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Preface
There is no need that I should say much by way of preface. I believed that such a handbook would be required after the passing of the Public Health Act 1872, and I have endeavoured to supply the want.
Amongst the numerous works which I have consulted, I desire especially to mention Dr. Parkes' work on Practical Hygiene ; Mr. Simon's Eeports to the Privy CoimcU ; Dr. Letheb/s work on Food ; Captain Douglas Galton's work on the Construction of Hospitals; and the writings of Dr. Angus Smith, Dr. Hassall, Mr. Eawlinson, Mr. Eassie, and Professor Eankine. Full acknowledgment of other authors is given in the proper places.
I have occasionally inserted extracts of reports to show how sanitary inquiries should be conducted and reports written, nor have I hesitated to use quotations when such quotations bear the stamp of authority.
In Appendix I., I have given an excerpt of the various sanitary enactments, or parts of them, which more immediately concern the duties of medical offiR,^\s»
VIU PREFACE.
of health ; and in Appendix II., I have added a price-list of analytical apparatus and reagents referred to in different portions of the work. It will be seen that, as regards food and water, I have only dealt with qualitative examination, so that those who are desirous of becoming proficient in quantitative analysis as well should procure Dr. Parkes' Manual.
While I have endeavoured to notice briefly all the points which are of importance to medical officers of health, I have so arranged the work that it may prove useful as a text-book to medical students, and as a handy book to medical practitioners generally. To all those outside the profession who are interested in sanitary matters, and who may care to read the work, I may at least say that it contains some amount of information freed from technicalities and worth knowing.
Chapter 1— Inteoductory. Public Health And Preventable Disease
Page
Public Hygiene, definition and scope of . .1
SECTION L — Hereditary Influence . . .3
Darwin's Theory of ** Pangenesis " . .3
Influence of Heredity as exemplified —
1. In the Resemblances between Children and
Parents . . . . .4
2. In Atavism . . . .4
3. In Characteristics of Race . . .5
4. Deviations not transmissible except within
certain limits . . . .5
5. Influence of Heredity on Disease . . 5
6. Influence of Heredity on Mental and Moral
Qualities . . . . .6
7. Influence of Heredity intensified in cases of
Parental Consanguinity . . .6
8. Characteristics of the Offspring influenced by the Condition of the Parents at the time of Sexual Congress . . . .6
Bearings of Hereditary Influence on Public Health 7
SECTION II. — Causes of Deterioration and Disease . 7 Material and Social Causes . . .7
Enumeration of Social Causes . . .8
CONTENTS.
Paop.
1. Intemperance . . . .8
Its Effects on the Individual ." .9
Its Effects on the Offspring . .10
Its Relation to Crime . . .11
Its Effects on Public Health . .11
2. Immorality . '. . .11
Cause of the Downfall of Ancient Greece . 12
3. Injudicious or Unsuitable Marriages . 12
In Relation to over-population . .12 In Relation to Pauperism . . .13 Doctrines of Malthus and Galton . .14 M. Quetelet's Deductions . . .15 Effects of a Diseased Parentage on the Offspring , . . . .16 Effects of Consanguine Marriages on the
Offspring . . . .16
Statistics . . . . .17
Effects of Material and Social Causes of
Disease on the physique of the English
Dr. Beddoe's Statistics . . . .18
SECTION IIL—Preventablb Disease . . .19
Influence of Education . . . .20
Mr. Simon's Estimate of the amount of Preventable Disease in this Country, and his Remarks thereon 20
Chapter II. Food
SECTION L — ^Functions and Constituents op food . 23
Conversion of Potential Energy of Food into Dynamic Energy . . . . .23 Organic and Inorganic Constituents . .23
CONTENTS. XI
Pagb
1. Functions of the Nitrogenous Constituents . 24
Liebig's Doctrines . , . .24
Experiments of Drs. Fick ^d Wislicenus . 24
Experiments of Dr. Parkes . . .24
2. Functions of the Fatty Constituents . .25
3. Functions of the Saccharine Constituents or
Hydrocarbons . , . .26
4. Functions of Water and Saline Matters . .26 Proportions of the several Constituents in a Standard Diet • . . . .27
SECTION II. — NuTRiTivB Values op Foods . .27
Dr. Letheby's Table of Nutritive Equivalents . 28
SECTION III.— Food and Work . . .29
Dr. Edward Smith's Estimates for a daily Diet during
Periods of Idleness . . . .29
Dr. Letheb/s Tables for Diets during Idleness, ordinary Labour, and active Labour . .30 Daily Requirements of the Body, as shown by the
Excretions . . . . ,30
Dietaries of Low-fed Operatives . . .31
Dietaries of Well-fed Operatives . . .32
Dietaries of Convicts . . . .32
Relation of Convict-labour to Diet . .33
SECTION IV. — Construction op Dietaries . . 34
1. Influence of Sex . . . .34
,2, Influence of Age . . . .34
3, Selection of Food . . . .35
Determined by —
(1.) The relative Propositions of Proximate Constituents . . . . .35 xu
CONTENTS.^
Page
(2.) Variety .
. 35
(3.) DigestibiHty
. 36
(4.) Price
. 36
4. Number and Distribution of M eals . . 36
5. diiriate
. 36
ION V. — ^Preserved Foods
.36
1. Liebig's Extract
. 36
2. Preserved Meat
. 37
3. Preserved Vegetables .
. 37
4. Preserved Milk
. 37
[ON VL — Examination op Food
. 38
1. Meat
. 38
2. Flour
1 •
. 39
3. Bread
. 40
4. Oatmeal
. 41
5. Milk
. 41
6. Butter
1 • <
. 42
7. Cheese
. 42
8.* Eggs
. 42
9. Potatoes
• •
. 42
. . 42
11. Coffee
• .
. 43
SECTION VII. — ^Thb Effects of Insufficient or Unwholesome Food on Public Health . . 43
1. Effects of Insufficient Food . . .43
2. Unwholesome Food . . . .46 (1.) Putrid Meat . . . , . 47 (2.) Diseased Meat . . . .47
Spread of Specific Disease througb the Agency of Milk . . . . . .49
CONTENTS.
XIU
CHAPTEiR IIL
Ant : ITS IMPURITIES, AND THEIR EFFECTS ON
PUBLIC HEALTH.
SECTION I— Composition op Air Paqs 51
SECTION n. — Impurities in Air, and'their Effects
Different kinds of Impurities . . .52
1. Air vitiated by Bespiiation . . .54 Minor Effects thereof . . . .56 Graver Effects thereof . . . .57 Typhus . . . . .58 Phthisis and Lung-affections . . .59 Hospital Gangrene and Purulent Ophthalmia . 60
2. Air rendered Impure by Sewage and Cesspool
Effluvia . . . . .60
Nature of Impurities . . . .61
Effects thereof . . . . .61
Diarrhoea . . . . .62
Enteric Fever . . . . .63
Cholera . . . . .64
Eisks attending Sewage-irrigation . .65
3. Effluvia from Decomposing Animal Matter , 66 Effects of Effluvia arising from Putrid Kemains . 66 From Graveyards . , . .66 From Manure and similar Manufactories . 67
4. Gases and Vapours given off by —
Alkali Works . . . .67
Chemical Works . . . .68
Brickfields . . . . .68
5, The Air of Marshes . . . .68
Effects thereof . . . . .69
XIV CONTENTS.
Paob 6. Air-Impurities in certain Trades and Occupations 69 Mining . . . . .70
Steel-grinding, and other Trades . .71
Dr. Greenhow's Inquiry into the excessive Mortality from Lung-Diseases . . .72 Mr. Simon's Comments thereon . . .75 Necessity of Sanitary Inspection . . . 76
CHAPTEE IV.
VENTILATION AND WARMING.
Division of Subject . . . .77
SECTION I. — ^Thb Amount op Fresh Air requirbd . 77
Dr. Parkes' Experiments . . . .78
Experiments in Prisons . . . .78
Dr. Angus Smith's Experiments . . .80
Dr. de Chaumonfs Experiments . . .81
Circumstances in which the amount of Fresh-air
Supply must be increased . . .81
SECTION II.— Cubic Space . . . .82 Pettenkofer's Experiments . . . .82
Difficulties of preventing injurious Effects when the
Cubic Space is small . . . .83
Different Estimates . . . .85
Summary of Kesults . . . .86
Bemarks thereon . . . . .86
SECTION IIL— Natural Ventilation . . .88
Forces engaged in . . . . .88
Diffusion . . . . . .88
Movements of Air produced by Inequalities of
Temperature . . . . .89
CONTENTS.
XV
Perflation . . Aspiration Ventilation by open Windows Air-Biicks Sheringliam Valve Transverse Ventilating Shafts Cowls Louvres .
Mr. Sylvester's Plan Dr. Amott's Plan .
Mr. Potts' Plan .
Mr. Varle/s Plan .
Mr. M'KinneU's Plan Dr. Stallard's Plan
SECTION rv. — ^Artificial Ventilation and Warming .
Propulsion and Extraction, or the plenum and vacuum Systems ....
Ventilation by open Fire-places Movement^of Air in a Kooni with an open Fire-place Amount of Heat which passes up the Chimney Galton's Ventilating Stoves Penfold's Fresh-air Cottage Grate .
Young's Grate for the Combustion of Smoke The Goldsworthy-Gumey Stove Musgrave's slow Combustion Stove Pierce's Pyro-pneumatic Stove-grate George's Calorigen Stove ....
Faults of Common Stoves ....
Construction of Stove Smoke-flues Chimney Ventilators . . . .
Fresh-air Inlets and Extraction-flues Mr. Kitchie's Plan of Ventilation and Warming Ventilation and Warming by Hot-water Pipes Ventilation by Furnaces in Extraction-shafts tvi CONTENTS.
Paob Combination of Methods . . . .103
Ventilation of Mines
Ventilation of Ships
Ventilation by Gaslights .
Extraction by Fan or Screw
Ventilation by Propulsion
Van Hecke*s System
Kelative Merits of the two Systems of Ventilation
viz. Extraction and Propulsion .
Relative Position of Inlets and Outlets Construction of Foul-air Flues Sectional Area of Inlets and Outlets
CHAPTEE V.
SECTION I — ^Examination as regards Ventilating
Arrangements
SECTION 11. — Examination by the Senses
SECTION ni. — Chemical Examination .
1. Carbonic Acid . . .
Description of Pettenkofer's method Dr. Angus Smith's Method
2. Organic Impurities
3. Ammonia
104 104 104 105 105 106
106 107 108 109
Cubic Space . . . . .111
Kelative Position and Size of Outlets and Inlets . 112 Air-currents . . . . .112
Use of Anemometer . . . .113
Amoimt of Fresh-air Supply best indicated by the
Amount found to be issuing through the Outlets 114 Proper Time for Examination . . .115
Method of Procedure . . . .115
116 117 122 123 124
CONTENTS.
XVU
SECTION III.— Modes of Supply Wells and Borings
Artesian Wells
Conditions affecting the yield of Wells
Norton's Tube-weU.
Water-works
Gathering-grounds
Average Annual Rainfall .
Channels of Gathering-grounds
. 134
. 136
XVIU CONTENTS.
Paob
Reservoir ..... 141
Construction and Adjuncts thereof . . .142
Construction of Aqueduct and Distributing Conduits 143 House Service-pipes . . . .144
Substitutes for Leaden pipes . . .144
Conditions affecting the Size of Conduits . .144
Intermittent and Constant Systems of Supply . 145
Relative Merits and Disadvantages thereof . . 145
Waste-preventers . . . .146
Water-cisterns . . . . .146
SECTION IV. — ^Purification of Water .147 Filter-beds ..... 147
Domestic Filters and Filtering Media . .148
Crease's patent Tank-filter . . .150
Cleansing of Filters . . . . .151
Clark's Process of Purification . . .151
Other Purifying Agents . . . .152
SECTION v.— Examination OF Water . .153 How Water may become polluted . . .153
How to collect Water for Analytical purposes . 154
1. Physical Examination . . .155
2. Microscopical Examination . . .156
3. Chemical Examination . . .157 Practical Deductions . . . .162
CHAPTEK VII.
" impure water, and its effects on public health.
SECTION III. — ^Dwellings for the Poorer Classes . 193 Plans and Estimates . . . .193
Bye-laws for Tenement-houses . . .194
Dwellings imfit for Habitation . » .196
Dwellings of Bural Labourers . . .196
Surface-crowding in Large Towns . .198
XX CONTENTS.
CHAPTER IX.
HOSPITALS.
Page
Preliminary Eemarks with regard to Site . . 203
SECTION L— Pavilion Hospitals . . .204
General Plan ..... 204
Conditions whicli determine the Size and Form of a Ward ...... 206
The Number of Patients . . . .206
The Floor and Cubic Space . . . 206
Eemarks concerning the Cubic Space of Workhouses 206 Floor Space in different Hospitals . .208
Ventilation and Structural Details of a Ward .208
Furniture ..... 211
Ward-oflElces . . . . .211
Administrative Buildings . . .213
Exercising Groimds, etc. . . . .214
Mr. Greenway's Plan of Hospital Construction . 215
SECTION II.— Cottage Hospitals . . .215
Begulations and Management thereof . .215
Structural Details . . . .217
SECTION HI. — Hospitals por Cases op Infectious
Memorandum of Privy Council relating thereto . 218 Floor and Cubic Space . . . .219
Tents and Huts ..... 220 Ground-plans . . . . .221
Hospital-ships . . . . .222
CONTENTS.
XXI
CHAPTER X,
BEMOVAL OP SEWAGE,
Paov
What is meant by the term Sewage
. 224
SECTluN L-^MiDDENS, Ashpits, and Cesspools
. 224
Dangers attending their Use
. 224
How they should be constructed .
. 227
Different Plans of Midden System .
. 228
Fosses Permanentes
. 229
Liemur^s System
. 230
SECTION H.— The Pail or Trough System .
. 230
Boxes .....
. 230
Tubs prepared on the Goux System
. 230
Pails and Troughs
. 231
Eureka System ....
. 232
Fosses Mobiles ....
. 232
Management of Pail or Trough System
. 232
SECTION III. The Dry Method
. 233
Moule's Earth-closet
. 233
Advantages and Disadvantages of the System
. 234
Taylor's Dry Closet
. 236
Other Modifications of the Dry Method
. 236
SECTION IV.— Kemoval BY Water . . 237
Its preference over other Systems for Tjarge Towns
Construction of Drains and Sewers
. 237
Pipe-sewers, their Advantages
. 238
Drain-sewers ....
. 239
Ventilation of Sewers
. 240
Flushing of Sewers
. 242
"Water-closets ....
. 244 xxu
CONTENTS.
Paob Trough-closets . . . . . ' 245
Tumbler-closets ..... 246 Water-latrines ..... 246 Intercepting Tanks .... 247
SECTION v.— Scavenging . . . .248 Kemoval of House-refuse .... 248 Street Scavenging . . . .249
Advantages of Asphalte in Street-construction . 250 Watering of Streets . . . .250
Cooper^s Deliquescent Salts . . .250
CHAPTEE XI.
PURIFICATION AND UTILISATION OF SEWAGE.
Eiver-poUution . . . . .252
SECTION I. — Town Sewage . . . .253 Composition and Amount thereof . . .253
Analysis of Urine and Faeces . . .255
Manurial Value of ... . 255
SECTION II. — Schemes for the Purification and Utilisation op Sewage . . .256
1. Precipitation Processes . . .256
Precipitation by Lime . . .256
Blyth's Process . . . .257
Holden's Process . . . .257
Bird's Process . . . .257
The "ABC" Process . . .258
The Phosphate Process . . .258 Hille's Process .... 259
General Scott's Process . . .259
CONTENTS. XXIU
Paob Wliitthread's Process .... 260 Anderson's Process . . . .261
2. Piltration Processes . . . .261 Simple Filtration . . . .261 Carbon Filtration, or Weare's Process . .261 Upward Filtration .... 262 Intermittent Downward Filtration . .262 How carried on at Merthyr Tydfil .262
3. Irrigation ..... 263 Details concerning Sewage-farming . .264 Professor Corfield's Bemarks on the Advantages
of Irrigation . . . .265
Table of Average Results of the Different Processes ..... 266
CHAPTEE XII.
THE EFFECTS OF IMPROVED DRAINAGE AND SEWERAGE
ON PUBLIC HEALTH.
SECTION I. — The Effects op Dampness op Soil . 268
Dr. Buchanan's Inquiries concerning the Production
of Phthisis . . . . .268
Dr. Buchanan's Conclusions . . .271
Dr. Bowditch's Researches . . .271
Other Diseases influenced by Dampness of Soil . 272
SECTION IL — Sanitabt Aspects op the Water-
Enteric Fever . . . . . 273
Influence on general Death-rate . . .275
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