51THE METROPOLITAN HOSPITAL SUNDAY FUND.

of abdut 80 000,000 gallons, or eight days’ supply of10.000,000 gallons per day. The service reservoir will be350 ft. above sea-level, and hence a supply will be assuredto the most elevated districts in the Belfast water-supply area.The Commissioners will not bring in the full supply availablefor the Mourne district just yet, but will limit the presentsection to what will meet the increasing demands of thecity for a number of years to come. Additional supplies canafterwards, if found necessary, be brought from the samedistrict at a very small increased outlay. The water isexcellent in its characters, and it is interesting to note that,while in 1850 the water for Belfast was obtained from asmall place on the Dublin road, in 1865, 1875, and in 1878 further powers were taken to increase the supply, andin 1884 the Stoneyford scheme was adopted and 750,000expended. The city of Belfast, however, is increasing sorapidly, and so much water is required, not merely fordomestic purposes, but also for the numerous manufactories,that on all hands it is felt the Commissioners have actedwisely in going in for a new supply which will, practicallyspeaking, be inexhaustible. We understand that at presentthere are in the various reservoirs of the Water Commissioners150 days’ supply.

METROPOLITAN HOSPITAL SUNDAYFUND.

THE collections in aid of the Metropolitan Hospital SundayFund received at the Mansion House up to the present time(Thursday noon) amount to nearly 39,000. There are

several large collections still to be received, and the syna-gogues have not yet forwarded their donations to the fund.We continue below the lists of the amounts received at theMansion House and at THE LANCET office.

THE ANNUAL DINNER OF THE EPI-DEMIOLOGICAL SOCIETY.

THE members and friends of this society dined togetherat the Grand Hotel on Friday, the 28th ult. The chair was

taken by the President, Mr. Shirley Murphy, and there werepresent, among others, Sir Walter Foster, M.P., Mr.

Christopher Heath, Professor Michael Foster, Sir B. W.-

Richardson, Professor Clifford Allbutt, Dr. Thorne Thorne,C.B., Dr. Tatham, Dr. Payne, Dr. Parsons, Dr. Klein, Mr.Cope, Professor Sherrington, Dr. Coupland, Dr. Bulstrode,Dr. Whitelegge, Fleet. Surgeon Preston, Brigade-SurgeonScriven, Mr. E. Gould and Mr. J. A. Redgrave,H.M.’s Inspectors of Factories, Dr. Newsholme, andDr. Hamer. After the toasts of "The Queen andRoyal Family," and of "The Army and Navy," to whichFleet-Sargeon Preston and Brigade-Surgeon Scriven replied,Professor Michael Foster gave the toast of "The PublicHealth Service," coupled with which were the names ofSir Walter Foster and Dr. Kenwood. In the course of ahighly entertaining speech Professor Foster discussed theprogress of preventive medicine, and expressed satisfactionat the scientific manner in which the study of epidemiologyis being carried on. He also referred in graceful terms to theprominent part which Sir Walter Foster as ParliamentarySecretary of the Local Government Board had taken inpublic health administration, and to the great services to theState which medical officers of health were renderingthroughout the country.

Sir Walter Foster, in replying, referred to the great pro-gress which had been made in the development of the publichealth administration of the country, and instanced itausefulness in safeguarding the country against cholera. The

immunity enjoyed by England had, he was satisfied, led to theservices which had protected England being less recognisedthan they would have been if cholera had obtained a footing inthe country. With his friend Dr. Thorne he had, through thecompleteness of success of their work, been deprived of thecredit which might probably have been given them.

Throughout the country there had been progress, butnowhere was this more marked than in London, and hecomplimented the President of the society on the development of the health administration of the London CountyCouncil and on the reports which were issued.-Dr. Ken-wood, in acknowledging the toast, expressed his appreciationof the work done by the Epidemiological Society, and alludedto the high place which its Transactions occupied in epi-demiological literature.

Dr. Thorne Thorne, in proposing "The Health of theVisitors," congratulated the President on the presenceof men of great personal distinction, each of whomrepresented a separate branch of work which was asso-

ciated in one or another way with epidemiology. The.

presence of the President of the Royal College of Sur-: geons of England reminded the members of the great; progress which had been made in antiseptic surgery and the

improvements which had been effected in the constructionand administration of hospitals. The presence of the Regius( Professor of Medicine of Cambridge University marked the

52 PUBLIC HEALTH AND POOR LAW.

sympathy of medicine with the work of the epidemiologist.Professor Michael Foster was an especially welcome guest,for his life had been spent in providing a scientific basis formedicine. The presence of Mr. Cope, the chief adviser of theBoard of Agriculture, marked the need which the epidemio-logist felt in the association of human and animal pathologywith the study of epidemic disease ; and of Dr. Tatham, thehead of the Statistical Department of the State, of the neces-sity of using the statistics which he provided, and of sub-mitting to the stern test of figures the work upon which themembers of the society were engaged. He commented onthe support he had always received from Sir Walter Fosterin the performance of his official duties.

Mr. Christopher Heath and Professor Clifford Allbutt

replied to the toast. Mr. Heath discussed the examinationof medical officers of health and dwelt on the excellence ofthe examination of the united colleges. Professor CliffordAllbutt, referring to the self-denying labours of the medicalprofession in preventing disease and in thus depriving them-selves of the work upon which they as a profession dependedfor their livelihood, instanced the work of one whose effortsbad resulted in the reduction of disease, and especially theabolition of enteric fever from the locality in which hepractised, and the consequent reduction of his income.

The President, in proposing the toast of " The Epidemio-logical Society," commented on the fact that the number ofpersons who associated themselves for the study of epidemicdisease had always been small, but, from the foundation ofthe society, among those who took part in the proceedingswere some of the best thinkers and most distinguishedmembers of the profession, and he alluded to the loss thesociety had recently sustained by the death of a belovedleader whose own work had largely added to our knowledgeof epidemic disease. He then referred to the history of the:study of epidemiology, of which the published proceedings ofthe society were an index. The beginnings of this study wereto some extent gropings in the dark, and theories were oftenformulated which had to give way to the teaching of thefacts which were observed. Theory and fact were sometimesstruggling against each other, but by degrees the factswere accepted. Scientific epidemiology had thus come into’existence and paved the way to a better knowledge of thediseases which attack communities.

Sir Benjamin Ward Richardson, in proposing "The Health,of the President," referred to the work in London in whichhe was engaged, and congratulated him on his recognition ofthe need for sound and scientific knowledge to be made thebasis of the health administration of London.

After a suitable acknowledgment by the President thesociety adjourned.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Leicester Urban Sanitary District.-Dr. Joseph Priestleyin his current annual report has continued his interesting- observations on the distribution of enteric fever in Leicester,which he commenced in his 1893 report, and it appears thatthe 1894 experience 13d to much the same conclusions as didthat of 1893-i.e., it showed a greater incidence of thedisease on houses provided with pails, privies, or water-closets with ashpits than upon those provided with water-closets and bins. We imagine, however, that there are somewho would object to the classification of houses furnishedwith waterclosets and ashpits with those provided withpails and privies. Dr. Priestley also gives an account of alocalised outbreak of enteric fever comprising 47 cases andthirty-seven houses, which he considered due to the inter--change of infected pails. In this account two series of casesare given; in the one, no less than 7 cases were, Dr. Priestleythinks, directly infected from the first case ; in the other,8 cases of the disease were apparently contracted eitherdirectly or indirectly from the first. Of the total thirty-seven houses invaded in the outburst 81 per cent. had pailsand 18 9 per cent. waterclosets. Dr. Priestley, after dis-cussing the causes to which outbreaks of enteric fever areusually attributable, considers that a thesis of typhoid feverinfected pails is the one which best explained the dis-tribution of the disease. Apart from the disuse of pailsaltogether-which is the course Dr. Priestley advocates- i

or the return of each pail to the house from which it wastaken, it is difficult to devise a remedy for therisks which the pail system would seem to incur.Obviously there must often be in a large town cases of un-recognised enteric fever, and probably in those instanceswhere diarrhoea is a prominent symptom there is considerabledanger of infection occurring before the nature of the diseaseis recognised. As regards the distribution of typhoid fever onpervious and impervious formations, Dr. Priestley observesthat the figures for 1894, like those for 1893, show thatthe greatest incidence of the disease occurred on graveland sand and the least on clay. The experience as regardsdiarrhoea in Leicester during 1894 fully bears out Dr. Ballard’sclassical researches on the relation between the prevalenceof this disease and the temperature of the earth at a depthof 4 ft. The registered vaccinations in Leicester for theyear 1894 show a considerable falling off on those of theprevious year, the respective numbers being 133 and 249.As, however, Dr. Priestley observes, the Vaccination Actsare practically a dead letter, the number of certificatesreceived by the vaccination officer is really little or no

criterion of the actual number of vaccinations performed,and many persons have apparently had their childrenvaccinated by private practitioners. In commenting uponthe high death-rate among illegitimate infants Dr. Priestleysuggests that the sanitary committee should keep a registerof the illegitimate children born in the town, so that anysuspicious cause of death might be inquired into; and he alsoreports that the percentage of uncertified deaths in Leicesterhas been increasing, while inquests seem proportionately tobe decreasing. The proper certification of all deaths should,he observes, be enforced by law. In that section of hisreport which refers to the fever hospital Dr. Priestley drawsattention to the fact that the present small-pox hospital isonly a temporary building, providing a maximum accommodation of twenty beds, and he points out that no troublshould be spared to find a suitable site for a proper small-poxhospital well outside the town, so that in the event of small-pox appearing again it may not be necessary to dischargethe scarlet fever patients. Dr. Priestley alludes, too, to thenecessity of providing a new fever hospital, one that shallbe worthy of "a town that, in other municipal and sanitarymatters, generally takes the lead." In Part III. of his reportthe vital and mortal statistics of Leicester are dealt with, butspace prevents our touching upon them save to state that thegeneral and zymotic death-rates recorded during 1894 werethe lowest chronicled in the annals of the borough.

Eastbourne llrbana Sanitary District. - Dr. W. G.Willoughby, in submitting his first annual report as medicalofficer of health of Eastbourne, gives a detailed account ofthe borough, describing its site, geology, water-supply, &c.He also enters thoroughly into the age and sex distributionof the population. The water-supply is, Dr. Willoughbystates, of excellent quality, save for its hardness, and toremedy this defect he advises its treatment by some such.process as the. "Porter-Clark." Dr. Willoughby alsoobserves that charges for water-supply to dwelling-housesshould be inclusive, so as to embrace baths. In Eastbournethese very necessary fittings are treated as luxuries, anddoubtless the visitors to Eastbourne have to pay their shareof the charges. The isolation of infectious disease is

increasing in popularity in Eastbourne, and the percentageof notified cases isolated during the past three years has beenrespectively 56’9, 64-5, and72.9.

.Kingston-upon-Thames Urban Sanitary District. - Mr.Beale Collins devotes a considerable portion of his report for1894 to a discussion of the desirability or otherwise, from apublic health standpoint, of the proposed extension of theborough so as to embrace the ecclesiastical parishes ofKingston and Ham. Without following Mr. Collins step bystep through his interesting observations, it may be statedthat he considers the proposal would tend to produce whathe terms a normal community in the matter of age, sex, andclass distribution, and that, as far as drainage is con-

cerned, "there is nothing to be said against extension andeverything in its favour" ; while in regard to isolationaccommodation and the control of infectious disease gene-rally, Mr. Collins thinks that much good would result.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN thirty-three of the largest English towns 6166 birthsand 3394 deaths were registered during the wae ending