1409

at Brussels, 9 cases and 4 deaths ; in the Province of Western Flanders, at Steendorpe, 2 cases and 1 death ; at Termonde,5 cases and 2 deaths ; and at Lokiren, 2 cases; in all, 9 casesand 4 deaths. In the Province of Liege, in the town of

Liege, 3 cases and 2 deaths. There is no cholera in the Pro-vinces of Limbourg, Luxembourg and Namur. Such, then,is the present state of affairs ; and though the epidemic is.evidently decreasing, still it is spread over such a multitudeof districts that it is impossible not to fear a virulent returnof the scourge.At the same time it must be noted that, of the seven

,epidemics of cholera which have occurred in Brussels, onlythose of 1832 and 1833 and of 1854 and 1855 followed one

upon the other. Dr. Janssens has prepared and justissued a most interesting diagram of these seven epidemicswhich he has kindly given us permission to reproducein the columns of THE LANCET. Unfortunately thelimits of space render it impossible to do full justice tothis work. The original diagram is divided into as manyvertical columns as there are days of the year, while everyhorizontal line measures one death. In the reproductionit has been necessary to leave out the winter months,and the horizontal line is drawn at every five deaths.Nevertheless, single deaths can be readily seen and,counted. What it has not been possible to show isthe significant fact that, though the influence of season onthe epidemics is very emphatic, the note of warning is oftensounded altogether out of season. Thus, in 1849, there wasone death on the 21st of February, then no further deathswere noted till the 24th and the 27th of April, on which daysthe second and third deaths took place. Again, in 1854, therewas one death on the 7th, 14th, 15th and 17th of January,two deaths on the 21st, one death on the 23th, and one death,on the 3rd, the 5th and 10th of February. Then nothingwhatsoever happened till the month of July, when, as it willbe seen by the accompanying diagram, there were threedeaths, and also three deaths in the month of August. Duringthe next three months there was a very small epidemic,which did not quite die out till January of the ensuing year.ln this latter month (January, 1855) there were 18 deaths,occurring from the first day of the year to the 18th. Then] o more cholera was reported before the following month ofAugust, when a very small epidemic broke out, which reachedits maximum intensity in October. These two epidemicsof 1854 and 1855, which were preceded by a few cases in thedepth of winter, only caused 282 and 236 deaths respectively,and this is equal to 19 and 16 deaths per 10,000 inhabit-ants. The smallest epidemic of all was that of 1859, whenthere were but 114 deaths, or 7 deaths in 10,000 inhabitants.’The epidemic of 1849, which was preceded by a few

warning cases, was more serious, as there were 1007 deaths,and this gives a proportion of 73 deaths per 10,000 inhabi-tants. The most serious were the first and the last epi-demics—that of 1832, with 864 deaths, or 87 per 10,000 ;and that of 1866, with 3469 or 212 deaths per 10,000 inhabi-tants. The epidemic of 1833 caused but 268 deaths, or 27deaths per 10,000 inhabitants. For the three severest epi-demics, those of 1832, 1849 and 1866, the month of August wasthe most fatal ; during the four slight epidemics of 1833, 1854,1855 and 1859, the greatest number of deaths occurred in’October ; but all the seven epidemics are chiefly fatal withinthe four months July to October. The effect of the seasonof the year on the disease is thus most emphaticallydenoted.The influence of locality on cholera is set forth with

’equal emphasis by Dr. Janssens, by statistics in which hegives for every street, court or alley in Brussels the number’of deaths from cholera which occurred during the seven

’epidemics ; then, calculating the number of inhabitants inthese streets, he adds the proportion per cent. of deaths.’Thus, in looking over this list, I find that during the’seven epidemics there were 39 deaths from cholera inthe Rue de Flandre, and these were only equal to 1 percent. of the population of that street. In the Rue auxlaines there were 25 deaths, or 12 per cent. Then,going to the other extreme, in the Impasse St. Medard, a

small court, there were 7 deaths, and this is the highestrecord, for it is equivalent to 20’8 per cent. of the population,or a little more than 1 death out of every five persons livingin the court. The next worst is the Impasse Welletiens with11 deaths, or 18’6 per cent. ; then follow the Impasse Peeters,41 deaths, or 17 ’3 per cent. ; the Impasse Tordier with 23deaths, or 17 ’2 per cent ; the Impasse du Templier with 2deaths, or 16 ’6 per cent. ; the Impasse du Charon and RUE

Ophen, each with 15’7 per cent. of deaths to the population,and so on down to the 1 per cent. mentioned above.

There are still unfortunately some black spots remainingin Brussels. Good sanitation does not altogether obliterate theeffects of poverty, and though a town may be greatly improvedas a whole, there still remain dark corners where no amount ofsupervision can prevent overcrowding and dirt. The choleraseems already to have found out one or two of these evil

places; but as yet little harm has been done. If it is

humanly possible, with the knowledge and the means actuallyavailable to prevent the mischief extending, past experienceshows that the population of Brussels may rely on the devotionand ability of its sanitary authorities and of their dis-tinguished chief, Dr. Janssens.

THE MUNICIPAL SLAUGHTER-HOUSE OFBRUSSELS.

(FROM OUR SPECIAL CORRESPONDENT.)

IN Brussels all private slaughter-houses have been rigorouslyabolished. A large public slaughter-house was built so farback as the year 1836, and there is a law bearing the date ofMarch 30th, 1836, and another that of Aug. 12th, 1848, whichregulate the management of this slaughter-house. Public

slaughter-houses organised by municipalities, controlled bymunicipal functionaries and belonging to the municipalityhave existed in Belgium for half a century, and yet inLondon, the greatest metropolis in the world, there is nosuch organisation. The innumerable private slaughter-housesof the British metropolis are not only a dangerous nuisancein themselves, but how is it possible to control the quality ofthe meat coming from such places ? The inspectors cannotbe everywhere at one and the same time, and though theyhave the right of entry and of inspection, it is practicallyimpossible to watch constantly so many slaughter-housesscattered over so vast a tract of ground. In London all privateslaughter-houses should be abolished and a few large modelpublic slaughter-houses substituted in different districts. Atthese large slaughter-houses an efficient staff of veterinarysurgeons, bacteriologists and public functionaries could bekept on the spot, and every animal and every carcase couldbe thoroughly examined by properly trained and qualifiedveterinary surgeons. Then and then only can we feel certainthat no unwholesome meat is sent to the market.To the municipal slaughter-house at Brussels has been an-

nexed the municipal cattle market. It stands to reason thatwherever it is possible the cattle market and the slaughter-house should be close to each other. On the exterior boulevardof Brussels there are handsome iron sheds with glass roofs,where the cattle are brought and exposed for sale. One day itis the market for horned cattle, the next day for sheep, theday after for swine, and so on. If the cattle, as is generallythe case, are bought for slaughter, on quitting the marketthey have only to pass through a gateway to enter the

slaughter-house. In the slaughter-house there are vast stables,where the cattle can be kept for a day or two, if necessary,before they are slaughtered. The cattle market is practicallyin the open air, though under shelter. It is built of iron and

glass and paved with granite, all non-absorbing substances,which can be easily washed and purified. The weighing-machine, made of iron, is carefully washed with a dis-infectant after each market. The fee paid for bringingcattle to this market is 5d. for horned cattle, 2d. for calvesand pigs, and ld. for sheep. The butcher having made hispurchases conveys his animals to the slaughter-house andthen pays for its use 2s. 5d. per head for big cattle, ls. 8d.for cows or horses, 10d. for a pig or a calf, and 22d.for a sheep. The stables in the slaughter-house are

lofty buildings with windows on each side. There is

nothing special to be said about them-they are neitherbetter nor worse than thousands of other stables. Nor isthere much to be said concerning the slaughter-sheds, whichare of about the same size and build, though of course theinterior fittings are different. The pavement is of large bluegranite flagstones, which are slightly chipped so that thesurface is roughened and thus the men and beasts are preventedfrom slipping. At the spot selected for slaughtering there isan especially large stone to which is affixed an iron ring.A rope passing through this ring pulls the bullock’s head

1410

downwards, when it is struck with a mallet. It requiresabout twenty minutes to skin and draw the animal, to slingit up, and push it along the beams, to which it is suspendedby the hind legs, and hung out of the way at the other sideof the slaughter-shed.There now comes into play an important regulation. The

heads, feet, liver, lights &c., have to be boiled on the spot,and there is an establishment set apart for tripe dealers inthe slaughter-house. Thus those portions of the carcase

which cannot be easily kept are boiled then and there, andare therefore in a much safer condition to be sent to thevarious retailers in the town. In another and distinct partof the slaughter-house the entrails are treated-washed, theskins secured and the tripe set aside. Here also the blood,collected in shallow tin pans, is exposed to the action of theair and the albumen secured for various industrial purposes.This section of the Brussels slaughter-house is certainly verydefective. The work is done in what looks like a railway arch-a vaulted structure with very inefficient ventilation. Thepave-ment is uneven and the foul splashing from the washing of theentrails can easily sink into the earth and contaminate thesubsoil. The ventilation is altogether inefficient and the stenchat times very objectionable. Of course, there are thousands offlies about, and their bites have occasionally, though fortunatelynot frequently, been known to be very venomous. This portionof the slaughter-house does no credit to the Brussels muni-cipality, and all that can be said is that it was built longbefore the attainment of the present knowledge of hygiene.It was therefore very satisfactory to turn from this unpleasantspectacle and visit the section devoted to the stabling and theslaughtering of pigs. This is admirably ventilated and beau-tifully clean. The central portion of the pointed roof overlapsthe lower portion, so that the air can pass freely in and outbetween these two portions of the roof, and thus there iscontinuous ventilation the whole length of the ceiling.From time to time various regulations have been issued for

the management of this slaughter-house. The latest bears thedate of December 10th, 1891, and is signed by the Burgo-master, M. Buls. These rules maintain the necessity of for-bidding the entrance into the town of any meat that doesnot bear the stamp certifying it has been duly examined.All persons who carry meat through the town must alsocarry with them a written statement giving the name ofthe owner of the meat and the address of the place whitherit is about to be conveyed. All meat must be taken directlyto its destination, any loitering on the road is illegal. Allhotel keepers, restaurant keepers, or persons who haveboarders staying with them, must, if they bring meat intoBrussels, observe the same rules with regard to the examina-tion of the meat, the stamp it bears, its rapid and directtransport through the streets ; in fact, must submit themselvesto the same laws and regulations as govern the butcher’strade.

Nevertheless, and this is a strange and inexplicable incon-sistency, a person may introduce meat into the town for hisown use without submitting to any control further than thatof giving his name and address. Thus a person may go out-side Brussels, buy some meat, and so long as he declaresthat it is for his own private consumption no measures aretaken to see that the meat is wholesome. Of course it will besaid that a control exists in the outlying district where suchmeat is purchased. But supposing the meat is not purchasedin the regular way,-it may have been obtained from somefarmer who has secretly slaughtered an animal because hewas doubtful as to its state of health,-such dangerous, un-wholesome meat can be introduced into Brussels under the

pretext that it is only for private consumption. This privateconsumption includes a dinner given to friends at which allthe friends can be poisoned. But if in such a case the hostwere to call upon his guests to pay for the dinner he hadgiven them, he would then be considered as a boarding-housekeeper, or restaurant keeper, and would be prosecuted if hismeat had not been examined and stamped. Thus a citizen ofBrussels may feed himself and his friends on bad meat so

long as he does it gratuitously. This, I take it, is a grossexaggeration of the respect due to individual liberty. If

persons can be punished for attempting to commit suicide,why should they not be punished for eating bad meat, or

meat that has not been properly examined ?Two other services attached to the Brussels municipal

slaughter-house are of interest. Here are kept under sur-

veillance the calves that have been employed to supply thevaccine lymph. These calves, having served their purpose, arebrought for slaughter, but before and after death they are

very carefully examined by the veterinary surgeons. It is.

only when a favourable report has been received that thelymph taken from the calves is given out for vaccinationpurposes. In another part of the slaughter-house there is thedepôt for stray dogs. Here they are kept in strong ironcages, and here also is the fatal lethal chamber. It is a simpleapparatus. On the asphalt flooring an indenture has beenmade. This is about three inches deep and two inches wideand forms a square. In the centre is placed the cage contain-ing the dog. By a pulley arrangement an iron box is let downover the cage. It is like a square bell covering over the cage,and fits exactly into the indenture or little trench made in theflooring. The trench is filled with water, so as to prevent thegases escaping, and ordinary coal gas is discharged insidethe cage. In this manner the dog soon dies of asphyxia.Though the abolition of private slaughter-houses and the

creation of a municipal slaughter-house offer the bestguarantees for the due inspection of meat, it must be con-fessed that the municipal slaughter-house of Brussels is nowin grave difficulties. Formerly it was a source of incometo the municipality, now its sheds are to a great extentabandoned, and it is difficult to defray the working ex-penses. This is due to an unexpected but a most energetic-and successful competitor. A private company, having at,command a very large capital, has purchased extensive groundsin the commune of Anderlicht. This is not Brussels, but it isjust outside Brussels. Here they have built a gigantic cattlemarket and slaughter-houses, which are much better situatedthan the Brussels slaughterhouse, for they are in the open,almost in the country, and by the side of both a railwayline and a canal. The cattle step out of the railwaytrucks into the cattle market, instead of being drivenalong the streets. The general conveniences are thereforemuch greater. But the buildings are not only modern, theyhave many new and scientific improvements. To beginwith, the water-supply is most ample and of good quality.An artesian well has been sunk to a depth of 100 metres.Above the well there is a water tower 35 metres high, andon its summit the water reservoir has a capacity of 150 cubicmetres. An engine raises water into this reservoir at therate of 500 litres per minute, and at present the consump-.tion of water in the slaughter-houses and cattle market is.about 150 cubic metres per day. A cheap and practicallyunlimited water supply should be one of the first considera-tions that should govern the selecting of a site for aslaughter-house.Then there must be a prompt and cheap means of disposing

of manure and all offensive refuse. This is supplied atAnderlicht by barges on the canal, which pass all along oneside of the slaughter-house and cattle market. The manurethese barges take away is sold at the market for from 2s. 10d,to 3s. 8d. according to the season of the year. As the stable-will hold 900 head of cattle there is naturally a considerableaccumulation of manure, and the stabling that now exists is.found to be insufficient. It is proposed to spend £ 40, 000 moreto extend the buildings. These stables are most carefully built.There are no angles, the mangers are carefully rounded offso that no dirt can accumulate in corners and all can be veryeasily cleaned. Along the whole length and slightly abovethe manger is a water pipe, so that it may be instantaneouslyflushed out. The flooring is of Kilker Dutch brick, whichis very hard, and is placed in full cement, so that the

flooring becomes absolutely watertight. For the older built.stables the more luxurious flag-stone pavement was used, butthis is not so good, though dearer, because it is not water-tight. The roofs are rounded and ten metres in width. Otherroofs are of tin, with inner stucco ceiling, which can be andis washed with the fire hose. There are louvre windows oneach side, and at the two ends are ventilators on the Venetianblind system.The slaughter-house sheds are more elaborately ventilated

than the cattle sheds. The doors are in part of wire-work, sothat even when shut the air comes through. On the roofthere are special cowl ventilators. The windows are face toface on both sides of the sheds, and to supplement these willbe found numerous openings on a level with the floor. In-the part of the building devoted to the preparation of tripe &c.the apex of the roof is open along its whole length, and thisopening cannot be closed. In some of the sheds the OttoMeurer patented flooring has been tried. This is a sort ofcompressed cement which does not get polished or slippery.It is formed into blocks slightly convex, perhaps a footbroad. On either side is a very small circular drain or gutterwhich is bridged over by a perforated iron piate. The whole

1411

of the flooring slightly inclines and all liquids are carried offinstantly. One bucket of water thrown over these convexblocks will do more effective cleansing than several bucket-fuls on an ordinary floor. Some interesting experiments are being made here in

the destruction of bad or diseased meat. To sterilise suchcarcases by exposing them to steam only arrests temporarily thedecomposition, and carcases thus treated might contaminatethe fields where they are thrown as manure. The chemist atAnderlicht prefers to use sulphuric acid. The gases thatarise from the dissolution of the carcase are made to passthrough a coke fire, so as to be purified and prevent nuisance.When the carcase is completely dissolved by the acid thisliquid, which retains practically all the nitrogenous matter ofthe animal in the form of ammonia, is thrown on phosphatesat about 20 per cent. It is calculated that 500 kilos ofdissolved animal carcase and sulphuric acid make with thephosphates 1000 kilos, or one ton of excellent manure, whichcan be sold for about f2 8s., and should not cost more, all told,than Yl 15s. to produce. From the public health point ofview it is most important that an advantageous method ofdealing with condemned meat or carcases should be dis-covered. There will then be less temptation to smuggle awaysuch condemned meat and convert it into sausages &c.

Altogether there is no denying the great superiority inposition, size, buildings and appliances of the slaughter-housesand cattle market built by a private company at Anderlicht.These are much superior to the municipal slaughter-house atBrussels. The result is that most of the trade has gone toAnderlicht, which is quite near enough to Brussels to

supply all the wants of the capital. Indeed, Anderlichtis a suburb of Brussels which happens to be under a dif-ferent municipal authority. The company hope to increasethe number of inhabitants at Anderlicht because of thebusiness that the market will bring, then they will be able tosell at a profit the land they bought before building themarket and slaughter-houses. It is, in fact, a gigantic specu-lation which has altogether overthrown the calculations of theBrussels municipality, and should serve as a warning to re-formers in England. Municipalities must be careful whenthey undertake to build slaughter-houses to see that undersome rival and neighbouring local authority other slaughter-houses are not brought into existence which shall disas-

trously compete with them. The experience of the Brusselsmunicipality is perhaps unique, and it is impossiblenot to sympathise with that body. They gave all European excellent example so far back as the year 1836 when

they built their municipal slaughter-house. Of course

Brussels was but a small town then, and the site selectedwas as much outside Brussels then as Anderlicht is to-day.The newer portions of the Brussels slaughter-house are betterbuilt; but, of course, so old an institution cannot be expectedto have all the modern improvements, and it compares un-favourably with the Anderlicht slaughter-house. And now,through want of a common understanding between the localauthorities of Anderlicht and of Brussels, a war is waging inrespect to slaughter-houses which has resulted in a veryserious loss to the Brussels taxpayers and in no gain in thereduction of local taxation at Anderlicht.

A WELSH MEDICAL SCHOOL.

THE University College of South Wales and Monmouthshireat Cardiff is a flourishing and progressive institution, andhaving done excellent work in the past is now desirous ofextending its influence, and in this wish is supported by allthe ardour of a strong local patriotism. So far as universityeducation in medicine is concerned the University of SouthWales has hitherto taught only the preliminary arts andsciences. It has taken as its ideal in this teaching thestandards of the University of London, and the successesof its pupils at that University have been well above theaverage. The students have evidently been thoroughlyand efficiently instructed in the subjects and syllabusesthat have been put forward by this University as a guide forits examinations, and university education on these lineshas been most systematically and vigorously carried on tothe great advantage of its numerous students from Cardiffand from the adjacent area of South Wales. For many yearspast the University authorities have been anxious to develop

a medical side, and donations to about £ 5000 have been

promised to its support. The finance committee presenteda detailed report to the Council on the 7th inst., and it was notonly determined to institute the proposed School of Medicine,but to advertise at once for professors of anatomy and phy-siology, each at a stipend of 350 per annum. We presumethat some large share of the students’ fees is to be added tosuch a remuneration. The medical school is evidently in-tended to fulfil two very different objects. It is to carryout the curriculum of the Intermediate M.B. Examination ofthe University of London, and this doubtless will be welldone. There are many reasons why the scientific portion of’a medical student’s education should be taught in the-

country, provided that good teachers, plenty of material and,efficient apparatus can be found. The second part of thescheme does not so well satisfy us. The earlier subjects ofthe curriculum for the non-university student can be learntin the dissecting-room and in the laboratory, side by side with,his fellow who is preparing for the University, but theattempt to add clinical work and hospital practice, if theyare to be at all thorough, is a much more doubtfulprocedure, and in laying down the opinion that students.should attend a hospital from the first, the Council is not in-accord with those who have drawn up the new regulations ofthe examining boards or with most university authorities. Ifwhilst he is spending two or three years at Cardiff the studentis only to learn bandaging and dressing and the rudimentsof surgery and medicine we have nothing to urge against it,but if anything more ambitious in the way of clinical instruc-tion and hospital work be attempted it will end in failure.Science may be well taught in University Colleges in many-provincial towns ; efficient clinical teaching and practicalwork with sufficient material for the future practitioner’sthorough training can only be obtained in the largest teaching;centres and in our most populous cities.

PROPRIETARY MEDICINES.

ON Wednesday morning last, Mr. Piper, grocer, of 20, Warwick-road,Pimlico, and others represented by counsel, appeared before his HonourJudge Batsman, at the instance of the Pharmaceutical Society, for analleged breach of the Pharmacy Act, 1868. The action was brought to-recover the penalty for selling a proprietary medicine, known as Dr.Collis Browne’s chlorodyne, said to contain a preparation of opium, a.poison scheduled in the Act.The plaintiffs were represented by Mr. Grey, and Mr. Bonsor-

appearea for the defendants.Mr. Bonsor said that he admitted the sale and purchase of the prepara.

tion, but not that it was a poison within the meaning of the Act. It was.true that it had been dee ided that they were subject to a penalty fornot labelling the preparation, but the preparations which his clientssold were not poisoos within the meaning of the Act.

His Honour: Is it not curious that. these questions should again be,raised before me after it has been decided by a police magistrate, whois a judge of first instance like myself ?Mr. Bonsor : The patent medicine question has never been gone into-

before a magistrate.His Honour: Surely it has and discussion after discussion has ensued.Mr. Bonsor: But no evidence has been called on behalf of the defend-

ants to show what a patent medicine is or is not.His Honour: Everybody knows what a patent medicine is.Mr. Bonsor: I think not.His Honour: Surely it is a medicine produced by letters patent.Evidence was given proving the purchase of the bottle and that it con-

tained two grains of morphine to the ounce.Mr. Bonsor said that the case was being defended by the Grocers"

and Provision Dealers’ Association, not in any captious spirit or toavoid payment of a paltry penalty, but because they considered it a,matter of considerable importance. It was a matter ot some surprise>that it was only after the expiration of twenty-four years that the-Pharmaceutical Society had thought proper to do what was now repre-sented to be a public duty. It was not a question of the safety of thepubhc, but it really meant that if the Society were right in their con-tention that no one but a chemist or druggist in this country could sella preparation containing as an ingredient one of the poisons mentionedin the Act, they would secure to themselves a monopoly of the sale of a.very large number of valuable medicines and deprive the public and a verylarge portion of the poorer classes living in outlying districts, of themeans of obtaining simple remedies in cases of illness. There washardly a cough drop, or anti bilious pill, or a tonic, or a medicine ofcommon’day use that had not some preparation in it containing poison.If their contention was good, these things, even cough drops, wouldhave to be labelled with the word poison and sold only by chemists andtdruggists. What the plaintiffs had to show was that this preparationwas in itself a poison. Proprietary medicines had always been regarded.as patent medicines in the trade, and the exemption in the Actreferring to medicines under letters patent included the proprietary orso-called patent medicines.In summing up his Honour said that the question was whether

chlorodyne was a poison or not. The defence was that although itcontained some of three different poisons, it was mixed with otherpreparations. The label itself settled the question. The question wasDid the poison cease to be a poison because it was mixed with some.thing else? The mischief intended to be prevented by the Act woulli,