the kingdom to the other, that if the supply of that prime essential of health, water, is to be efficient it must be constant, and upon the principle of "high pressure," the bill in question, recognises and perpetuates the old intermittent supply, with all its costly and clumsy incumbrances of cisterns, water-butts, ball and stop-cocks; a system condemned without exception by all who have investigated the subject, as being injurious to the health and morals of the labouring classes; as vitiating the water, curtailing the supply, and putting the consumer to unnecessary trouble, inconvenience and expense. We would call the earnest attention of those who are occupied in so many towns of England in devising plans for their improvement, to the following extract from the Report, which concludes the admirable review of the whole subject; and which is particularly applicable at the present moment, since we are ourselves acquainted with more than one town, where the interested opposition of a few powerful individuals, interested in water companies, threatens, if not to arrest the progress of improvement, at least to inflict on the rate-payers a heavy pecuniary sacrifice in legal expenses. "Your Committee submit that the facts and reasonings now adduced completely establish the case for which they thus earnestly contend, namely, that every water company seeking legislative aid and protection ought to be compelled by the legislature to furnish the public with filtered water at constant service and high pressure. But if it is right that the legislature should require all existing water companies to submit to this condition, and to whatever other regulations are proved to be necessary for the maintenance of the public health and the protection of public property, à fortiori it ought to withhold its sanction from the establishment of new water companies until the provisions are determined on which the powers and privileges sought can be granted withont compromising the interests of the community. Her Majesty's Commissioners state, as the conclusions to which they have arrived from the vast mass of evidence that has come before them, that the water supply should be constant; that it should be consolidated with the works of drainage; that to separate these works is to render both inefficient, and to double or treble the expense for the construction, maintenance, and working of each. The Commissioners will therefore, indeed, have laboured in vain, if the legislature should listen to the applications now before Parliament; applications which the very announcement of the conclusions of the Commissioners appears to have suggested; schemes for the pre-occupation of towns by water-works for trading companies, without the slightest additional security for the public interests. "A regulation appears, indeed, to have been adopted during the last session of Parliament, that the water companies then sanctioned should be subjected to any future regulations that might hereafter be made in respect to such companies. But the subjection of these companies to future regulations will not prevent them from making large claims for compensation for the alteration of their first arrangements."—Report, p. 64–5. The abolition of those unseemly and demoralising abominations, cesspools and privies, and the substitution of self-acting water-closets, have been proved by a vast amount of evidence to be economical, as well as highly conducive to health, decency, and morality; and yet in Lord Lincoln's bill the present debasing system is perpetuated. There can, we conceive, be no dissent from the opinion expressed in this paragraph: "These and similar statements have satisfied your Committee that legislation on this point ought to be in accordance with the evidence, and with 1847] Duties of the Officer of Health. 25 the recommendations of Her Majesty's Commissioners; that the construction of the cesspool in all new dwellings ought to be positively prohibited; and that the removal of all existing cesspools ought to be made compulsory, as soon as the general introduction of sewers and drains, combined with an ample supply of water, shall have rendered the general introduction of the water-closet apparatus practicable."-L. c., p. 71. Another most remarkable defect is that of ventilation, which is altogether omitted, the bill "resembling in this respect those modern encyclopædias of architecture and building, in which the very word ventilation never once occurs from beginning to end." Although it is impossible to overrate the advantages which would result from the general introduction of efficient ventilation in the houses of the poor, yet it would be inexpedient to attempt this by compulsory provisions, as these would interfere with the privacy of domestic life. "But this objection does not apply to buildings intended for public resort, such as churches, courts of justice, concert and assembly rooms, theatres, houses and rooms for the public use of which a license is required; factories already under government regulation and inspection; workshops in which great numbers of workpeople habitually assemble, lodging-houses, and schools. The introduction in a general sanatory measure, of compulsory provisions for the purpose of securing proper ventilation in all places of this description, appears to be justified by the absolute necessity of the case, and to be free from any objection in principle."-L. c., p. 79. In alluding to the clauses defining the duties of the officer of health, as set forth in the bill formerly laid before Parliament, the Report before us contains the following judicious remarks: The duties assigned to the medical officer of health in the first of these clauses are highly important, and the able performance of them throughout the country will produce beneficial results, the true value of which it is impossible at present to estimate. Still, however, these provisions do not go to the root of the matter, nor embrace the primary and fundamental duties of the officer of health. These fundamental duties are the verification of the fact as well as of the cause of death, the correct registration of both, and the personal examination on the spot of the sanatory circumstances under which death takes place. It is only by the performance of these primary duties that the duties described in the Bill can be properly performed; that the existence and prevalence of diseases can become known; that the local causes originating and maintaining such diseases can be traced; that the most efficacious modes of checking or preventing their spread can be ascertained; and, consequently, that a true report on the sanatory condition of any town or district can be framed."-L. c., p. 91. If such officers had existed, the frightful scenes described as often occurring in the abodes of the poor in large towns, when one of their number is struck by death, could never have arisen. One or two instances will suffice to show how urgently this subject calls for the interposition of the legislature. "There are some houses in my district," says Mr. Leonard, surgeon, one of the medical officers of the parish of St. Martin's in the Fields, "that have from forty-five to sixty persons of all ages under one roof; in the event of death, the body often occupies the only bed, till they raise money to pay for a coffin, which is often several days. Upon the 18th of December, 1840, and her infant were brought, ill with fever, to her father's room in * Eagle-court, which was ten feet square, with a small window of four panes; the infant soon died. Upon the 15th January, 1841, the grandmother was taken ill: upon the 2d of February the grandfather also. There was but one bedstead in the room. The corpse of the grandmother lay beside her husband upon the same bed, and it was only when he became delirious and incapable of resistance (on account of his violent objection to his own removal and that of the dead body from the room) that I ordered the removal of the body to the dead-house, and him to the Fever Hospital. He died there, but the evil did not stop here: two children, who followed their father's body to the grave, were, the one within a week, and the other within ten days, also victims to the same disease. In short, five out of six died." The following case is taken from the evidence of Mr. Wild, an undertaker: "The other day at Lambeth the eldest child of a person died of scarlet fever; the child was four years old; it had been ill a week; then came two other children, one three years and the other sixteen months old. When the first child died there were no symptoms of illness for three days afterwards; the corpse of the eldest one was in a separate room; but the youngest child had been taken by the servant into this room; this child was taken ill and died in a week. The corpse was retained in the house three weeks, at the end of which time the other child also died."-L. c., p. 95. We believe it impossible to exaggerate the beneficial results which may be anticipated from the investigation of disease with a view to prevention. The author of the Report we are noticing, justly observes, "man has but little power over the progress of disease when once it is produced; but he may exercise a very important control over the circumstances and conditions that give origin to it, when those circumstances and conditions are once ascertained." (L. c., p. 101.) To know with certainty the cause of a disease, is very often to prevent its occurrence. Do we not see this in the case of intermittent fever; do we not know that effectually to drain a marshy district, is to eradicate the ague formerly prevailing? And can it be doubted that were the diseases characteristic of our crowded towns thoroughly investigated, they would, in like manner, by removing the cause, be also exterminated? One, then, of the chief objects to which the attention of the officer of health should be directed is "the science of prevention." After noticing the advantages derived from the systematic observations made by military and naval surgeons on large bodies of men, the writer of this Report goes on to affirm; "but in towns and cities large classes of persons often exist under conditions as well defined and as steady in their operation as the circumstances presented to the observation of medical officers of the army and navy; the knifegrinder of Sheffield, for example, the ironmongery and toy manufacturers of Wolverhampton, the persons employed in particular departments of colliery and factory labour, persons who work together in large numbers in common workshops, as tailors, dressmakers, &c. In each of these cases, and there are many others, the circumstances injurious to health are common in great numbers: they are steady in their operation, they are uniform in their result; the connexion between cause and effect can be clearly traced, and in this manner the efficacy of some particular remote cause in producing some peculiar form of disease may be determined sta 1847] Conclusions respecting Sanitary Bill. 27 tistically and with absolute certainty, and knowledge of the highest importance may be thus acquired, leading directly and certainly to the prevention of disease. What additions may be made to our knowledge of these causes and of the means of counteracting and removing them by the combined and continued labours of such a body of public servants, it is impossible to predict; but surely these observations indicate a new direction in which protection of the highest kind may be extended to the community, and especially to the poorer classes, that well deserves the attention of the statesman."-L. c., p. 102. We have now noticed in some detail the leading branches of this great question; but in order to present in one view what should be the principles guiding an enlightened legislative enactment, we are anxious to lay before our readers the general conclusions with which Dr. Smith concludes his valuable report; and which, although taking the form of critiques upon Lord Lincoln's bill, embody in reality the whole bearings of the sanitary question. The sound provisions of the measure are affirmed to be as follows: "1. The general enactment, that the supply of water, the sewerage, the drainage, the cleansing, and the paving of towns, including the suburbs, shall all be placed under one and the same authority: 2. The appointment of a Government Inspector: 3. The appointment of an Inspector of Nuisances: 4. The appointment of Local Boards of Commissioners for carrying out the provisions of the Act in their respective districts: 5. The preparation or the local examination of surveys, plans and estimates, by 6. The publication of these surveys, plans and estimates, with expository Re- 8. The appointment in districts of medical officers of health."-Pp. 118-19. The errors and defects of the Bill are so grave that they require to be prominently pointed out. “1 .The limitation of the Act to England and Wales, to the exclusion of the Metropolis even of England, and to the total exclusion of Ireland and Scotland, without providing for the immediate preparation of a survey and plan of the Metropolis, and a Report as to the special measures applicable to the Metropolis, to Ireland and to Scotland: 2. The omission to create a central superintending authority in subordination to the executive government, invested with the same sort of powers with reference to the local Boards intrusted with the execution of the details of the Act, that the Poor Law Commissioners have with the Boards of Guardians; instead of this, giving the entire superintendence of the Act to the Secretary of State for the Home Department: 3. The omission to take adequate powers for compelling the Boards of Local Commissioners duly to execute the Act: 4. The creation of a new, complex, and needless machinery for electing Boards of Commissioners, instead of adopting the mode of electing Boards of Guardians now in use throughout the Poor Law Unions, which is found in practice to work perfectly well: 5. Investigating the Boards of Commissions with powers to execute works, instead of rendering their functions entirely and strictly ministerial and supervising, and neglecting positively to restrict by an express enactment their duties to acts of this class: 6. The omissions to prohibit by a sufficient stringent enactment, Boards of Commissioners from commencing any works without having caused plans and estimates to be prepared by their own surveyor, and without having obtained for these plans and estimates the sanction of the Inspector: 7. The omission to secure by sufficient stringent enactments that all works whatsoever shall be executed only by contract upon open tenders, and shall be maintained in repair for terms of years; and that the contractor shall be bound to undertake any extraordinary works at a fixed remuneration: 8. The omission to provide facilities for the formation of public companies for carrying out by contract the provisions of the act: 9. The omission to make sufficient provision for raising the necessary capital for the execution of large sanatory improvements: namely, by loan raised on the security of a special rate to be levied on the properties in the several localities, the principal and interest to be repaid by annual instalments within a limited number of years. 10. Fixing the cost on owners, whereas it ought to be placed on occupiers: 11. Neglecting to provide in the manner above recommended, that the expense remain a charge upon the several properties, unless the owners prefer to pay the cost in the first instance: 12. Neglecting to make it compulsory on water companies to give the public a constant instead of an intermittent supply, and to deliver it in all cases at as high a pressure as is practicable: 13. Neglecting to make it compulsory on water companies either to filter the water or to provide a sufficient area of depositing bed: 14. The omission absolutely to forbid the construction of cesspools in all new dwellings, and to provide for the compulsory removal of all existing cesspools as soon as the general introduction of sewers and drains, combined with an adequate supply of water, shall have rendered the universal adoption of the water-closet apparatus practicable: 15. Neglecting the entire subject of ventilation, one of fundamental importance in a sanatory measure: 16. The omission to give adequate powers to the Commissioners to remove, under the direction of the Inspector and the District Officer of Health, any house or houses which may be so situated as to render a street a cul-de-sac, preventing the possibility of a current of air from passsing through it; and, the further omission to give power to the same authorities to raise money for opening thoroughfares, and for the construction and maintenance of public walks: 17. The omission to provide for the removal of nuisances arising from manufactories in towns and populous cities: 18. The omission to provide for the removal of the smoke nuisance : 19. Neglecting in reference to the medical officer of health to make provision for the performance of his primary and essential duties; namely, the verification of the fact as well as of the cause of death, the correct registration of both, and the personal examination on the spot of the sanatory circumstances under which death takes place : 20. The omission to make any modification in the mode of assessment of the window-duties, though a principle of assessment has been pointed out by the adoption of which the revenue need lose nothing, while great facilities would be afforded for the better construction of dwelling-houses, and for the freer admission of light and air. "If the provisions enumerated are passed into a law, and if the errors and omissions pointed out are corrected and supplied, this Act will, in the opinion of |