Show I OBSERVATIONS TO HOUSE SANrrATIOi RELAT 1ti DR FRANK IT HAMILTON i CAN SCARLATINA OROTRE i OROTREzy DrSEASES BE CONVEYED drrr FRO w 0 TO HOUSE THROUGH THE OC i MEDlr SEWER GAS C1 D I The readers of the Medical Ga I will remember that in my na paper titled The Struggle for Life w er Civilmion I c read before RAtar AcKdcray of Medicine March ic I 1882 P lid published in tbia 16D c iournn I c urea I expressed a suspicion that bll I atirm diphtheria and other znno eea t disease might be conveyed zFniott this tbe e were and those who were uB5 rc exit during the diaeuaaion which Pre sued will Et Do remember that Dr Jat way challenged any one to hOW C F 1 case of scarlatina thus conveyed t The suspicion entertained lEI by I1n self Las for some time been eat tamed by others and nile bte j t expressed publicly by medici m s b me although the opportunities J ea for ceat It1 proving such a fact have been rah In the number of the faJdtary Iv atrtarr II cord of March loth 1882 Pl1bj9h r in London and just receivedj l TOI very carefully prepared article fa fo 01 the of Alfred 0 pen Carpenter 1 Jj 5 London C C 8 Cambri l1 Cambrige e tic titled Some of the conditions wc = modify or increase the infective Ir > ci i j aoter of scarlatina Dr Carpenter says I base fer f I long time paat had my opinions Be 1 the causation of scarlatina and the conditions which modify or K h crease its infectious character Itl E opinions have been based upon i experience which has not no been car 1I rnwpcL nr ronlrtnf tn nnn nd Ullit1 I He then proceeds to give a resum if a personal investigation and study J four severe outbreaks of ecamtai ar all of which in spite of the mcst energetic 181 en-ergetic sanitary measures e to recur at longer or shorter imern = I th until the connection with the sweti or with sewage sinks were severe ev and the epidemics disappeared aw l1l geth ere al All of these outbreaks occurred to private or public school houses L 161 i the first example the echopl I boas tb was connected with an abaadjtf in cesspool on severing which COOCK ht tion the aiseaee promptly aud pert i nently disappeared andDr Carpenfc fhC remarks It must be evident t lithe li-the cesspool in the school yard sari tbi timately associated with the reappear ltpl ante ot ijarlaiina that it contafnd Lp l W some material which continued tie i M vitality of the disease germs I The second example was in thacatt w of a private school Threesucce as ive outbursts of scarlatina occurred Ie until the water closet wss taken w away altogether Since which time til it has not reappeared DOry a period di of nearly eight years The third set of cases appealed in II an elementary school Alter fruUlea ° OJ attempts to expel it I came ul to the conclusion rays Br pc Carpenter that the tault in dE the construction of the aeror 81 system which I am about to detau I 1i to you was the foundation of tin Ii epidemic ta The fourth set of cases was ia > I ti school connected with a large pH 01 per establishment We know says Dr Carpenter how scarlatin + tl gained admission to the infirmary o The washings and excreta of tt t patients naturally found admission 11 tE the sewer and I proved that theta 1 t1 was a current up the eewer some il j c times il I n Finally Dr Carpenter remade n what inference do I draw from the cages It is that the oauaatic of scarlatina may ae often arise froG 0 sewage emanations and sewage con b laminated with the scarlatina germ bas b-as from personal contact e Dr Carpenter also states that be b haa on eeveral occasions conned g outbreaks of diphtheria with certain f g conditione of the sewers ITo To which the writer adds considering c con-sidering the well known fact that tlK a germs of scarlatina and of all zymo t tic diseases are nourished and malt r f t plied by warmth and filth it woa2 c seem probable indeed almost certain I that the germs of disease might b t conveyed in this way from bouse b t 1 houee However startling the W a t r geation may be it hardly becomes Ito t I-to conceal from ourselves and tba t i s public the fact that things are po 1 ble and even probable 1 THE SINS OP THE PLUMBE3 I The same journal contains a paper 1 t written by W K Burton liesidec Engineer to the London SaniM t Protection Association in wbd fanoalinnr of Inn nina i4vcino nrCWl the > w following w i i passageAe W Uh X H v fcj 7 Jrgs J the first the leakage I believe I i not in any way exaggerate the deleclo ive state in which it ia common tow drains when I Eay that not one l i cent of those under the houe3 1 London would stand the test of bf j i closed at the sewer end and of beta j t filled with water A leakage gre5Cfl or less would be found in ato Cfl every one and very often BnciJ leakage as would make it imposs j to fill the drain at all This be the case we are broapht face to t 3ff with two alternatives EitneI i practically every house in Lond f should have its drain unresetredJ f 1 condemned or a certain smalls mepat of leakage must be allowed to Pad f I do not propose fo enter into t question as to what extent an iDPf ia sligM d o tOI justified in passing J feota but could point out that su anUs as are email in extent almost universal and are gene passed by inspectors1 do not of t = trjctly under the head of sip ° the lluml1er a |