In one instance, where a case of the most virulent type of diphtheria had occurred, the examiner scented an odor in the house. He asked, "Where do you store your vegetables?" "Oh, doctor, we store them right down here." And turning around, a trap-door was raised, and he went down with the man of the house, taking a light. He said the odor from the decaying vegetables in that cellar, was such that he could scarcely get his breath.

No wonder a virulent form of diphtheria occurred there; and no wonder also, that the moment access was had to the open air, by cutting away the pile of earth that had been made for the purpose of protecting these vegetables from the air, the disease vanished, and the house again became healthy.

The inspection of a water supply should include the original source of the water itself, the spring, stream or reservoir, on account of the possibility of fouling by sewage, manufactories, manure heaps, house drainage, overflow in case of unusual rains, etc. It will take too much of your time to go into the detail of this as I would like to. If I had time to draw from the supply of illustrations which I have continually occurring to me, it would be marvelous to you.

Let me give one little illustration. A pretty village in Chester county, a healthy village, with a magnificent supply of most excellent water, which has its source in a little stream above.

Right on the bank at the place where this water pours into the reservoir, are four houses inhabited by very filthy people, and at any moment a case of typhoid fever might occur in one of those houses, the excreta be washed down from the cess pools which wash into this stream and thus decimate that handsome village; as was the case with Plymouth in times gone by.

All these might constitute a nuisance, but an inadequate supply of water would equally cause disease for want of proper use of the water for cleanliness, or for proper culinary purposes.

I will mention a point here which many may be surprised to hear. Some of the poorer classes, either from their laziness or their inability to get water without too much expense, have the habit of cooking and washing in the same supply of water. Fancy it! Hence is it to be wondered at that such people are often rendered ill and from an unknown cause? As some too readily say, “A visitation of God." But 1 will not detain you longer; I will merely indicate in a cursory way, by notes of cases, the proper method of inspecting public buildings. First, commence with the foundation; and when I say that, I mean I mean that I see continually in the big city of Philadelphia, houses being built upon a foundation from which the filth has not been removed prior to the laying of the foundation of the house. I mean that I have seen again and again, instances where the foundation stones were laid in ground that was so reeking with filth, that it was marvellous the workmen were able to work on account of it.

Made ground is always dangerous, as where a building is erected upon ground which has been filled with garbage, ashes and the like. Always examine it from cellar to roof. I would especially examine the ventilation. And here I may give you an instance how the very best ventilation may fail of its purpose, occurring in a neighboring city where a school house had been put up with the best possible means of heating and ventilation. In a short time after the school was occupied, teachers and scholars alike began to have headaches, vertigo, sick stomach, and in a short time the school was in such a condition that the people were afraid to go into it. An investigation was ordered, and a friend of mine (a very good sanitarian by the way), was on that committee; the remark was made by one of the committee "It is not necessary to look around much; this certainly must be something we can't understand, because the very best appliances have been put here for the purpose of ventilation." My friend went into the cellar and he found the chamber where the cold air was intended to come in, and then be warmed to be carried to the rooms, had been closed up by a son of the janitor and converted into a chicken coop. Hence, the cold air which was allowed to come in from the outside to a certain extent, when the chickens were not too cold, by that means was brought up fouled by the excreta from these chickens.

As if this was not enough, when they went to the roof a patent ventilator which had been put up at a great cost, had been stopped from its use, and had been converted into a pidgeons cote. Now, if there could be anything more stupid, anything more ignorant, in the effort how not to do a thing I would like to know it.

The subject of air from the cellar to the heater has been already so well spoken of I can add nothing to it. You know all about that. I can, however, tell you a little incident that occurred in my own neighborhood. A family was surprised to find that in spite of all their cleanliness, their house was continually laid in ashes; every portion of their house that was supplied with hot air from the heater was covered with ashes. Upon a proper investigation it was found that the air supplied, was not taken from outside, but was from an opening directly opposite the ash heap, and, of course, it was continually drawing in, along with the air, a quantity of ashes, which were disseminated through the house. The gentleman who was the owner of the house, by the way, told me something very peculiar. He is not a tobacco user; but after it was fixed so as to have cold air brought in from the outside, he couldn't understand why every now and then there would be a strong smell of tobacco even in his third story, and sometimes, a smell of something a little stronger. His attention was called to the explanation of it by hearing a nice little altercation on the outside. He looked out of the window and found a couple of very drunken individuals with big cigars or pipes in their mouths, having a wordy controversy on the step right

in front of the window, which allowed the cold air to come into the heater. Hence, of course the cold air brought in the fumes of whisky and tobacco.

The air in the steam heater is continually fouled by want of proper cleansing of the boiler, from which that heater is supplied. Of this I can mention an instance of one of the most prominent schools in Pennsylvania, which was rendered almost uninhabitable by this very fact. The engineer had allowed a little water to accumulate there, and that water had a large number of small decaying fish in it, which were continually being boiled and thus the fumes of decayed fish, were carried all over the house.

Again, in another instance I knew that the servant who supplied the vessel with water from which the hot air came, carelessly supplied that water by means of a garbage bucket, which, of course, was not in a very cleanly condition; hence the odor of decaying garbage was carried over the house.

Finally, we must remember that in spite of all our efforts, in spite of all our teaching, in spite of all our nurses in our sick rooms, eternal vigilance is the price of our being able to keep ourselves from disease. One more illustration on that point and I will close.

case.

In the year 1866, I had a case of cholera at one of the most prominent hotels in Philadelphia; I had a carefully trained nurse in charge of the Her orders were to remove the dejecta the moment they were passed. One day I went in suddenly; she evidently was flurried, and after I examined my patient and found that she was not improving as I would like, I said, "Nurse, there is an odor in this room I don't like, and my rule is not to depend upon the nurse but to look for myself." And in hunting around I found in a corner, among some clothing that had been hastily put aside, a vessel two thirds full of cholera dejecta standing there as a means by which to disseminate that disease, not only through that room, but perhaps through other portions of the house.

The PRESIDENT. The next paper is the "Importance of Vital Statistics from a Physicians Standpoint," by G. E. Abbott, M. D. of Bryn Mawr, Pa. I will call upon Doctor Atkinson to read it.

(Paper read.)

The CHAIRMAN (Mr. Herron in the chair). The paper just read is now open for discussion. If there are no remarks the next paper is by Preston H. Bailhache, M. D. Surgeon U. S. M. H. S, San Francisco, California, on the Cremation of Garbage.

Doctor LEE. I would state on behalf of Dr. Bailhache that, after he promised to prepare his paper, he was ordered to California (he is a surgeon of the Marine Hospital Service); he placed his paper together with the accompanying documents in a trunk so they could be looked

at as soon as he arrived, and that trunk was lost in transit ;consequently the paper itself is wanting.

The subject however of garbage cremation is one of practical importrance. Garbage cremation is successfully carried on in this city, and I trust there will be some one present who will be able to give us some of the details of the success of the experiment here. I understand there are two garbage crematories successfully operating, one for Pittsburgh and one for Allegheny, and I should be extremely glad to hear something in regard to them.

The CHAIRMAN. We should be glad to hear from any person on that subject.

Dr. ATKINSON. I know nothing about the garbage crematory but I do know I have in my room at the hotel a very successful garbage cremator for use on a kitchen fire. I did not expect we would get this far down the programme or I would have brought it along with me. I had a sample of this machine sent me and I proposed to exhibit it here. I do not know anything about its value but I do know from an inspection of it it looks to me as if it ought to do its work.

I was told by the Ladies' Health Protective Association of New York, that they had been very successful in using it in their homes. A number of them have formed an association for the protection of their health, and they use this garbage cremator in their homes on their kitchen fire, and they have no trouble in getting rid of all their kitchen garbage without any odor whatever. I do not know whether we can have a chance to put it in practical operation in this room, but it certainly would be a good idea if we could have some garbage brought here and burn it up before you in this machine and prove to you whether it is good or bad.

On Motion, Adjourned.

THIRD SESSION.

Convention called to order by Chancellor M. B. Goff, of the Western University of Pennsylvania..

The CHAIRMAN. Dr. Lee, Secretary of the State Board of Health desires to make an announcement.

Dr. LEE. I desire to announce that the following invitation has been received.

"WILLIAM METCALF, President.

SANITARY CONVENTION, PITTSBURGH.

DEAR SIR:-At a meeting of the Executive Committee of the Homeopathic Medical and Surgical Hospital and Dispensary of Pittsburgh, a resolution was passed extending an invitation to visit the Hospital,

to the members of the Sanitary Convention and the State Medical Association."

I would move that the invitation be accepted with thanks.
This motion being duly seconded was unanimously carried.

Dr. LEE: I desire to make an apology to the City of Pittsburgh. I made a statement here this morning to the effect that a very admirable system of notification of contagious diseases was carried out in this city, which I believed to be superior to that of any other city in the country. It reminds me of a little story of an Irishman who came to this country and got occupation with a mercantile house in Philadelphia. After he had been with the house about a month he came to a leading member and said he would like the gentleman to write a letter home for him. "Well, Pat, what do you want to say." Pat sent his love to his mother, and said one or two things. Then he said," Tell her I get meat once a week," "Why," the gentleman said, "what do you mean by that Pat?" "You know you get meat every day." "Yes," he says, "I know, but if I tell her that she would not believe it."

Now the statement I made this morning was that twice a week the Board of Health of Pittsburgh, notified every school teacher in the city of every case of contagious disease occurring in the district from which pupils to the school came. I have since had put in my hands this paper, which I am told is issued, not twice a week, but every day, containing the name of every case of contagious disease, the ward, and the house in which that disease exists; and this notification is sent every day to every teacher in Pittsburgh. I feel that this apology is due the city.

The CHAIRMAN. I have now the pleasure of introducing to you Dr. Jackson Piper, who is President of the State Board of Health of Maryland, who will deliver the Annual Address.

17.--ANNUAL ADDRESS.

JACKSON PIPER, M. D.

Ladies and Gentlemen, Sanitarians and Members of the State Board: I am here this evening. by invitation of the energetic and accomplished Secretary of the State Board of Health, of this great Commonwealth, to add my humble quota towards the advancement of sanitary science. Unlike European countries, where reforms are fostered and maintained by the strong arm of government, we, in this republican land, must be influenced by the consent of the popular will, consequently our efforts must be directed towards the education of the masses.

We cannot expect to effect any great results in sanitation unless public sentiment is with us. I hate to acknowledge this; in this matter I am sometimes, strongly inclined to believe that conviction is apt to