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of being enforced where necessary. There are many of the districts of the metropolis
in which the local sanitary authorities have not yet provided the mortuary house,
which they are empowered to provide by the 27th section of the Sanitary Act; even
where it has been provided the limitations imposed by that section render the statute
practically valueless. In all cases a packet of Mc Dougal's or of Calvert's disinfecting
powder should be strewed over the body before the coffin-lid is screwed down, which
should be done as quickly as possible.
" 11. The sanitary authorities should provide such a staff of assistants, or labourers,
and such appliances as may be necessary to carry out the disinfection of houses,
clothing, bedding, &c., where people are too poor or ignorant to be trusted with the
work ; and also proper means of destroying certain things by fire.
" 12. There should be arrangements by which articles of clothing, bedding, &c.,
destroyed by order of the Medical Officers of Health may either be replaced or paid
for. At times when the " Diseases Prevention Act" is not in operation by order of
the Privy Council, no such arrangement can be made.
" 13. During the disinfection of a house or apartment, or when the sick person
cannot be removed, it is necessary to remove the healthy; for this there should be one
or more houses of refuge provided, in which poor families may be temporarily lodged,
and with means of disinfecting the persons and clothing of those removed. A house
of refuge is a thing at the present time utterly unknown to the sanitary arrangements
of the Metropolis.
" 14. The " Diseases Prevention Act" should be put into operation by order of the
Privy Council on any severe outbreak of scarlet-fever in London, or at times
when, from season or cyclical period, it is probable that the disease will spread extensively.
Practically, this otherwise invaluable Act is a dead letter, except on certain
occasions, when an unusual disease prevails in the country, such as an epidemic of
cholera.
"15. The services of public nurses to superintend the administration of nourishment
and medicine, and the disinfection of discharges, would be invaluable. One bad
case of scarlet-fever furnishes quite occupation enough for one woman.
" 16. The Medical Officers of Health desire to put in force the lodging-house clauses
of the Sanitary Act, 1866, sect. 35, which, by restricting the number of inmates, and
by enforcing periodic cleansing of the homes of the poor, might in some degree limit
zymotic disease."
It cannot be too strongly impressed upon the public mind that the contagion
of typhoid fever, and probably of all other epidemic diseases, is
conveyed by the exposure, without previous disinfection, of the excrements of
patients suffering from any of those diseases ; and hence the importance of
pouring carbolic acid, or some other powerful disinfectant, on all the excretions
immediately they are discharged.
I have on several occasions pointed out the danger to which persons
are exposed who live in those rooms on the ground floor into which the
staircase opens and forms a part, and which are necessarily used as thoroughfares
by the occupants of the upper rooms of the house on their way to the
privy, or house-drain, to empty house slops and the discharges of persons
living in the upper rooms, when they are attacked with epidemic disease.
The danger to persons living in the upper rooms of houses so constructed is
also very great, when any person on the ground floor is attacked with contagious
disease, in consequence of the emanations from the sick making their way up
the staircase, which necessarily forms a ventilating shaft of the lower room,
and conveys the foul air of the lower room into the rooms above. Houses
so constructed are, in my opinion, except in special cases, unfit for habitation.
I am, Gentlemen,
Tour obedient Servant,
JOHN LIDDLE.