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described. But the influence of the flood is not confined tothe cesspool and the sewer. Every dirty hole and corner iswashed out by it; the manured field, the slaughter-houseyard, the factory, the pigstye, and the dunghill alike con-tribute, and the foul muddy torrent pours into the Londonwater supply. Dr. Tidy properly distinguishes betweenprimary and secondary flood water--that is, between theearlier and later washings of the dirty earth. The formerare much more objectionable than the latter; but all thatconcerns us is the obvious fact that both alike go into thereservoirs of the water companies.

It will be evident from what has been said that our lateststudy of the question has confirmed our previous opinion,so often expressed in these columns, that the Thames is atpresent, and is likely to remain, an unsuitable source ofwater supply for the metropolis. For the sake of distinctnesswe offer a summary of our conclusions :-

1. The upper Thames is a highway of commerce, a vastand increasingly popular pleasure resort for rich and poor,and the natural drainage channel for a district alreadyhighly populated and certain to become more populousyear by year. 2. Although such a watercourse should forevery reason be kept as pure as possible, it must always beexposed to so much continuous as well as casual pollutionas to be a dangerous water supply for London. 3. Al-though much has of late years been done by the Londonwater companies in improving their supply, particularly bymore careful filtration, there is no proof that they can nowor will ever be able to exclude from the water which theysupply to London all matters injurious or dangerous tohealth. 4. In any case, the pollutions to which Thameswater is necessarily exposed are of such a disgusting characteras to render its use for drinking purposes undesirable.While formulating the above objections, which seem to

us undeniable, we wish to give prominence to all fairarguments which have been adduced on the other side. Weadmit fully that, as a general rule, chemical analysis failsto point out anything certainly deleterious in the water

supplied by the Thames companies; but on this point wewould desire it to be remembered that recent experiments forthe Local Government Board have led to the conclusion that" we must [at any rate until other methods of recognitionare discovered] go beyond the laboratories for evidence ofany drinking water being free from any dangerous pollution."Furthermore, we admit that modern researches in bacterio-logy, among which those of Dr. Percy Frankland deservehonourable mention, have shown that filtration is a morepotent agent in purification than was at one time supposed.But granting all this, we are still obliged to reiterate ouropinion that the risks attendant upon the use of a watersupply so foul, and increasingly so, as that of the Thamesshould not be lightly incurred by the largest and wealthiestcity in the world. The experience of Lausen, quoted in thesixth report of the Rivers Pollution Commission, seems toprove beyond a doubt that the poison of typhoid may undergowhat appears a very efficient natural filtration withoutlosing its activity; and the history of the late epidemic ofcholera in Spain, as told by Mr. George Higgin,l reminds ustoo forcibly of our English experience not to suggest fearsthat ought not to be laid aside.

It will naturally be asked, What alternative scheme ofwater supply is offered if the Thames is to be abandoned ?There are many alternative schemes, each of which wouldgive us a safer and better water supply than we nowpossess. Our limits prevent us discussing them at present;but lest it should be supposed that they are merely dreamsof sanguine engineers, we will quote once more, inconclusion, a passage from the Sixth Report of theRivers Pollution Commission (p’)ge 430) :-" Abundance ofspring and deep-well water of excellent quality can beprocured in the basin of the Thames and within a moderatedistance of London; and we are of opinion that the metro-polis and its suburbs should be supplied on the constant i

system exclusively with this palatable and wholesome water."

1 Nature, June 17th. 1886.

PROPOSED FEVER HOSPITAL FOR DUNDEE.-It is pr0-posed to erect a fever hospital in Dundee at a cost of X9000At a meeting of the Sanitary Committee of the Local PoliceCommission on the 4th inst., plans of the hospital were sub-mitted, and the committee approved of the erection of twopavilions and half of the proposed administrative department.

VON PETTENKOFER’S LATEST VIEWS ONCHOLERA.

No living epidemiologist has dedicated more time or

greater talent to the study of cholera than von Pettenkoferof Munich. Three years ago, after the outbreak of thedisease on the Mediterranean seaboard, and when Koch’S.

discovery of a comma bacillus was still recent, he wrote aseries of papers on the theme, papers which were translatedin full and published in THE LANCET. Since then a gooddeal of fresh light has been thrown on the subject. and vonPettenkofer has utilised it to supplement or reinforce whathe had already given to the world. This "revised version "

of his views has just been concluded in the Archiv fiiK"Hygiene, and we now offer our readers a succinct digest ofthe fourteen sections (Abschnitten) in which it is contained.Having confirmed by additional proofs, drawn mainly

from the experience of Persia and England, his demon-stration of the worthlessness of quarantine afloat andà fortiori of inland cordons, he passes on to what may becalled the "pilgrimage theory of the diffusion of cholera.Here, again, he ranks himself with the sceptics, and shows,in a masterly summing-up of the evidence adduced byBryden, Cuningham, and Bellew, that while pilgrimages, bythe hardships and privations which attend them, undoubt-edly predispose to the disease, they never convey it.The vindication of these views occupies the first three

sections of his treatise, and in the fourth he proceeds toestimate the practical worth of the comma bacillus ofKoch. For the pathologist and clinician this, he admits, is ofundoubted importance-mainly in the differential diagnosisbetween cholera nostras and cholera Asiatica. But for theepidemiologist and the hygienist in quest of prophylaxis ithas little or no value. In the epidemics that ravaged Munichand Heilbronn in 1873, what, he asks, would have been thepractical gain if the comma bacillus had been known then ?-

Nothing; or as little as the tubercle bacillus proves in thetreatment of phthisis. The infant science of bacteriologyshows that nothing can be achieved against the diffusion ofcholera by restriction of communication, however elaborate,because we can never make communication of any kind,least of all human communication, absolutely germ-proof(pilzdicht). To the bacteriologist, he says, in effect, it is nomarvel that in any place whatever the best sterilised brothquickly presents germ growths, if the place has not beenmade hermetically germ-proof. If you put a broth in themost artistically prepared box, with as many bolts and barsas you please,a box whose fabrication, shutting and opening}costs no end of money and pains, the tyro in bacteriologycan tell you beforehand that all your trouble is thrownaway if the seclusion from germs is not absolute. The tiniesttrace of a non-germ-proof chink will suffice to introduce theenemy, where it will always find its nidus. Meat, sterilisedat a high temperature and kept in air-tight tin boxes, canmake the tour of the world and arrive fit for consumption,at its destination; but if an opening, invisible to the nakedeyf, admits to the interior of the box, the meat will get" high," even in a temperate climate. Had germ-proof casegbeen the sine quâ non of fresh meat conservation, this wouldnever have been a successful enterprise ; but it succeeds byother means than the exclusion of germs. Slaughtered inAustralia, meat arrives at the London market fresh, not bybeing sterilised or made germ-proof, but simply by beingconveyed in ice chambers, and thus reduced by cold to acondition in which no bacteria can live or thrive. As theair everywhere carries putrefactive germs, so communica-tion with cholera localities always and inevitably bringswith it the germs of cholera. So long as the contagionistschool fails to render every avenue of communication with cholera localities germ-proof, all their precautions count fornothing, all their restrictions of communication are worth-less, and they must bethink themselves of some other meansto keep human flesh (so to say) from corruption. On thisand similar grounds von Pettenkofer also holds the isolationof cholera patients and the disinftction of their evacuationsas of no use, and, in the two following sections, confirms hi&position by an elaborate induction of facts.From his argument against the Efficacy of regulations

which are founded on the assumption that the infection ofhealthy subjects proceeds from cholera patients and their

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- excreta, von Pettenkofer comes to answer the question :" What, then, are we to do, if we admit free communicationwith the cholera-stricken, and assume that the infection pro-ceeds from the cholera locality?" First, he takes into con-sideration the abandonment of the cholera locality itself-the so-called "cholera flight."On grounds public as well as private he thinks it desirable

that during an epidemic the population should abide on the.spot, where, by personal care and management, they canprotect themselves as thoroughly as if they had fled to.another place; but still he is of opinion that cholera flightwill always remain a practical question, to be dealt withpractically. The magnitude of the flight depends on theintensity of the fear, and it is difficult to calculate whetherthis is greater if one assumes that the infection proceedsfrom the cholera patients (the contagionist view), or that itcomes from the cholera localities (the localistic view). Thefear, and the consequent flight can be prevented neither fromthe contagionist nor from the localistic standpoint; and in thecase of persons who are not officially chained to the spot, we ’,have no right to hinder them if they choose to go. That it is an effective prophylactic measure is proved, not merely in shipswhich leave an infected harbour for the high seas, where,- as a rule, they remain exempt from the disease, or soonbecome so ; but also in the abandonment of infected placeson land, as is now practised successfully in British India inthe case of all barracks and prisons as soon as cholera,declares itself. The cholera flight is useless either when itis adopted too late, or when it is directed to a place which isalso a focus of infection, or which becomes perhaps a worse.quarter than that which is fled from. Having adduced mostinteresting illustrations from the movements of our garri-sons in India, von Pettenkofer admonishes those who willand can run away not only to do so as soon as possible, butalso to know whither they are going; for they might beexchanging " the frying-pan for the fire" (aus dem Regen in.die Traufe Kommen). In this respect they will bestbe guided by the experience of former epidemics. On thissubject and on the return of the cholera fugitives he givesa number of practical suggestions, and then passes on toshow that, from the localistic standpoint (his own), cholerafugitives are not to be dreaded as importers of the disease.,On this question he adduces a cogent array of facts allgoing to prove that cholera fugitives are freely to beacquitted of all charge of diffusing the epidemic, whileonly infections which are never more than exceptionally:sporadic can be traced to them. If here and there, he says,the outbreak of an epidemic coincides with the arrival of acholera fugitive, it is a case of casual coincidence merely,.and the place would have been visited by the disease had nostranger come to it. How many thousands of fugitives inFrance since 1832 have fled from Marseilles and Paris to thecholera-exempted Lyons and Versailles without ever

importing the epidemic ? From cholera districts, he.admits, one may here and there bring with him justas much ot the locally-produced infective matter as maysuffice to cause in another place a few sporadic cases; as,for instance, in 1854 an arrival from Munich occasioned threeinfections in the cholera-exempt Stuttgart, but these threeproduced no further infection, and the disease took no root.Besides, that any importation of the infective matter fromcholera localities through travellers or fugitives can be pre-vented is shown by von Pettenkofer in a striking series of.examples taken from the prisoners released from gaol inLaufen and Rebdorf during the last epidemic in Bavaria.While the disease prevailed in these two establishmentsthere were ninety-four inmates set free, of whom each one,from the prison door to his permanent destination, and formore than six weeks, was followed by the police. Theseticket-of-leave men, as we should call them, were scatteredin the most various directions over Upper and LowerBavaria, Swabia, and Neuberg, some even into the UpperPalatinate. En route, or on arrival at their destination, two.of them fell ill of distinct asphyxial cholera, seven ofcholerine and suspicious diarrhœas, but none of them died.These ninety-four fugitives, in fact, fared far better thanthe comrades they had left behind in their carefullysuperintended prisons, very many of whom died of the.disease. Of these same ninety-four, moreover, of whomnine became ill outside the gaol, and who took the mostdiverse routes, not one communicated to the persons withwhom for six weeks they were more or less in contact asingle ailment bearing any resemblance to cholera. So, saysvon Pettenkofer, " from these two prisons we may learn

how flight may be taken from a cholera district to the

surrounding country without spreading the disease." Andhow were the prisoners set free? Only after a thorough bath,after laying aside every article they had worn within thewalls, after getting fresh linen and clothes, and takingnothing with them from the establishment but a littlemoney they had earned or saved. To these articles noinfection could cling, in such quantity at least as to causeinfection elsewhere; and as in the localistic view only thecholera locality and not the cholera patient produces the in-fective matter, so these nine patients outside the prison wereunable, in the many places through which they passed and inwhich they sojourned, to communicate the faintest vestigeof the disease. All the localities they came in contact with,several hundreds in number, remained free from cholera.

(To be eoncluded.)

THE PAIL SYSTEM AT MANCHESTER.

No. II.

IN dealing with the contents of the pails removed fromthe 66,000 ash closets of Manchester, the authorities have atleast the advantage of treating a substance which doespossess a commercial value. For many years the hope ofderiving pecuniary benefit from the precipitation &c. of

sewage water has been abandoned, but this is not the case withregard to the pail system. Nevertheless, this pail system, asworked at Manchester, is not managed on a commercial basis,Public health and public convenience are the first considera-tions ; commercial advantages are relegated to a secondaryposition. It is needless to say that the working of thepail system has not been handed over to any private con-tractor, but is managed by the municipality of Manchesterin the public interest. Such being the case, the first objectheld in view is not that of obtaining a concentrated andvaluable manure, but of shielding the community from allnuisances or risks. If the commercial interests were para-mount (and this would be the case should the enterprise belet out to a private contractor or a company), efforts mightbe made to prevent anything entering the pails except thesoil. The municipality, however, justly conceive that suchpails must occasion considerable nuisance; therefore, todeodorise their contents, it is arranged that the pails shallalso receive the finer ash of each household. This ash is

very effective in preventing bad odours ; but, on the otherhand, it greatly increases the difficulty and expense of con-verting the contents of the pails into a marketable form ofguano. In this respect, therefore, there is a direct conflictbetween the interests of public health and the desire torealise financial profit. This situation points to the necessityof placing the management of all such works in the handsof those to whom money considerations are not of the firstimportance.The pails are brought to the sanitary works, established by

the municipality at Holt Town, Beswick, on the north-eastside of Manchester. The prevailing winds would, we pre-sume, not blow from the works towards the town. Nosooner are the pails removed from the van than the lids aretaken off, and the contents tilted over into a bottomlesstrough. Eight men are employed exclusively at this work,and it is calculated that each man empties about 1800 pailsin a day. Other eight men seize and dip the emptiedpails into a bath of water charged with a strong solution ofcarbolic acid. As a further precaution the bottom of eachvan is strewed to a depth of about half an inch with a car-bolic acid powder; hence, if anything is spilt within the van,it falls on a disinfectant. Proceeding to a lower floor, wefound that the soil, as discharged from the pails, falls on arevolving riddle from which there are two exits. On oneside, the rougher materials, such as the larger pieces of cinderor any foreign objects accidentally thrown into the pail, fallon the ground. On the other side, the more liquid materialis drained off into vats, whence it is discharged into a con-centrator that holds 480 gallons. Here it is mixed witheight gallons of sulphuric acid, and heated to 230° F., undera pressure of 40 to 50 lb. of steam.From the top floor, forty feet above, a twelve-inch pipe

discharges water upon the gases evolved from the concen-