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37
Annual Report of the Medical Officer of Health.—1867-8.
Whether it rests within the compass of man's power to rid the world of the sources
from which Zymotic diseases take their rise I know not. The poison germs may be present
every where; they may be carried on or in water; they may adhere to walls, clothing, and
bedding; they may float idly about in the atmosphere, but if no suitable soil be prepared
for them whereon to settle, and work out their results, then no more consequences would
follow than if good seed were scattered upon the brown and naked rock, or upon the dry
and parched sand of the desert. The fact is certain, that the extent and mortality of
Zymotic diseases will always be found to correspond with the social and sanitary condition
of a people, rather than upon the strength and power of the epidemic. The International
Sanitary Conference, which met in Constantinople in the beginning of the year 1867,
anticipated a period when the minds of all men would be penetrated with the truth, that
most endemics and epidemics owe their violence and spread to the massing together of
people, and to the fatal customs prevalent amongst them—a period, when all shall understand
that it is in the power of man, at the same time that it is his duty, to overcome by his
efforts, that condition which he has created by his ignorance. The conference asserted that
if man was to be preserved from cholera epidemics, he must live on a clean soil, drink pure
water, and breathe a pure atmosphere. "The preventive power" of disease "which we
possess, is amongst the happiest possessions of science."

To constitutional diseases were referred 305 deaths. This class consists of two
divisions; one only of which will demand our attention. This includes that most fatal of all
diseases, consumption, as well as tabes, which destroyed 76 persons, 74 of whom were under
five years of age; as well as hydrocephalus, a disease also fatal to children. Consumption
has caused 184 deaths; the lowest number that has happened in five years, except the
year 1864-5, when they were three less. A curious and very important fact has been
brought to light with reference to this disease, by Dr. Buchanan. He found, whilst on his
search into the results of the sanitary improvement in English towns, that the drying of
the soil, which has followed in most cases from the laying of main sewers, has led to a considerable
diminution of this disease. At Leicester it was observed that when a diminution
occurred in the subsoil water, a corresponding reduction was observed in the consumptive
death rate. Clearly some intimate relation exists between the subsoil water and consumption.
I need not say that the mortality of other diseases is also influenced to a greater or
lesser degree by efficient drainage. Any knowledge which may tend to diminish the ravages
of consumption cannot be too widely known, consequently I think it right to inform you,
that it is the opinion of a modern writer, that if we avoid breathing the same air over again
we cannot incur the disease; but that if we breathe the same air again we cannot in the
long run avoid it. Simply by shunning re-breathed air, tubercular and tubercle induced
maladies may be got rid of for ever. Granting the result should not be so complete as here