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Fischer, Professor of Ophthalmology at the School of the DRAINING and SEWERAGE of LONDON

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Fischer, Professor of Ophthalmology at the School of the DRAINING and SEWERAGE of LONDON 704 de Peyrelongue allows all this, but conditions are being DRAINING AND SEWERAGE OF Wireless no suffer as improved. operators longer formerly LONDON. from mercurialism, since the old mercury interruptor has been done away with. Anaemia among them, too, will in THE MOST of us in London must have noticed the time be mastered, and as a matter of fact after two years during past few years a number of wooden enclosures in the main of discussion one has now a fan installed in ship ventilating thoroughfares in various districts, evidently connected with the wireless operator’s office. works of excavation. Yet comparatively few, perhaps, are aware that, deep below the surface, there is in progress one of the largest additions to the existing network of sewers yet A MEMORANDUM ON CHOLERA. undertaken since their formation by the Metropolitan Board of Works. The additions, estimated to cost £3,750,000, are a on for the WE have received Memorandum Cholera, shown on Fig. 1, and include new outfall and intercepting guidance of Europeans in the remote out-stations of British sewers, additional provision for storm water, extra pumping Malaya, which has been prepared under the directions of the facilities, and so on. Colonial Office by Mr. John D. Gimlette, Residency Surgeon, In these strenuous days all are apt to take their surround- too much as a matter of course. Drains-unless Kelantan, Straits Settlements. A large number of copies ings they become a nuisance from some defect--being out of sight, are have been sent to for distribution the Govern- Singapore by more than many things likely to be out of miud also. Who ment. The memorandum is a four-page sheet of foolscap, and associates the outlay of £11,000,000 with the opening of a is written in clear, simple language which can easily be under- bath wast3 ?‘! Yet the present system has cost this sum to a resident within the of London to stood by any educated person. It begins with a rough sketch enable County satisfac- this moreover, it entails that an of the disease and its mode of spread, with a short and vivid torily perform simple act ; army of 2000 men shall spend their lives immured of the onset and of an working description progress ordinary case, and in darkness, often midst noisome fumes and exposed to risks for brief directions putting the patient in the way of recovery of flood and of fire from petrol gas. About 1000 of these in the absence of medical aid. Instructions follow for the dis- men are employed by the local district councils. The aspect infection and disposal of excreta and contaminated substances, that such work bears in its relation to the public health may and stress is laid on the virulence of stale cholera stools well claim our attention. and discharges. Owing to the deep-rooted Malay prejudice Hydroyraph6cal Features of the London Area. against hospital wards, the treatment and isolation of natives That we may the better realise the elemental difficulties with which have to and of the during an outbreak in a purely Malay district are beset with engineers grapple, engineers London Council in a it will be difficulties ; but where the native is mixed it is County particular degree, population well to refer to the hydrographical features of the district to to field or on possible organise temporary hospitals camps which they have to minister, covering as it does an area of high ground within a mile or two of the main centre and to some 120 square miles. Reflection shows that these features 2upplement these with segregation camps for contacts and are the basis of the whole scheme of drainage, the streams and of either bsen converted into suspected or doubtful cases. The memorandum proceeds to springs bygone days having our main sewers or been for their con- rules for the of the health largely responsible give general safeguarding public struction and position. Whitaker’s Geological Survey of in infected with reference to the water- districts, special England and Wales " includes the results of many borings in supply and the disposal of the dead and the danger of and around London. These indicate that a very different uncooked foods. It points out that judgment is required in condition of things, in times not far remote from the present, giving directions for the burning of dwelling places and in must have existed on each side of the river than is now noticeable. Note The continual of the surface burial because the confidence of (See A.) raising disturbing Malay customs, of the ground in the neighbourhood of the city and the the native is and there is community easily shaken, always nearer suburbs must not be forgotten. Each load of building risk of concealment of deaths and of general panic. Ten material ever brought in by barge or cart or rail has aided to days’ quarantine is recommended, in order to be on the raise the level. At the of the Christian era much of the low- safe side, although this is twice as long as the period beginning land on the south side of the river within the laid down the Venice Convention. The import- lying (now by jurisdiction of the London County Council) from Abbey Wood ance of and calmness on the of care, courage, part to Barnes was under water, and in many places on the north Europeans in time of epidemic, both for their own side also. Certainly at a period not very remote the river sakes and as an example to the natives, is insisted on. spread over Plumstead Marshes and parts of North Woolwich, Above all things, prejudice must not be aroused in the native across the Isle of Dogs, some parts of Deptford, and the of Rotherbithe and over much of mind. treatment out of the greater part Bermondsey, Organised hospital being Southwark, Walworth, Lambeth, and of Vauxhall, where the the uneducated has to be treated in his own question, Malay Effra River from Dulwich-now an important sewer, with a home in the midst of his family, and "personal interest in branch from Nine Elms-emptied into Effra Creek. The - the patient is almost everything." Personal influence may Thames spread across to Westminster, round Thorney Island as far back as the ornamental bv the Horse be of immense value in checking the disease at the, water Guards’ Parade, where it was a branch of the river beginning of an outbreak. The memorandum concludes joined by Tyburn (see Note B), over Pimlico, and round the backwater of with a of instructions to natives, couched in the copy what was then Chelsea Island, formed at the mouth of the which phrases of the East, have been translated into the Westbourne, now the Ranelagh sewer, and still further back Malay tongue and distributed among the head men of, over Fulham and parts of Hammersmith up to Shepherd’s where it met the now into infected areas. They are from the pen of Mr. Warren. Bush, Stamford Brook, emptying . Hammersmith Creek. On the the river Barnes, and their picturesqueness by no means impairs their opposite side, again, covered portions of Battersea a nd lower Wandsworth, where the or their practical value. simplicity still open waters of the Wandle, much polluted, empty into the Thames. The higher ground of the places named would show as islands here and there. Spreading over this lagoon THE King has been pleased to grant to Dr. Ernest CottonL in times of flood, the swollen river, checked in its course, Fischer, professor of ophthalmology at the School ofE deposited its load of earthy matter from the upper reaches to Medicine, Cairo, the Royal licence to accept and wear the form the marshes, with their tidal creeks kept open by the many streams that gathered on the The by Insignia of the Third Class of the Imperial Ottoman Order of‘ uplands. city some is believed to have been named by the Celts ’’ the Medjidieh, which decoration has been conferred upon Lyn Din," or Lake Town. (See Note C.) him by the Khedive of Egypt with the authorisation of the The three low eminences of Ludgate Hill, Cornhill, and ;Sultan of Turkey. Tower Hill, on which the City proper stands, were surrounded 705 on the north by the great moor, and on the east by the marsh proved both a source of annoyance and disease. The and fen and the estuary of the Lea. This is at Blackwall, saturated ground was contaminated by the cesspo0ls and between the East India and Victoria Docks. The south and middens of the many generations of dwellers within the west were bounded by the Thames and the Fleet river (see limited area, and the conditions were ripe for the distribu- Note D). The Walbrook, now a sewer, drained the moor, tion of any water-borne disease when an epidemic once passing through the centre of the City from north to south, obtained a foothold. The population in 1831 had risen to entering near the Moorgate and running out into Dowgate 1,424,896, and in this year cholera appeared. Dock. Another stream, the Langbourne, yet another sewer, Cholera Epidemics. drained the eastern fen, the due west to its crossing City Dr. Thomson,Thomson in 1852 of the visita-visita- and there, south where is is now St.St. Spencer writing in centre, and there, turningturning south by Mary’s tions of cholera, says that the first visitation in 1831 Woolnoth, spread into two or three streams or sheres and and was then called the the Thames tions traced back through Europe visitation in 1831 Sherebourne,’ entering bydistrict round the mouth of the in 1817.
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