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From numerous examinations of the Oder water before and after filtration, Hulwa concludes, that, with the exception of occasional disturbances at times of high water, the impurities of the river-water are so far removed by the process of filtration as to furnish a drinking-water almost above suspicion. In order to remove the fine particles of clay which give to the water, in times of flood, an opalescent appearance which filtration will not remove, Hulwa recommended treating the water, before filtration, with alum in the proportion of from one to ten parts of alum to a hundred thousand parts of water (by weight), according to the degree of turbidity of the water. This use of alum, which is becoming very common on a smaller scale, has not been adopted at Breslau. At the time of Hulwa's examinations, the sewage of Breslau all ran into the Oder opposite and below the city, in anticipation of the completion of the sewagefarms now in use. The study of the effect of this discharge upon the stream is perhaps the most interesting part of the document. Although the volume of sewage is, on the average, only r of the volume of river-water, and in times of flood only 7, the river opposite and just below the city gives abundant evidence of pollution, - pollution which becomes less and less marked as the stream flows. Thirty-two kilometres below the city neither chemical nor microscopical examination was able to show any evidence that the water was not quite as suitable for water-supply (after filtration) as the water from the same stream above the city at the present pumpingworks. Hulwa is of the opinion that the natural purifying agencies are quite sufficient to take care of the amount of sewage which was then discharged into the river, and that, a fortiori, the effluent from the sewage-farms may be safely disposed of in that way. He is careful, however, to admit the possibility of overloading this or any other stream, and of calling upon the natural agencies to do more than they are capable of doing. He thus agrees with most experts who have studied this matter, that the discharge of sewage or other polluting matters into a stream is not to be decided in all cases by an absolute prohibition, but that the size of the stream, the proportion of polluting matters, and other circumstances, must be taken into consideration.

THE CONSUMPTIVE PERIOD. HIPPOCRATES declared that consumption gathers the greatest number of victims between the ages of 25 and 35 years, and the same observation holds true to-day.

As a first and natural deduction from this fact, the opinion has obtained, that men are more susceptible to consumption between 20 and 35, and that, passing

Die schwindsuchtssterblichkeit in den dänischen städten im verhältniss zu der lebenden bevölkerung in den verschiedenen altersklassen und geschlechtern. Von Dr. JULIUS LEHMANN. (Ergänzungshefte zum Centralbl. allg. gesundh., 18 p., pl. 8°. Bonn, 1884.)

Ueber den einfluss des geschlectes und des lebensalters auf die schwindsuchtssterblichkeit. Von Dr. JACOB SCHMITZ. Bonn,


this period, they gradually acquire an immunity from the disease.

A more careful study of the statistics, however, reveals a fallacy in this reasoning. Hitherto it has been the custom to reckon the mortality of each period of life as a fraction of the entire mortality of all ages. By this method it is shown merely that during certain decades of life more individuals die of phthisis than during other decades. This amounts, however, simply to saying that within these periods of life a greater number of people are living. The total number of deaths from any disease, at any given age, must be greater or less, according to the number of people existing at that age; and a large proportion of mankind are from 20 to 35 years old. In order, therefore, to determine the individual risk of consumption at any specified time of life, it is necessary to know the whole number of persons living at that age, and then compute the percentage of them who die of consumption.

Figuring in this manner, Würzburg estimated the annual percentage of mortality from phthisis at different periods of life in Prussia, and he found the following table for every 10,000 persons living at each period:

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From this table it is seen that a large phthisis mortality prevails during the first year of life; thence it descends to a minimum between 5 and 15 years of age; from this point it increases with rapid strides, until, between 60 and 70 years, it reaches the high figures of 112.25 per every 10,000 living beings of that age in other words, these figures mean that a man's liability to death by consumption increases from puberty till 70 years of age.

The companion column of the phthisis mortality of women shows that they are more frequent victims during childhood, but during the third decade and thereafter their relative liability is diminished.

These figures of Würzburg are confirmed in their main features by the investigations of Lehmann in Copenhagen, and of Schmitz in Bonn. Lehmann also extended his query to the relative duration of phthisis at different ages, and found that under 20 years of age more than 75% of phthisis patients die within a year. This rapid progress of the disease diminishes with increasing years until at least onehalf of the cases terminating after 55 years of age present a record from three to many years' duration. It follows from this that a portion of the increased phthisis mortality of advanced years is due to cases which have lasted over from the earlier decades.


THE Committee having in charge the preparations for, and the direction of, the German exhibition of hygiene, decided wisely, it seems to us, to substitute for the usual premiums a scientific report upon all objects shown, and possessed of real merit. At the close of the exhibition in the autumn of 1883, the work of preparing this report was placed in the hands of Dr. Börner of Berlin. The first part of his report has recently been published, and is soon to be followed by a second and concluding volume. This report contains a number of papers upon topics of the greatest interest to students as well as to the interested general reader. Drs. Wolffhügel, Sell, Löffler, König, and Baginsky, among others, have contributed, each in his own field of work, articles that have all the value of special treatises upon the topics assigned to them.

This exhibition, which came into existence in consequence of the direct exertions of the Deutsches verein für öffentliche gesundheitspflege, was to have been opened in May, 1882. A fire, however, destroyed in a few hours the completed building and contents. A new and more secure structure, with a larger collection of articles, was ready in the following year, and was opened to the public on May 12, 1883, under the patronage of the Empress Augusta. This was not a display of new things only, but a very complete exhibition of what has been done, or is now doing, for the protection of human life. Many of the objects exhibited have been secured by the Prussian government as a foundation of a permanent museum of hygiene.

The author truly enough asserts that exact science is extending constantly its territory within the domain of hygiene, and then adds with equal satisfaction Prince Bismarck's oflicial declaration that the best work of medical science lies, not in the curing of disease, but in the higher office of preventing it. A study of the German exhibition of 1883, and of that at London in 1884, shows once more that the Germans may fairly claim the leadership in the scientific investigation of questions that belong to hygiene, while to the English still belongs the credit for the technical execution that brings the results of these investigations to the protection of the public health.

Nothing in this exhibition attracted more notice than the pavilion of the Imperial health office, a model building, containing a com

Bericht über die Allgemeine deutsche ausstellung auf dem gebiete der hygiene und des rettungswesen. Breslau, 1885. 8°.


plete collection of the apparatus used in the investigations of the infectious diseases, and in the examination of articles of food. The relief plan of Berlin, prepared by Prof. H. Gruner for this exhibition, is another proof of the excellent work carried on in this city in the department of hygiene. The plan, in addition to the peculiarities of the surface of the ground, gives the soil in section to the ground-water level, making apparent to the eye the great difficulties in the way of a thorough system of drainage, now accomplished under G. Hobrecht's energetic direction. visit to the very extensive and successfully managed irrigation fields of Berlin was an instructive addition to the plans and descriptions of this work shown at the exposition. In the years since the war of 1866, a very valuable work has been done in Berlin by an association of ladies, and largely under the direction of Frau Lina Morgenstern, in the people's kitchens, which are, in effect, schools for instruction in the proper and economical preparation of food. This was all well shown, together with a large collection of articles of food and drink in all stages of preparation, and also in all degrees of adulteration.

The best form of shoe is the subject of an instructive paper by Dr. F. Beely. The various forms of shoe tried in the German armies were exhibited, with indications of defects and merits, from the time of Professor Meyer's first publication at Zurich, in 1857, upon the proper shape of the shoe. The military authorities of Germany have made a careful study of the subject. The normal form finally adopted by them closely resembles a muchadvertised English one.

Another public necessity, well represented in the exhibition, and made the subject of an exhaustive paper by Dr. Lassar, is that of baths and laundries. Among these stand easily first the public baths of Bremen, built in the years 1876-77, at an expense of a hundred and twenty-five thousand dollars, not including the cost of the land. A bath here, with all the conveniences of the best private house, may be had for twenty-five cents, while one provided with all that is really necessary can be had for six cents. It is not necessary to add, perhaps, that a large part of the capital was given.

Institutions for the care of the poor, prisons and reformatories, were well represented by plans, models, and statistical tables, notably the great prison at Plötzensee, containing at present a population of two thousand, and the workhouse at Rummelsburg, both mod

els of their kind. Tenement houses and schools, as exhibited, present nothing of unusual interest. The first-named are distinctly inferior to the better English models.

This volume closes with a review by F. O. Kuhn, architect, in Berlin, of structures exhibited by plan, for the shelter of soldiers in times of peace. The most conspicuous example shown was the new caserne at Dresden, a complex of buildings, containing shelter for seven thousand men. A characteristic feature of this caserne is the complete separation of the rooms for day use, sleeping, eating, washing, and working, an arrangement from which the Saxon authorities already claim a marked improvement in the health of the inmates.

If Dr. Börner's second volume is as satisfactorily edited as this has been, the work will have a permanent place in the history of preventive medicine.


JOSEF KÖRÖSI is the director of the Bureau of statistics in Budapest, and he has apparently brought to his work a mind well adapted to the difficult task of handling figures in bulk. The essay which he presents to us under the above title was read in September last, before the Association of hygiene in Berlin, and in it he has confined himself to a few points only. He has endeavored to determine the influence which the varying pecuniary conditions of life, with their attendant privileges or privations, have upon the longevity of the people of his city. For convenience he recognizes four classes, according to their endowment in worldly goods; those who are very rich at one end of the category, and those who suffer from abject poverty at the other. Between these extremes lie the great mass of the people, whom he divides into the middle class and the ordinary poor.

He does not claim that his figures possess an absolute mathematical value, because he could not determine the number of living individuals in each category; but by excluding children under five years of age, and taking the average age of those dying during a period of eight years, he found that

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privation, lengthen the average life nearly ten years.

The second point which he studied was the relation existing between epidemic infectious diseases, and the pecuniary status of the different grades of the community. Upon this point he finds that poverty does not exercise a uniform influence upon the occurrence of these diseases indeed, viewing them as a whole, the well-endowed, excepting the very richest, are more seriously afflicted than the poor.

Viewing the infectious diseases separately, he finds that cholera, small-pox, measles, and typhus are more prevalent among the poor, while diphtheria, croup, whooping-cough, and scarletfever are more prevalent among the rich. Consumption and pneumonia claim the poor, and brain-troubles attack the rich.

In view of legislative action regarding the abodes of the poor, Körösi next studied the influence of basement tenements upon the occurrence of epidemics; and he found, that, taking the infectious diseases as a whole, they are 60% more frequent in the cellar than in the elevated tenements.

The cellar residence, however, does not favor all diseases alike. Measles and whoopingcough are very prevalent there, croup less so, while diphtheria and scarlet-fever are 10% less frequent among cellar inhabitants than among those more loftily housed. This is in accordance with statistics from other places, and notably from Boston, where epidemics of diphtheria have swept over the finest parts of the city, and have left the low sections and cellar regions almost exempt.


Lastly, Körösi considers the influence of crowding upon epidemics. To obtain a standard, he noted the number of rooms in each house, and the number of people occupying them. Combining these figures, he obtained the average number of persons per room. possession of one or two persons to each room was taken as normal, while three, four, and five persons per room were considered overcrowding. He found that the intensity of some infectious diseases was notably increased in the crowded tenements. This increase amounted to 364% for measles in houses inhabited by more than five persons per room. Whoopingcough is likewise greatly intensified by crowding. On the other hand, it does not appear that scarlet-fever and diphtheria are similarly favored by the increased number of people in the house. These are rather surprising conclusions, and may find their explanation when we discover the manner in which these various diseases are transmitted from person to person.




THE object of this book is to introduce to the people of this country the higher purposes of veterinary medicine.' These higher purposes are the better protection of the public health, and the mitigation of certain evils relating to our food-supply.

The amount of capital invested in live-stock is enormous, and the animal product a most important part of our national resources. The better protection of this property from disease is discussed in the third part of the book. Writers have usually treated this material or pecuniary side as the more important aim of veterinary medicine: it is here, however, discussed as secondary to that of public sanitation. In part second the author gives an excellent history of veterinary medicine, and of veterinary schools in Europe, along with much information not easily accessible elsewhere.

This age of steam has in many ways stimulated the production of live-stock; and the relative proportion of animal to vegetable food has of late years been rapidly growing. This is in part due to the fact that the art of stockbreeding has greatly advanced, and in part to the modern facilities for the preservation and transportation of animals or their products. While this is, as a whole, doubtless a benefit to mankind, it has at the same time enormously increased certain dangers to public health. Old dangers have increased, and new ones been introduced that our fathers knew nothing of. Moreover, modern scientific investigation has traced to our domestic animals certain diseases of man the origin of which has heretofore been a mystery; and we now know that the public health is related to that of our domestic animals in more ways than the public yet appreciate.

Dr. Billings has therefore an important theme, and he tells his readers not to forget that the author is an enthusiast;' and we will add, that, like many enthusiasts, he advocates measures for the details of which, even if practicable, the public are by no means yet ready. Indeed, like the public, the author himself devotes the most attention to some of those dangers which are by no means the greatest, if we measure their results by mortuary statistics.

That the flesh of obviously diseased animals is unwholesome food for man, has been the common belief for ages; and communities that have any public markets at all have generally

The relation of animal diseases to the public health, and their prevention. By FRANK S. BILLINGS, D.V.8. New York,


placed legal restraints on its sale. In most civilized countries, there are severe penalties for selling diseased flesh of certain kinds; but in our country the administration of sanitary laws in this direction is very defective, and the methods very faulty. In some directions there is, as yet, no official or organized effort to meet dangers the existence of which is reasonably well demonstrated.

We may say, in a general way, that the health of the people is directly related to that of their domestic animals in at least five ways. In the first place, some of their contagious diseases are directly transmissible to us, and are very fatal; and to this class belong some of the most dreaded of diseases. For example: in proportion to the relative number of its victims, hydrophobia inspires more terror than any other disease known to us, and greater exertions are made against it than against any other one disease which slays so small a proportion of the population. This, in man, comes only from animals. In the same category we may place anthrax and glanders, both very fatal. The foot-and-mouth disease of cattle, transmitted to man through the milk of diseased cows, is less fatal, perhaps, but still too troublesome, and unfortunately too common, to ignore, and others of less note are well known. The mortality in any community, due directly to this class of diseases, is relatively small; yet there is a positive danger, against which we have as yet inadequate protection, and where we especially need intelligent official action founded on proper veterinary authority.

Closely related to this is a class of diseases less contagious, and where the direct transmission to man does not so commonly follow exposure, or where, at least, the demonstration is as yet incomplete; where we can say that the public health may, and probably does, suffer, but where the proof is lacking, and the extent of the danger very uncertain. Such is the case with tuberculosis. That tuberculosis of cattle is very common in the old world, that it is less common here but is increasing, all who have studied it believe. That tuberculosis in man is in a degree transmissible, is, we think, now generally conceded; and that tuberculosis in cattle may be transmitted to other animals through the milk of tuberculous cows is proved. That it is transmitted from cattle to man through milk is not proved, but the analogies are most suspicious, and have of late attracted much attention. The author gives an excellent history of the investigation in Germany, and gives suggestive statistics of the extent of the disease among European cattle.

In the light of our present knowledge, few intelligent parents would knowingly allow their children to use the milk of tuberculous cows; but as yet we are powerless to prevent its sale in our cities.

A third class of diseases grows out of animal parasites in the flesh of the animals we use as food. Of these, trichiniasis has of late played the most sensational rôle. For the last few years this has been prominently before the public; but in our own country, curiously enough, our officials, because of commercial complications, have tried to hide the danger, rather than guard against it. Outside of the advertisements of quack medicines, no more astonishing sanitary literature can be found than some of the public, not to say official, utterances regarding trichinae in the swine of this country. Our author gives numerous statistics, both from other sources and from original investigations, which show that the disease is common enough and wide-spread enough to need more careful watching. Fortunately, each household can protect itself from this class of diseases by thorough cooking; but, considering the customs of cookery, there should be other protection. Tape-worm belongs in this class of diseases. We think that the author overrates the danger from the Taenia medio-canellata derived from beef (more probably from veal?), and quotes Thudicum of twenty years ago to show that the rarity of the cysticercus in beef makes it more dangerous, a doctrine from which we entirely dissent. In this country the vast majority of tape-worms appears to be the T. solium which we get from 'measley' pork.

There is still another way in which the flesh of diseased animals probably affects the public health. Animals are subject to certain diseases which affect their flesh, but which are not, so far as known, transmitted to man. The so-called hog-cholera is such a disease; yet experience has shown the propriety of forbidding the sale of the pork in the markets when sufficiently affected to have the red spots.

The author advocates much more extensive inspection of animals, but we fear that his zeal has led him to impracticable lengths. When we consider the enormous number of animals slaughtered by the producers of the same on their own farms, and the production of milk on small farms not called dairy' farms, we fear that a system of inspection which will extend to all animals slaughtered,' and to all the cows on all the farms which may supply milk for sale, is impracticable. Nor would he, we think, have written that 'city inspection [or



milk] is next to useless,' if he had had any experience in official sanitation in a large city, drawing its milk-supply from regions over which its officers had no jurisdiction whatever. Because we cannot have the most perfect means of protection, it is nonsense to decry the only means that are available, and which, experience shows, make a great improvement in affairs. And, however necessary and important official inspection may be, one cannot hope for 'the unquestionable guaranteeing' of safety by any official board: that is asking a great deal.

His short chapter on hippophagy, as practised in Europe, is both interesting and opportune. The growing consumption of this cheap, nutritious, and wholesome meat is a good thing, which the next generation will doubtless find common in all enlightened countries. The poorest chapter in the book is that relating to infection and bacteria, some portions of which (and notably the botanic portion) are lame. But the book is an important one: it deals with an important subject, and is the repository of much useful information in an interesting and available shape.


Or the numerous books which have appeared during the past year, devoted to this subject, plumbing and drainage of houses and tenemany are too exclusively taken up with the

ments in cities and towns provided with sewerage systems. In Col. Waring's book; entitled 'How to drain a house,' the individual householder, to whom the volume is chiefly addressed, will find valuable counsel, whether his domicile is in a crowded city, or in a country or suburban village where connection with public sewers is impossible.

The great value to the state, of sanitary works, such as pure water-supplies and the proper drainage for the removal of sewage, has been successfully demonstrated, and the same principle is none the less true of each individual dwelling.

The first and principal portion of the book treats mainly of that portion of the drainage system which is included within the interior of the house. The closing two chapters are devoted to the disposal of the sewage of isolated houses, and the special method of sub-surface irrigation.

The style is concise, and the illustrations are clear and simple, and shorn of all unnecessary

How to drain a house. Practical information for householders. By GEORGE E. WARING, jun., M. Inst. C.E. New York, Holt, 1885. 222 p. 12°.

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