action of the sanitary authority or authorities; and in cases requiring it, he shall certify, for the guidance of the sanitary authorities, or of the justices, as to any matter in respect of which the certificate of a medical officer of health or a medical practitioner is required as the basis or in aid of sanitary action.

5. He shall advise the sanitary authority on any question relating to health involved in the framing and subsequent working of such bylaws and regulations as they may have power to make.

6. On receiving information of the outbreak of any contagious, infectious, or epidemic disease of a dangerous character within the district, he shall visit the spot without delay, and inquire into the causes and circumstances of such outbreak, and advise the persons competent to act as to the measures which may appear to him to be required to prevent the extension of the disease, and so far as he may be lawfully authorised, assist in the execution of the

same.

7. On receiving information from the inspector of nuisances that his intervention is required in consequence of the existence of any nuisance injurious to health, or of any overcrowding in a house, he shall, as early as practicable, take such steps authorised by the statutes in that behalf as the circumstances of the case may justify and require.

8. In any case in which it may appear to him to be necessary or advisable, or in which he shall be so directed by the sanitary authority, he shall himself inspect and examine any animal, carcase, meat, poultry, game, flesh, fish, fruit, vegetables, corn, bread, or flour exposed for sale, or deposited for the purpose of sale or of preparation for sale, and intended for the food of man, which is deemed to be diseased, or unsound, or unwholesome, or unfit for the food of man; and if he finds that such animal or article is diseased, or unsound, or unwholesome, or unfit for the food of man, he shall give such directions as may be necessary for causing the same to be seized, taken, and carried away, in order to be dealt with by a justice according to the provisions of the statutes applicable to the case.

9. He shall perform all the duties imposed upon him by any bylaws and regulations of the sanitary authority, duly confirmed, in respect of any matter affecting the public health, and touching which they are authorised to frame bylaws and regulations.

10. He shall inquire into any offensive process of trade carried on within the district, and report on the appropriate means for the prevention of any nuisance or injury to health therefrom.

11. He shall attend at the office of the sanitary authority, or at some other appointed place, at such stated times as they may direct.

12. He shall from time to time report, in writing, to the sanitary authority his proceedings, and the measures which may require to be adopted for the improvement or protection of the public health in the district.

He shall in like manner report with respect to the sickness and mortality within the district, so far as he has been enabled to ascertain the same.

13. He shall keep a book or books, to be provided by the sanitary authority, in which he shall make an entry of his visits, and notes of his observations and instructions thereon, and also the date and nature of applications made to him, the date and result of the action taken thereon, and of any action taken on previous reports, and shall produce such book or books, whenever required, to the sanitary authority.

14. He shall also prepare an annual report, to be made at the end of December in each year, comprising tabular statements of the sickness and mortality within the district, classified according to diseases, ages, and localities, and a summary of the action taken during the year for preventing the spread of disease. The report shall also contain an account of the proceedings in which he has taken part or advised under the Sanitary Acts, so far as such proceedings relate to conditions dangerous or injurious to health; and also an account of the supervision exercised by him, or on his advice, for sanitary purposes, over places and houses that the sanitary authority has power to regulate, with the nature and results of any proceedings which may have been so required and taken in respect of the same during the year. It shall also record the action taken by him, or on his advice, during the year, in regard to offensive trades, bakehouses, and workshops.

15. He shall give immediate information to the Local Government Board of any outbreak of dangerous epidemic disease within the district, and shall transmit to the board, on forms to be provided by them, a quarterly return of the sickness and deaths within the district, and also a copy of each annual and of any special report.

16. In matters not specifically provided for in this order he shall observe and execute the instructions of the Local Government Board on the duties of medical officers of health, and all the lawful orders and directions of the sanitary authority applicable to his office.

17. Whenever the Diseases Prevention Act of 1855 is in force within the district, he shall observe the directions and regulations issued under that Act by the Local Government Board, so far as the same relate to or concern his office.

SECTION V.-Remuneration.

Art. 1. The sanitary authority or authorities, as the case may be, shall pay to any officer appointed under this order such salary or remuneration as may be approved by the Local Government Board; and where such officer is appointed for two or more districts, the salary shall be apportioned amongst the districts in such manner as the said board shall approve.

Provided that the sanitary authority or authori ties, with the approval of the Local Government Board, may pay to any such officer a reasonable compensation on account of extraordinary services, or other unforeseen circumstances connected with his duties or the necessities of the district or districts for which he is appointed.

Art. 2. The salary or remuneration assigned to such officer shall be payable quarterly, according to the usual feast-days in the year-namely, Lady Day, Midsummer Day, Michaelmas Day, and Christmas Day; but the sanitary authority or authorities may pay to him at the expiration of every calendar month such proportion as they may think fit on account of the salary or remuneration to which he may become entitled at the termination of the quarter.

Given under our seal of office, this eleventh day of November, in the year one thousand eight hundred and seventy-two.

JAMES STANSFELD, President.
JOHN LAMBERT, Secretary.

The actual working of the Public Health Act of 1872 is that there are three classes

Medical officers of health to combined sanitary districts, such as Kent, Shrewsbury, Gloucester, North Devon, &c.; these devote their whole time to the office, although some few hold other appointments-such as analyst, coroner, &c.—which do not interfere with their duties. 2. Medical officers of health who are not restricted in any way, but are given either a fair salary or an annual sum, which though perhaps inadequate, is yet indirectly sufficiently remunerative. 3. Union medical officers and the like, to whom is given a paltry annual fee, or, as in some places, a stated sum for each report, a report not to be sent in unless required by the sanitary authority. (!) What are, or rather should be, the qualifications of a medical officer of health? First, he must be a medical man-that is legally essential; then he must be a man of capacity, of good education, and of sound common sense, riding no dangerous hobby-horse to death. A knowledge of the mode of propagation of all contagious diseases, with their pathology, and an acquaintance with practical chemistry, microscopy, and the chief sanitary statutes are essential. These things may be easily acquired by any man of average abilities, and no one can possibly be an efficient officer without a sound knowledge of them all. In addition to the foregoing, it is desirable, although not essential, that a knowledge of the following branches of science should be acquired: geology, engineering (especially the practical parts relating to sewers and drains, the taking of levels, the measurement of heights, and the best methods of conveying and storing water), meteorology, and the kindred sciences.

There is nothing more instructive and useful to medical officers of health than an acquaintance with the history of the different epidemics of ancient times, and of the middle ages, as compared with our own. It is, how ever, possible that the man best qualified as to knowledge, may by infirmities, either of body or of temper, make a very indifferent officer, since it is a post requiring a knowledge of the world, a robust body, and sound judgment, as well as the special acquirements mentioned above. Previous experience was only obtained in a few instances in the first appointments under the Public Health Act, 1872; but, of all things, experience would be a necessary qualification for future highclass appointments. And here, again, sanitary authorities may be misled by the specious testimonials of medical officers belonging to the third, the roi-fainéant class, who most assuredly will be tempted to play upon the name of medical officer of health, which they may have borne for many years without at

experience whatever in its duties.

A health officer cannot well take any other post, or engage in private practice, if his dis trict is very large or populous; on the other hand, if he has leisure, and is duly qualified, there are certain offices, such as analyst and coroner, which are of a kindred nature, and which would harmonise with his duties. Much has been said against medical officers of health as public analysts. It must depend upon individual qualifications and amount of time whether such a union is desirable or not. The adulteration of food has always been taught at the same time and in the same manuals as sanitary science, and the Adulteration Act is carried out by sanitary authorities and sanitary officials; so that it has evidently been considered a part and portion of hygiène.

Routine Work of Medical Officer of Health. -It has been well said, one of the first things that should be done is a house-to-house inspection by the subordinates, as described under HOUSE-TO-HOUSE INSPECTION. Such a course equally applies to rural and urban districts; and the medical officer should also accompany from time to time his inspector, and gain a knowledge personally of the district. In strictly urban districts, the work will often be somewhat of a special character; there will be manufactories, lodging-houses, butcheries, dairies, and other places which will require the continual care of the sanitary authorities. Public buildings should be narrowly watched. There are many things that are neglected by sanitary officials because they have never been thought of; for instance, the dressing-rooms, &c., of theatres (see THEATRES) and other places. The water-supply of every large town should be analysed by the ammonia process at least once a month, and for such analysis the health officer should be paid. He should have an office in some convenient part of the town, where the inspectors can confer with him, and to which official correspondence can be addressed. His attendance at this office would be probably regulated by a bylaw, but whether that be so or not, for his own convenience it should be regular.

Every month, by analysing the rain falling in different parts of the town, he can estimate the sulphuric acid in the air, which will give the measure approximatively of impurity through smoke of the atmosphere. See RAIN.

In case there should be an outbreak of fever, it will be his duty to personally isolate every case which cannot be removed to hospital; and at such times he may require assistance, which should be given to him. A record

of each death and of each contagious case of sickness should be transmitted to the office daily. (See BIRTHS, DEATHS, AND SICKNESS RETURNS.) The returns of death are easily obtained; the returns of sickness will be by no means perfect, but an officer must make the best of his resources.

In large rural combined districts a central office can only in some cases be established. Each union is so distinct in itself that one office is seldom of any practical value; a room in the workhouse is generally easy to get, and may be used when required. The routine is very much the same as in urban authorities. The medical officer meets the inspector at different places, obtains returns of deaths and sickness about once a fortnight, receives the notices the inspector sends him of contagious disease, overcrowding, &c., and attends the sanitary meetings in all combined rural sanitary authorities. It is most convenient that each rural sanitary authority should have a special monthly meeting; then, if well arranged, the health officer can generally attend each in turn. Parochial committees (from their local knowledge) are also sometimes of use in meeting the health officer. On inspecting a parish, the officer of health should place himself in communication with the clergyman, guardians, and medical men, if there be any, and inquire (a) into the water-supply; (b) into the drainage; (c) into the health of the inhabitants and past sanitary history of the place; and (d) into overcrowded and unhealthy

houses.

If there should be any disease-such as goître-that would appear to spring from some endemic cause, no one has so good an opportunity of investigating it as the health officer. If possible, he should construct a map of his district, the spots where this endemic disease appears being appropriately marked. On this head he will find the maps of the distribution of heart and other diseases by Haviland help him much.

It is the medical officers of health of rural districts to whom the profession will look to solve the problems of the causes of contagious disease, as to whether they do or do not arise de novo- the disturbing conditions of towns are too many to elucidate them satisfactorily. Had Dr. W. Budd lived all his life in Bristol, he would have hardly been able to trace so satisfactorily the sequence of events in his book on typhoid fever.

All reports to the sanitary authority should be made with the greatest care, and a copy kept; for these reports may be used for any purpose by the sanitary authority, being the property of that authority.

Melting - House, Melting - Place.(P. H., s. 114.) See TRADES, OFFENSIVE.

Mercury (Hg = 200) The Arabian physicians Avicenna and Rhazes first employed this metal medicinally, but they only ventured to use it externally against cutaneous diseases and vermin. The Hindoos were probably the first to prescribe it internally. It is obtained chiefly from its sulphide, native cinnabar, by distillation with iron. Sometimes it is met with in its metallic state, sometimes combined with chlorine. The mercury of commerce is purified by redistillation and washing with dilute hydrochloric acid. The principal mines are those of Idria in Carniola, Almaden in Spain, and New Almaden in California.

The purity of this metal is shown by its brilliancy. Mere mechanical impurities-such as dust, dirt, &c.-may be readily removed by squeezing the metal through chamois leather or flannel; and it may be further cleaned by shaking well with a little strong nitric acid, washing with distilled water and drying by blotting paper, or filtering through warm chamois leather. When pure, mercury is a brilliant white metallic liquid, becoming solid at 39° F.; specific gravity, 135; entirely vapourised by a heat below that of visible redness; and when small globules of it are rolled slowly upon a sheet of paper, not the least particle adheres. Above 40° F. a slight vapour arises from it. It forms two classes of salts-proto and per salts. It dissolves many metals, as tin, bismuth, zinc, silver, and gold, and forms amalgams with them. One of the most important salts of mercury is the perchloride of mercury (HgCl), or corrosive sublimate, which is obtained by heating together certain quantities of sulphate of mercury, chloride of sodium, and black oxide of manganese. A double decomposition takes place, resulting in the formation of chloride of mercury and sulphate of soda. This substance appears in the form of white crystalline masses of prismatic crystals, soluble in 20 parts of water, in alcohol, and in ether. It gives a white precipitate with ammonia, and curdy white precipitate with nitrate of silver; and it precipitates albumen. When heated it should sublime without decomposition, leaving no residue. There are many other compounds of mercury, which in a work of this description it will not be necessary to discuss. All mercurial compounds, when heated with carbonate of soda, give a sublimate consisting of globules of metallic mercury. Solutions containing mercury give a silvery stain to copper when that metal is boiled in them. When acidified and mixed with excess of protochloride of tin, they give

excess.

Some doubt appears to exist as to whether the liquid mercury is innocuous or not; but the generally-received opinion, notwithstanding that several fatal cases have occurred of poisoning from metallic mercury, is that it is perfectly harmless. It is well known that it has been repeatedly taken in doses of a pound or more in cases of obstruction of the bowels without proving noxious; while, on the other hand, may be instanced a case which recently occurred to Sir D. Gibb. For the purpose of causing abortion a girl swallowed 4 oz. by weight of mercury. It had no effect on the uterus, but in a few days the girl suffered from a trembling and shaking of the body (mercurial tremors) and loss of muscular power. These symptoms continued for two months, but there was no salivation, and no blue mark on the gums.

Pereira is of opinion that in the few instances in which it has acted injuriously, it has been retained in the bowels for a -considerable time, and has become oxidised.

Mercury breathed or swallowed in a state of vapour, or absorbed in a finely divided condition, in which form it appears to be highly susceptible of oxidation, may prove deleteri

ous.

As shown by numerous recorded cases, death has occurred from excessive doses of blue-pill, and also from inunction by strong mercurial ointment. The latter ointment contains half its weight of mercury, and has been used as a dressing to sheep and cattle in place of arsenic. Mr. Gamgee informed Dr. Taylor that 25 tons alone of this ointment had been sold in one year by a druggist in Boston, chiefly to farmers; and that sheep poisoned with mercury have been sent for sale to the dead-meat markets in London, and have realised more money than sound mutton sold in the county of Lincoln. - (TAYLOR.) This, then, may be a serious danger; hence, in any case of suspected illness from meat, although the meat may look sound and good, it is well to have it analysed for metallic poison.

Water - gilders, looking glass silverers, barometer-makers, men employed in quicksilver mines, and others exposed to mercurial emanations, become subject to a form of paralysis and salivation called mercurialismus. Some constitutions appear to be capable of resisting the effects which the inhalation of mercurial vapours induces for a considerable

exposure to their insidious influence. At a meeting of the Medical Society in April 1872, Mr. Spencer Watson showed a patient suffering from mercurial tremors. He was a barometer-maker, and had been in the trade for fifteen years. For seven years he had resisted the influence of the fumes of mercury. He had never been salivated, but his gums were sore, and marked with a blue line; and his teeth were most of them loose, and some much decayed. Ever since the first attack he had been unable to sign his name from the unsteadiness of his hand. Dr. Crisp at the same meeting instanced the case of a family of five who were all sufferers from mercurial tremors. They were water-gilders. This gentleman was of the opinion that efficient ventilation was all that was required in buildings where mercury was largely employed.

A well-known instance of the effect of mercurial vapour is afforded by the Triumph man-of-war and Phipps schooner, which received a large quantity of quicksilver on board, saved from a wreck. The bags in which the mercury was stored became rotten and allowed the mercury to escape. In the space of three weeks 200 men were salivated, two died, and all the animals were destroyed.

Dr. Meyer has obtained excellent results in preventing all symptoms of mercurial poisoning in the looking-glass manufactory of St. Gobain, by sprinkling the floor with ammonia. He states that during the five years that it has been employed at St. Gobain, not one case of poisoning has been observed among the workmen, whilst there is a marked amendment in the symptoms of those who were previously affected. About half a litre of common liquid ammonia is simply to be sprinkled on the floor of the workshop every evening after the day's work. This preservative effect of ammonia was discovered accidentally, and Dr. Meyer cannot explain its action.-(Lancet, 1873, i. 601.)

In slow or chronic poisoning by mercury, the constitutional effects are indicated by irritability or looseness of the bowels, difficulty of breathing, spitting of blood, cough, general trembling or convulsive movements of the limbs, and palsy, with fever and emaciation, under which the patient sinks. The most marked effect of slow poisoning by mercurial compounds is salivation or ptyalism, indicated by an increased flow of saliva.

The elimination of mercury takes place by all the fluid secretions, but chiefly by the urine and intestinal liquids.

Antidotes.-The only efficacious antidotal treatment consists in the administration of albuminous substances. Peschier states that

one egg is required for every 4 grains of mercury; but although albumen retards, it does not prevent the absorption of the poison. There can, however, be little doubt that, among these preventive measures, workmen exposed to mercurial fumes should swallow the whites (raw) of one or more eggs daily. The tests for mercury have been already indicated.

Bisulphuret of mercury has been used as colouring agent in articles of food, and frequently has been discovered in Cayenne pepper. See CAPSICUM.

Mercurial salts were used by Ryan as disinfectants and antiseptics, but they are of too poisonous a nature to be commonly employed. Ryan used them for preserving timber.

Meteorological Influences.-The influence of temperature and the seasons plays a most important part on, and is intimately connected with, public health. Full information on the different branches of meteorology itself will be found under the articles BAROMETER, THERMOMETER, CLIMATE, CLOUDS, &c. It only remains to point out the connec tion between seasonal influences and disease. The late Dr. Edward Smith has worked this out in a truly philosophical manner, and we therefore borrow the following from his work, "Health and Disease: Periodical Changes in the Human System: "

"Statements of the Ancients.-It is almost impossible to turn over the pages of the medical fathers without finding how much importance was attached to season in the production and cure of disease, or without admitting that the information which they have handed down to us is true and applicable to our own era. We do not purpose to enter at any length into the history of this department of knowledge; but we think that it will be instructive to notice with what extent and accuracy the influence of season was known to Hippocrates, as is shown in the twenty-four Aphorisms which he has transmitted, and which have been so ably edited for us by Sprengel, Adams, and Clifton.

The division of the seasons has varied with different nations and eras, and has been arbi trary, except in so far as it was associated with the occurrence of certain natural phenomena more or less general or peculiar to the locality. We find that in the most ancient periods the Egyptians + divided the year into three seasons -viz., the 'Season of Vegetation,' the 'Season of Manifestation,' and the 'Season of the Waters,' or the 'Inundation;' and at the

Aphorisms of Hippocrates, by Dr. Sprengel. London, 1708.

Hora Egyptiacæ, 1851.

present time the first is called Winter,' the second 'Summer,' and the third Inundation,' or literally 'The Nile.' This division was associated with terrestrial changes; but in ancient Greece it was determined by astronomical phenomena, as it is with us at the present day.

Dr. Adams informs us that with the ancients Winter began at the setting of the Pleiadesviz., the period when they set with the sun, and continued to the vernal equinox. Spring commenced at the last-mentioned period (the vernal equinox), and ended at the rising of the Pleiades-viz., the rising with the sun. Summer began at the rising of the Pleiades, and continued to the rising of Arcturus; and Autumn extended from the rising of Arcturus to the setting of the Pleiades. Thus the division of the seasons was purely astronomical, and the constellations of the Pleiades and Orion were the dividing objects; the rising of the Pleiades with the sun separating the first from the second half of the year, and the setting of the same constellation with the sun terminating the year.

Having thus defined the several seasons, we will now, in a few words, give a condensed account of their influence as gathered from the opinions of Hippocrates, expressed in the Aphorisms above mentioned.

Change of seasons, and the alternations of cold and heat in those seasons, are most effectual causes of diseases. Some natures are well or ill affected in summer, and some in winter. Some diseases and some ages are well or ill affected at different times of the year, &c.

Autumnal diseases may be reasonably expected when on the same day it is sometimes The south wind hot and sometimes cold. dulls the senses of hearing and sight, causes headache, heaviness, and faintness. When it prevails, these incidents occur to the weak and sickly. The north wind affects the chest and throat, and causes constipation, dysuria, and muscular pains. The south wind relaxes and the north wind contracts the tissues of the body. When the summer is like the spring (viz., cool and wet), we must expect much sweating in fevers. Dry seasons are the cause of sharp fevers.

Constant and seasonable times of the year are accompanied by diseases which are regular and mild, but in inconstant and unseasonable times the diseases are uncertain and difficult of cure.

In autumn diseases are most acute and pernicious, and that season is hurtful to those in consumption. Spring is most healthy and free from fatal disease. If the spring be rainy with southerly winds, and have followed a dry and