Sanitary Association. No fewer than 28 members of the medical profession, connected with the Poor-Law unions, the hospitals, the workhouses, and gaols, unite in furnishing weekly returns respecting the number and nature of the new cases of disease which may come under their own personal observation. In addition to these tabulated statistics, they frequently specify the particular houses infected by contagious diseases, the causes which appeared to excite them, and other interesting points bearing on the public health. A return, with a summary, drawn up by the Honorary Secretary, is now published at the end of every week, and inserted in the daily papers. In this manner, the very first outbreak of an epidemic, and the quarter in which it may appear, are speedily noted; while the amount of sickness which prevails among a population of nearly half a million may be read at a glance. On the intensity which some of the more formidable diseases assume during different epidemics, and on the localities they select as their most congenial haunts, much interesting information is accumulating in these returns-the more interesting from the little attention these questions have hitherto received. They are valuable, likewise, as enabling us to compare the sanitary shortcomings of different places. To take an example: disease returns, corresponding to those of the Sanitary Association, were collected and tabulated by the late Dr. R. D. Thompson. On comparing the two sets of observations, it has been found, that the law of diffusion which characterises the distribution of some of the more ordinary maladies in London and in Manchester differs materially. Thus, while diarrhoea is invariably more general in the metropolitan parish of Marylebone, bronchitis, and kindred affections of the chest, predominate in the north. The impurity of the water distributed by the metropolitan companies, as compared with the Manchester supply, points to this important necessary of life as the probable cause of alimentary disturbance; while the bronchial irritation with which Manchester is affected seems referable, either to more trying climatic influences, or to the more extensive contamination of the air by the products of combustion.

To sum up the foregoing suggestions, we may say that, on some subjects, accurate and more general observations are urgently called for-such are those relating to the composition and temperature of the atmosphere, not taken in airy suburbs, but in centres of industry. where men and women are congregated together. So, likewise, in addition to what the registrars tell us, respecting the result of every man's last illness, we require to know the nature and extent of the invaliding which precedes it; and such information we can only obtain from disease returns. So, too, if we would set a check on those maladies which are truly preventible, we should organise special wards for the reception of sufferers from contagious diseases, and retain our patients until convalescence is established. We must likewise supply more accommodation at our Lock Hospitals, and adopt stringent measures for preventing the class of patients who attend from becoming a general source of infection. The employ

ment of married women also, more particularly when they are mothers of young children, should in every way be discouraged. Schemes of emigration, specially calculated for the relief of the mother country, should be brought into operation. Settlements along the railways should be established for the working classes, with special cheap trains at early hours in the morning and at breaking-up time in the evening. Cellar dwellings should be closed up, courts and alleys cleared out, and the sites which they occupied left open to serve the double purpose of air-shafts and play-grounds. Streets also should be widened. Factories and workshops, instead of being piled up in the centre of our towns, should be scattered over the country in airy and healthy localities. If these suggestions are in any degree practicable, and if the importance I have attached to them is not overdrawn, it will be admitted that they can neither be too often nor too urgently pressed on those who have the power of enforcing them.

The Local Government Act, 1858, and the necessity of extending its usefulness to the suburbs of large towns. By JOSEPH JONES.

So patent are the advantages conferred by the Local Government Act, that no attempt will be made in this paper to enumerate them. The following remarks will be confined exclusively to two points,First, as to what the Act is accomplishing in the widening and improving of streets by means of provisional orders, confirmed by parliament, for putting in force the Lands Clauses' Consolidation Act, 1845; and, second, how the benefits of the Act generally may be advantageously extended to the outlying suburbs of populous places. I. Until August, 1858, when the Local Government Act came into operation, and, together with the unrepealed portions of the Public Health Act, 1848, formed as it were one important measure, of which towns might avail themselves for the purposes of health and improvement, local authorities could not purchase lands and premises compulsorily for widening streets and other sanitary purposes, unless armed with a special Act of Parliament, which had probably been obtained at considerable cost. Such purchases cannot now be compulsorily effected without legislative permission, but the process of obtaining these powers has been simplified and cheapened to a marvellous extent. Any place to which the Public Health Act, 1848, was applied before 1858, or by adopting subsequently the Local Government Act, may now, through its local representative board, present a petition to the Home Secretary, praying for powers to put in force the Lands Clauses' Consolidation Act with regard to the purchase of premises defined in such petition, and in respect of which the usual parliamentary notices have been inserted in the local papers in November (insertion in the London Gazette being dispensed

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with), and have been served during the month of December on the parties interested in such premises, service by means of registered letters being allowed in the case of persons residing at a distance. The merits of the petition being then duly inquired into, and no serious objection urged against the scheme of improvement therein set forth, the Home Secretary issues his provisional order for granting the required powers, and afterwards brings in a bill for its confirmation by parliament, the same bill generally including provisional orders for other purposes, granted on petition, and applicable in the whole to six, eight, or perhaps a dozen towns, as the case may be. So great, in fact, has been the extent to which local boards have availed themselves of these new powers, that since 1859 to the end of last session, no less than 16 Local Government Supplemental Acts have been passed, confirming provisional orders, which affect in one way or another not fewer than 122 different towns and places.

Of these provisional orders confirmed since 1859, the earliest session in which this feature of the Local Government Act could be carried out, 49 relate to putting in force the Lands Clauses' Consolidation Act, 31 to an extension of borrowing powers, 41 to a repealing or altering of parts of local Acts, and 16 to an alteration of boundaries and of former provisional orders. The average cost to the government of these orders, as charged to local boards, is about £6 each.

These arrangements, it will be understood, are altogether independent of what has been done in the cotton manufacturing districts, under the Public Works' Act, passed in 1863 for the purpose of granting loans of money, and thereby giving employment to thousands of distressed operatives during the cotton famine, when at one time half a million of people had to be saved from starvation, to whom had been paid when at work £170,000 a week. The report of the central relief committee at Manchester, who concluded their labours in June last, announced the very gratifying fact that during the two years this Act had been in operation, no less a sum than £1,000,000 was expended; £10,000 a week was on an average paid in wages; 35,000 men had been employed, and as only a part of what had been accomplished, 200 miles of streets had been sewered, formed, paved, and channelled, and lad had foot-walks constructed.

II. The second point on which a few suggestions will be offered relates to large towns, more particularly corporate districts, which enjoy the advantages of the Local Government Act, but whose immediate suburbs, just beyond the municipal boundary, claim an immunity from proper sanitary control as to drainage and other regulations. The most serious results may be auticipated from a continuance of this state of things in some quarters. Railways and manufacturers are causing an increasing population to spring up close to many of our old towns, thus giving an augmented value to the land around, for which the owners eagerly claim the rights, Lot are apt to overlook the datles of such property, because there is n recognised authority, as in the adjoining borough or town, to enforce

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them, and what is more, the legislative power itself is lacking. Streets are formed and new houses are built, but they are subject to no control or inspection as to width, drainage, or ventilation. In a few years, therefore, the same kind of structural evils which ancient towns have long groaned under, and which can be but partially and with difficulty relieved, will be reproduced in all their aggravated forms, in adjacent hamlets, whose green fields are being covered with partially sewered and ill-formed streets, with imperfectly ventilated houses and open cesspools, whilst in the midst of all a blood-boiler or a tallow-melter may establish and carry on his business with impunity. It may be said that places like these, if containing more than 3,000 inhabitants, can adopt the Local Government Act. This is admitted; but if such adoption be negatived by the ratepayers, who too often act capriciously, is the adjoining town, to which such a suburb owes its advantages, to be threatened with fever and sickness by reason of this indifference to sanitary control? Besides, if the Local Government Act were adopted, it has been found that the practical working of the measure in small places is not, as a rule, followed by results so satisfactory as in large towns, where much valuable experience is being acquired daily. remedy suggested, therefore, is a simple one. Let parliamentary facilities be given in the next session for extending the municipal boundaries of corporate towns, and enlarging the area of jurisdiction in populous places, where the Local Government Act is in force, so as to include any such defined outlying limits for sanitary and other purposes. A short Act of Parliament, permissive in its character, might give the required relief; the machinery for its adoption could be set in motion by means of provisional orders issued by the Secretary of State on petition, and confirmed by the legislature, as is now done in other matters. Difficulties will of course be started, and objections raised against any such fusion or extension; but surely the claims of the public health are paramount, and the outlay of important towns in securing valuable sanitary regulations for their own citizens ought not to be neutralised, or their health jeopardised, by neighbouring incapacity or indifference. This proposal need not involve uniformity or equality of rating in the new and old parts, as existing circumstances would be taken into account. The principles of taxation and representation would be determined by the provisional order, after due inquiry on the part of the Home Secretary. At the same time the fact should not be ignored, that in scores of towns at the present day, thousands of pounds have been expended in sanitary and other public works, such as main drainage, water supply, markets, baths, washhouses, parks, recreation grounds, free libraries, museums, and the like, from which the inhabitants of adjoining suburbs derive advantages equal to those who are taxed to pay for them, and yet not one farthing of the expense is contributed by the former. An anomaly this, which demands alteration.

With such enabling powers, therefore, as those suggested, my conviction is, that a sound and healthy stimulus would be given to

the further operation of the Local Government Act, and other measures of a social and beneficial character, the introduction and extension of which to our suburban population, on equitable terms, is imperatively called for in the present day.

Causes of the Difference existing between the Death Rates of Rural and Urban Districts, and, incidentally, of Sheffield. By G. L. SAUNDERS.

No work has contributed more to the improvement of the sanitary condition of this country than the annual Returns of the Registrar-General, which place before us the amount and the causes of disease and death. But, unfortunately, these Returns cannot point out the peculiarities of each district, and the averages of death are based upon the Poor-law unions, so that little comparison can be made between one town and another. As a general rule, however, the Returns correctly mark the progress of disease in the country, and clearly exhibit the general causes of rise or fall in the death-rate. One great error, however, is to be found in these Returns, and indeed in the writings of most sanitary reformers-not even excepting those of Mr. Chadwick, to whom the country owes so much sanitary improvement. This error consists in the assumption that urban districts can, by the adoption of certain legislative sanitary measures, be made as healthy as rural districts; that is, that the death-rate ought to be no higher in the former than in the latter. But while society is organised as at present in our large townswhere men are compelled for a living to undertake labours injurious to life-where there are classes congregating together, lost in the depths of ignorance and weighed down by poverty-and where vice is rampant it is quite useless to expect the inhabitants to be as healthy as those of villages. It is certain, that though the same public sanitary measures may be adopted in a town as in a village, there are in the former many causes of disease which are absent in the latter. The populations of towns and villages are so differently circumstanced that it is quite impossible to equalise the death-rate; and the loss of life must be-until perhaps the millennium-considerably greater in urban than in rural districts.

The first great point to be considered is, density of population. In towns, the trade is concentrated on a small space, and for the sake of that trade the people huddle together and live in masses; and this cannot be prevented without many arbitrary regulations; for the tradesman wishes to live near his shop, and the working man near his labour. If the narrow streets are pulled down, the result is, that larger numbers crowd the wide. You cannot get the people away from the place where they are employed. If a narrow street of one hundred houses, each house containing six persons-or six hundred in the whole-were, for the sake of improvement, taken down,