October 0. 
THE COTTAGE GARDENER. 
8 
of guardians. These are all onerous duties. I mention 
these things because acts of pure benevolence, such as 
those referred to at the commencemeut of my remarks, 
should not be clogged with the necessity of making-up 
for the shortcomings of the policeman; or the surveyors 
of highways; or the poor-law officials. J. J. 
[The “Notification" from the Board of Health, dated 
September 20th, is so excellent, that we publish it entire.] 
“ It is the painful duty of the General Board of Health to 
notify a third visitation of epidemic cholera. This disease j 
again, first breaking out in Persia, has extended, within the ; 
present year, over a large portion of Russia, stretching as • 
far northwards as Archangel, on the shores of the Arctic 
Ocean; it has ravaged Denmark, Norway, and Sweden; 
and then developing itself in the North of Germany, it has 
attacked Stettin, Berlin, Rotterdam, and Hamburgh; and, 
subsequently, it has appeared in England, again breaking 
out on its north-east coast, in the near neighbourhood of 
the town in which it made its first appearance in this 
country in 1831. In this wide-spread course it lias every¬ 
where overleaped the barriers which quarantine has erected 
to stay its progress; and where this means of protection has 
been most rigidly enforced, it has not only disappointed the 
expectation of those who have relied upon it as a safeguard, 
often to the neglect and exclusion of the most important 
precautions, but has aggravated the evils of the pestilence, 
and added disastrous consequences of its own. The ex¬ 
perience already obtained of this pestilence at Newcastle, 
Gateshead, and Hexham, is decisive, that where the con¬ 
ditions are favourable to its localisation and development, 
as is the case in these towns, the disease has lost nothing of 
its former virulence. In the two former, indeed, the severity 
of the disease, as far as it has yet extended, has greatly 
exceeded that of any former visitation ; and it has attacked, 
in all those places, as it has abroad, a much larger propor¬ 
tion of the middle and higher classes. It is deeply to be 
lamented that the interval between the last visitation of 
this pestilence and the present has not been generaUy 
employed in effecting a larger amount of improvement in 
our cities and towns. From such inspections as the General 
Board have recently been enabled to make of the state of 
populous districts, the former seats of the disease, in appre¬ 
hension of its re-appearance, they are compelled to state, 
that there are extensive districts, and even entire towns, 
in which no perceptible improvement of any kind lias been 
effected. On the other hand, there are instances in which, 
even where no general permanent works of improvement 
have been effected, better supplies of water, extensive 
flagging and paving, more frequent scavenging, and a more 
active removal of nuisances in epidemic localities have 
been accomplished. Combined and permanent works, in¬ 
volving elaborate engineering measures, capable of remedy¬ 
ing the neglect of years, cannot be effected in a few weeks; 
but the consciousness of past neglect should stimulate to 
immediate and resolute exertion, that all which the time 
requires, and whicli can be done, may be done. The results, 
in some instances, oven of limited and partial improve¬ 
ments, are highly encouraging. During the present epi¬ 
demic in Hamburgh, which has now been prevailing upwards 
of six weeks, only six cases of cholera have occurred in the 
improved parts of the town; and during the whole of the 
epidemic in the metropolis, in 1849, not a single case of 
cholera occurred in any one of the model dwellings for 
the poor, occupied by similar classes of the population, 
though the pestilence raged in the districts in which 
those buildings are situated; and there were instances of 
two, and even four deaths, in single houses, close to their 
walls. Even in towns in which the greatest amount 
of improvement has been effected, and in which works 
under the Public Health Act are most advanced, much re¬ 
mains to be done, and may be done. Local boards of health 
are invested, under the Public Health Act, with ample 
powers for cleansing, for the removal of nuisances, for pre¬ 
venting the carrying on of unwholesome or noxious trades 
in such a manner as to injure health, for pieventing the 
occupation of cellars as dwelling-houses under certain con¬ 
ditions, for preventing the occupation of any dwelling-house 
which, on the certificate of an oflieer of health, shall appear 
to be in such a filthy and unwholesome state as to endanger 
the health of any person, until such house have been pro¬ 
perly and effectively whitewashed, cleansed, and purified, 
and for administering the Common Lodging House Act, the 
provisions of which are most important. All these powers 
should be exercised at the present juncture with extraordi¬ 
nary activity, vigilance, and stringency. But though it may 
be needful to prosecute the work of cleansing more vigo- 
I rously than in ordinary periods, yet it should be done under 
supervision and with extraordinary care. In removing accu¬ 
mulations of filth, precautions should he taken for disinfec¬ 
tion, and for preventing the increase of noxious evaporation. 
The contents of foul drains, sewers, and ditches should in 
no case be spread upon the surface, and no large accumula- 
I tion of filth should be removed, except under the direction 
| of a medical officer. The escape of noxious effluvia is far 
more dangerous in an epidemic than in an ordinary seasou. 
, The evil of overcrowding, so general, not only in common 
! lodging-houses, but in tenements of all descriptions occupied 
i by the poorer classes, especially by the Irish—an evil pre- 
ventible, and to a considerable extent removable, should be 
at once and by all practicable means reduced. Wherever 
local boards of health exist, they should in all cases co- 
J operate with the boards of guardians, and it is believed that 
I the boards of guardians will, on their part, co-operate with 
local boards. The existing means for the extraordinary 
service now required are divided among independent local 
jurisdictions; medical officers in England and Wales being 
under boards of guardians ; works of sewage and cleansing 
in towns, not under the Public Health Act, being under 
town commissioners acting under local acts ; and the en¬ 
forcement of orders required for the public service being 
; with the magistrates, or municipal authorities. It is confi- 
j dently expected that a common feeling will give precedence 
to the branch of service specially needed on this occasion, 
and insure that unity of action which it is the main object of 
the rules and regulations issued herewith to authorise and 
promote for the common object. Experience has shown 
that in the case of the actual outbreak of the epidemic, the 
chief measures to be relied on for cheeking its spread are 
those which prevent overcrowding, remove persons from 
aflected houses, and bring the infected population under 
prompt and proper treatment during the premonitory stage 
ot the disease. During the epidemic of 1849 an organisation 
for effecting these objects was brought into operation, the 
main parts of which were the establishment of a system of 
house-to-house visitation, the opening of dispensaries and 
houses of refuge in affected districts for the gratuitous supply 
of medicines, the establishment of houses of refuge for the 
reception of such indigent persons as appear to be in 
imminent danger, resident in the most filthy and overcrowded 
houses, the provision of temporary hospitals for the recep¬ 
tion of those who could not be properly treated at their own 
homes, and in some instances the supply of tents for the 
removal of the most susceptible and destitute classes to a 
distance from infected localities. The result of this system 
was, that out of 130,000 premonitory cases brought under 
its operation, no fewer than 0000 of which were on the point 
of passing into the developed stage, only 250 went into 
the collapsed stage of cholera, or 1 in 520. But of the 
43,73? cases under visitation in the metropolis, including 
978 cases on the point of passing into the collapsed 
stage of cholera, only 52 actually did so—not 1 in 800; 
so that, taking together the general result of this ex¬ 
tended experience, it appears that the proportion of cases 
under early treatment which passed from the premonitory 
into the developed stage varied from 1 in 500 to I 
in 800. No doubt is now entertained of the efficacy of 
this system, or of the duty of local authorities to carry 
it into effect on the very first appearance of this disease 
in an epidemic form; and, as none can tell where or 
how suddenly the pestilence may alight, it is the duty of 
local authorities to be prepared for the emergency before 
its arrival. Preparation will be attended with little cost: 
the power to act with promptitude and efficiency, when the 
necessity for action arises, will be attended with a great 
economy of money as well as of life. With reference to 
those precautions against the disease which each individual 
may take for himself, or the heads of families or establish¬ 
ments for those under their charge, the first in importance 
