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she has almost invariably found this to be the case. Still the demand for trained ladies to occupy positions of responsibility is very great, and the institu

THE

tion affords facilities for training and employment SANITARY RECORD.

which few others possess, and which would probably be more sought after if better known. The association, although it derives a considerable income from private nursing and hospital contracts, fails to pay its own expenses, and appeals, like similar establishments, to the benevolent for support. The deficiency of income is explained by the fact that it receives from hospitals only the bare wages of the nursing staff, and that all expenses in connection with the central home, and also the training and supply of extra hands, constantly in requisition for filling up gaps caused by sickness, must be met by the institution.

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A PRIZE of twenty-five guineas is offered for open competition for the best essay on the following subject:'The application of Sanitary Science to Rural Districts with a view to insure the highest condition of Health and the Prevention of Disease.' All essays to be forwarded not later than June 30, 1875, to Dr. Lory Marsh, 10 Adelphi Terrace, Strand, to whom the copyright of the successful essay shall belong.

SIR JOHN HAWKSLEY has been gazetted to be H.M. Commissioner for the purpose of inquiring as to what towns and places contributed to the pollution of the river Clyde and its tributaries; and how and by what means the sewage of such towns and places and the refuse arising from industrial processes and manufactures carried on within the same can be utilised or got rid of without risk to the public health, or detriment to trade and manufacturing operations.

* Since the above was written, this excellent lady (Miss Cholmeley Coles), whose mental energies and devotional zeal far outstripped her physical strength, has succumbed to her self-imposed task at the early age of thirty-one. She was connected with the British Nursing Association from its commencement, and was mainly instrumental in its development. The opinions of such a one on lady-nursing are so valuable that we do not hesitate to quote them. The following extracts are from a letter to the writer. 'It is in my estimation as foolish to consider it beneath a lady's intelligence to learn the drudgery of a nurse's work as it would be to consider it beneath her intelligence to learn the alphabet of a new language. If her capacity admits it, I certainly think every lady should take a larger work than that of nurse, but, with my experience, it is not every lady who can organise work or govern others. I have met many kind and loving women who could nurse one patient most tenderly and well, yet when put in charge of a number she was completely lost, distracted with various calls, incapable of taking a calm view of anything, and peevish because the failure of her own plans appeared to be everybody else's fault. This is the sort of lady who will let her nurses run wild while she is engaged with trifles, and then suddenly awake to a sense of her own shortcomings, and snatch up her reins so short that the nurses will rebel forthwith, and consider her the greatest tyrant that ever lived, and very likely with good reason, for she is quite as likely to pull up short when she thinks of it as when they require it. Surely it is better that such a person as this should be a mere nurse, than be forced into a position in which she will worry herself and everyone else to death because she has the misfortune to be a lady. The weak part of ladies' work, in my mind, is want of obedience and discipline. It is an immense advantage to have an educated intelligence at your command, to which you can say, "I want such a thing done," and to feel sure that it will set itself to do it; but, ninety-nine times out of a hundred, it will think that it has a right to be something

more than a mere machine, and so will think and do something different, and throw other people's work out altogether. We have had about twenty ladies with us, first and last, and I have only found two exceptions to this rule.'

SATURDAY, JANUARY 2, 1875.

TO SECRETARIES OF SANITARY ASSOCIATIONS AND

KINDRED SOCIETIES.

The Editor will be glad to receive, with a view to publication, announcements of meetings, reports of proceedings, abstracts of, or originals of papers read before the members of any sanitary or kindred association.

WHAT IS SANITARY CONDITION?

THE charges against the arithmetical value of the Registrar-General's death-rates having been in the main disproved, their opponents have somewhat shifted their ground of attack, and now insist upon disputing the existence of any intimate connection between death-rates and sanitary condition. The discussion which took place the other evening at the meeting of the Society of Health Officers, if it threw little new light upon the real points which have been in dispute, at least served the following purpose: it proved the necessity of defining what is meant by sanitary condition.

The words sanitary condition simply mean, and have till now been generally understood to mean, the state of health of a place, or rather of its inhabitants. There is, however, now a manifest desire on the part of some health officers so to limit the meaning of this expression as to signify only that portion of sanitary condition which is within their undeniable control. This restriction of the meaning of the term was, moreover, on a recent occasion, distinctly declared to be necessary in order to protect health officers from being 'branded with incompetence' whenever the community which is in their sanitary charge is proved to be suffering from a high deathrate. It does not appear to us that there is much danger of the public or the press arriving at so unreasonable a conclusion, but there is undoubtedly real danger to the due progress of sanitary reform in the assertion that a high death-rate can exist in a community without the sanitary condition, or health of the population, being unsatisfactory.

It has been proved beyond a doubt that high death-rates signify a fatal prevalence of zymotic diseases, and a high rate of mortality among both infants and elderly persons; and that these circumstances betoken a low standard of health, or sanitary condition, no one till recently would have ventured to deny. If the public were once persuaded that these ever-present elements of high death-rates do not necessarily imply low sanitary condition, it would fatally affect the progress of the comparatively new science of sanitation.

The cause of low sanitary condition is quite a distinct question, and is the first subject for inquiry when a high death-rate proves its existence. This is most distinctly the province of the medical officer of health. As with an individual, so with a community, when evidence of ill-health is observed, professional advice is sought, in the first place to diagnose the form of disease, and then to prescribe a remedy, or, at least, a palliative. The public, with the aid of statistics, have become convinced that the health of communities, as tested by their death rates, differ to an extent that cannot be explained by the variation in the proportions of the sexes, or the different age-distribution in the population. The force of public opinion has called into existence an army of health officers to advise on health matters, and it cannot be too well understood between the public and health officers, that the public knows its health is unsatisfactory, and is in earnest when it asks how it may be improved. No impossibilities are looked for from health officers, but if they cannot reduce the death-rates under present circumstances, it is, at least, expected that they will point to the causes which limit their usefulness, and if further co-operation of the part of the parson, the schoolmaster, and the policeman be necessary, let them boldly ask for it. If they do not get the support they ask for, their responsibility will cease. Above all, let us hear less of high death-rates being unavoidable where density of population and a large proportion of the working-classes prevail. It is just these very conditions that render the advice of a health officer most necessary, and where it can be followed with the best results. There is a tendency to talk of the poor as of a class who must die at a higher rate than those who are well off, and to consider their existence in a community in large proportions as a sufficient reason and explanation of a high death-rate. The unsanitary condition of the poor and of their dwellings is doubtless often the cause of high death-rates, and is thus one of the principal reasons for the necessity for the appointment of health officers, but it is indeed a hopeless view to take of the future of sanitary progress, if we allow ourselves to regard this unsanitary condition as in

evitable.

No reasonable person will expect from the unaided efforts of any health officer that the death-rate in St. Giles' can in a year or two be reduced to that of St. James', but it is no less true that the excess of death-rate in the former is due to low sanitary condition; and it should be clearly understood that it is quite possible to have density of population combined with good sanitary condition and low death-rates, and further that there is no physical reason why the working classes should suffer from higher death-rates than do the professional and upper classes, who live a more artificial, and in many respects, a less healthy sphere of existence.

of complaint against the Registrar-General's figures is that they do not show a satisfactory result for the sanitary work of recent years. This is, in fact, evidence of reliability of these death-rates as a test of sanitary condition in its broad sense. Real sanitary progress has been made in many places, and deathrates there show it incontestably. The rate for the whole of England, however, shows little reduction, because what has been gained by sanitary work in some places has been lost in others from the want of it. During the past twenty years we have been gradually turning our rivers into open sewers, and contaminating all the old sources of water-supply; and this with increasing aggregation in towns, and the growth of numberless colliery villages, without the shadow of sanitary forethought or provision, would, without the balancing effect of improved sanitary condition in other ways and places, have told most unfavourably upon our death-rates. Our present sanitary organisation, full of imperfections as it is, is already bringing all sections of the nation under some sort of sanitary control; and it may confidently be hoped that in the last six years of the decade, 1871-80, a great advance will have been made in the sanitary condition of the people. Of one thing, however, we may rest assured, that no such real improvement can take place without its becoming apparent in the death-rate, for it is impossible to reduce the fatality of zymotic diseases, or the proportion of infant mortality, or the death-rate among elderly persons, without reducing the general death-rate calculated by the simple population standard. Death-rates are inevitably a sound test of sanitary condition in its broad simple sense, but they cannot be used to prove the competence or incompetence of a health officer, and for this purpose we are not aware that they have ever been used by the Registrar-General.

THE STANDARD OF MILK ADULTERATION.

THE recent case in the police-court at Greenwich, in which a milkman who was charged with adulterating his milk with ten per cent. of water, and acquitted notwithstanding the concurrent testimony of four public analysts to the fact of the adulteration, dence, has afforded a subject of comment for the and in the absence of any relevant rebutting evidaily newspapers. One of our contemporaries has particularly distinguished itself by its curious misrepresentations, and, after representing the case as forms its readers that the analysts had recently met one in which analysts gave conflicting evidence, into discuss whether milk contained 9 or 9.3 per cent..

of water, and then-gushing with eloquence-declares that though all the analysts in the kingdom should resolve that it (the water) ought to stop at nine per cent., still it would go up to ten or eleven

Dr. Letheby now asserts that his greatest ground | per cent.

The event commemorated by our contemporary in this manner happened at the general meeting of the Society of Public Analysts, at which the committee proposed for general adoption a standard of 9 per cent. of 'solids not fat,' and were met, not with proposals for a lower standard of 'solids not fat,' but with the proposal to enact the figure 9.3.

In order to understand the difference between the two proposals, it should be borne in mind that if a given sample of milk which had been analysed were calculated by the standard 9.3, it would be represented as having been watered to the extent of 4 per cent. more than if calculated by the standard 9. The reason, moreover, why the standard 9 was proposed by the committee (instead of the true standard, 9.3) was a desire to be cautious and to provide against experimental error. Indeed, as was explained at the meeting, the proposal to prosecute if the solids not fat' fell in the smallest degree below 9 per cent., and the proposal to state the standard at 9'3, and to abstain from prosecution unless a small margin of experimental error were overpassed, would come in practice to the same thing.

A Greenwich correspondent of the Standard writes to that paper to say that a very important piece of evidence for the defence did not come out at the trial; viz., that in April a sample of milk taken from one of the defendant's cows, in presence of an independent witness, was analysed by Mr. Heisch, the public analyst, and found by him to contain too much cream and too much salt, and 10 per cent. of added water. In giving publicity to this statement, we should fail in our duty if we did not, at the same time, publish that Messrs. Heisch and Wigner have written to the magistrate who presided over the case, offering to make analyses of twenty samples of milk milked in their presence from twenty of the milkman's cows, and to abide by the results.

PRIZE DESIGNS FOR DWELLINGS.

THE daily journals of the past few weeks have contained two modest but nevertheless significant paragraphs with respect to the dwellings of our working-classes, which, taken together, may almost be considered as a satire upon our times. One day, the directors of the Improved Industrial Dwellings Company, aided in their judgment by the highest professional talent, awarded two prizes for designs of houses best adapted for the working community, and commended four others. But whilst appropriating the premiums, they were constrained to confess that each and all of the plans were too costly to suit them, although otherwise commodiously planned and economically designed. Almost the next day we read that a prize had been offered for the best essay upon the application of sanitary science to rural districts and dwellings. The competitors for

this new guerdon are recommended to recognise the powers possessed, but not exercised, by the Local Government Board, the diversity of opinions amongst its advisers, and, taking everything into consideration, are to suggest what new powers it would be advisable to grant that honourable Board. The fact is, that if we are truly careful to meet all the requirements of the Metropolitan Building Acts, and provide for all the claims of the Lodging-Houses and other Acts, we shall not be able to design a house for our London artisans that will prove self-remunerative under a rent which they cannot afford to pay; and if we desire to erect a new hamlet in the country, we are lost as to our exact rights of sewage conveyance and water-supply.

The intelligent foreigner would smile at this, as in duty bound. But we are the pioneers of sanitary progress, and must root up many curious anomalies whilst planting our new vineyards. We are demolishing the squalid houses where our artisans once resided and we wish to build them new ones which theoretical Hygeists shall find little fault with, and which shall not much trouble the practical sanitary inspectors. We have also the remaining half-good and half-bad dwellings to torture into healthy circumspection. And surely we have striven hard to achieve at least passable honours in this simple branch of architecture. We are not first medallists in the architecture of public buildings perhaps, but we have been blessed with scores of decorated essayists upon domestic construction. The Associated Architectural Societies, the Associations for Improving the Dwellings and Domestic Condition of our Labourers, the Royal and other Agricultural Societies of England, the Highland Society of Scotland, the Royal Dublin and other Societies, have all issued more or less voluminous prize reports and published model designs for houses and cottages. Royalty itself has condescended to plan residences. for our workmen, and even erected them in our midst in 1851; and when Paris was in the throes of its house reconstruction, the commendable occupation was followed by an Imperial potentate. More than this, the artisans themselves have competed with each other, and the Workmen's Exhibition of 1870, held at Islington, yielded up to criticism some plans of homely house architecture.

With all this we are unhappy. For one thing, we know full well that the bulk of those who build the houses of our working poor care little for learned reports and prize-designs, and oftener than otherwise they are run up by those of their own class who have been successful in life, and who are a law unto themselves even in the matter of architecture-busy bees who have made honey and who have just sense enough to escape the legal cobwebs which hang about the scaffolding of our Dwelling House and Public Health Acts. And we may also rely upon it full well, that it will not be until many more agitations have been got over somehow, and many more

halting and incomplete Acts passed through the Legislature, that houses will be built which the workmen will rush to inhabit, nor occupy merely through impecuniosity, or for the sake of contiguity to the industrial hives of their working hours. The time may come, and that right early, when something good and practical will follow the example set by the marquisate-town of Shaftesbury, and when such as these, completed, will prove luminous guides for future dealings with artisan requirements, but it will take considerable time to polarise all the experiences which they will set before us. And if the model dwellings of our poorer classes are to fill our suburban sites, and not nestle, Somers-Town like, in our cities, it may be that it will be found necessary to compel our railway companies to grant still further advantages to our workmen in the shape of morning and afternoon locomotion. And speaking of railway companies, many a lesson in the erection of cheap and good labourer's cottages might be obtained from their drawers and pigeon-holes. Their engineers know how very many plans were carried out and practically tested before the best levelcrossing cottage was hit upon, and the design put away and labelled as a stock-drawing of railway servant's cottage on the line, probably for ever.

Notes of the Wech.

PUBLIC HEALTH EXAMINATIONS. WE believe that the Society of Apothecaries are about to institute an examination for medical men who purpose becoming candidates for Public Health appointments.

Candidates possessing this diploma will have a far higher credential of fitness than any private testimonials could be, and in taking this step the society is not only following its traditions of concern for the public interest, but is the first of the medical corporations to take action in recognising the importance of this branch of science.

SALT AND SNOW.

MR. CHURCH, in a communication to the Times, and Mr. Mackie, in another to the Standard, advocate the employment of salt whenever, through snow or frost, the roads become dangerous or difficult. The suggestion has evoked considerable opposition in many quarters, and especially from Dr. Alfred Carpenter, of Croydon, who points out that the application of salt to snow will have the effect of producing a very cold mixture, which is likely to penetrate the boots of pedestrians, and produce serious results. To this objection it may be answered that such would be the effect of the admixture of snow and salt, were they enclosed in a close vessel, such as a refrigerator; but spread out on the road and pavements the conducting power of the earth will prevent the mixture from falling above one degree lower than that of the surrounding atmosphere. It is a certain fact that if the roads be kept moderately salted, which can be easily done by the admixture of rough salt with water in the ordinary watering carts, and its subsequent distribution over the roads, travelling through the slippery streets will be greatly facilitated, and much of the suffering and damage to horses which has been observable during the last fortnight will be greatly lessened, if not entirely obviated.

NEW FACTORY ACT. YESTERDAY (January 1) the act passed in the late session came into operation to improve the health of women, young persons, and children employed in the manufactories, and the education of such children. The period of employment is to be from six to six or from seven to seven o'clock; the employment not to be continuously longer than four hours and a half without half an hour for a meal, except on Saturdays, when the employment is not to be beyond half-past one o'clock. Two hours each day, save on Saturday, to be allowed for meals, and one hour before three o'clock. There are provisions in the new act as to education and school attendance. Employment during meal time is strictly prohibited.

METROPOLITAN WATER-SUPPLY.

THE monthly report of Dr. Frankland, on the London Water-Supply for December, does not show satisfactory results. The Grand Junction and Lambeth companies supply contained 'living and moving organisms,' whilst that of the Chelsea Company, in addition to abundance of such organisms, was served up with fragments of woollen and cotton fabrics, clots of the mycelium of a fungus, and fibres of partially digested or decomposed flesh meat.' The above is a somewhat unsavoury description of the London water. In the face of such a report, however, it behoves the various water companies to take some more active and efficient measures for purifying their supply, which Dr. Frankland very properly describes as being unfit for dietetic purposes, and it could not be so used without serious risk

to health.'

ARSENIC IN WALL-PAPERS.

Ir might have been thought that enough had been ascertained and written of the amount of arsenic to be found in the ordinary bright green wall-papers to deter people from having them used as mural decorations in their houses.

It appears, however, that this is not the case, for we have been supplied by Mr. Carter, of Liverpool, with the details of a case of the kind which has lately come under his notice, and singularly enough in the house of a medical man, whom it would naturally have been supposed would have been alive to the danger lurking in the bright green colour of the paper in question. It appears that a few weeks since Mr. Carter was asked to see in consultation a brother medical man, who was dangerously ill of erysipelas of the face and scalp. He had only just removed into a new house. On entering his consulting-room Mr. Carter was struck with the bright green of the wall-paper, and asked to have a piece supplied to him. After some time this was done, when he found, on examining it, that it was, as he anticipated, arsenical. Mr. Carter does not, however, suggest that the newly hung wall-paper had anything to do with the attack; but he does offer the simple and valuable suggestion that, as the methods for discovering arsenic are so simple and so accurate, medical men should always take care to guard themselves, at least (and without much trouble they may guard their patients also) against the risk of injury from this source.

THE REGISTRAR-GENERAL'S WEEKLY
RETURN.

WE are informed that with the new year the RegistrarGeneral's weekly return for London will be enlarged, so as to furnish information relative to the whole of the city and metropolitan police districts. This area, at the last census, contained a population of 631, 381 persons in addition to the 3,254,260, who lived within the boundaries of Registration London. The population of the metropolitan and police districts at the middle of 1875, is estimated at about four and a quarter millions of persons. The suburban area of the metropolitan police district, for which the registrar-general will now, for the

first time, publish weekly returns, includes Acton, Chiswick, Ealing, Edgware, Enfield, Stanmore, Hampton, Wick, Hanwell, Harrow, Hendon, Hornsey, Isleworth, Stanmore, Shepperton, Staines, Sunbury, Teddington, Tottenham, Twickenham, Willesden, and Uxbridge, in Middlesex; Barnes, Carshalton, Cheam, Moulsey, Epsom, Croydon, Kew, Kingston-on-Thames, Ditton, Mitcham, Mortlake, Richmond, and Wimbledon, in Surrey; Beckenham, Bexley, Bromley, Chislehurst, Crayford, Erith, Hayes, and Orpington, in Kent; Barking, East and West Ham, Little Ilford, Walthamstow, and Woodford, in Essex; and Bushey, Cheshunt, Barnet, Elstree, and Totteridge, in Hertfordshire.

The importance of having reliable and early returns of deaths from these important suburban districts can hardly be overrated from a sanitary point of view.

ENGLISH AND FOREIGN FIREPLACES. THE adoption of the close stove as a means of heating air-chilly rooms, has again been earnestly advocated this season. No doubt a great deal may be said in its favour, but it has many disadvantages. The Dutch stove is a close stove, but its heated iron surface is apt to burn up the air and the dust which settles upon it. The American stove is less objectionable because of the moisture yielded to the air from the vessel of water which is generally placed upon it. The stoves used in Russia and Germany, which are sometimes of iron and sometimes porcelain-cased, retain within them the heated products of combustion until the whole surface of the stove-structure

has been heated. The saving of fuel in all these close stoves is considerable. The question is, are our open grates more healthy?

We have not a word to say for the common, wasteful, and ill-devised grates which are in every day use with us. They send nearly all their heat up the chimney, and heat merely by the radiation of the most paltry surfaces. But a room heated by a grate which, besides radiating its heat into the room, sensibly warms a large body of fresh air in gills behind it, and permits that to issue into the room, is preferable to all the close stoves which we have seen abroad. Nor have we forgotten many cases of asphyxia, for which these close stoves are answerable There are scores of engineers in England who would undertake to make the rooms of any house here quite as comfortable as any in Russia, and maintain the heat which is implied in this comfort, without running any risk of suffocating the inmates.

scene of the rapid growth and prosperity of Bournemouth, and it undoubtedly has much to do with it, why should not other places, with natural advantages fully as great, follow an example which adds beauty to the scenery, while it is a source of health to the residents and visitors?

FACTORY CHILDREN AND FULL-TIME'

CERTIFICATES.

It

A CONFERENCE recently took place at Bolton, between Messrs. R. Baker, R. W. Coles, and W. D. Crampton, factory inspectors; Messrs. F. Ferguson and J. B. Garstang, certifying surgeons under the Factory Act; and a deputation of operative cotton-spinners, as to the system of examination and certification of children as full-timers. This is a subject not very indirectly connected with the sanitary condition of our manufacturing population. appears that several children, though proved to be of the certificates because they had not the ordinary strength and required age of thirteen years, have been refused the full-time Mr. Baker, the appearance of young persons of that age. inspector, ruled, however, that provided the child were of the required age, the surgeons have nothing to do with its appearance, and provided it were not incapacitated by disease or infirmity they were bound to pass it. This may be the letter of the law, but its spirit is undoubtedly to protect the health of children by preventing their strength from being over-taxed; and it is, therefore to be regretted that no discretion is to be allowed to certifying surgeons under the Factory Act to refuse full-time certificates in cases of weakly and undersized children aged thirteen years, although they may not be suffering from actual disease or bodily infirmity. It was moreover strongly recommended that surgeons should discontinue the system of weighing children, as Mr. Baker holds it to be an utterly fallacious test of the physical condition of a child.

A DISINFECTION DIFFICULTY.

MR. PATTESON, the police magistrate of Greenwich, has been applied to by a local house agent for advice under somewhat peculiar circumstances. The agent stated that he represented an owner who had been served with notice by the Board of Works to disinfect rooms in a house from which several fever patients had been removed. Most of the rooms had been duly disinfected; but there was one still not touched because inhabited, and the tenants refused to leave. The reason assigned seems in our opinion to demand some explanation from one of the parties concerned. The tenants declined to turn out because they said that the SANITARY EFFECTS OF PLANTING. district poor-law medical officer had recommended them not THOSE who wish to limit the interpretation of the term to do so unless they had been previously provided (under 'sanitary condition' within the narrowest limits, will doubt- the Sanitary Act, 1874, we presume) with new articles of less be at a loss to understand the connection between bedding and clothing to replace those condemned. Meanhealth and the planting of trees, and yet it is far from while they remained in the room, and the room continued visionary. A useful lesson may be learned from the con not disinfected because this same medical gentleman sideration of the results of 'judicious planting,' as exempli- seems to have advised the workpeople employed to fied by a contemporary in a comparison of the climates of perform the disinfection not to enter the room in quesHastings and Bournemouth. Hastings derives great tion. The agent's difficulty was that he could neither natural advantages from hills which protect it from north get the rent nor admission to execute the board's order, and east winds; but because the adjacent slopes have not failure as to which involved daily cumulative penalbeen planted, the town is essentially a draughty one. ties. The magistrate advised the agent to execute the consequence is, that whereas comparative summer may be order of the board, and in effect said that the poor law enjoyed on the parade during cold windy weather, to turn medical officer had much better mind his own business, into any of the streets which contain the principal shops, and not interfere with those whom the law had charged and see open to the north, is to experience a sudden with the duty of carrying out the work of disinfection. change to absolute winter. Hence Hastings does not We quite approve of the worthy magistrate's views, and afford the advantages for winter residence that it might be the poor law medical officer seems to have strangely mismade to do Bournemouth, on the other hand, year by apprehended the present state of the law regarding comyear, becomes more and more appreciated as a winter pulsory disinfecting, which is pardonable; and likewise resort, especially for those whose respiratory organs are the obligations of duty and common sense resting upon delicate or diseased; and this is in great measure through himself, which is not pardonable, and for this reason: the hills, or rather the high lands in the neighbourhood As a poor law medical officer this gentleman ought to having been carefully planted with pines, and belts of trees have been perfectly aware that unless he had been being found everywhere breaking the force of the wind appointed to perform sanitary work by the sanitary authoand preventing violent draughts. If this be really therity, which clearly was not the case, his interference with

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