1260 SANITATION FOR HOPPERS.

reason for further police investigation. Whilst regrettingthat the coroner’s inquiry should have led to a difference ofopinion between the medical men, we see no reason to alterour previous statement-that the coroner is to bs thankedfor his painstaking care as are the jary for their logicalverdict.

Annotations.

IRRITABLE HEART AND TRANSIENT MURMURSAS A CAUSE OF REJECTION OF CANDIDATES

FOR THE ARMY AND PUBLIC SERVICES.

"Ne quid nimis."

IN the annual address to the North-West London Clinical

Society delivered on Oct. 20th Sir William Broadbent dealtmainly with this subject. He alluded to the hardship whichrejection on medical grounds entails upon the young man whohas gained a place on the list for admission to Woolwich orSandhurst and added, "In my j judgment this has sometimestaken place on totally inadequate grounds." In illustrationhe mentioned cases of so-called "irritable heart," cases

of bruits heard over various cardiac and pulmonary areas, andalso cases of intermittent or cyclic albuminuria, on accountof which candidates may be refused their commissions. Thecandidate with irritable heait has usually been spending longand late hours in study, with restricted exercise and limitedfreh air, and with possibly unlimited tobacco. He presentshimself for medical examination in a state of extreme

nervous excitement. His pulse is rapid and perhapsirregular, his cardiac impulse is violent and may be diffused,even beyond the right sternal border. Murmurs may be

heard at one or more orifices and his respiration is short andhunied. He is referred for three or six months, but

on again presenting himself before the same examinerthe ordeal reproduces symptoms which have beenabsent in the interim, and he fails to pass. SirWilliam Broadbent pointed out the importance in such casesof considering the personal history, saying : "It would takea great deal to make me rejEct the captain of a footballteam of a large school....... Such disturbance of the actionof the heart, however exaggerated, is not inconsistent withperfect soundness and efficiency." " A fair test " wou’d beto make the man run a mile round one of the cinder pathsat his own pace, noting his time, but especially the period atwhich he got his second wind, and how he finished up.Sometimes, he added, 11 a run up two flights of stairs wouldbring the heart to its senses." A more common cause of

rejection is the presence of a murmur which may be per-fectly innocent of significance. Such murmurs maysimulate closely a soft systolic mitral, but are heard

only during inspiration or when the chest is full, andare due to compression of the overlapping lung bythe heart during systole. Pulmonary murmurs may dependon bulging of the conus arteriosus against the chest

wall; they disappear when tte lung is interposed on deepinspiration. Sometimes bruits are heard, not only in thecourse of the ordinary mitral regurgitant, but over the

greater part of the lung. In such cases there is usuallypleural adhesion. 11 "I have known such bruits," saidSir William Broadbent, " to be looked upon as indicative ofvalvular disease, requiring treatment by digitalis and

demanding all sorts of precautions in the matter of

exercise," and he mentioned the case of an athlete, agedtwenty years, who presented a murmur resembling the mitralregurgitant, and also one over the pulmonary area. Apartfrom the bruits the heart sounds were normal, and in

particular there was no accentuation of the pulmonic

second sound. The left ft side of the chest was nar..

rower than the right and moved less on respiration,The condition was probably due to pleuro - pericardialadhesion, and after five months’ very vigorous exercisethe patient was none the worse. The criterion of pseudo-mitral disease is absence of displacement of the apex beatand of accentuation of the pulmonic second sound, or undueright ventricular impulse, together with absence of

symptoms. Restrictions as to games in such cases, exceptwith regard to football, house runs, and training for races,are often needlessly imposEd. Other murmurs are heard!in the tricuspid area which are perfectly harmless..And such tricuspid bruits are rarely constant. Sir William

Broadbent also alluded to dilatation of the heart and inter-mittent albuminuria. Sir William Broadbent’s address shouldbe of great practical value, not only to the authorities onwhose fiat appointments to our public services depend, butalso to all practitioners who meet with the difficulty of’

diagnosing organic and permanent from functional and tem-porary disease. --

SANITATION FOR HOPPERS.

THE Maidstone epidemic has, at any rate, had one goodresult-namely, that of calling attention to the grosslyinsanitary conditions under which hoppers are compelled to-

live during the ingathering of the hops. A special corres-pondent of the Times has been investigating the circum.stances, and his letter on the subject reveals a state of thingswhich we can only describe as disgraceful. With all ourboasted and ruinously expensive system of education, our

sanitary organisation, county councils, health boards, and thelike, it appears that hops are gathered by a process whichfor total disregard of decency, sanitation, and cleanliness;,to say nothing of the first principles of Christian charity,carries us back to the most immoral period of the eighteenthcentury. This beiog so, for a district to put up with thegathering ground of a hop-garden for its water-supplyis to invite disaster. To begin with, hops are a

very exhausting crop and the ground therefore requiresconstant manuring. Neither is the manure solely that ofanimals. Every kind of filth is employed-fish. offal, oldwoollen rags and waste, street sweepings; and the like areused; and water running off a gathering ground pollutedwith this sort of stuff is almost sure to be contaminated.But this is only the minor evil, it is the herding togetherof a mass of human beings, some of them of the very lowestclass, under such circumstances as preclude the observanceof the most ordinary laws of health which, does the mischief.It must be said that all the hopper houses are not equallybad, for the newer ones are built of wood with iron

roofs and are portable ; but even these are grosslyovercrowded. There is absolutely no sanitary accommoda-tion whatever, and this being so, says the Timescorrespondent, "the most dangerous of all pollutionstakes place on the ground." The hop-garden itself is

generally used for this purpose; and where part of theFarleigh supply arose the collecting pipes were only 2ft.below the surface of the ground used by the hoppers. Itmust not be supposed that we object to house refuse, offal,or excrement being deposited in the fields. The fields are thebest and most suitable place for such materials, and earthpurification the cheapest and most thorough. What we dc’object to is the fact that such substances are deposited closeto the gathering pipes of a water-supply which is sure to getfouled by these waste products before the kindly earthhas had time to render them innocuous. Again, thereis no water laid on to the hopper houses, the hoppersare not allowed to get it from the farmhouses, but have todo so where they can. And yet water is laid on to nearlyall the hop-gardens themselves. It would be easy to put up

1261IMPORTANT DECISION AS TO AIR-SPACE IN COWSHEDS.

a stand-pipe and so ensure a clean water-supply, but this isnot done. It would appear that the primary cause of thesehorrible abuses is, as in so many other commercial enter-

priser the high-pressure race for wealth. In some of the

bop-gardens the gathering of the hop-crop is a kind of

village festival, there are no imported hoppers, and theresult is a small return to the farmer. But in the neigh-bourhood of Maidstone "it is a great money-making con-cere, in which the imported hop-pickers are but part of themachinery and of somewhat less account than the rest."

Epidemics are hard masters, but possibly the sufferingsthrough which Maidstone is passing will bring about asincere reform of the present system of hop-gathering. Ifit is impossible to carry out the harvest on the lines onwh’ch it is worked in some places it should be made abso-lutely compulsory up an the grower to provide a proper supplyof water, proper sanitary accommodation of the nature ofa latrine, and housing at least as good as that of a stableor a kennel for hounds, and overcrowding should be abso-lutely forbidden. We suppose we shall be accused of

interfering with legal commercial pursuits, but the wholesalepoisoning of a neighbourhood is of more importance thanthe price of beer, and as at present excellent beer can beobtained from Maidstone for something under 2d. a pint itwould hurt no one to pay 3d. for it, and no one would

object if he had an assurance that by so doing he wasfurthering the cause of sanitation, to say nothing of thatof humanity. It is right to say that in the Ttmes of Nov. 9th ,,

appear two letters, one from the Principal of the AgriculturalCollege at Wye, Mr. A. D. Hall, traversing every statement ofthe special correspondent, and the other signed " Spectator,"which avers "that he is strictly within the limits of the

truth." After this we may well ask, " What is truth ? " and,

unlike jesting Pilate, would stay for the answer. The Times

correspondent maintains his attitude, and his words bear thestamp of accuracy. -

BRAIN DESUETUDE.

SPEAKING at Selkirk on the 8th instant, Sir JamesCrichton-Browne dwelt on the dangers to health involved inindolence and disuse of the brain. The medical profession,he said, adapting itself to the needs of the times, had feltit incumbent upon it during the last decade to insist mainlyon the evils of misuse of the brain, on the excessive strainnot seldom imposed on it in these days in the fierce struggleof the race to be rich, and more especially on the over-pressure imposed on it in the name of education when in animmature state, but they were not less keenly alive to thecorrelative evils of the disuse of the brain. Elderlypersons who gave up business and professional men

who laid aside their avocations without having other interests or pursuits to which to turn were in many casesplunged in despondency or hurried into premature dotage. He did not know any surer way of inducing premature c

mental decay than for a man of active habits to retire and do nothing when just past the zenith of life, and, on the other Ihand, he did not know any surer way of enjoying a green old age than to keep on working at something till the close. It (

had been said that one of the rewards of philosophy was s

iength of days, and a striking list might be presented of a

Men distinguished for their intellectual labours which they s

had never laid aside, who had far exceeded the alloted a

span of human life. Galileo lived to seventy-eight, c

Newton to eighty-five, Franklin to eighty-five, Buffon tto eighty, Farraday to seventy-six, and Brewster to eighty- tfour years. Sir James Crichton-Browne drew special atten- ttion to the great age generally attained by our judges, c

Oar judges were, he said, men who could never fall into routine, but were called upon, as long as they held office, for tlmental effort in considering and deciding on the new points c

and cases which were constantly submitted to them. For ti

s the most part they had at one period of their lives undergonee some over-strain in the active practice of an exacting pro-fession, and yet they lived to a ripe old age, and were, hee believed-notwithstanding the jokes and jibes of hungryf aspirants at the bar -more exempt from dotage thane any other class of the community. The sustained’ brain-friction in their case kept that organ bright and

polished. These facts, he thought, ought to inspiree us with some doubt as to the wisdom of the compulsory"

retirement and pension régime under which we lived. Hes had known several cases of mental disease induced solely

by enforced idleness in men turned out of the public service,f and more particularly the army, in conformity with a fixed1 rule, while still in the prime of life and capable of useful. work. On entering the public service a man had to ascend

by graduated steps of increasing work and responsibility.Was it not possible to arrange graduated steps of diminish-

ing work and responsibility by which he might descend on. leaving it ? Much waste and wretchedness might thus be

saved. The physiological notion of life was not cruel over-pressure at the beginning, penal servitude in the middle, andsilly superannuation at the end, but the timely, continuous,orderly, well-balanced exercise of all the functions and

; faculties with which tne being is endowed.

IMPORTANT DECISION AS TO AIR-SPACE INCOWSHEDS.

A VERY important case bearing on the question whether aregulation under the Dairies, Cowsheds, and Milkshops Orderof 1885 enables an authority to specify a definite amount ofair-space per cow in a cowshed has just been decided. Thecase is that of Baker v. Williams, and it was an appeal fromthe decision of the magistrates of Southport, which camebefore the court of Queen’s Bench on Nov. 1st. The

appellant, a dairyman, contended that a regulation as toair-space could not be made by the town council; that theword "ventilation" in the thirteenth section of the Orderdid not authorise any requirement as to air-space ; that theprovisions of no Act of Parliament authorised the PrivyCouncil-now the Local Government Board-to make a

regulation as to air-space; and that therefore the Dairiesand Cowsheds Order was, in so far as the requirementas to air-space is concerned, invalid. The appellant’sstrongest point was that whilst in Sections 7 and 8 ofthe Order the words are "ventilation, including air-space,"Section 13, under which the authority make their regula-tions, omitted the words "including air-space." But bothMr. Justice Wright and Mr. Justice Kennedy decided thatin such cases the Order was in effect an Act of Parliament,that the Order and the statute must be read concurrently,and that consequently the authority had power to include thequestion of air-space when making a regulation in the matterof ventilation. It may be admitted that it would have beenmore satisfactory if the words relating to air-space had notbeen omitted from Section 13 of the Order, but it is most

satisfactory that the decision is in the direction both of

common sense and of the protection of public health. In cow-

sheds ventilation in its health aspect could not be obtained

apart from a regulation as to a minimum amount of air-

space ; the two go necessarily hand in hand. And in so far

as public health is concerned, it is notorious that the wantof cubic space per cow, with its consequent crowding of cowstogether, is one of the most potent factors in conducing tobovine tuberculosis and to spreading that disease from cowto cow. The public as yet hardly realise the danger whichchildren incur from tuberculous milk owing to overcrowdingin cowsheds, but we hope some definite pronouncement onthis point will be made by the Royal Commission on Tuber-culosis, and that the report will contain a distinct condemna-tion of some of the regulations sanctioning insufficient cubic