such a degree as to endanger health in all the pottery towns. The village of Kidsgrove is, in respect of drainage, much in the same condition as Tunstall. Neither here nor in any of the towns mentioned is there any plan in operation for disposing harmlessly of the sewage, all of which that does not soak into the ground finding its way into watercourses, and finally into the Trent. Some partial and very imperfect attempts at utilising the sewage by irrigation do not materially affect the correctness of this statement. No proper system of main sewering and house drainage is found in operation in the other large villages; imperfect attempts at drainage have been made, but they altogether fail to effect their object. And with regard to the smaller villages scattered about the more rural parts of the sub-districts of Stoke and Wolstanton, it may be said that there are no means of drainage whatever. Offensive sewage runs along the sides of the roadways, and lodges in disgusting pools anywhere; or, if it has a sufficiently long course, soaks gradually into the earth, or gradually evaporates.

Water Supply.-The pottery towns and also the villages of Wolstanton, Goldenhill, and Kidsgrove, together with some outlying villages near Stoke, are supplied with water by the Staffordshire Potteries Waterworks Company. The quantity supplied in several parts is however very inadequate, and some places have at times been altogether without water for many days together. The Company appears to have undertaken more than it can well perforin. Even in Hanley the upper parts can only be supplied when the water is shut off from the rest of the district. The water is not filtered, and consequently is sometimes supplied in a condition unfit for drinking. In parts of the registration districts of Wolstanton and Stoke not supplied by the Company, the people have recourse to public or private wells, most of which furnish undrinkable water; to springs, many of which are polluted, some very dangerously so, with domestic or town sewage, and liquids oozing from privy tanks; or to land drainage water, or the water pumped out of the mines. In one instance a record is made of two villages which derive their water supply mainly from some "spouts," one of which drew water directly from a field drain which received the overflow of a sewage deposit pond; and in another instance an out

break of enteric fever is traced to the use of the water of a spring polluted by receiving the sewage of a number of houses which, after skirting an imperfectly constructed and full privy tank, flowed directly into the spring. Full details are given of nearly every spring and pump in these districts supplying drinking water to the population.

Disposal of Excrement and Domestic Refuse.-Water-closets are, as might be almost assumed from what has just preceded, exceptional conveniences throughout the Potteries. The usual system adopted is to store excrement in brick tanks attached to the privies. These privies, with their tanks or cisterns, are everywhere abominable nuisances; they were commonly found over-full, especially in Longton and Fenton and in the villages, often leaking, and sometimes leaking into dwelling-houses. In some places where the tanks are altogether sunk into the ground the covers were found broken in, the contents of the tanks being thus exposed, and on the occurrence of rain flooding the adjoining surface of the ground. Throughout the Potteries also, even in such a large town as Hanley, ashes and domestic refuse choke up the ashpits with large accumulations, or are deposited, without any interference of the Local Authority, in the roadways or on any waste land that may be convenient for the purpose. All this not only endangers health in various ways, but gives to the pottery towns and villages an aspect of universal neglect.

Dwellings of the Poor.-The dwellings of the poor and artisan classes quite correspond with the conditions of bad drainage, defective water supply, and excrement nuisances among which they are placed. In the towns, with the exception of Stoke and generally of Tunstall, they are unwholesome, crowded together in narrow, close, unpaved, and undrained streets or courts, often dirty, and more or less dilapidated. As a rule, the poor and artisan classes in the Potteries have an almost insuperable dread of fresh air in their cottages. Hence the practice, almost universal among them, of bricking or pasting up the flues in the bedrooms, and that of so constructing the windows that they cannot be opened at all only to the extent of one small pane of glass. The detailed description given of some of the worst of these cottages, which are designated as quite unfit for the habitation of a human being, shows how entirely, in some parts, the

Local Authorities have neglected to perform their most obvious sanitary functions. Towns and villages are all alike in this respect. Town Councils, Commissioners, Local Boards of Health, and Guardians, all fall within the same condemnation.

Of all the pottery towns, Longton, however, is pointed out as the closest, worst ventilated, worst drained, and generally, as respects its surface, its dwellings and its atmosphere, the dirtiest and most polluted. Few people are said to reside there who can afford to reside out of it. All this quite corresponds with what has previously been stated as to its death-rates.

ENTERIC FEVER FROM INFECTED MILK.-THE OUTBREAK IN THE METROPOLIS.

THE parishes of Marylebone and St. George's, Hanover Square, are at the present moment the scene of an outbreak of enteric fever remarkable in its history and limitation. The details of the outbreak are only yet imperfectly known, and it is feared that when they are fully ascertained the number of cases which have occurred will probably amount to several hundreds. The families attacked belong with hardly an exception to the wealthier classes, and among them are those of numerous wellknown physicians and surgeons. The disease has exhibited its greatest violence in the streets adjoining Cavendish Square, Portman Square, and Grosvenor Square, but scattered cases have occurred over the whole area of the parish of St. Marylebone, and over the northern portion of the parish of St. George's Hanover Square. The outbreak began in the third week of July, and among the families earliest attacked was that of Dr. Murchison, five of whose children, we regret to state, now lie ill of the disease. The children were attacked in two groups, so to speak, at an interval of eight days, and circumstances connected with the second group of cases led Dr. Murchison to suspect that the probable source of infection was the milk used in the family. While this suspicion was haunting his mind, numerous cases of enteric fever came to his knowledge in the vicinity of Wimpole Street, all occurring in families who obtained

milk from the same source as that used in his own family. Dr. Murchison, now fully alarmed, cast about for further information, and very shortly he obtained the particulars of enteric fever then prevailing in about thirty families living for the most part in the vicinity of Cavendish Square, Portman Square, and Grosvenor Square. In these families the disease had appeared almost simultaneously, under conditions which did not admit of explanation from defects of sewerage, drainage, or water supply; in many of them it had attacked several members about the same time; young children formed a considerable proportion of the persons attacked; and there apparently was but one known condition common to the whole of the families, with the exception of two or three, by which the infection of enteric fever could have been conveyed, namely, the milk supply. All the families, with the exceptions referred to, obtained their milk from the same dairy.

Dr. Murchison's suspicion now appearing to be largely confirmed, he communicated with the Medical Officer of Health for Marylebone, Dr. Whitmore, and measures were immediately adopted to stop the issue of milk from the suspected dairy. The directors of the dairy, incredulous as to the infection of their milk, at first hesitated to take any measures for stopping its issue or for seeking the source of infection, and it was not until the aid of the Medical Department of the Local Government Board had been sought, and after several days had been lost, that active steps were taken to search for the source of mischief. Pending this action additional facts came to the knowledge of Dr. Murchison, which more directly implicated the milk supplied from the dairy as being the source of mischief. Two of four servants left in charge of a house, on board wages, were seized with enteric fever. The servants attacked used milk from the suspected dairy; the servants who escaped the disease used preserved Swiss milk. Enteric fever appeared in one of two adjoining houses, both having milk from the suspected dairy, and both receiving their milk from the same delivery can. In the family which escaped, the milk was invariably scalded, but among the persons using the scalded milk there were several cases of obscure indisposition. The family which was infected used the milk in the state in which

it was received. A lady who had been on a visit in London, and who during her stay in town used milk largely from the suspected dairy, was seized with enteric fever in three or four days after returning into the country. No other person among a large family, including several young children, suffered from the disease. A young girl spent the day with a family which had its milk from the suspected dairy, and during the day she drank about two pints of the milk: four days after she became indisposed, her sickness eventually proving to be enteric fever. About the same time eight members of the family she visited, all using milk from the suspected dairy, sickened of the disease. In many streets enteric fever appeared only in families having milk from the suspected dairy; in not a few families those members only were attacked who used the milk.

A medical inspection, conducted by Mr. J. Netten Radcliffe for the Medical Department of the Local Government Board, Dr. Whitmore for the Vestry of Marylebone, and Dr. Corfield for the directors of the suspected dairy-these gentlemen being accompanied also by Mr. Chalmers Morton on the part of the dairy company,—was now made of the farms from which the dairy obtained its supplies of milk. These farms were eight in number, two of them situated in the vicinity of Oxford, the remainder in the neighbourhood of Thame. The inspection showed that no suspicion as to the issue of infected milk attached to seven of the farms; but as to the eighth, there was a strong probability, amounting for practical purposes to a certainty, that infected milk had been issued from it at a time immediately preceding and during the development of the outbreak of enteric fever in London. The farm itself was situated in a district in which enteric fever had been prevalent for several months, and all its labour was obtained from villages infected with the disease. The occupier had died from heartdisease (as certified) while recovering from, and in the fifth week of enteric fever, on the 8th June. A son was ill of enteric fever at the time of inspection. Several modes could be suggested in which the milk might have become infected, enteric fever being on the premises; the most probable mode, however, was through the water used for dairy purposes. This was manifestly impure, and it was exposed to excremental and