUR SPECIAL CORRESPONDENT.)

III.

WHILE a large proportion of the local authorities concernedhave availed themselves of every pretext and every quibble andlegal obstacle to postpone the execution of sewage works, asmaller proportion have from the very first sought to do theirduty. For instance, the corporation of Bolton have had sewageworks in operation at Burnden for many years, and in 1886they built additional works at Hacken. They have also madearrangements for dealing with the sewage of eight surroundingtownships. Again, at Rochdale the greater part of the

sewage is thrown on to a farm, with the result of producinga good affluent. At Swinton and Pendleburythe internationalsystem of sewage purification is applied, and there are otherplaces that have fairly attempted to grapple with the diffi-

culty. The majority, however, of the seventy local autho-rities have either done absolutely nothing or are only dis-cussing and squabbling over various schemes. When publicbodies set so bad an example, it is not surprising that privateindividuals or firms have shown themselves to be equally