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water supply.
Dr. Houston, Director of Water Examinations, in his fourth annual report, for the year ended
March, 1910, alludes to "the striking new fact . . . now shown in this report that London is not
really drinking merely filtered raw river water, but raw river water which by storage processes has been
purified bacteriologically antecedent to filtration to a remarkable extent." Storage, Dr. Houston says,
acts in three ways. It permits of sedimentation; it favours devitalisation of "the microbes of waterborne
disease"; and it has a "levelling" effect, spreading the dose of poison over weeks or months,
and it may be, indeed, quite apart from any question of devitalisation, rendering innocuous " a
microbial contamination which in a concentrated form would be apt to be highly dangerous." " These
three factors of sedimentation, devitalisation, and equalisation are," says Dr. Houston, " of supreme
importance in connection with the storage of impure river water antecedent to its filtration." During
the year there appeared Dr. Houston's third and fourth research reports; the former dealing with
the subject of storage generally, and the latter with the vitality of the cholera vibrio in raw river water
with special reference to the question of storage.
Health Visitors.
London County Council (General Powers) Act, 1908.
Section 6 of the above Act empowers the Local Government Board to make regulations prescribing
the qualification, mode of appointment, duties, salary, and tenure of office of health visitors, and in
September, 1909, the Board made an Order for these purposes. The Order—Article I. (1) and (2)—
with respect to qualification, prescribes that:—
I.—(1) A woman shall be qualified to be appointed a health visitor if she—
(а) Is a duly qualified medical practitioner within the meaning of the Medical Acts;
(b) Is qualified for the appointment of nurse by having undergone for three years at least a course of instruction
in the medical and surgical wards of any hospital or infirmary, being a training school for nurses, and having a
resident physician or house surgeon;
(c) Is certified under the Midwives Act, 1902;
(d) Has, for a period of not less than six months, undergone, in a hospital or infirmary receiving children as
well as adults, and having a resident physician or house surgeon, a course of instruction including subjects relating
to personal hygiene, and holds the certificate of the Royal Sanitary Institute for Health Visitors and School Nurses,
or the certificate or diploma of the National Health Society, or of any other body which may from time to time be
approved by the Local Government Board;
(e) Has, in the service of a sanitary authority, or of the council of a borough or of another urban district or
of any other public body or authority in England or Wales, discharged duties which are similar to those described
in the Act or prescribed by these Regulations in relation to the office of health visitor, and produces such evidence
as suffices to prove her competency;
(2) Where, in the opinion of the Local Government Board, the circumstances so require, the sanitary authority
may appoint to the office of health visitor a woman who, though not possessing any such qualification as is prescribed
by sub-division (1), has a competent knowledge and experience of the theory and practice of nurture, of the care and
management of young children, of attendance on women in and immediately after childbirth, and of nursing attendance
in cases of sickness or other mental and bodily infirmity.
Sanitary Inspectors.
Appended to this report is a return showing the number of sanitary inspectors in London in
June, 1910 (Appendix VI.). The return also shows the numbers of men and women inspectors in the
several years since 1893, and the number of health visitors employed in the several sanitary
districts. It should be noted that, as compared with the return published as an appendix to the
annual report for the year 1907, there has been an increase in the number of men inspectors from
279 to 286, and one additional woman inspector has been appointed.