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1561 Notes, Short Comments, and Answers to Correspondents. THE PREVENTION OF SPITTING IN THE STREETS. A CORRESPONDENT has written to ask us whether any regulations exist to prevent spitting in streets and puhlic places. There is no difficulty in obtaining by-laws relative to spitting in closed places, ’, such as institutions, in railway carriages, or in tramcars, and notices prohibiting such a practice may be found in numerous places in many parts of the country. The London County Council has a by-law to this effect. But streets and open spaces have, we believe, been regarded as coming within an entirely different category, and clearly the same objections cannot be raised against the practice in the open as can be urged against it in confined localities. Apart from the question of health, the practice is an objectionable one, and there would be advantage in its control, especially in public places such as promenades and the like. We are under the impression, indeed, that by-laws prohibiting spitting in promenade shelters or in the neigh- bourhood of seats upon promenades have already been sanctioned in certain places either by the Local Government Board or the Home Office. In 1903 the London County Council approached the Secretary of State for the Home Department with a view to extending its by-laws so as to prohibit spitting on pavements and footways. The Secretary of State, however, stated that he would not be prepared to allow the extension as there were not the same grounds for prohibit- ing the practice of spitting in the streets as existed in the case of public carriages, waiting-rooms, and similar closed places. In Manchester and in other towns notices as regards spitting are exhibited in factories and workEhops, as well as in common lodging- houses and public-houses, and copies of these could no doubt be obtained from the Town Hall, Manchester. We believe that in America heavy fines have been inflicted upon persons who persisted in the objectionable habit of expectorating in public places, and in that country the question has been carried further, and in New York it is enacted that " spitting upon the sidewalk of any public street, avenue, park, public square, or place in the City of New York, or upon the floor of any hall in any tenement house which is used in common by the tenants thereof, or upon the floor of any hall or office in any hotel or lodging-house which is used in common by the guests thereof, or upon the floor of any theatre, store, factory, or of any building which is used in common by the public, or upon the floor of any ferry-boat, railroad-car, or other public conveyance, or upon the floor of any ferry-house, depot, or station, or upon the station, platform, or stairs of any elevated railroad, or other common carrier, or into the street from the cars, stairs, or platforms of the elevated railroads is hereby forbidden." This by-law is a section in the " Sanitary Code of the Board of Health of the Department of Health of the City o New York." TWO WARNINGS. To the Editor of THE LANCET. SIR,-A person representing himself to be a partner in a firm of wholesale druggists carrying on business at 9, Mincing-lane, E.C., has I recently been calling on members of the medical profession with the object of selling a mineral water of which his firm are said to be sole consignees. This person represents himself to be the father of an assistant physician of one of the London hospitals, and by this repre- sentation (which is entirely untrue) endeavours to interest the medical profession in his article. We write on behalf of our client, whose name we give you in confidence, to ask you if you will be good enough to give publicity to the denial of this representation, which is injurious both to our client and his father. We are, Sir, your obedient servants, RADFORD AND FRANKLAND. 27, Chancery-lane, W.C., Nov. 15th, 1909. Messrs. Wilcox, Jozeau, and Co., chemists, 49, Haymarket, S.W., desire to warn members of the medical profession against a man, thinly built, apparently about 40 years of age, shabbily dressed, with a pronounced habit of sniffing, who has been representing himself as their agent, and making extraordinary proposals. No such person i3 in their employ or has had any authority whatsoever to use their name. HEALTH MATTERS IN GOLD COAST COLONY: EPIDEMIC OF PLAGUE. THE Acting-Colonial Secretary (Mr. C. Riby Williams, C.M.G.), reporting on the Gold Coast Blue-Book f,)r 1908, estimates the present population of the colony (including Ashanti and the Northern Territories) at about 2,700,000. The European population is returned at 1768. The health of European residents was not as good as in the previous year, there being an increased death and invaliding rate with a decreased population. So far as can be ascertained the death- rate among the native community was high Towards the end of the year small-pox broke out in Ashanti, and the epidemic would appear to have been characterised by a high case-mortality. The plague I epidemic which occurred early in the year at Accra, and which spread from there to other towns on or near the coast line, accounted for a mortality of 288 of the total number of cases (336) officially recorded. At Boso in the Volta River district an outbreak of pneumonia in epidemic form occurred and led to many deaths. Such outbreaks have been recorded previously. Major Bryan, C.M.G., the acting Governor, comments in his report at some length on the epidemic of plague at Accra, which, he observes, is the first recorded instance of plague in a British West African Colony, though an outbreak occurred at Grand Bassam, in the neighbouring French colony of the Ivory Coast, in the year 1899. The origin of the infection remains uncertain. Many theories have been put forward to account for its conveyance to the Gold Coast, but none is supported by trustworthy evidence. The outbreak was not definitely diagnosed as plague until Jan. 10th, but it is practically certain that deaths from plague had occurred before the disease began to develop the character of an epidemic. The fact that the medical authorities did not announce the existence of the disease at an earlier date has been made the subject of local criticism, but the preliminary inquiries and investigations were most thoroughly and conscientiously made by the deputy principal medical officer and his assistants. It is to be borne in mind that these officials had no previous experience of the disease nor were they familiar with the plague bacillus; in such circumstances a degree of reticence was not only reasonable but wise. An authoritative pronouncement that plague has appeared in the midst of a community where hitherto its existence has been neither known nor suspected argues the deputy principal medical officer to possess courage and self-reliance of a high order, and these qualities were no less apparent subsequently in the suppression of the disease. Major Bryan describes in detail the measures immediately taken to deal with the outbreak, and says they were speedily successful. The disease at Accra never assumed the alarm- ing proportions which had been developed in other countries, though the town’s sanitary conditions and certain thicklv populated native areas were favourable to the growth of a virulent epidemic, Though the steps taken were sufficient to keep the epidemic in check for the time being, the Secretary of State for the Colonies decided to send out a specidlist to advise as to the measures necessary to stamp out contagion, and the colony was fortunate to obtain for this purpose the services of Professor W. J. Simpson. As is usual, the outbreak was associated with an epizootic of plague amongst rodents. A special laboratory for the examination of rats was established at Accra, where Dr. Graham was on various occasions able to acquaint the health committee that areas were infected in which the epi- demic had not yet appeared. The invaluable information thus received enabled the committee to take preventive measures in such localities, with the result that human beings remained free from contagion. One of the most satisfactory features of the preventive measures was the readiness with which the natives voluntarily presented them- selves for inoculation by Haffkine’s prophylactic, some 35,000 in all submitting themselves to the process. In spite of the measures taken to prevent natives leaving Accra by sea and land, a few fishermen evaded the police by night and left for towns on the coast. In each case the panic-stricken men carried contagion, with the result that outbreaks of plague occurred at Temma to the eastward and a Nianyano, Brewa, and Anamabo to the westward. Prompt steps were taken to deal with these villages, and the progress of the epidemic was checked in each instance, but not before 64 deaths had occurred at Nianyano, 19 at Brewa, and 12 at Anamabo. The Acting-Governor adds: " The courage, determination, and devotion shown by Professor Simpson and the medical staff in preventing the spread of and stamping out the epidemic were worthy of the high traditions of the profession to whIch they belong, and their efforts were ably and energetically seconded, not only by officers of all departments resident in infected areas, but also by professional men and representatives of the mercantile community who served on the committees of public health." RADIOGRAPHS OF PULMONARY DISEASE. To the Editor of THE LANCET. SIR,-We would ask to be allowed to say that the radiographs referred to in your issue of Nov. 6th, pp. 1397-98, as showing " various stages of pulmonary tuberculosis with striking clearness," were the work of Dr. W. B. Knobel, of Bourne Castle Sanatorium, to whom we were indebted for the loan of them in connexion with the Royal Photograph Society’s Exhibition at the New Gallery.-We are, Sir, yours faithfully, I Ilford, London, E., Nov. 12th, 1909. ILFORD, LIMITED. AN INGENIOUS HATPIN GUARD. Messrs. F. V. Patterson and Co. of Birmingham have forwarded for our inspection an appliance known as the " Cromwell " Protector for the ’ points of hat and cap pins. It consists of a thin metal hollow sphere, which can be made either of silver-gilt or plated metal, with one of , its poles cut off so as to expose the composition with which the ball , is filled. This consists largely of uncured rubber, which may be ’, punctured any number of times without losing it grip on the end of the hatpin which it is designed to protect. The patentees point out its suitability for use with nurses’ cap-pins, but rightly add that the protectors should not be used in insane wards as they form such attractive-looking bodies to swallow. We have not seen a better pin protector; it is much less trouble to use than those of the older screw pattern.
