*

grinders should on no pretence be allowed to work in the same room. 3. That the owners of wheels should be compelled to find fans for all dry grinders. 4. That all wheels should be put under proper inspection, properly ventilated and kept clean, the rooms built of a sufficient height with enough space for each man, and every wheel properly provided with conveniences, the want of which at present-or the substitutes for which at many wheels-is a disgrace to the civilisation of the nineteenth century, and in a sanitary point of view a great evil. No floor should be of mud. Where wet grinding is carried on the floor should be flagged with a sufficient incline to let the water run off.

Let me read what I wrote in 1867. To send a boy at eight or nine years of age into a grinding hull is an act of refined cruelty which the powerful arm of the law ought to restrain. The application of the Factory Act to the grinding trades of Sheffield would in my opinion be most wise and salutary. These helpless children I would indeed commend to the protection of the State; and glad indeed shall I be if these remarks attract the eye of any member of the House of Commons, and induce him to bring the question before Parliament; or, if the evils, religious, moral, and physical, under which these poor boys are suffering, lead the inhabitants of Sheffield to petition the Legislature to cast around them that protection which they have not at present. Such was the opinion I published in my work on "The Causes, Prevention, and Treatment of the Sheffield Grinders' Disease," eight years ago. I repeat that opinion now, and right glad am I to see it in every respect confirmed by the evidence collected by Mr. White, and by the recommendation made to Her Majesty by the Children's Employment Commission. The early age at which these boys are sent into the grinding hulls, by parents who seem only to regard their children as machines to add to their weekly income, by making them work as soon as possible, enfeebles them in mind, and renders them dwarfed, decrepit, and often deformed in body. Prematurely used up-their spring of life exhausted, too often they never arrive at manhood's summer. It is impossible, under such circumstances, to give these children that general education which they require-that general training and religious instruction which it is the duty of the State to see extended to all classes in a Christian land. And so we go on in Sheffield, “like clings to like the whole creation thro'"-one generation passes away ground off in the wheels-but another comes like in ignorance, like in intemperance and folly-the children of to-day are the types of the fathers of yesterday; they have come into the world without

* Ventilation of the wheels. The hulls cannot be constructed with windows before and behind the grinder as has been suggested. The light at his back would interfere with his work. Ventilation, however, could be provided by gratings at the back of the hull. The fan also, when at work, powerfully assists ventilation. Too commonly the grinders regards the hull as "only a place to work in," and take every care that it shall remain, as the word implies, a stye. D D

God's blessing, in the homes where but too often their parents have left it without a hope. Without education, without moral or religious training, these children are compelled at ten or eleven years of age to work in the hulls, and there we see them, rocked by the cradle into a maturity of vice, and their education completed by the conversation of older boys and men, whose every breath is an offensive expression, or an oath; and who appear to be suckled in sin, cradled in profligacy, and catechised in blasphemy. Are not these children worthy our consideration-children who but too often never hear afather's loving voice, and but too often never know a mother's solicitude.

"Where shall their hope find rest-no mother's care,
Protects their infant innocence by prayer:

No father's guardian hand their youth maintains;
Calls forth to virtue and from vice restrains."

Surely these facts have been unknown to our philanthropists, otherwise we should long ago have heard of the mission to the grinding wheels, and of sermons and collections for the preachers at the hulls. "Is it nothing to you, all ye that pass by?" These evils are at any rate known now, and until steps are taken to remove them I trust in future no Sheffield guinea will be diverted from its proper course. Even the grinders themselves are becoming aware of these enormous evils. The Saw Grinders' Union does not now recognise boys under the age of 14; and at the next general meeting of the spring knife grinders, the secretary of that union informs me the question will be considered of preventing boys from coming into the hulls at an early age. To my fellow townsmen, the file-cutters' of Sheffield, who neglect those sanitary regulations so requisite for health, who eat their dinners without washing their hands, who dip their dirty lead-begrimed fingers into the salt, and who wear the same clothes in the workshop and out of it, to the dry grinders who work without the protection of a fan, and also to all artisans who lead intemperate lives, I say, "turn ye, turn ye, why will ye die ?" I can only hope that the preventing boys from entering the grinding wheels at the early age, now so common, and the better education the coming generation must receive, will make men understand more fully their duty to themselves, their neighbours, and their God; and lead them to realise that whatever may be our station in life, we have each and all of us a duty to perform. I ask them carefully to onsider the advice I have ventured thus plainly to give them, satisfied that if they adopt it, they will one and all of them be convinced, in the language of the immortal dramatist

"I am not an impostor that proclaim
Myself against the level of mine aim;

But now I think, and think I know most sure,
My art is not past power, nor you past cure."
"All's Well that Ends Well."

403

CONTAGIOUS DISEASES.

Quarantine and the Cholera, with special reference to the present Epidemic in the Mediterranean. By GAVIN MILROY, M.D.

THE Association having taken so prominent a part in the investigation of quarantine, through the committee which was appointed at the Annual Meeting in Liverpool, in 1858, and which continued its labours till 1861, it seems but right that the attention of this Depart ment should be drawn to the subject at the present time, when its operation is being felt in all the countries bordering on the Mediterranean, and as this operation will be still more widely felt if the cholera extend to other countries.

It may be remembered that the circumstance which led to the institution of that committee was the then recent outbreak of a malignant fever, having many of the characters of the Oriental plague, at a point on the Eastern Barbary coast, not far from the town of Benghazi. The disease, it was afterwards found on inquiry, had been existing for a great many months, among the wretched and famishing Arab population of the district, without any special notice having been taken of it; and it was only when the dreaded name of the plague began to be given to the fever, which hitherto had been regarded as typhus, that all the complex machinery of the quarantine system was immediately set in action, not only throughout the entire extent of the Mediterranean, but in the oceanic ports of Spain and Portugal, and even as far as St. Petersburg, and other Russian ports in the Baltic, The system, in all its rigour, was kept up for many weeks and months. The disease never extended beyond the district where it first broke out, nor affected any persons there but those who were living in squalor and want. It was a purely local outbreak, and ceased when the people were moved out of their filthy dens, and were duly supplied with food. Not even a trace or suspicion of the distemper was ever seen either in Alexandria or any other place on the coast of Africa, or in the hundreds and thousands of vessels that were subjected to a more or less lengthened quarantine detention, throughout the entire extent of the Mediterranean sea-board.

On the present occasion, the danger against which quarantine has been, and is being, directed, is much more formidable, alike from the already wide spread of the cholera, and the extreme malignity of the disease wherever it has appeared. If quarantine can preserve a country from the invasion of such a scourge, it is clearly the duty of every enlightened government to enforce its vigorous adoption, whatever may be the cost incurred, or the inconvenience and loss inflicted on individuals or on commerce. Salus populi suprema lex will unquestionably hold good, in the judgment of wise men, in such matters; and as the subject is, unquestionably, one of the most

important with which State medicine has to deal, its consideration appears to me to be peculiarly suitable at such a meeting as the present; for it is eminently a social question, and pre-eminently an international one. Moreover, it is one of those mixed questions on which laymen may fairly judge of the value of the evidence on which the system rests, nearly as well as medical men; and it is very certain that no satisfactory solution of many of the controverted points relating to it will ever be come to, until enlightened public opinion is brought to bear upon this investigation.

Fortunately, the subject has recently been attracting a good deal of attention in several foreign countries; and it is likely to attract still more throughout Europe, since the institution of those annual international gatherings, on the plan of this Association, in different leading cities on the Continent. At the meeting of the "Association Internationale des Sciences Sociales," last year, held le progres pour in Amsterdam, it formed one of the questions set down for special consideration in the Public Health Department; and it was mentioned at the séance, when the subject was discussed, that the Dutch Government has lately had it under their consideration.*

I wish, in limine, to state that the object of the present paper is simply narrative and historical, viz., to record, from the imperfect means of information at command, what has hitherto taken place throughout the Mediterranean; and then briefly to compare some of the recent circumstances and results with what occurred in former epidemics of the pestilence-chiefly with the view of keeping public attention to the subject, and of inviting all, and specially medical men, to follow the devious course and progress which the present epidemic will yet in all probability pursue (it may be this year, or it may be next year) in countries yet unattacked; and to watch the results of the measures, adopted in each, to avert or exclude the scourge from their peoples. Hitherto, far too little profit has been gained from the experience of former visitations, in the way of guidance for the future. When the danger is past, all is forgotten; the next visitation is left to care for itself; and then the very same things are done, and the same efforts are made, and the same anxiety and panic incurred, with little or no regard all the while to the teachings of the past.

One other prefatory remark. Let the true and real nature of quarantine, or, in other words, its interpretation in practice be steadily borne in mind, whenever the subject is spoken of; for much, very much, of the error and controversy about it, even in the writings of medical men, is owing to the want of a clear definition of what is meant by the term. It is not, as we shall presently see, the mere detention of sick persons, or of sickly ships, arriving in a port hitherto exempt from the apprehended disease, and the segregation and purification, during an allotted time, of such sick persons or

* I had the honour of being requested by the Council of the Association to read a paper on the subject; it is printed in the "Annales de l'Association." &c.,1865.

ships. But it is the detention and segregation of all persons, and of all vessels, coming from an infected place, whether or not any sickness whatever has occurred on board during the voyage, or exists on board at the time of arrival; the theory being, that the persons or ships, although remaining healthy themselves, may yet hold and bring with them, in some way or other, the disease, in a latent or undeveloped state. I would again state, that it forms no part of my present paper, nor comes within its scope, to enter into any discussion of this or any other theoretical topic of the subject. All who may be interested in the inquiry, I would beg leave to refer to my former papers in the Transactions of this Association, and to the report of the committee already mentioned.

The earliest acknowledged cases of the epidemic in Alexandria occurred in the second week of June; but whether these were really the first instances which had been seen, and whether there had been any peculiarity in the antecedent state of the public health indicating the advent of the disease, we have at present no means of accurately determining. That the cholera had been previously prevailing at Mecca, and at other points of the Arabian peninsula on the Red Sea, is known; but, beyond this single fact, more cannot be affirmed. Considering the season of the year-about Midsummer-a season, too, remarkable almost everywhere for excessive heat, it is more than probable that the development of the cholera on the present occasion, as in former epidemic visitations, was not a sudden or unheralded event, but had been preceded, for some time, by the prevalence of diarrhoeal and other intestinal affections among the lower classes in Alexandria, and the other towns and villages in the delta of the Nile which were first attacked. The pestilence seems to have appeared almost simultaneously at several widely-distant points of the country, in that malarious region. Rosetta, Tanta, Damietta, &c., were affected about the same time as Alexandria. The panic soon became so great in the latter city that thousands of the population took to flight, scattering themselves in all directions, and spreading alarm, if not the disease, wherever they went. All the Mediterranean ports had of course resorted, on the earliest intelligence, to the adoption of quarantine restrictions, of greater or less rigour and duration, upon arrivals by sea from Alexandria. The Austrian government was among the first to establish a quarantine upon all arrivals therefrom at Trieste passengers to be detained seven days in the lazaret, the ship to be fumigated, and goods and letters on board to be subjected to the customary purification of being smoked or passed through water. At Malta, too, similar measures were put in force about the same time; so that the Peninsular and Oriental Company's steamers ceased to have any direct communication with the island on their homeward or return voyage, to the no small inconvenience of a multitude of passengers, as well as to the interruption of considerable commerce. Such persons as were landed-although in health at the time-were confined in the lazaret for seven days, if no sickness had occurred on board during the voyage, and for twelve days if other