1537VEGETARIANISM & PHYSIQUE.—THE METROPOLITAN WATER-SUPPLY.

Most surgeons will not be in accord with Dr. KIRK as to the

bad results of the ordinary methods of treatment in earlycases ; in fact, in the average early case of spinal caries im-mobilisation gives excellent results, bony union taking placewithout the formation of an abscess. It is very definitely aninnovation to adopt operative procedures in early cases

and we shall watch with interest the further developmentof the method.

__________

Annotations.

VEGETARIANISM AND PHYSIQUE.

" No quid nimis."

PHYSIOLOGICAL considerations have long disposed of theview that a purely vegetarian diet ministers best to the needsof the human body, and although objection has been raisedagainst physiological reasoning on the ground that it was

largely theoretical a good deal of practical evidence hasbeen forthcoming which has justified all speculation. Itis well established, for example, that the individual who

subsists upon an exclusively vegetable diet is far more

susceptible to the attacks of disease than is the consumer

of animal food. In short, the former’s power of resistance todisease is decidedly weakened, for the reason that, after all,he is underfed, or in chemico-physiological terms, he failsto realise a sufficient intake of protein substance which

makes for bodily energy, not to mention intellectual capacity.Every day as knowledge advances and powers to add to thatknowledge are increased is the view strengthened thatvegetarianism is a fallacy. The vegetarian school has

pointed with triumph in its own mind to the oriental

peoples as examples of physical strength and endurancesupported alone by a vegetarian diet. These examples in thelight of an exceedingly interesting practical inquiry on thesubject can no longer serve the arguments of the vegetarianadvocate. We refer to a study of the problems of nutritionconnected particularly with the well-being and physique ofthe teeming natives of Bengal in relation to their diet whichconsists principally of rice. The investigation was under-taken by Captain D. McCay, I.M.S., the professor of physio-logy at the Medical College, Calcutta, and it will be

admitted, we think, that he has added a masterpieceof physiological inquiry to previous contributions. Theo-

retical considerations may be left out, although theyare obviously of interest compared with the results of

practical observations. Experimental details, also, thoughfull of scientific interest, may be omitted, but it is enough tosay that the results fully justify the conclusions arrived at.Anyone, we are told, who has seen the ordinary Bengalicoolie at work will not require much statistical evidence toconvince him of the marked superiority of the European;men have often to be employed in India for workthat women will do in England. Again, from an insurancepoint of view the life of the Bengali is very inferior tothat of the European. In spite of the fact that the Bengaliexists on a protein metabolism very close in amountto that stated by Chittenden to be sufficient, his powers ofresistance to disease are impoverished owing to an un-

replenished condition of the blood accompanying a low

protein intake. Nor is the function of the kidneys thebetter for a low protein intake, for kidney disease is morecommon among natives than among Europeans, whilst

amongst the upper middle classes the extreme presenceof glycosuria would prove conclusively " that the

danger of an excess of carbohydrate intake is even

a more real’ and present one than that of proteid excess."

From this it would appear that the human machine in healthis able to eliminate more completely the toxic productselaborated from a generous diet of protein than from

a diet overstocked with carbohydrate. At all events,in the latter case the resisting power of the tissuesto disease is decidedly lowered, so that diabetes,pneumonia, tuberculosis, spreading gangrene, and so forthare very prevalent amongst the Bengalis who subsist on a

beggarly protein diet. It follows that vegetable food, unlessconsumed in large quantities, does not yield a sufficiency ofprotein, and therefore, in order to obtain this sufficiency, aquantity of carbohydrates has to be consumed simultaneouslywhich places a strain upon the resources of the body ulti-mately leading to a reduced vitality which is favourable tomicrobial invasion and its results.

THE METROPOLITAN WATER-SUPPLY.

THE report of the Water Examiner on the condition of themetropolitan water-supply during the month of August hasbeen issued and does not call for any exceptional comment.The condition of the London water during the month appearsto have been as satisfactory as can be expected under exist-ing conditions, thanks to the absence of floods on the Thames,although the mean rainfall for August was all but an inchabove the mean average for that month. It is probable, how-ever, that this increase of rainfall will be reflected in the

bacteriological report for September. As it was, 13’ 6 percent. of 100 cubic centimetre samples of filtered Thames

water contained bacillus coli in August. This report alsocontains tables giving a summary of the state of the variouswater-supplies during the three summer months-June, July,and August. Comparing this quarter with the same months of1907 it is found that during this year the raw waters containedthe more bacteria, and in the case of raw Thames and Leawaters a larger proportion of samples contained typicalbacillus coli in one cubic centimetre of water. There were,however, slightly fewer microbes of intestinal origin in thefiltered water, which is perhaps to be accounted for by addi-tional storage before use. The report further states that"chemically, the raqv Thames water was less turbid and

discoloured, and also contained less albuminoid nitrogenand absorbed less oxygen from permanganate in the 1908summer quarter than in the 1907 quarter. The rcrnv Lea

and New River waters were slightly worse in 1908, as judgedby the foregoing tests, except as regards albuminoid nitrogenin the case of the Lea. As regards the filte’l’ed waters the1908 results compare favourably with the corresponding1907 results with the exception of the New River and

East London (Lea) districts." The further improvementof the London water-supply depends now upon increasedstorage accommodation, and it will be within our readers’knowledge that extensive works are at present beingundertaken by the Metropolitan Water Board to con-

struct a new pumping-station and reservoir at Island

Barn, West Molesey. It was high time that the Board

took advantage of the powers which were obtained bythe Lambeth Waterworks Company in 1900 but which

hitherto have been resolutely opposed by the local autho-rities on financial grounds, and this in spite of the factthat the Lambeth water has often been notably unsatis-factory. The water is to be taken from the Thames

through an open conduit taking eight feet of water

when the river is at normal level. The pumping engineswill be able to raise 25,000,000 gallons daily. Mr. C. E.

Hearson, chairman of the works and stores committee ofthe Board, in an address which he delivered recently whenMr. John Burns "turned the first sod," said that the occasionmarked th (ommencement of a series of reservoirs whichwould add a storage capacity of 4700 million gallons to the

1538 THE CONTINENTAL HOTEL.

accommodation for 4530 million gallons which had beenprovided since the Board came into existence. That the

&250,000 which this undertaking is to cost will be thoroughlywell spent is certain, and this is made more certain byDr. A. C. Houston’s striking experiments upon the effect ofstorage of water upon typhoid bacilli, which we have reportedin a previous article. 1 Where the money is to come from

is another matter. The financial state of affairs disclosed atthe meeting of the Board on July 17th last was eminentlyunsatisfactory, and still more unsatisfactory is the feelingwhich has been raised in the City by the new water assess-ment on the rateable value of business premises introducedby the Board. The late Lord Mayor, before retiring fromoffice, presided at a meeting of protest against these chargeswhich was held at the Mansion House, and we understandthat in certain cases indignation has passed beyond theadoption of resolutions to the sinking of private wells, thoughthis would not seem to be a means of escaping the rate.A body which exists for the public service is surely taking awrong view of its functions when it adopts a policy whichleads to this kind of retaliation.

THE CONTINENTAL HOTEL.

THE "hotel industry" has just had its International

Congress in Rome, at which nearly every European countrywas represented. The motions submitted, discussed, andeither carried or deferred to the Greek Kalends were

numerous enough to convey an impression of the graveinterests involved in the said "industry," but little was

proposed, still less effected, in the way of innovation or

reform so as to reassure the English-speaking contingent ofthe "great army of travel " that long-standing abuses wouldbe done away with and long-desired conditions of healthand comfort introduced in their stead. Much was said and

something done as to the responsibilities of landlords in thematter of their clients’ property when that has more or lessmysteriously disappeared, if not left in deposit " at thebureau; much debate, moreover, turned on the question oftips, pourboires or mairaaie-a question becoming yearly moreclamant for solution ; prominence was also given to theconsideration of how to prevent the evils of competition,such as the spread of false news as to the health conditionsof this or that rival resort, and kindred devices for

detaining the client in one locality and preventing himfrom "patronising" another. These and questions ofa kind more directly interesting to the landlord thanto the public were duly formulated and considered; butnothing was said or even hinted at as to the essentialsof sanitation in the hotel buildings themselves, as to

the security of the clientele in the matter of food and

drink, as to the protection of the newly arrived guest fromthe "hotel rat," or chevalier d’industrie, so familiar to thetravelling world on either Riviera. In fact, the ° congress-isti " in Rome committed the mistake that vitiates all the

procedure of the cognate committee for ° promoting theinflux of foreigners into Italy," that of insisting on

the secondary, and ignoring the primary, momenta in theirbrief. The committee referred to becomes eloquentlyexpansive on the attractions, natural, historical, and artistic,of the Italian cities and the necessity of impressing these onan imperfectly appreciative world ; but in ignorance of thefact that the said attractions are better understood andesteemed abroad than in Italy itself, it omits to satisfy theforeign guest (often an invalid) as to the health conditions ofthe locality which he affects as a place of sojourn, as to thequality of the food meted out to him, or the purity of thewater-supply, or the genuineness of the wines offered forhis consumption. Cases of poisoning from tinned meats

1 THE LANCET, July 25th, 1908, p. 255.

or tinned fish have been frequent enough of late years todeter many an intending visitant from the scene of such acasualty ; intestinal troubles of various kinds caused byadulterated wine or by "table-waters" " that have longsurvived their premirre jm.6nesse have further reinforced thedisposition to I I fight shy" of the otherwise attractive sun"trap impressed with such or similar associations. The landlordinterest is so intimately dependent on the reputation as tohygiene and diet enjoyed by the hotel that the wonder is thatin such congresses as that just held in Rome, or on committeeslike those for the attraction of the foreigner, the medicalconsultant it not invited to bear a part in their deliberations.The advances made in hotel enterprise and organisation, inhotel management and comfort, are doubtless conspicuousand praiseworthy. We have but to recall the descriptionof the mediaeval inn in the "Colloquia" " of Erasmus, or,

better still, in Scott’s "Anne of Geierstein," to realise theinterval that divides the hostel available for the post-Renaissance travellers with the hotel he may alight at inany provincial town on the continent. But the superiorityof the latter is still far short of what it might be, and theideal hotel will continue to be a desideratu until the firstconditions of health and comfort are provided in thedirection above indicated-in the essentials of sanitation,local and domestic ; of pure air and pure water; of adequateventilation and genial "exposure" ; of sound food, animaland vegetable ; and of a choice of beverages, stimulating ornon-stimulating, with which the analytical chemist " ofDickens has as little as possible to do.

SUNLIGHT IN THE TREATMENT OF HIPDISEASE.

IN the Canadian Journal of Medicine and’ Surgery for

November Dr. B. E. M’Kenzie has called attention to the

value of sunlight in the treatment of hip disease. He beganto treat cases of the disease in 1888 and in the first decadethe mortality was about 10 per cent. In the next decade his

results were much better. Careful scrutiny of the methodsused showed that the improvement was chiefly due to thegreater use of direct sunlight. The patient is kept upon acot called a "Bradford frame." This consists of a

rectangular frame about a foot longer than the patient andvarying in width from 11 to 14 or 15 inches, according to

the size of the patient, and covered with a sheet of canvas onwhich the patient lies. At each end is a bracket for

attaching straps for extension and counter-extension. The

patient is kept recumbent on this frame for months, not

being allowed to rise even to the sitting posture. If much

covering is necessary it may be wrapped :around the patientand the frame and secured by safety-pins. A cage is thrownover the feet to prevent the bed clothing from resting uponthem and producing a state of equinus or undue rotation of thelimb and subsequent deformity. A pad is placed under theknee to maintain a few degrees of flexion. Extension is main-tained by an anklet or gaiter with a ouckle on each side fromwhich a strap passes to the bracket at the lower end of theframe. Counter-extension is maintained by a pad in theperineum on the sound side round which passes a bandage tothe bracket at the upper end of the frame. Dr. M’Kenziefinds this method of extension comfortable and more con-venient than the use of a cord and weight. The cot can becarried from one place to another without disturbing thepatient. Every day, whether in winter or summer, he is

carried out of doors so as to be as fully exposed to the sun’srays as the grass. When the weather is suitable the

affected part is exposed without any covering. This can be

done during the greater part of the year without discomfort,and even in winter the patients are left out in the sunshine’from morning till night on suitable days wrapped sufficiently