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respect of typhoid - mortality being coincident with the improvement made during the last twenty years in providing public water-supplies. In the words of one of the State reports, "The death-rate from typhoid fever has generally fallen as the per cent. of the population supplied with public water has risen, for the reason that the majority of the deaths from this disease have occurred among communities and portions of communities not supplied with public water."

That this improvement is being maintained is seen from the fact that in the four-year period 1896-99 the deaths from typhoid fever in Massachusetts were further reduced to 2.6 per 10,000.

It is, however, in the city of Lawrence that the most striking insight is obtained as to the manner in which typhoid fever may be controlled by conditions surrounding the water-supply to the community. Thus, whereas the death-rate from typhoid fever reached a mean of 11'2 per 10,000 in 1886-90, it fell to 77 in 1891-95 and to 2'5 in 1896-99. It was in the autumn of the year 1893 that the raw river-water supplied to the city from the Merrimac River was first begun to be filtered, and since that time the sandfilters have been subjected to systematic and most elaborate bacterial supervision, and improvements have been constantly introduced so as

to secure the most efficient purification possible of the water before distribution, and the results are reflected in the marked diminution in typhoid fever which has followed these strenuous efforts to obtain the best water-supply available.

The splendid example set by the State of Massachusetts, in promoting the welfare of the people by the encouragement of original researches in practical hygiene, has stimulated other American States to create Boards of Health and enact laws for the protection of their rivers and streams. In view of all that has been done to promote sanitary science in the United States, it is surprising to learn that Lake Michigan, which receives the untreated sewage of municipalities and small towns aggregating over two million people, still furnishes Chicago with its drinking water, and undergoes no preliminary purification before distribution. The city of Chicago, by constructing the Chicago Drainage and Ship Canal, opened in January, 1900, has diverted its own sewage from Lake Michigan, but this great sewer has only been made possible because of its advantages as a commercial waterway; and it has been stated, on high authority, that every project for the drainage of Chicago into the Illinois which has not recognised the waterway features has been predestined to failure. Dr. Egan, of the Illinois State Board

of Health, however, points out that "with the present increase in population the Great Lakes, if they continue to be used as common sewers, will soon become totally unfit for use as drinking water, .. and one of two alternatives must be followed either every source of water-supply must be filtered, or the sewage of the towns must be efficiently purified before it is allowed to flow into the lakes."

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Doubtless this seeming inertia of the citizens of Chicago in the matter of filtering their water is attributable to the fact that already the authorities have expended eighty-five million dollars in their waterworks and sewerage systems, which represents an investment of something over fifty dollars per head of population, and that plans in connection with the great canal which has been described as "the greatest feat of sanitary engineering in the world," and to which reference has already been made, will, when carried out, involve an expenditure of thirty or forty million dollars more. the face of such burdens even so prosperous a community as Chicago does not care to contemplate further capital charges, at any rate until the unsatisfactory conditions shadowed by Dr. Egan become more pressing in regard to the source of their water-supply.

In

The systematic investigations carried out in the

great Institutes of Health on the Continent and elsewhere should surely make the sporadic work, as by comparison it must be designated, produced in this country an eloquent argument for the creation of a British Imperial Board of Health adequately endowed by the State, manned by the ablest investigators, and forming a centre for the prosecution of researches which in other countries, as in our own, have contributed so greatly to the health and welfare of mankind.

Why should England for ever have to knock at the door of foreign institutes for information and guidance in matters in which once she was the leader and enlightened example to every civilised country?

The question of how far polluted water-supplies, besides possessing the potentiality for spreading cholera and typhoid, may disseminate consumption, has been approached in a very instructive manner by Dr. Musehold, of the German Imperial Board of Health.

Some ten years ago the discovery of the tubercle bacillus in water for the first time was announced by a Spanish investigator, Fernandez. The water containing the bacillus tuberculosis was derived from an open ditch, and hence had been doubtless exposed to contamination of divers kinds.

In the course of the elaborate experiments on

London sewage and its treatment, carried out by Professor Frank Clowes, Chief Chemist to the London County Council, an instance was recently met with in which a guinea-pig, inoculated with a portion of coke-deposit derived from a bacterial sewage bed, died from typical tuberculosis, and sections of its organs showed the presence of numerous tubercle bacilli. Dr. Musehold has now submitted the whole question of the vitality of virulent tubercle bacilli present in the expectorations of consumptive persons in sewage, in river water, and on cultivated land respectively, to an exhaustive examination, and the novelty as well as importance of these researches merit their being carefully considered.

In the first instance tuberculous sputum was introduced into river water in its natural condition, and as this water was abstracted from the River Spree, in Berlin, it was exposed at any rate to a certain degree of surface contamination. In this water, kept in ordinary daylight, the tubercle bacilli remained alive and in a virulent condition for over five months; in ordinary sewage for six and a half months. Some of the sewage-infected samples were left in the open air and exposed to ordinary meteorological conditions, but even the ordeal of getting frozen up in their surroundings did not in the slightest shorten the lease of

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