In the middle of the nineteenth century, England alone, and with absolute conviction and determination, demonstrated to the civilised world the beneficial results in diminishing the death-rate of large towns, to be obtained by cleanliness, the destruction or removal from man's body and surroundings of organic "dirt," viz. his excreta, the exudations and exuviations of his body, the waste and fragments of his food. The names of Rawlinson, Chadwick and Simon remain as those of the prime movers in that legislation which has given us improved water supply, sewerage, removal of dust heaps, clearance of cesspits, cleansing of houses, and prevention of over-crowding. Yet there are writers who, in ignorance and infected with the modern madness which makes half-educated Englishmen presume to teach where they have yet to learn, and to pose as prophets by belittling and running down, without regard to truth, their own country and its finest efforts in the cause of civilisation, actually declare that Germany has led the way in this matter. This is the very reverse of the truth. Foreign countries are, in this matter, following long in the wake of England. There are no cities in the world so healthy as British cities. Practical measures of cleansing, faithful activity in destroying dirt and preventing over-crowding, enforced by legislation, have reduced the death-rate of our great centres of population in fifty years by more than one third--that is to say, from something like 29 per 1,000 to something like 18 per 1,000. No other country can show such a result. Gaol-fever, spotted or putrid fever, or typhus fever has practically ceased to be a regularly occurring disease in the West of Europe. The last cases in London were, I well remember, in a poor district near the Marylebone Road about thirty years ago. A very few cases have appeared since, in the over-crowded and poorest districts of our largest cities. Beleaguering armies and beleaguered cities suffered from it as late as in the Crimean War, but we may now fairly say that it has disappeared from our midst. It, however, still abounds in Russia and her eastern provinces, and in Algeria, Tunis, and Morocco. It is a disease of cold and temperate climates rather than of the tropics.