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the outside air) rise during daylight, or after dark when only electriclight is used, beyond 12 volumes of carbonic acid per 10.000 ot air, andthat when gas or oil is used for lighting the proportion shall notexceed 20 volumes after dark or before the first hour after daylight;the only exception to this rule to be in cases where the extra carbonicacid is produced in other ways than by respiration or combustion, as inbreweries, &c.

2. That in the case of cotton-cloth factories with artificially humidi-fied air the occupier should have the option of coming under theregulation just mentioned, instead of remaining under the existingregulation.

3. That inspectors of factories should inform etr’ployers of the resultsof any official analyses of the air in their factories or workshops, shouldgive notice that the ventilation is deficient to any employer in whosefactory or workshop the above proportions have been found to be

exceeded, and at the same time supply, so far as practicable, informa-tion as to the nature of any defect noticed : and that legal proceed-ings should not be taken against an employer unless, after a reasonableinterval following such notice, the stated proportion is found, on anaverage of two or more samples taken in different parts of the room, tobe again exceeded by one volume or more and he is unable to show thathe has taken measures reasonably calculated to secure the requisiteventilation.

4. That arrangements be made by the factory department of theHome Office for the analysis by a specially qualified person or personsof samples of air collected by inspectors (see Appendix IIL) and thatany analysis on which a prosecution immediately depends shall havebeen performed by such qualified person or persons.

5. That arrangements be made for inspectors of factories to have theuse, when desired, of a properly tested portable apparatus for estimat-ing on the spot the proportion of carbonic acid in air.

It may be seen from what has been said that the reportdeserves careful consideration. In regard to the recom-mendations which are given in extenso it must suffice to saythat the first is open to very grave objection ; the last two,it will be seen, are devoted to recommending the general useof Dr. Haldane’s apparatus.

I

PUBLIC HEALTH IN BOMBAY.

IN his annual report for the year 19011 Dr. J. A. Turner,executive health officer of the city of Bombay, gives muchinformation highly valuable from the point of view of urbansanitation and public health. A report in which he dealtwith the occurrences of the first quarter of 1901 was

published a considerable time ago and was reviewed at somelength in THE LANCET of Sept. 14th, 1901, p. 746, chieflywith reference to proposals which he had made for animproved sanitary administration of the city. The presentreport with its statistical appendices consists of 96 closelyprinted pages and is illustrated with four coloured diagrams.Bombay is built on an island which has an area of about 22square miles and part of which is below the level of high-water mark, so that drainage presents considerable diffi-culties. Increase in sickness during, and immediately after,the rains, which occur in June, July, and August, is chieflydue to the dampness of the soil and moisture of the atmo-sphere. In most of the houses of the poorer classes the floorsare of mud and cowdung and the people sleep on the ground.The cold weather season, extending from December to March,is the period of highest mortality, the hot weather fromMarch to June the lowest, and from June to November theperiod of seasonal increase in the mortality. In the coldweather when the people are obliged to sleep indoors, over-crowded and in a vitiated atmosphere, plague spreads rapidly,while the cold air easily affects them when exposed to it,causing diseases of the respiratory system. The population,according to the census of 1901, was 776,006, the proportionof males to females being 161’9 to 100. The principaldivisions of the population were as follows: Hindus,522,947 ; Mussulmans, 155,121 ; Parsees, 46,231 ; Jews,5357 ; Native Christians, 29,645 ; Eurasians, 3258 ; and

Europeans, 12,273.The number of births registered during the year was

13,520, giving a birth-rate of 17’42 per 1000. The numberof deaths during the year, exclusive of stillborn, was 59,495,giving a death-rate of 76 per 1000. Of late years thedeath-rate has fluctuated considerably and has increasedvery much since plague acquired a footing in the city.Thus the rates per 1000 were 29-0 in 1891, 30-5 in 1895,583 in 1897, 63-2 in 1898, 68-1 in 1899, 96-5 in 1900, and

1 The issue of this report is not so belated as might be inferred fromthe fact that it only reached us about a fortnight ago. Much time issometimes taken up in the preparation of such documents for publica-tion and in submitting them to various official departments. More-over, the statistical returns of patients admitted into the Arthur-roadHospital are brought down to May, 1902.

76 6 in 1901. The number of deaths from zymotic diseaseswas 30,593. giving a zymotic death-rate of 39 4 per 1000. Thedetailed list shows that 18,736 deaths were due to plague,7266 to remittent fever, 1560 to relapsing fever, 1341 to

dysentery, 514 to puerperal fever, and 198 to cholera. Thetotal deaths among Europeans were 189, the detailed list

showing that of these 18 were due to enteric fever, 14 to agueand remittent fever, 10 to plague, 29 to diseases of thenervous and circulatory system, 20 to diseases of he

respiratory system, and 46 to diseases of the digestivesystem. The deaths are also classified according to theoccupation of the deceased-whether engaged in, or belong-ing to, the service of the imperial, local, or municipalgovernments, the army or navy, the learned professions,domestic work, commerce, agriculture, and so on ; for someunexplained reason one of the nine sub-headings under" learned professions" specifically includes dancers, jugglers,snake-charmers, and billiard-room keepers.

During the greater part of the year the control of all

plague measures was under the Government, as in theprevious year, but in October Dr. Turner took over theduties of supervision in addition to his own and the controlof plague is now in the hands of the Health Department.The mortality from this disease began its seasonal rise inDecember, 1900, reached its maximum in February, 1901,and then declined. There were 21,006 attacks and 18,736deaths from plague during the year, as against 17,913attacks and 13,285 deaths during the previous year, andthe increase was felt in all the communities exceptthe Europeans, among whom there were only 10 deaths, asagainst 11 in the previous year. The mortality from plaguewas highest on Feb. 26th, when 214 deaths were registered.The measures adopted for controlling the disease were theprovision of camps for those willing to evacuate plague.stricken houses, disinfection by washing the rooms with

perchloride of mercury and phenol, and fumigation withsulphur. Compulsory removal to hospital was not practised.The disease was of a very virulent type, the mortality inhospitals varying from 79 to 91 per cent. The preparationof Lustig’s anti-plague serum was continued throughout theyear at the municipal laboratory and patients at the Arthur-road Hospital were treated with it.

Dr. Turner devotes several pages to an enumeration of thedefects existing in the sewerage system of the city and inthe methods of dealing with excrement and refuse. He alsomakes a variety of suggestions for their improvement. Onthe subject of the administration of the Health Departmenthe says that during the past three years the investigationinto the cause and control of all epidemics of infectiousdisease has not been vested in the Health Department, andthat a health officer’s ardour must be damped when his moreimportant and interesting work is transferred to othersunqualified in any way for the position. The work of theHealth Department has, however, now reverted to its properchannel. During the year he was called upon to submit areport on the reorganisation of the department, and hisreport was directed chiefly towards-(l) an improvedsanitary inspection ; (2) a better class of inspectors ; (3) abetter system of refuse removal ; (4) a more completesystem of registration of births and deaths and notificationof infectious diseases ; (5) inspection of food, drugs, andmilk-supply ; (6) a laboratory for analysis of food and drugsand chemical and bacteriological examination of water andpathological products ; (7) a municipal analyst ; and (8) tenmunicipal dispensaries. Progress has been made in the

carrying out of these recommendations. Of the otherpoints in which improvement is required the chief are:

(1) hospital accommodation ; (2) medical relief ; (3)house drainage ; (4) housing of the poor and over-

crowding ; and (5) control of milch cattle stables by theHealth Department with registration of all cow-keepersand milk-sellers. The Arthur-road Hospital is at presentthe only accommodation provided by the municipalityfor cases of infectious disease other than plague and theexpenditure on it is relatively small, being only Rs.40,000,or .E2660, per annum. Dr. Turner recommends that theaccommodation should be increased and made sufficient forthe reception of 100 patients. In order to counteract the

prejudices which the poorer classes have against hospitaltreatment he proposes to issue a circular inviting them tovisit Arthur-road Hospital so that they may see for them-selves how well the sick are treated. We presume that thesevisitors would be admitted only to the parts of the institutionoccupied by convalescents fit for discharge. The highest

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mean monthly shade temperature recorded at BombayObservatory was 86 6°F. for May. The total rainfall was75’32 inches, of which 72’33 inches fell in June, July, andAugust.

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CLEANING BY VACUUM.

THERE are few surely who are not averse to the ordinaryannual house-cleaning process commonly called " springcleaning," at any rate during its progress, however pleasantand comfortable the results may be. "Spring cleaning," infact, entirely disturbs the routine of a household and theoccupant, unless he is lucky enough to be able to go awayduring the process, is put to manifold kinds of inconvenienceand discomfort. Therefore, a process by which it is pro-

posed to reduce this inconvenience to practically nil whilstthe work of cleaning is done effectively is certain to bewelcomed by a very large section of the community. But thevacuum cleaning process deserves attention not on accountof its being expeditious only but because it removes dust,and therefore septic matter, in such a way as to render theircomplete destruction ultimately possible. The process is

simple enough and, indeed, such that it is a little astonishingthat it has not been suggested and applied before. When

spring cleaning is to be done a machine is sent to the houseprovided with a pair of vacuum pumps actuated by an oilor electric motor which serve to maintain an " exhaust" " ofseveral pounds to the square inch. Varying lengths ofhose are connected with this "exhaust" " and terminate in so-called "cleaners" or "renovators" which consist of tubesdattened out at the end into a kind of long slit. The" I renovator " is rubbed up and down the carpet or the clothcoverings of seats or chairs from which it rapidly sucksout all the dust. The result is quite remarkable. Thedust is extracted not only from the surface but fromthe body of the carpet also, so that at the end of the

process not the slightest cloud of dust can be detectedon beating the material. On sprinkling the carpet withflour, rubbing it well in so that it disappears to view,the vacuum renovator will be found to remove every particle.As is well known, flour is a somewhat greasy dust andit is therefore a severe test on a heavy carpet. To illustratethe rapidity and efficacy with which the dust and dirt areremoved in this way a bottle may be interposed in a lengthof the hose at a point between the renovator on the carpetand the pumps outside. With a very dirty carpet or heavilyupholstered chair (especially the saddle-bag) or curtain, oreven with dust-laden clothes, the bottle is seen to be full ofdust taking the form of a spiral rapidly passing through thetottle. It is difficult to reproduce what takes place, butthe following illustration gives some idea of the effect.By this system it is thus possible to extract all the dirtand dust in the carpets, curtains, furniture, bedding, &c.,

Bottle during the application of the "renovator."

in sitic. Carpets need not be taken up and need not besent away, or curtains, furniture, or bedding, and the wholeoperation in a 10-roomed house need not occupy more thaneight hours, the time taken depending upon the amount ofdirt it is possible to remove and upon the nature of thefurniture,

It is remarkable, as it is important from a sanitary point of

view, that during this process dust or dirt is not raised inthe room, for exhaustion is proceeding the whole time, theair of the room is constantly being changed, and it will befound when the cleaning process is over that the shelves,the mantelpiece, or the cover of the piano will be free fromall signs of deposited dust. This result alone constitutesa great advance on other methods which at their bestremove the dust from one place only to scatter it inanother. Such, at any rate, is largely the result of sweep-ing. Far from producing any deteriorating effect upon thecarpet it improves it by restoring the pile and its colour. Therestoration of the colour, especially of a dirty oriental carpet,is very marked and is seen the moment the renovator isapplied. In a similar way the dust may be removed fromthe walls by means of a special cleaner which consists of abrush of horse-shoe shape provided with an exhaust tube inthe centre. The dust and dirt rapidly travel along the hoseto the exhaust cylinder of the machine where they are

deposited upon a screen.An idea of the amount of dust which this method is

capable of removing will be gained from the follow-ing results of its application to certain of the theatresand hotels of London. The carpets, curtains, and up-holstery of the Royal Camden Theatre yielded no less than408 pounds of dust by this method ; similarly the KenningtonTheatre yielded 382 pounds and the Coronet Theatre,Notting-hill-gate, 300 pounds, the Midland Hotel, St.Pancras, 196 pounds, the Savoy Theatre 822 pounds, thecoffee-room and smoking-room of the Junior Army andNavy Club and smoking-room carpet 68 pounds, a restaurantcarpet from the Carlton Hotel 46 pounds, a railway-carriageon the London and North-Western Railway 4t pounds,the tea-room and corridors of the House of Commons25 pounds, and so on. We have seen the process atwork in a music-hall and in a private dwelling-house andin both cases the results were very striking and the demon-stration was very satisfactory. The value of this methodfrom a sanitary point of view is self-evident, for the dust i-<

entirely removed without scattering and is then collectedfor subsequent incineration. According to Mr. Stanley Kentof the Clinical and Bacteriological Research Laboratory,University College, Bristol, the following organisms wereisolated from a specimen of dust removed by this process-proteus vulgaris and other forms of proteus, bacillus subtilis,streptococcus (several forms), staphylococcus pyogenes

aureus, staphylococcus pyogenes albus, diplococcus (severalforms), sarcina flava, micrococcus tetragenus, micrococcusprodigiosus, and the following moulds : mucor mucedo,penicillium glaucum, and a red yeast. A sample of housedust removed by this process and taken by ourselves at ademonstration gave the following results on analysis :organic matter, 35-30 per cent. ; moisture, 5’30 percent. ; and mineral matter, 59’40 per cent. Under themicroscope starch cells, human hair, cotton fibre, &c., were

easily detected. The mineral matter contained common salt,potassium carbonate with some lithium carbonate (probablyfrom tobacco ash), sand, clay, silica, alumina, and iron.The process is not costly considering the thorough way inwhich the work of cleaning is done and having regard to theinconvenience which it avoids and the expense which itsaves, due, under existing methods, to removing carpets andreplacing them, picking mattresses to pieces, and so forth.The satisfactory removal of dust and dirt from the interiorof a house has long been a troublesome matter, though sani-tation demands that it should be regularly done, and thisprocess, it seems to us, deals with it in a much morescientific way than has hitherto been possible. This methodof cleaning by vacuum is being developed by the VacuumCleaning Co., Limited, of 25, Victoria-street, Westminster,London, S.W.

ASYLUM REPORTS.

London Coicnty 1 sylzcna, Hanrvell (Report for tlte yearended 31st March, 1902).-The average number of patientsresident during the year was 2537, comprising 957 males and1580 females. The admissions during the year amounted to480-viz., 297 males and 183 females. Of these 396 werefirst admissions. Dr. R. R. Alexander, the medical super-intendent, states in his report that 19 per cent. of the maleadmissions and 4 per cent. of the female were cases ofgeneral paralysis. As the result of careful inquiry into the