point of their history, therefore, the Romans were wise and liberal enough to dispense with the waters of the Tiber for drinking. They carried their system every where when they became the masters of the world; in France, in Spain, and in Italy many aqueducts can still be traced which were their work. We may be quite certain that if Britain were now a Roman province, the Thames Water-Companies would never be allowed to supply water except for the streets, and great aqueducts would long since have brought us the pure water of Bala Lake or Windermere. Thanks to the Popes, modern Rome, though not so profusely supplied as in Imperial times, is still very far in advance of all other cities in the world in this respect.* M. Vacher reckons the water-supply in ancient Rome as 1492 litres a day for each inhabitant; in modern Rome it is 1040; in New York, 159; in Vienna, 134;† in Paris, according to the new system, 109; in London, 132. But no city seems to have its houses so well supplied as London; in Rome a great quantity of water is wasted, being left to run away from the fountains, while the houses are not conveniently provided with water. We suppose that our old friend the house-cistern, against which we have heard so many complaints lately, is not an essential feature in our system of house supply.

M. Vacher gives the following conclusions as to the sanitary effect of good and abundant water. He tells us that inorganic substances contained in water are comparatively innocuous to the health of those who drink it; on the other hand, great injury is caused by the presence of organic matter. The best water in Paris-that of the springs on the north-contains nine times as much of calcareous salts as the water of the Seine; but it is justly preferred for drinking purposes. On the other hand, M. Vacher quotes the testimony of M.

*M. Vacher attributes the salubrity of Rome-for, considering its posi tion, it enjoys remarkable salubrity-to the abundance and good quality of its water. Lancisi, who practised there as a physician in the last century, accounts for the longevity of its inhabitants in the same way. At all events, remarks M. Vacher, "il est impossible de n'être pas frappé de ce fait, que les historiens ne mentionnent pas un seul exemple de peste à Rome, et qu'au moyen âge et dans les temps modernes elle a constamment échappé aux atteintes de la peste et du choléra, qui ont sévi à plusieurs reprises en Italie." But Rome has certainly been visited by the cholera more than once, and the rest of the statement is surely contrary to history.

†This statement is, however, an anticipation. The municipality of Vienna has undertaken some immense works in order to improve the watersupply, at a cost of 16,000,000 florins. The works are not yet completed; but M. Vacher gives the quantity of water for each inhabitant which they are expected to furnish. Hitherto the city has been supplied, it would seem, partly from the Danube, partly by wells. The new supply will be drawn from three different sources among the neighbouring mountains.

Bouchut, a Professor at the Ecole de Médecine, for the fact that he noticed the frequency of epidemic diarrhoea during the summer months in the Quartier de Sèvres, and that it had been almost stopped in cases where the doctors had ordered the water of the Seine to be no longer used, and had substituted for it water from the Artesian well of Grenelle. He adds his own experience at the Lycée Napoléon, which is supplied from the reservoir of the Pantheon, which receives its water from the Seine and the aqueduct d'Arcueil. He had known as many as fifteen students at once ill of diarrhoea, and the disease was stopped by the "alcoholisation of all the water."* As regards cholera, the proof is even more striking than that lately furnished in the case of London by the great and almost exclusive ravages of that disease in the Eastern districts. Mortality by cholera seems ordinarily, as M. Vacher tells us, to follow the laws of general mortality, that is, it prevails most in those districts which are ordinarily the most unhealthy. But the one element of good or bad water-supply seems to be enough to counterbalance the influence of the other causes which affect the comparative mortality of districts. For instance, difference of elevation is supposed to be one of these causes. Mr. Farre tells us that the mortality of a district is in inverse proportion to the elevation: that in nineteen high districts the proportion of deaths by cholera was as 33 to 10,000; in the same number of low districts, as 100 to 10,000. This law, however, is not enough, nor is it free from exception. Sometimes places loftily situated are attacked, and lower places are spared. The elevation of Montmartre is almost equal to that of Belleville; but Montmartre had last year 3-6 cholera cases to 1000, Belleville only 1.1. Again, a rich quarter has ordinarily immense advantages over a poor quarter. The mean mortality by cholera in the poorer arrondissements of Paris was almost three times as great as that in the rich arrondissements. The reason is obvious: the poor work hard, have insufficient food, and are crowded together in discomfort and want; the rich are well fed, not over-worked, well and healthily housed. Yet there was one arrondissement of Paris, and that one of the very poorest, which in the three first visitations of cholera (1832, 1849, 1854) had actually the lowest proportion of deaths by cholera of all these districts. In 1865 it had barely more deaths than the very richest of all, that of the Opéra,

* P. 106. M. Vacher here cites the Indian case quoted by Mr. Farre in his Cholera Report. The natives in India drink boiled water as a preventive against cholera; and it has been found that out of a great number in the family of a single proprietor in Calcutta, all of whom took this precaution, not a single person had been attacked even in the worst times of the prevalence of cholera. But Dr. Frankland has disproved at least the uni

versality of this fact.

which headed the list on that occasion as the most lightly visited. This arrondissement was Belleville. Another cause of comparatively greater mortality is density of population; but here again we are met by the fact that this fortunate Belleville is very densely populated. The nature of the soil is another. M. Vacher mentions a number of departments in the centre of France which have never yet been attacked by cholera. They are those which consist of a huge granitic mass, like an island in the midst of the more recent formations around them. Nevertheless, though this will explain much, and though Belleville has an advantage in this respect over many of the arrondissements of Paris, still it has the same geological formation as Montmartre, which had three times as many deaths (in proportion) from cholera. In short, there is no way left of accounting for its comparative exemption, except that which we have already mentioned, the superior character of the water consumed by its inhabitants. The argument certainly seems as complete as it can possibly be, and we know that it has been strongly confirmed by our own late experience. Let us hope that no time may be lost in acting on the lesson which we have received.

We pass over some interesting statements on the meteorological phenomena which were observed during the prevalence of the cholera last year in Paris.* M. Vacher rather contradicts current opinion by some remarks he has made as to the relation of cholera to other diseases. Sydenham has remarked that when several epidemic diseases are rife during the same season, one of them usually absorbs to itself, as it were, the bulk of the mortality, diminishing the influence of the rest even below the ordinary level. Thus in the year of the Great Plague in London, just two centuries ago, the small-pox was fatal to only 38 persons, its average being about eleven hundred. However, the general fact is now questioned. In October last, though 4653 persons were carried off by cholera, the mortality by other diseases in Paris was greater than in any other month of the year. Yet October is usually one of the most healthy of all the months; and the epidemic maladies which ordinarily rage during the autumn-typhoid

*M. Vacher here tells a story of his endeavour to make some ozonometrical observations in the Paris Hospitals, which were prohibited by the Directeur de l'Assistance publique-an officer of whom M. Vacher is continually complaining-on the ground that they would frighten the patients. He remarks that on one occasion when travelling in the Pontifical States, some gendarmes found in his possession a psychrometer and an aneroid barometer, and thought they were weapons of destruction. He would have been arrested, but for M. Matteucci, then Director of Police. He complains bitterly of the comparative want of enlightenment in the "administration" of his own country. But no hospital would have allowed his experiments.

fever, small-pox, diphtheria, croup, hooping-cough, erysipelas, and puerperal fever-were prevalent to an extraordinary degree. It is curious also that there was an unusual number of children born dead.

mer.

The most destructive of all ordinary complaints is undoubtedly consumption. At Vienna it actually causes 25 per cent of the deaths, at Paris 16 per cent, at London nearly 12 per cent, at New York 14 per cent. It is more frequent in women than men; it is twice as destructive in poor quarters as in rich quarters: the age which suffers most from it is between 25 and 40. The difference between the sexes M. Vacher attributes to the more confined and retired life led by women. If observations in Paris are to be taken as enough to furnish a general conclusion, it would appear that more consumptive patients die in the spring than in the autumn. Here again a common opinion is overthrown. The most destructive months are March, April, and May: the least destructive are September, October, and November. We believe that in this country the fewest consumptive patients die in winter, and the most in sumM. Vacher also attacks the notion that maritime climates are the best for consumptive cases. New York is situated on the sea, but it loses as many by consumption as London; and in the maritime counties of Kent, Sussex, Hampshire, Dorset, and Devonshire, the deaths by consumption are as 1 in 7 of the whole; while in the Midland Counties of Warwickshire, Buckinghamshire, Worcestershire, and Oxfordshire, they are as 1 in 9. "Les phthisiques qu'on envoie à Nice et à Cannes, ou même sur les bords du Nil, sur la foi d'un passage de Celse, y meurent comme ceux qui restent sous le ciel natal. Ceux-là seuls en reviennent guéris, chez qui le mal n'était pas sans ressources et qui auraient guéri partout ailleurs" (p. 129). We must remember, however, that if such patients are sent to the seaside, and die there, they raise the death-rate there unfairly. M. Vacher insists that the guiding principle in selecting a place for the residence of a consumptive patient should be the absence of great variations in the temperature rather than the actual number of deaths by the disease. Consumption, he says, is unknown in Iceland; but that is not a reason for sending a consumptive patient to that island. As to New York, we have already quoted his observation as to the variableness of the temperature there, notwithstanding its maritime position.

Although we have already stated the results of a general comparison of the mortality in the four capitals-results very favourable to the salubrity of London-it may be interesting to our readers to learn the state of the case with regard to particular classes of disease.

In most cases, of course, we have the list in actual numbers: our comparative immunity is only evident when the great excess of our population is considered. In Zymotic diseases we have little more than a majority of a thousand over Paris; but then we must remember that in the year of which M. Vacher speaks between 5000 and 6000 persons in Paris died of cholera. This, therefore, would seem to be one of the classes of disease as to which we are really worst off. As to Constitutional diseases, consumption, cancer, scrofula, gout, rheumatism, and others, Paris exceeds us in proportion; and it is the same with diseases of the nervous system. From diseases of the heart we lose between two and three times as many as the Parisians; this proportion, therefore, is greatly against us. On the other hand, in diseases of the digestive organs, Paris, notwithstanding its inferior population, exceeded London by a hundred deaths in the last year. London, however, regains a sad preeminence when we come to diseases of the respiratory organs, asthma, bronchitis, influenza, and the like: Paris losing between 7000 and 8000 a year against our 12,500. It is in the commoner diseases that the worst features of London mortality in 1865 were found. Typhoid was nearly three times as fatal last year in Loudon as in Paris; measles four times as fatal; scarlatina not far short of twenty times; hooping cough more than thirteen times. As the population of London is to that of Paris as five to three, it is clear to how great an extent the balance was against us. It was probably an accident. These diseases prevail very generally for a time, and then retire: and we have lately been visited by a period of their prevalence.

We have hitherto spoken only of diseases; but M. Vacher's researches extend to the comparative frequency of deaths of other kinds. In suicides, New York has the best account to give, Paris the worst. To speak roughly, London has twice as many suicides as New York, Vienna twice as many as London, Paris more than twice as many as Vienna-in comparison, that is, with the total number of deaths of all kinds. The actual numbers stand thus: Paris 716, London 267, Vienna 813, New York 36. For the last nine years there has been little change in the number in London; in New York it has diminished, in Paris it has increased, having more than doubled itself since 1839. The two years, 1848 and 1830, which were marked by revolutionary movements, were also marked by a diminution in the number of suicides. The relative proportion of suicides increases with age; that is, it is four times as frequent with people above 70 as with people between 20 and 30. Paris has for a long time been noted as a city in which there were more suicides than any other. More than eighty years ago, Mercier noted this,