NEXT to the need for respirable air, the need for water-including, of course, beverages containing itis the most urgent necessity of our being. A man will live longer without solid food than without water; nor is this surprising when we consider that four-fifths of the human body consist of water. Moreover, a supply sufficient in quantity for purposes of cleanliness is as essential to health and comfort and, one may almost say, to morality, as a supply sufficient for the needs of the body is to life. On the other hand, it is only too familiar to us as officers of health, that impure water is a frequent and fertile cause of disease, both of widespread and rapidly fatal epidemics, and of lingering maladies, which slowly and insidiously impair the sufferer's health.

Looking to the means by which we obtain our supplies of the three prime necessities of life-air, water, and food-we find that water differs from the other two, in that in the majority of cases fixed appliances, 'structural works,' are needed, as it is not omnipresent like air, and is required in too large a quantity to be transported like solid food for long distances. If, then, we ask what legal means has a legislature, which professes to make the health of its subjects a main object of its regard, provided that no inhabited house shall lack that most important requisite for health and comfort, an adequate supply of water, the answer in a large class of cases is, practically, None whatever." The powers which sanitary authorities possess for compelling the provision of a proper supply of water are contained in section 62 of the Public Health Act, 1875, which provides that if any house within the district is without a proper supply of water, and if such a supply can be furnished thereto at a cost not exceeding 2d. a week, or not exceeding the rate authorised by any local act, or at such other cost as the Local Government Board may determine to be reasonable, the local authority shall require the owner to obtain such a supply, and in his default may do the necessary works, and recover the cost. In the special case of common lodging-houses it is enacted, that if a proper supply can be furnished thereto at a reasonable rate, the local authority may require such supply to be provided, under pain of removal from the register.

As I was anxious to know whether this clause might not be put in force in cases where, in the absence of public waterworks, a supply might be obtained by sinking wells or cisterns for a sum the interest on which would not exceed 2d. per week, I wrote to the Local Government Board asking for an official explanation of the law on the subject. The reply was: As regards the case to which you refer, the Board can only state generally that it does not appear to them that the enactment referred to applies to cases where the water-supply to a particular house can only be obtained by the digging of a well.' I should observe that this correspondence took place

Read before the Yorkshire Association of Medical Officers of Health, April 26, 1876.

when the Public Health Act, 1848, was in force, and that in the Act of 1875 the word 'rate' has been altered to cost;' but as in the circular letter issued last autumn by the Local Government Board no mention is made of the extension of the powers of sanitary authorities as regards compulsory watersupply to cases where there is no public service, it that the board do not consider the incidence appears of the law to be altered.* It appears that there are two important classes of cases in which the law gives no power to compel the provision of a supply of water-viz.: first, where there is no public service laid on; and, secondly, where, there being such a service, the value of the house is such that the waterrate would exceed 2d. per week. Of the second case I shall not speak, as I presume that the owners of the better class of houses are compelled, by self

interest, if not by statute, to have them properly supplied with water, though possibly my confreres the case; but, at any rate, those whom the law fails from large towns will tell us that this is not always to help are those who are best able to help themselves. In rural and small urban districts, where there is no public water-supply, the case is far worse, as there is no power to compel an owner to supply his not in a position, even if he had the inclination, to with water, and the tenant is frequently property spend much money in improving another man's property, from which he may be evicted at a month's notice. Where there is a water company to make a

profit out of the sale of water, there are powers to enforce its use; but when it comes down free from a bountiful heaven and has only to be collected or dug for, our legislators in their wisdom do not see fit to the inconsistency of the law by supposing that water grant compulsory powers. I can only account for companies and rural landlords are represented in Parliament, and that the tenants of cottage property

are not.

The evils resulting from this defect in the law are manifold and great. It is not very often, indeed, that a house is built confessedly without any attempt to provide it with water, but it very frequently happens that the water becomes inaccessible for want of repairs to the pump, and these no one can be called on to do, nor are they likely to be voluntarily done by the tenants, where, as often happens, one pump serves for a number of houses. I could have shown you last year a street of forty-four houses without any water whatever, beyond a little black contaminated rainwater, the turbid water of a tidal river laboriously carried up a muddy foreshore, dirty canal-water retailed at a halfpenny a bucketful, and what the tenants could beg, borrow, or steal from their more fortunate neighbours. Yet this state of things the sanitary authority is powerless to remedy except by sinking a well at the public cost-that is to say, by taxing the whole township for the benefit of one or two proprietors who have neglected their duty to their own property,-a course which most sanitary authorities would be loth to adopt.

taminated, much sickness arising in consequence ; Wells and cisterns very frequently become con

* The words of the Act of 1875 are at a cost not exceeding twopence a week, or at such other cost as the Local Government Board may, on the application of the local authority, determine, under all the circumstances of the case, to be reasonable. I have not, however, heard of any sanitary authority having tried the question whether the Local Government Board consider the cost of a well to be a reasonable cost.

possessed by the mother country, for at the present moment New South Wales and Victoria are suffering from a severe epidemic of scarlet fever which, suddenly making its appearance during the month of August last, a period corresponding with early spring-time in England, has continued its ravages to such an extent as to awaken grave doubts respecting the possibility of permanently checking its further advance save by the adoption of sanitary regulations of the most stringent and comprehensive character. Besides the two colonies above-mentioned, Queensland, South Australia, and New Zealand have furnished cases of scarlet fever, but not in sufficient numbers to awaken misgiving, although the experience of Melbourne shows that the authorities in each of those colonies would do well to commence setting their houses in order. We mention the Victorian capital because in that city not only have the fatal effects of the epidemic been most severe, but the predisposing causes of the unwelcome visitation placed beyond all reasonable doubt. In Melbourne the ordinary rate of mortality has become more than doubled, and that for several weeks the number of deaths was in excess of the births. During the week ending January 1, 1876, the number of deaths was 126, the normal death-rate being 60 per week. Of these 126 deaths, 37 were from scarlet fever, leaving 89, or an increase of nearly fifty per cent. over the ordinary mortality from all causes. The deaths were principally among infants and children of tender years, the largest number of victims being between the ages of one and three years, and the next largest under the age of twelve months. The total number of deaths from scarlet fever in Melbourne during the last four months of 1875 was 706, of which 251 occurred during the single month of November, which at the antipodes corresponds with the month of May in this country. Even so late as the last week in January of the present year the rate of mortality continued so excessive that the number of deaths was still larger than that of the births. There, however, existed hopes that with the approach of milder and less humid weather, the average temperature in Melbourne having been exceptionally low during the period when the epidemic assumed its most virulent character, efficient means would be taken to prevent not only the extension of the disease but likewise its future re-appearance on a similar widely spread and fatal scale.

to be covered with a dense population.' At the same time he alludes to the tendency of the colonial population to repeat the mistake, so common in all civilised countries, of massing closely together under conditions most unfavourable to the proper maintenance of health, by living in a vitiated atmosphere, indulging in habits of drinking and eating to excess, and scarcely taking any exercise. The fatal example of Melbourne, he tells us, is repeated throughout the colony. We build towns and villages in places where we know there can be none or insufficient drainage, and try to patch up the mistakes when too late, and then wonder that people die prematurely.' In fact, it is the old story retold in a new country.

6

If we turn to Sydney we find the state of sanitary affairs in that city scarcely less encouraging, especially in the poorer localities, where, to quote the recent report of the Sydney City and Suburban Sewage and Health Board, the total absence of all sanitary precautions' has 'made its mark in the mortality table of the district.' In one of these places, named Shea's Creek, scarlet fever has been unusually prevalent during the last few months, and no wonder, for we are told that not only is the whole of the subsoil of the neighbourhood 'saturated with sewage, giving the most offensive fumes,' but that 'many of the houses have been constructed in what are now green fœtid pools,' no language being adequate to describe the foul and noisome filth of the drains in the immediate vicinity.' In the report of the committee appointed by the Board we are informed that the members thereof, 'guided by the returns furnished by the Registrar General, inspected a number of houses in various parts of the city in which scarlet fever had been the reported cause of death, and found in all of them to a greater or less extent the same defective arrangements for ventilation and drainage.' In one tenement visited by the committee, 'the only ingress for air and light was through the door leading into the dwelling, and a second door leading to another part of it, the said door being only five feet high, and unusually narrow.' The committee add that in the yard attached to the house, there was a large accumulation of rubbish. In another house, immediately adjoining, the watercloset was in such bad order that the contents of the closet were washed into a passage leading to one of the rooms of the house.' In a third house, containing three small rooms, in which five persons resided, the only means of access for light and air were 'the small door of entry to the dwelling and a very small window in the roof of one of the upstairs rooms.' Numerous similar details are given, but the foregoing will suffice to show that a portion of the inhabitants of Sydney are dragging on an unhealthy existence under conditions which we might expect to find among certain wild tribes in Africa, but certainly not in a community professing to be both civilised and highly enlightened.

houses badly constructed, ill-ventilated, and without proper drainage, there were the dwellings where there had been fatal cases of scarlet fever, that we are forced to the conclusion that it is in such localities, among a population predisposed to disease and with depressed vital powers less able to resist its attacks, an epidemic finds its ready victims.' Of course there is nothing new in these conclusions, but it is painfully suggestive to find the sanitary experiences of the mother country so ignored by the Australian colonies that, instead of the colonial cities and towns being constructed in a manner

journals fulfil properly their true functions as popular guides and instructors, and there are not a few in this country which might profit by the wholesome example of their colonial contemporaries. If ever Australia becomes a sanitary paradise, it will have to thank its leading papers for their assistance in effecting the transformation.

THE

essential to the preservation of the public health, they are often built in a fashion which reminds us of the medieval ages, when pestilence was regarded as a visitation which could not be avoided.

The Australian newspapers have not been slow in showing the necessity for a radical change. The Melbourne Argus even went so far as to publish a sensational article, entitled, 'The Black Death in Melbourne,' somewhat after the style of the famous 'Battle of Dorking.' The article opened with a terrifying picture of the fearful epidemic of 1348, and the conditions under which it was engendered, after which the writer proceeded to show that the existing sanitary state of Melbourne was almost identical with that of the cities ravaged by the black death, and that accordingly a similar visitation might at any time be anticipated by the colonists. The publication of this article excited much hostile comment, and the writer was hotly censured for what was designated his want of taste;' but one good result was achieved by its appearance; it caused the citizens to perceive that, unless something were done and very speedily, Melbourne would acquire the reputation of being one of the most unhealthy cities under the southern cross. Unfortunately, partyspirit runs high in Victoria, and it is possible that the sanitary legislation which is declared to be so urgent may become postponed in obedience to the requirements of political strife, but such a scandalous neglect of public duty cannot be much longer tolerated.

The real difficulty, however, has been, as in England, the apathy of the general population. As one of the colonial papers very justly remarks, 'The mass of the population do not seem to realise the dangers they incur. From want of early instruction on the subject they are for the most part unacquainted with what to do or what to avoid, in any given state of circumstances, in order to ward off disease or maintain health unimpaired. Especially are they ignorant of what slight causes are sufficient to endanger infant life.' This reads like an extract from one of the reports of the Health of Towns Commission in bygone years. The same paper continues, It is a great defect in our system of public education that it does not comprise the instruction of youth in a practical knowledge of the laws of health, of the structure and functions of the body, and of how completely the maintenance of a sound condition of body and mind depends upon such simple things as abundance of fresh air and pure water, a clean skin, wholesome unadulterated food, and moderation in eating and drinking.' There is hope for a community which possesses newspapers that are not above speaking the language of common sense, of appealing to the natural intelligence of their readers rather than seeking to gratify their appetite for the sensational and demoralising. Such

SATURDAY, JUNE 3, 1876.

The Editor will be glad to receive, with a view to publication, announcements of meetings, reports of proceedings, and abstracts or originals of papers read before the members of any sanitary or kindred association.

THE SANITARY CONFERENCE.

STRONG common-sense is the characteristic of one and all the resolutions carried at the late Sanitary Conference. The Government will be wise if it at once accepts the advice these resolutions tender, and promptly gives effect to the administrative sanitary reforms which the Conference with a practically unanimous voice declares to be so urgently needed. Hitherto it has generally been urged that from interested motives the doctors have been endeavouring to be the sole administrators of the sanitary destinies of the kingdom. Under any circumstances these fears are groundless, for doctors live on and by sickness, and their incomes decrease as public health increases. But fortunately the late Conference was thoroughly catholic in constitution. All professions and all callings were represented. There was no attempt made by engineers to ignore medical health officers, neither did the medical profession for one moment underrate the value or importance of the services required at the engineer's or surveyor's hands. At this Conference engineers, surveyors, lawyers, chairmen and members of sanitary authorities, together with officers of health, took kindly and skilled counsel together, and as a result arrived at some twelve resolutions, which are at once so simple, so practicable, and so self-evident as to their necessity, that they cannot fail to carry the greatest weight with the Local Government Board. The resolution proposed by Dr. Farr, as a summary of his own experience, 'That the same sanitary laws should be applied to the whole area of the country without distinction,' is so obvious a necessity that the only wonder is that such is not already the case. This resolution, if acted upon by Government, of course remedies the mischief deplored by a previous resolution, which states 'That the existing division of the country into urban and rural districts does

Again it is clear that the present subdivision of the country into sanitary areas is capable of amendment, and in subdividing anew a readjustment is possible, which will not only be more convenient for local government purposes but which will effect an economical result of equal importance.

There was great unanimity of opinion as to the appointment of a county board, and equally so as to the duties of such a board when appointed, and while defining these duties broadly, all possible care was taken not to encroach upon real liberty of local

action.

Another resolution carried unanimously was one on which the whole of the thinking portion of the community is equally unanimous. As things are now in infectious discase outbreaks, at a great expense we endeavour to stamp out such fevers as small-pox, scarlet fever, typhoid, typhus, etc.. after it has had an uncontrolled start of days, weeks, and often months Sanitary authorities and their officers only hear of the existence of infectious diseases after deaths have occurred. Attention is strongly called to this great drawback to effective sanitary work, as well as to the want of power to prevent houses being built on improper and unhealthy sites.

The resolutions relating more especially to officers, their appointment, qualification, and salaries, are sound in principle. Practical experience has already demonstrated that from the very nature of their work the officers to a sanitary authority should be restricted from other than the official duties for which they are specially engaged.' To promote this object it is essential that the area of supervision should be made as large as can be conveniently worked. It is also recommended that a health officer should be appointed to every Local Government District and to every county, and that these health officers should be in communication with each other, and with the health officers especially attached to the county board. Also that the salaries should be such as to insure the services of first-class members of the medical profession devoting themselves to the health-service of the country, and that these regulations, are equally desirable in the cases of surveyors and inspectors of nuisances.

We know well and thoroughly appreciate the difficulties which surround any measure of reform in the slightest degree encroaching on our dearly loved and jealously guarded local self-government, but it is possible by following the broad lines laid down in these resolutions so to amend sanitary legislation and administration as not to limit local and individual liberty as it ought to be exercised. Natural health is natural wealth, and it will speedily be found that sanitary reform pays its own way, and gives a large bonus besides. Moreover, it is quite certain that the money now spent by the government and by local authorities, as salaries to health officers and

ample for all the purposes proposed at the Conference. To-day, frittering away is the order. Three or four officers do the work one could easily do at a less cost. There is no order, no system, and no consolidation of duties under the Local Government Board. The same ground is traversed by several officials, and all disjointedly and gradually strong vested interests are growing up. The resolutions under consideration involve new legislation, but in another article we will endeavour to point out how the president of the Local Government Board, with determination as his assistant, might promptly rearrange the sanitary administration of his department to the good of the country, to the relief of the national purse, and in strict accordance with the spirit of the Conference's resolutions.

ON WATER-SUPPLY IN RURAL

DISTRICTS.

A RECENT characteristic letter by Archdeacon Denison has again called public attention to the extremely defective nature of the water-supply in rural districts. So far as the particular case is concerned, to which the Archdeacon alludes, it appears to be, we must confess, of a somewhat exceptional character. Water is there in abundance, and from the relations of Brent Hill to the villages at its foot, there would seem to be but little expense involved in storing the waters which spring from the hill-sides, and carrying them in proper conduits to the villagers' doors. Under these circumstances we are naturally led to ask why such a simple scheme has not been carried out, and who is responsible for the neglect in so doing, when the law not only invests certain authorities with the responsibility of looking after these matters, but gives them adequate powers for meeting it. In such a case it is the duty of the medical officer of health to make himself acquainted with the sanitary requirements of his district, amongst which that of a defective supply of water is certainly one of the gravest, and to urge upon the local sanitary authority the duty of providing a proper supply. When he has done this, and has forwarded a copy of his report to the Local Government Board, the responsibility for the neglect is removed from his shoulders, and is placed conjointly upon those of the bodies just mentioned. It is in regard to this point that the Archdeacon's letter is, unfortunately, deficient in the information which is necessary in order to enable us to decide who is to blame in the matter. It is rather strange, and illustrates well the ignorance as to the powers which the law already provides in regard to sanitary matters that even so well-informed a man as Archdeacon Denison appears to be unaware of the fact that it is, and has been for three years past, incumbent on the local sanitary authority to deal with such matters as this, and that he should have put himself to the