1 867.] TJie Puhlic Health. 597 



and the ' Lancet,' have had notices of it, bnt up to the present time 

 no copy of the report can be obtained at the Queen's printers. Mr. 

 Simon is said to give an elaborate account of the stages by which 

 the present Vaccination Bill has assumed its present form, and also 

 a defence of the presentation of gratuities for results. 



The most interesting portion of the report appears to be the 

 appendix, in which is published a paper by Dr. Buchanan " On 

 the Kesults of Sanitary Improvements, as applied to the Large 

 Towns of England." The ' Lancet' remarks on this paper, with- 

 out giving any reason for its opinion, that it "is undeniably one of 

 the most important contributions to State-medicine which has been 

 made for many years." In a postscript to his report Mr. Simon 

 gives an account of his visit to the International Cholera-conference 

 at Weimar. We quote from the ' Lancet ' the conclusions at which 

 Mr. Simon arrives. The local conditions of safety against cholera, 

 and we may add typhoid fever, are — 



" 1. That by appropriate structural works, all the excremental 

 produce of the population shall be so promptly and so thoroughly 

 removed that the inhabited place, in its air and soil, shall be ab- 

 solutely without faecal impurities ; and 2, that the water-supply of 

 the population shall be derived from sources and conveyed in such 

 channels that its contamination by excrement is impossible." 



The last volume of the ' Transactions of the Social Science 

 Association' contain two papers "On the Medical and Legal 

 Aspects of Sanitary Keform," by Dr. A. P. Stewart and Mr. E. 

 Jenkins, which have recently been published by Mr. Hardwicke in 

 the form of a pamphlet. Dr. Stewart's paper is the result of a very 

 elaborate inquiry into the sanitary condition of our large towns, 

 and contains a number of tables giving a summary of information 

 obtained by sending a series of printed questions throughout the 

 country. The impression produced by the study of Dr. Stewart's 

 paper is very painful. Throughout the length and breadth of the 

 land people pay no attention to the prevention of disease and death. 

 The local authorities neglect to put in operation the provisions of 

 the various Health Acts. A list is given of thirty- six towns in 

 England (at the head of which is Birmingham, with a population of 

 340,000), containing above two and a half million of inhabitants, in 

 which there is no medical officer of health. In many of these towns 

 there is a death-rate of from 25 to 30 in the 1,000 ; in a large 

 number the drainage is imperfect; and in many typhoid (drain) 

 fever is never absent. Water is constantly supplied from wells in 

 communication with cesspools, and in many instances water is 

 supplied for public use, known to be contaminated with sewage. 

 That decent English people, cultivating in many cases the excessive 

 refinements of life, should allow themselves to live, and their families 

 to grow up, amongst such a mess of nastiness is astonishing, and 



