271

librarian’s staff this coming year. More money is urgentlyneeded, both for the purchase of books and for the runningexpenses. Truly 11 of making many books there is no end."

The cry for more room is universal throughout the librariesof the world, and the output of books increases day by day.Especially is this the case with medical literature, andthe United States are more prolific in this direction

than any country. The subdivision of subject-matterhas made the old text-book of medicine give placeto elaborate " systems," published in 10 volumes or so,

or else we have fully and carefully written monographsupon one disease. The mere literature of the youngestdaughter of medical science-namely, bacteriology-almostrequires a library of its own, and as for periodicalliterature, medical journals and magazines are showeredabroad like the leaves in autumn. In many of these thereis doubtless a great deal of chaff to very little wheat andas no library is capable of indefinite extension some processof exclusion will before long become inevitable.

THE EXTENSION OF THE BOROUGH OF WORTHING.

THE growth of our urban, and the depopulation of ourrural, districts is one of the greatest problems of modern life,and the exceptions to this rule are often more apparent thanreal. As a matter of fact, however, in the proximity of ourlarge towns the rural districts in no sense suffer from de-population, and vigorous efforts are sometimes required toprevent the population from being distributed in a mannerinconsistent with healthy urban conditions. There must

obviously be some limitation to the aggregation of popula-tion which can be properly administered from one centreby one administrative body, and perhaps in certain citiesin the world such limitations have already been reached.But, conversely, there are obviously great disadvantages,more particularly from a public health standpoint,in the several parts of what is structurally a

single town being administered by multiple authorities.This phase appears to have been already reached in Worth-ing, a considerable portion of which town is situated outsidethe borough proper, and in the rural parishes of West

Tarring and Broadwater. Originally the villages bearingthese names were separated from the town of Worthing bya stretch of open country, but the increased population hasresulted in covering the area with habitations, and Worthingis now seeking powers to embrace both parishes within itslimits. The general merits or demerits of the proposal willdoubtless soon be fought out by means of a public localinquiry, but from our point of view, that of the publichealth, there are sundry reasons which must be held

strongly to support the consolidation scheme. The rural

district council administering the affairs of what may betermed the towns of West Tarring and Broadwater are

hardly likely to pay as much attention to these two parishesof the-rural district as their importance demands. Indeed,rumour has it that at times meetings of the rural districtcouncil are so poorly attended that a quorum is not forth-

coming. Moreover, the fact that the offices of surveyor andinspector of nuisances are occupied by one and the sameindividual is sufficient to indicate that no very adequatesupervision can be maintained over the erection of new

buildings and the sanitary condition of old buildings, andwe should not be surprised to hear that the roads and

footpaths are not quite up to urban standard andthat the lighting is bad. Houses, too, which are

within a few feet of the sewers are said not to have beenconnected with the sewers owing to the absence of properadministrative action. As regards the control of infectiousdiseases the people of the rural parishes seem to be

dependent upon the goodwill of Worthing; and it is,

perhaps, in accordance with civic nature that Worthingshould give preference to the infectious sick of its owndistrict. In all these directions, as, indeed, in many others,there would seem to be advantage in the extension of theborough in such fashion as to focus the control of infectiousdiseases, the water-supply, the sewerage, and the householddrainage, while in the matter of the investigation of out-breaks of disease, whether water-borne or not, the concentra-tion of the notifications into one office cannot fail to beof value. We expect that these facts will have someinfluence with the Local Government Board in theirdetermination.

____

‘

MR. SAM LEWIS’S BEQUESTS TO CHARITY.

WE are happy to learn that general and medical charitieswill benefit largely under the will of the late Mr. Sam Lewis.The Prince of Wales’s Hospital Fund for London will

eventually receive a quarter of a million from the estate of’the deceased money-lender, and many of the principalmetropolitan hospitals have also a separate interest in thefuture disposition of his enormous wealth. Mr. Sam Lewiswas a remarkable man. He was a usurer who conductedhis business with such scrupulous honesty that he gainedthe real regard of his clients. Money-lending mustalways be a nasty trade, for it thrives on the failingsof the weaker section of society and cannot allow scopefor much kindness of heart. A money-lender who,was moved to disregard business precautions out of sym-pathy with his clients’ stories would in a few hours haveno money to lend. Mr. Sam Lewis did his best to

show that usury can be run on fair lines. He took largerisks and exacted large profits, and the value of his estateshows that he neglected no means to ensure these profitsaccruing to him. But he received only what he compoundedto receive. And in his disposition of his property he has

displayed the generosity which he was obliged to suppress inhis purely business relations.

ARSENIC IN BEER.

THE Manchester and Salford Trades and Labour Councilat a -meeting last week passed the following resolution :-

" That, in view of the serious consequences which haveresulted from the sale of unwholesome and poisonous beer,this council is of opinion that it is absolutely essential, inthe interests of the public, that the Government should atthe earliest possible moment promote such measures inParliament as will ensure that only pure and wholesome beershall in future be sold to the public throughout the country.This council is further of opinion that as the health and livesof the public are involved in this question it is the duty ofthe Government to proceed with legislation at once upon thesubject, without waiting for any report of any Royal Com-mission, as there is already ample evidence that very manypeople have of late been injured and a number killed throughdrinking poisoned beer, and the protection of the publicdemands immediate legislation without the delay whichattends the proceedings of a Royal Commission."This is exactly the view which we expressed in a leadingarticle last week and we heartily congratulate the Manchesterand Salford Trades and Labour Council on their admirableand sensible resolution. We have already pointed out thatthe use of malt substitutes is more a matter of expediencythan economy. Indeed, as is pointed out in a letter in theTimes of Jan. 22nd by Sir Walter Greene, who has tad alarge experience of practical brewing, it would appearthat invert sugar may cost nearly Is. per quarter morethan barley malt. Whatever the economic considera-tions may be, the introduction of arsenic into beer

must be effectually stopped. The inquiry at Manchesterwas concluded this week and the verdict is a com-

prehensive censure on all those concerned. The juryagreed that death had been caused by arsenical poisoning,

272

and they returned an open verdict with a rider censuringbrewers, sulphuric acid makers, and chemists alike for

carelessness. The reports from the medical officers of healthof the counties affected by the epidemic are coming to hand.We have received that of Dr. G. Reid, medical officer of

health of the.county of Stafford. According to this report 667- cases were traced to arsenical beer poisoning and these hadoccurred in 25 districts. The report is accompanied by astatement of the county analyst, Mr. E. W. T. Jones, whofound that of 140 samples of beer analysed 15 were decidedlyarsenical and seven slightly so. We note with satisfactionthat the machinery provided by the Sale of Food and DrugsAct is being set in motion and followed by reports ofsuccessful prosecutions on all sides. What purpose is

served by waiting for the ponderous proceedings of a RoyalCommission? 2

____

THE SANITARY INSTITUTE LECTURES.

THE thirty-first course of lectures, with demonstrations, for-sanitary officers will be delivered during February, March,and April next at the Parkes Museum, Regent-street, W.9m the syllabus it is announced that Dr. E. J.

Steegmann will deal with Mechanical Physics on Feb. lst,4th, and 6th, while Dr. J. Priestley will discourseon Sanitary Law on Feb. 8th, 12th, 14th and 15th.Dr. H. R. Kenwood will take for his subjects" InfectiousDiseases," "Methods of Disinfection," "Water Pollutionand Purification,’’and " Elementary Statistics on Feb. 25thand 27th and March 1st and 4th respectively. The Signs inHealth and Disease in Animals Destined for Food will be con-sidered by Mr. W. Hunting, F.R.C.V.S., on March 29th.Dr. E. Petronell Manby will lecture on the Appearance andCharacter of Fresh Animal and Vegetable Foods,dealing at the same time with methods of preserva-tion, on April 15th. Among the inspections and demon-strations in connexion with this course Mr. A. E. Harriswill conduct a party over the disinfecting station at Islingtonon March 2nd and Mr. James King, M.R.C.V.S., will give ademonstration at the Metropolitan Cattle Market on

April 15th. -

THE SCOTTISH POOR-LAW MEDICAL OFFICERS’

ASSOCIATION.

THE annual report of this association, which we publishedin THE LANCET of Jan. 19th (p. 204), affords proof that themembers are alive to the necessity of united and energeticaction in order to accomplish a real reform, or, indeed, anyimprovement at all, in the terms and character of Poor-lawmedical work in Scotland. It is especially satisfactory tonote that they realise that the fundamental condition of

all such improvement is some legal assurance of security oftenure of office. So long as Scottish Poor-law medicalofficers are liable to dismissal for no assigned reason, onthe action of a section of the parish council, and possibly’for faithfulness in the discharge of their official duties, solong is it vain to expect any energetic or effective agita-tion for the removal of grievances. The report tells us thatthe finding of the Committee that the initial step in reformmust be the securing fixity of official tenure has not given,universal satisfaction to members of the association in the

Highlands and islands. But members in remote parts willdo well to trust those more centrally placed as to the bestmeans of securing the ends which all have in view.

Inadequate salaries, inadequate holidays, and the with-

holding of the whole or part of special fees are some of thespecial grievances which call for urgent redress. Some ofthese practices are inconsistent with the existing law andofficial rules for the guidance of parish councils and could.not resist the earnest protest of a united and independent

profession. Unfortunately the profession is not inde-

pendent, and least of all in the very remote parts wheregrievances are most glaring and acute. We counsel

unanimity in the support of the association, especiallyin its efforts to secure protection to medical officers

against all capricious and unreasonable dismissals. Whenthis reform is obtained others will follow. No timeshould be lost if anything effective is to be done in the

coming session of Parliament.

CONGENITAL TYPHOID INFECTION.

IN the Jowrnal of the American Medical Association of

Dec. 29th, 1900, Dr. George Blumer relates a rare and

important case of typhoid h2amorrhagic infection, probablycongenital. About nine cases of congenital typhoid infec-tion in which the diagnosis was proved bacteriologically areon record. All the cases occurred in children born when themother was suffering from typhoid fever. In many the birthwas premature. In three cases abortion took place about thefourth or fifth month, in two about the eighth month,and in two the children were born at term. Most ofthe children were born dead, but three lived nine hours,four days, and five days respectively. In most of the

cases in which the child had reached only the fourthor fifth month the necropsy was entirely negative and thediagnosis rested on the bacteriological examination. In

some of the later cases definite macroscopic lesions were

present, though in all except one the intestines were spared,and in that one only a single solitary follicle was involved.The disease took the form of a general infection. The mostconstant lesion was slight enlargement of the spleen. Otherlesions were slight icterus (two cases), haemorrhages intothe skin, liver, or kidneys (two cases), and slight swellingof the mesenteric glands (one case). The condition of the

placenta is recorded in four cases. In all it was normal,but typhoid bacilli were found in it when it was examined

bacteriologically. Typhoid bacilli were present constantlyin the spleen and frequently in the blood, occasionally in thelungs (two cases), kidneys, and mesenteric glands (one case),and liver (one case). Dr. Blumer’s case differs from those

previously reported in that the mother was in good healthat the time of birth. But she had an acute illness withremittent fever four and a half months previously whichconfined her to bed for 21 days.. Presumably she sufferedfrom typhoid fever, for she resided in a non-malariousdistrict. A female child was delivered with forceps after adifficult labour. On the fourth day the infant had a slightconvulsion after nursing. At each subsequent nursing shebecame rigid, as if in pain. On the fifth day there werespots of blood on the diaper. The amount of blood lost

gradually increased until on the sixth day it became alarm-ing. The vagina was packed with cotton, which was soonexpelled with large clots of blood. Examination revealedan eroded cervix as the source of haemorrhage. This wascauterised with nitrate of silver and the vagina was againpacked. But the cotton was soon again expelled and

vaginal haemorrhage continued until death, which took

place on the ninth day. Before death there wereslight bleeding from the guma and a petechialeruption on the forehead. There were slight elevations oftemperature. At the necropsy the mucous membranes were

very pale. The mesenteric glands were all red and bsemor-rhagic. The liver had a mottled, reddish-yellow appear-ance, and looked as if it had been boiled. On section it

was very cloudy. The kidneys showed a few cortical

haemorrhages, and the bladder one large submucous heemor-rhage and numerous small ones. The vagina containedclots and showed two submucous haemorrhages. The

uterus was four centimetres in length and much dilated.Above the internal os was a blood-clot of the size of a pea.