instances been placed upon antiquated sewers whose original construction was faulty in the extreme, admitting of an excessive amount of deposit, such as is certainly not contemplated in laying down modern works of this class. Under such circumstances, it becomes impossible to maintain that degree of interior purity in sewers which I regard as being not only an indispensable concomitant to the open system of ventilation, but also as otherwise essential to the proper management and beneficial effect of sewerage works. The same remark applies also to sewers which, while they are satisfactory in themselves, and even provided with adequate flushing arrangements, are neglected by the Local Authority in which they are vested, the result, in this event, being sometimes as disastrous as anything arising from primary and inherent defects.

The absence of any well defined and systematically performed routine of flushing is the most obvious, as it is also the most common shape which this neglect assumes, but there are other points, tending to the same result, which Sanitary Authorities generally are only too apt to make light of. There are, for example, many towns which, having been sewered at a time when there seemed to be little, if any, prospect of practical legislation on rivers' pollution, adopted a combined system of rain-water and sewage removal, instead of being careful, as they now would, to limit the total volume of fouled liquid to a minimum by the greatest possible exclusion of surface water. In these cases the rain falling upon the wide areas of streets and roads is necessarily admitted to the sewers, carrying with it, unless judiciously restrained, a large amount of heavy and insoluble material which no well regulated sewerage system should receive. It may, of course, be objected that the gullies in the street channels are, or ought to be, so constructed as to intercept the objectionable matters referred to, and this is, indeed, generally the case, but, as a matter of fact, the value of this provision is too frequently nullified by the want of sufficient attention to gully cleansing, sludge-boxes and catchpits being, more often than not, allowed to lapse into a chronic state of overflow. The same qualification holds good even with regard to yard-gullies, which are frequently of such a type as to render their effectual cleansing an unnecessarily difficult, if not, indeed, insuperably repulsive operation. Thus it comes that large numbers of sewers are the constant receptacles of substances which should be dealt with on the surface, instead of being allowed to interfere with the proper flow of liquids in underground channels, a circumstance which occasions one of the greatest difficulties arising in sewer management, and enormously increases the necessity for powerful and frequent flushing. It will, moreover, be apparent that sewers of a capacity equal to the reception of the rain falling in heavy thunderstorms (which must, of necessity, be the case in the combined system) require, even when well managed in other respects, an exceptional amount of flushing in dry weather, when the natural velocity and scouring power of the sewage are so much lessened by the excessive reduction in the depth of stream.

All these circumstances point to the imperative necessity for the regular and frequent flushing of public sewers to an extent varying inversely with the efficiency of their design and construction, and the care devoted to their maintenance in respect of the details above alluded to. In no case, however, can flushing be entirely dispensed with, unless with corresponding danger to the health of the locality

affected, and this, too, altogether apart from the mere annoyance caused by offensive smells from the ventilating gratings. These gratings form, in fact, the best and most reliable index of the state of the sewers with which they communicate. The fact of smells arising from them must be taken as an infallible testimony to the existence of a wrong and dangerous state of things, and to the necessity for investigation in the first place, and for improved sewer management thereafter. To adopt any other conclusion, and to act upon it by closing the offending apertures, is to emulate the feat popularly ascribed to the ostrich, which, by thrusting its head into the sand, hopes not only to ignore but to clude the possibility of danger from its pursuers.

Closely connected with the nuisance often found to arise from the adoption of the open surface grating system is the state of the private drainage of the town, even where the design, construction, and management of the public sewers may be unexcep tionable, if, indeed, a place conforming in all these particulars to the latter description can be found. Private drains are, as is well known, the weak point of most sewerage systems, owing to the much smaller degree of importance which is, unfortunately, almost universally attached to this category of work by Sanitary Authorities and others. As a consequence of this, many house-drains so far fail to comply with the canon of 'constant movement' laid down for all sewage, that filth lodges and decomposes within them until such time as it is propelled into the sewer, in a putrid and horribly offensive condition, by such adventitious means as a heavy rain or the recurrence of 'washing day'. To expect that sewers receiving sewage of this character shall not smell offensively is as hopeless as it is to look for sweetness in a dungheap. But although the smell which escapes from sewer gratings under such conditions is, with all its unpleasantness, less inimical to health than the presence of such foul matter in confined drains, I am far from urging this as a palliative for the retention of drains of this defective character. On the contrary, these should be lifted and relaid wherever found to exist and, where necessary, provided with flushing arrangements, self-acting or otherwise, as the circumstances of each case may require.

With reference to the open grates themselves, it must be remembered that they are frequently applied to sewers in insufficient numbers, so as to throw too much work upon any given opening, instead of effecting a constant and imperceptible interchange between the air of the sewers and the external atmosphere. This I find to be especially the case in sewers laid down during the first twenty years after the passing of the Public Health Act of 1848, in many of which ventilation confined to the 'dead-ends more or less effectually thr These are now practically removal having, however, of revealing the necessit general aëration of the management in the dire indicated.

.1.

Messrs. Atkins & Co., of .... completed the second order for 4,000 ..... for the Cape. The filters are of the same pattern as those sent out on previous occasions to Ashantee, Abyssinia, and other parts of Africa, by Messrs. Atkins & Co., and which were highly approved of by Sir Garnet Wolseley.

and fitted with improved disinfecting appliances, with coal and coke furnace of wrought-iron; sliding furnace and ash-pit doors; improved arrangement with sliding valves for consuming tainted air in furnace; arrangement for evolving sulphurous acid gas if desired; pyrometer; iron-grated floor on rolled girders; two improved composite non-conducting doors and frames, with hinges, bolts, etc., complete with all minor improvements; chimney shafts and metal radiator flues, etc.

Dr. Scott's Improved Portable Disinfecting Chest (see next page) is intended to be used for Cottage Hospitals, or in private houses, where a full-sized chamber is unnecessary. It is fitted with improved gas-heating apparatus, pyrometer, basket-work trays for clothes, and hinged cover. The dimensions of No. o are 2 feet by 3 feet by 4 feet inside measure. The chest can also be supplied with a charcoal heater where gas is not available. It is a most serviceable apparatus: it will disinfect clothing and destroy vermin, and may be used in the ward or in a bedroom to prevent the spread of infection caused by the removal of infected clothing or bedding.

The 'Nottingham Self-regulating Disinfecting Apparatus' (see next page) consists of an iron chamber, or chambers, of different sizes, according to require ments-completely enclosed in a wooden case, with five inches of felt packing between, for retaining the heat-into which the articles to be disinfected are placed, and through which a strong current of hot air passes, at a temperature of from 245 to 255 deg. Fahr. Draw-out slides are fixed at the top, for fastening beds to, and slides are attached to the sides, for carrying cross-bars, over which clothes, sheets, blankets, etc., can be hung, or the large baskets provided with each apparatus can be placed. Inlet and outlet flues are attached to the chambers, for the passage of the hot air. The inlet has its connection at the bottom, and is covered inside the chamber with perforated iron plates, arranged in such a manner that the supply of air is equally distributed through all

Goddard & Massey's The 'Nottingham Self-regulating Disinfecting Apparatus'.

A. Furnace (cast-iron truncated double concentric). a'a'a', gas supply pipe.

a. Atmospheric ring burner;

B. Inlet flue, the exposed parts covered with wood and packing; the inner walls of wrought-iron. b. Automatic regulator. b, b. Thermometer marking the temperature of entering current (or maximum of chamber).

c. Hot chamber, a cubical wrought-iron box, cased with packing and wood. g. Inlet aperture, with perforated plate. h. Outlet aperture. i, i. Arrangements for suspending or supporting articles to be disinfected.

D. Outlet flue, the exposed parts covered with wood and packing, the inner walls of wrought-iron. j. Thermometer measuring temperature of out-going current (the minimum of chamber).

fixed in the centre, which gives the minimum temperature. A safety apparatus is also fixed in the outlet flue, in case of articles which are being disinfected taking fire, through having a match concealed in them, the temperature here being then the highest. It consists of a fusible link, which melts at 300 deg. Fahr., the breaking of which closes the outlet and inlet flues, and, by another self-acting movement, shuts off the supply of gas and rings a bell.

The furnace for heating the air consists of a double-cased cast

EIGHTEEN YEARS' EXPERIENCE OF THE BOARDINGOUT SYSTEM.

BY WM. D'ESTERRE PARKER, ESQ. AT a meeting of the Board of Guardians of the Cork Union held on Thursday, 5th August 1880, T. H. Gallwey, Esq., in the chair, the following Report of the Boarding-out Committee was read, and unanimously adopted. The

The

annual inspection of the boarded-out children presents an opportunity of furnishing the Board with Committee, in the first instance, departiculars concerning them. sire to mention that the pecuniary cost of this mode of rearing the pauper child is less than the cost in the workhouse. For instance, the average cost of each child in the workhouse is 3s. 6d. a week, or by the year, £9.

The following is the scale for those boarded out: Infants under two years of age, 13s. 4d. a month, or £8 a year; children over two years and under five years, 11s. 6d. a month, or £6 14s. a year; children over five years, and up to thirteen years, 12s. 2d., or £7 6s. a year. These several sums include clothing and school fees. The supervision of the children, which is an allimportant element in the entire system of boarding out, is carried out in a thoroughly satisfactory manner,through the agency of the several relieving officers, assisted by the local clergymen of the several parishes where the children are located, and wherever practicable the assistance of those fare of the ch ladies who take an interest in the wel

lieving officers are obliged to see that they attend regularly, and in case of not doing so, they report to the Committee, who duly inquire into the matter. The children are periodically examined by the several dispensary medical officers, who report in a book, specially provided for the purpose, the state of health of each child; and in case of any sudden illness, the medical officer immediately attends to the child. In this particular branch of the boarding-out system the Committee desire to convey to the Board their warm approval of the unceasing attention, and, they may add, paternal care of the several medical officers to those children. With regard to the several localities in which the children are placed, the Cork Union, which includes the sea-side districts of Passage West, Glenbrook, Monkstown, Ringaskiddy, and Carrigaline, as well as the inland districts of Ballincollig, Blarney, Dripsey, Carrignavar, and the mountain ranges of the commons, presents the most favourable positions for insuring healthy homes for the children, while the number of small farmers and well-to-do labourers who apply for the children are so numerous that the Committee are enabled to select, without difficulty, persons of really good character, who have shown that they regard the proper care of the ehildren as of paramount importance. These foster-parents are recommended by the clergymen, the Poor-Law Guardians, the medical and the relieving officers of the divisions, and a record is kept in a book specially provided for the purpose, showing the several parties who recommended them.

The Committee proceed to submit to the Board the results accomplished since 1862, when first the Boarding-out Act was put into operation. From that period up to the present there were 650 children removed from the Workhouse and boarded out in the several districts above-mentioned; of this number there are 209 at present boarded out, 417 have been adopted by their foster-parents, and are going on well, 20 died, and 4 have returned to the workhouse, and now are ready to go out to service.

The following is the report of Dr. Callaghan, the medical officer who has the special charge of the infants in the workhouse :

'June 26, 1880. I, this day, inspected the children brought in from the country, and found them in excellent health. Their clean appearance and happy faces testify to the care taken of them. Some of the nurses informed me of their intention to adopt those children now in their charge.

'(Signed) R. Callaghan, Medical Officer, 'Cork Workhouse.' Since the date of the annual inspection, all those children who have attained the age of 13 years, have, plication of their respective foster-parents, hem, and the ratepayers cease to their support, while the

robust health and from the ranks of

tee have great cause rivileged to undertake ng-out regulations, in se children, where they have been, and are, brought up as members of an industrious, thrifty family, and treated with the like affection as the children of the foster-parents; and they record with pleasure the valuable assistance which they have received from the several clergymen, ladies, medical and relieving officers of the several districts, in the selection of the foster-parents,

and in the constant visiting and inspection of the children; and after an experience of eighteen years in the practical working of the boarding out of these children from the earliest period of infancy to the age of eleven years, the Committee, in the strongest possible language, recommend the system to the earnest consideration of the Board, in the hope that they will urge the Local Government Board to bring the subject before Government, and show the vital importance of having the provisions of the Boardingout Act extended to all children, especially to suckling infants whose parents have become inmates of the Workhouse, and who, by reason of mental or bodily infirmity, or inability to earn their own livelihood, are incapable of bestowing proper care upon their offspring.

BRIEF NOTES ON THE ORIGIN AND SPREAD OF AN OUTBREAK OF

DIPHTHERIA.

By F. A. McEwEN, M.B., C.M.,
Medical Officer of Health, Alnwick and Canongate Urban
Sanitary Authority.

THIS painfully interesting disease, at least, painfully interesting to those who have seen it in its most virulent form, cutting off whole families in periods of time varying from a few days to a few weeks, bids fair now to be better understood than it ever has been. It is to be hoped that, with clearer views of the etiology of the disease, the treatment may be more successful than in a great many instances it has hitherto been, and that in a short time medical men shall be saved the pain of seeing strong healthy subjects suddenly cut off by a disease that in its worst form has so fatal a tendency.

It fell to my lot to observe a peculiarly interesting and fatal outbreak of diphtheria in a rural district in the north of Scotland in the Autumn of 1878. The burden of the outbreak fell on a brother country practitioner. It was in the month of August that the disease broke out at a farmhouse in the county of Aberdeenshire. Most of the individuals about the farm (including the servants) were adults. Within a short time, of nine individuals who were attacked, seven died. My friend the medical practitioner in attendance at this time delivered the wife of a mechanic who lived at least five miles from the seat of the outbreak. Within a few days of her delivery, diphtheria appeared in the family, and in a few days more the father and five children were dead of diphtheria. About the same time he also attended in her confinement the wife of a farm labourer in a small village further away from the seat of the outbreak. Here, too, not many days afterwards, diphtheria attacked the family and carried off father, child, and mother. I here assisted my brother practitioner to perform tracheotomy, in the hope of saving the man's life. While in the house the wife complained of being ill and having a sore throat, and on looking into it there were diphtheria patches to be seen. I learned afterwards that she also had diphtheritic patches on the vulva. I believe there was also another instance of the unfortunate coincidence of the disease following so fatally in the wake of the obstetrical track of the practitioner in attendance at the seat of the outbreak. This 'unfortunate coincidence', as I called it at the time, in some notes on the treatment of some of my own cases contributed to the Practitioner, seems to me now more forcibly than it did even then