1606 THE METROPOLITAN BOROUGH COUNCILS.

the same material, furnished in its turn with two doors madeto close automatically. I protected three huts in this way,two at the Cervelletta and one at the Castella.

It is more difficult to induce half-educated people tobelieve that malaria may be conveyed by the hites of

mosquitoes than it is to convince the ignorant peasantry ofthe fact. Oa thii account I met with much less difficultyfrom some of the more intelligent among the latter than Ihad expected in getting them to carry out the new prophylaxis8 j as to insure success.

In the hamlet of the Castella the family of the managerand the medical man of the Red Cross Society escapedinfection, notwithstanding that some stagnant water from aditch, which was brought into the house in an old cask,might have developed many mosquitoes. So also the 17Lombard peasants who slept in the protected part of thehamlet of Cervelletta were rewarded for the great care theytook by only one of their number falling sick with malaria,a man who was in the habit of getting drunk fromtime to time and while in this helpless state of sleep-ing in the open air. In the part of this hamletwhich served as control we had at the same time 10cases of primary infection and several relapses fromthe previous year’s epidemic. And the house so cursed withthe disease in former years had no fresh cases in it. One

family was, however, obliged to leave its protection in theearly days of September, and now (between Ojt. 15thand 17th) the two children have already contractedfever.In the midst of the other straw huts all stricken with

malaria, the protected hut at the Castella, with a family,consisting of father (a very industrious man), mother, andthree children, remained, wonderful to relate, quite freefrom fever, as did also one of the protected huts at theCervelletta with five inmates-father and mother and threechildren. In this latter hut we never found mosquitoes ; afew which found their way as far as the outside cage werekilled. On the other hand, in the third protected hut,notwithstanding all our warnings, we found mosquitoes inthe cage every morning and also often inside the hut itself.Finding it impossible to induce this family, on account oftheir apathy or their ignorance, to take the necessary pre-cautions, we removed the protection, and three out of four ofthe inhabitants took fever. Thus, so long as the peasantswere careful, they were able to defend themselves frommalaria even in the most primitive of dwellings, the strawhut.

In order to protect from fever the nomadic rural p,)pula- tion who come down to the Campagna at the season whenthe most dangerous kind of work is in progress, and who areeasily infected on account of their sleeping in the open, theCaetani family are making a preliminary trial in the PontineMarshes of a large hut constructed of wood and wire-gauzewhich can be taken to pieces and transported to wherever itis wanted.

Naturally, in order to make quite complete what we maycall this mechanical prophylaxis for the peasantry it wouldbe necessary to stop their work in the more dangerous hours.Besides this one must not lose sight of the ideal kind of

prophylaxis for people who work-namely, that of makingthem artidcially immune agairst the disease. With this

object in view I have made, and continue to make manyexperiments, especially with euchinin, and I propose shortlyto give an account of the results obtained by this medicinalmethod of procuring immunity. For the present I wish toinsist upon the fact that by means of the mechanical prophy-laxis for malaria (protecting the houses and the uncoveredparts of the body) a great step in advance has beenmade for practical purposes. Among railway employei,caretakers, and even the peasants of the malarious Cam-

pagna the lesson of the last two years has been so

persuasive that all of those who have hitherto served ascontrols are anxious to be protected during the next feverseason. Within no very distant date all houses in malariouslocalities will be defended against the entrance of insects ;thus during the day there will be no inconvenience from fliesand other insects of an unclean, troublesome, or injuriouskind, and at night there will not be the annoyance and evileffects of mosquitoes. In all low-lying, warm, moist places,where myriads of insects of every species swarm, thismechanical means of defence against their invasions willbecome the best of the prophylactic rules for the preventionof malaria and other diseases.

THE METROPOLITAN BOROUGHCOUNCILS.

THE following list, compiled from official information, is.a substantially complete enumeration of the medical menwho have been elected members of the first metropolitanborough councils. There are, however, we believe, one ortwo vacancies to fill in consequence of the election ofaldermen from the council, but the filling of these vacancies,will probably leave the list unaltered.

Battersea. —Councillor : Mr. L. S. McManus, M.D., M.Ch.R. U. I.

Bermondsey.—Councillor Mr. J. Mulqueen, L.R.C.P.,,L.R.C.S. trel.Bethnal Green —Councillors : Mr. W. A. Farebrotber,

L.tS.A., and Mr. F. E. Rogers, M.R.CS.Eng., L.R.C.P.Lond.

Camberwell. —Councillor : Mr. A. Smith, L.R.C.P. Irel.Chelsea. -Councillor : Mr. J. W. Erskine, B.A., M.B.

T.C.D , L.R.C.S. Irel.Deptford. —Councillor : Mr. F. T. Tayler, B.A., M.B.,

L.R.C.P Lond., M.R.C.S. Eng.Finsbury.—Councillor : Mr. E. Jones, M.R.C.S. Eng.,

L.R.C.P Lond. (Chairman of the Pnblic Health Committee).Fulham.—Councillor : Mr. E Cooney, L.R.C.P. Edin.,

L.F.P.S Glasg., L.S.A., D.P.H. Camb.Greenwich. - Mayor : Surgeon-Lieutenant-Colonel R.

Gooding, V.D., il2.D Lond.. M.KC.S. Eng., J.P.Hackney.—Aldermen : Mr. F. H. Daly, M.D. R.U.I.,

L.R.C.S.Edin., J.P., and Mr. T. Hoskin, LR.C.P.Lond.,M.R.C.S. Eng., J P. Councillors: Mr. J. 0. Adams, M.D.Durh, F.R.C.S. Eng.. Mr. F. M. Milter, M.R.C.S. Eng.,L.R.C.P. Lond., Mr. F. Wallace, L.R.C.P. Lond., M.R.C.S.Eng., and Mr. M. E. A. Wallis, L.R C.P. Lond., M.R.CS.Eg.

Hammersmith.—Councillors Mr. 0. C. Coker, L.RO.P.Lond., L.S.A., and Mr. W. A. Davidson, L.S.A.

Hainpstead.-C)uncillors: Mr. E. C. Andrews, M.D.Lond., M.R.C.S. Eng., Mr. C. W. Cunnington, M.R.C.S.Eng., Mr. A. 0. Grosvenor, M.D. Edin., M.R.C.S. Eng.,and Mr. F. E. Scrase, F.R.C S. Eng.

Holtorn, -Councillor : Mr. W. R. Smith, M.D. Aberd.,F.R.S Eriin.

Islington.—Councillor : Mr. John Walker Smyth, L.R.C.P.,.L.R C.S. Edin.

Kensington.—Councillor : Mr. F. H. Alderson, M.B. Durh.,M.R.C.S. Eog., L.R.C.P. Lond., and Mr. E. D. Vinrace,M.R.C.S Eng.

Lewiskam.—Alderman : Mr. J. W. Elliott, M.R.C.S. Eng.,(retired). Councillors: Mr F J. L. Hart, M.B., C.M.Edin.,Mr. F. S. Smyth, F.R C.S., L.R.C.P. Edin., and Mr. H.Visger. M R C.S. Env., L.S.A.

St. Marylebone.—Councillors : Mr. L. A. Bidwell, F.R.C.S.Eng., and Mr. J. Edmunds, M.D. St. And., M.R.C.P. Lond.,M.R.C.. Eng.

Paddington.—Councillors : Mr. J. L Atkinson, L.S. 4,., Mr.B. F. Popham. M.D. St. And., L.R.C.S. Irel., LS.A. Mr.A Prince. L.R.C.P. Edin.. M.R.CS Eng., and Mr. D. A.Waite, M.A. Oxon., M R.C.S. Eng., L.R.C.P. Edin.

St. Pancras.—Alderman : : Mr. W. Smith. M.R.C.P.Elin. Councillors : Mr. J. A. Angus, Mr. W. F. Hazel,M.R.C.S. Eng., L.S.A., Mr. R. P. Long, L.F.P.S. Glasg.,L.S.A., Mr. E. F. T. MacCarthy, L.R C.P., L.R.C.S. Irel.,Mr. R. Paramore, M.D. Brux., M.R C.S. Eng., and Mr. J.Thompson, M.D. St. And., M.R.C.S. Eng., L.R.C.P. Edin.

Shoreditch.—Councillor : Mr. J. Davies, M.D.Durb.,M.R.C.S Eng., L.S.A.

Southwark. —Alderman : Mr. W. G. Bott, L.R.C P. Edin.,M.R.C.S. Eng. Councillor: Mr. E. C. Perry, M.A., M.D.Cantab., F.R.C.P. Lond., M.R.C.S. Eng.

Stoke Newington.—Councillor : Mr. R. Ostlere, M.B., C.M.Aberd.

Wandsworth.—Alderman : Mr. T. A. Ives Howell, L.R.C.P.Lond., M.R.C.S. Eog. Councillors: Mr. J. Gay, L.R.C.P.Lond., M R.C.S. Eng., Mr. C. R. Lucas, M.R.C.S. Eng.,L.R.C.P. Lond., and Mr. Mark Robinson, M.R.C.S. Eng.,L.R.C.P. Lond.

Westminster.—Councillor : Mr. H. A. Des Vceux, M.D.Brux., L.R.C.P. Lond., M.R C.S. Eng.

Woolwich.—Councillor : Mr. J. Jeken, ’ M.R.C.S. Eng.,L.S.A.

1607PUBLIC HEALTH AND POOR LAW.-VITAL STATISTICS.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF INSPECTORS OF THE MEDICAL DEPARTMENT

OF THE LOCAL GOVERNMENT BOARD.

On the Sanitary Condition of the Bororgh ot Windsor, andupon the Character of the Town Council’s Administration,by Dr. H. TIMBRELL BULSTRODE —Attention is drawnelsewhere in our present number to the immediate circum-stances which determined the issue of this report. It wouldseem, however, that the sanitary condition of Windsor has onseveral previous occasions been the subject of investigationfor the Local Government Board, particularly in 1886 when,in consequence of local demands following on the put3licationof the report 2 an inquiry was held by Dr. H. Airy andMr. Arnold Taylor, and a series of official recommendationsto the Town Council was issued.

In the present report ample evidence appears that thebackwardness of local administration in Windsor, whichwas conspicuous 15 years ago, has largely remaited acharacteristic of the borough. If this has been due mainlyto the ignorance or apathy of the Windsor public Dr.BIllstr01e has now done much to enlighten them. Depart-ing from the somewhat frigid recital of facts of whichofficial reports are apt to consist, he has produced a

document which should certainly succeed in capturing theattention of that important person in modern politics, the" man in the street." After giving details ai to the

present estimated population (12,715) and a descriptionof the physical and geological features of the town,Dr. Balstrode deals with its water-supply. Shallowwells, which used to be common in Windsor, have nowdisappeared, and the public supply of the Windsorand Eton Waterworks Company serves the whole district.This supply is obtained by pumping from several wellssunk in river gravel alongside the Thames, the source ofsupply being largely composed of subsoil water and ofThameR water which has percolated to the wells through agreater or less thickness of natural gravelly soil. The wateris not filtered before being pumped into the service pipes.Certain of these wells are within a few yards of inhabiteddwellings, but Dr. Bulstrode was assured that special pre-cautions had been taken as regards the sewers serving thesehouses. Although, having regard to the sources of supply,systematic examination, chemical or bacterial, of waterfrom each separate well is unquestionably desirable, the onlyexamination hitherto practised has been occasional chemicalanalyses made for the water company of samples taken fromthe town mains, which of course represent a mixture ofwater from all the wells.

As regards excrement disposal, "up to a comparativelyrecent date there was a large number of closets not providedwith water, and the unsatisfactory method of hand-flushingwas resorted to." Much amendment in this respect has, how-ever, been lately made. With respect to house-drains in thepoorer parts of Windsor their "nature, direction, and sound-ness is usually a matter of pure conjecture. Ventilation isoften entirely absent, as also are opportunities of drain

inspection. Probably but few of the older drains wouldwithstand the water test, and it does not seem that any veryextensive effort has been made to ascertain the exact stateof affairs in this respect. Numerous instances of defectiveand broken traps came to my notice and on several occasionscomplaints of smells from the house sinks were made."Thase drains were probably laid before the existing by-lawscame into force ; in certain new houses, however, Dr.Bulstrode found that in laying house-drains the by-laws hadbeen contravened.The sewers of Windsor are of diverse kinds. " Some are

old brick barrel sewers, others pipe sewers with clay joints,and others, again, as for instance the more recent, pipe-sewers with proper joints. The levels vary considerably,and in certain instances the fall of the sewer is in the oppositedirection to the flow of sewage." The contents of themain outfall sewers are pumped on to a sewage-farm on an

1 London: Eyre and Spottiswoode, East Harding-street; Edinburgh:John Menzies and Co.; Dublin: Hodges, Figgis, and Co. Price 9d.

2 Report of THE LANCET Special Commission on the Sanitary Con-dition of Wiudsor: THE LANCET, August 15th, 1885, p. 306.

island at Old Windsor. This outfall sewer is liable to beblocked during a considerable portion of each 24 hourswhen pumping is not going on, and hence " acts as a storagetank"; this accumulation "must place great strain on thesewers and facilitate deposit in them, a fact easily verifiedby an examination of the walls of the inspection chambers."Surface water and drainage, which reaches Windsor sewersby the " Clewer ditch," give rise to considerable incon-venience by increasing the pumping requirements. Houserefuse in the poorer parts of Windsor is often stored in ash-pits which are much dilapidated or altogether broken down,and frequently heaps of refuse are allowed to accumulateon the Dare ground. " In times of rain this decomposing-refuse is washed into trie subsoil in the neighbourhoodof inhabited houses, and in times of drought and wind isscattered broadcast. This aspect of public health control inthe borough has, there can be no doubt, been muchneglected." Save for a temporary stiucture for cases ofsmall-pox, situated alongside the sewage farm, there is noi.olation hospital for the borough. Dr. Bulstrode points outthat some responsibility in this matter attaches to themedical officer of health, Dr. E. Casey, whose advice to thetown council shows that his views on the subject "are notthose held by the vast majority of his colleagues in the

public health service." These views Dr. Bulstrode combats,setting out in reply a temperate claim for the utility ofisolation hospitals on broad lines of expediency to the com-munity and advantage to the individual.With regard to the housing of the poor of Windsor Dr.

Bulstrode shows that a most undesirable state of affairs exists.He gives in illustration detailed notes of his inspection ofVictoria Cottages, a row of about 100 houses with dilapidatedroofs, falling ceilings, unpaved yards, defective gullies, broken

rain-pipes, accumulations of refuse in backyards, and manyother deficiencies rendering them, in his view, 11 difficult to

regard as suitable for human habitation." Of this visit he says :" 1 was especially invited to enter certain houses, the tenantsbeckoning to us to inspect their abodes and to see the con-ditions under which they were obliged to live. There was

distinctly a pathetic side to this inspection of VictoriaCottages, i he inmates seeing members of the town councilwith me, thinking that at last, at any rate, there would besome rt dress." In other streets, such as River-street

(formerly Bier-lane, which figured prominently in the reportin THE LANCET in 1885), Distil Huuse-row, REd Lion-row court, Garden-court, Keppel-row, and Queen’s-square,numerous instances of hopelessly dilapidated and over-

crowded dwellings are also detailed. In the common

lodging-houses the custodians were frankly ignorant of, andsystematically transgressed, the borough by-laws-a copy ofwhich the inspector seems to bave had considerable difficultyin securing. Slaughter-house by-laws were also disregarded.As regards storage of milk in many cases ’’the circumstancesunder which the cleansing and the storing of the milk-panswere carried out left much to be desired, and customers wouldnot have been reassured by a visit to these places."

Dr. Bulstrode reviews in considerable detail the attitudeof the town council (which he describes as "without back-bone") and their officers towards the measures of sanitaryprogress which should have been taken to remedy the variousevils which he has described. Taking as instances certainspecific nuisances he gives a chronological history of the

dealings of the local authorities with them. From these wegather that five years of reports and discussion may notsuffice to produce amelioration in some of the worst dilapi-dated cottage property in the place, and that it may take thesanitary inspector four years of reports and orders before aproper supply of water can be obtained for a closet.Not the least instructive part of the report lies in the

indications furnished by the inspector of the degree ofresponsibility respectively attaching to the town council andto their officers in matters such as these. That his inspec-tion resulted in immediate improvement in certain directionsis evidenced by a memorandum by the town council whichis appended to the report. This circumstance seems hopefulfor the future.

_____ ______

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 33 of the largest English towns 6323 births and 3923deaths were registered during the week ending Nov. 24th.The annual rate of mortality in these towns, which