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c155bf86-4b23-4b75-9890-4f2a474cb187 | Male 45 years Accident—burns , „ Male 64 years Accident—run over , , Male 55 years Psoas abscess , , Male 1 3/12 years Accident—scalds „ „ Male 45 years Suicide—cutthroat , „ Male 2 years Accident—burns , , Male 52 years Digestive „ , Male 6½ years Accident—burns Non-Parishioners Bolingbroke Hospital Female 7 8/12 years Accident—burns , , Male 36 years Accident—run over , „ Male 42 years Cancer , Male 17 years Congenital Hernia Peritonitis , , Male 50 years Open verdict— poisoned „ , Female 43 years Digestive , , Male 3 years Accident—run over , , Male 30 years Tuberculosis , , Female 45 years Suicide— fracture of skull „ „ Female 59 years Cancer „ , Male 30 years Accident—fall , , Female 72 years Cancer , |
d8bef9a7-1720-4721-b6eb-47cb590794a9 | „ Female 92 years Accident—burns 27 Of the deaths under one year, two hundred and eighty-two were from premature birth, malformation, or low vitality at birth, a little more than one-third of the total number of deaths recorded at that age. All deaths under five years, the infantile period of life, were equal to forty-four per cent. of the total deaths. This is an improvement even upon that which has been maintained during recent years; formerly sixty per cent. of the total deaths were under five years of age, showing an immense saving of infantile life, which can only be ascribed to the improved sanitation which has prevailed in this parish for many years. At the other extreme of life, three hundred and ninety-three persons died above sixty-five years of age, including the deaths of aged parishioners in the Union Infirmary, where the deaths of seventy-six aged non-parishioners also took place. |
287f9a46-9e0e-404a-9f2c-2eb17acc7a9b | In public institutions, &c., outside the parish thirty Battersea people died above sixty-five years, making a total of four hundred and twenty-three parishioners dying at this advanced age. Table B. This, the second table prescribed by the Local Government Board, contains particulars of the population, births, notifications of infectious disease in the several localities and various public institutions (themselves treated as separate localities), situated within the parish, and the cases of infectious disease removed from their homes in these several localities for treatment in the Metropolitan Asylums Board isolation hospitals. The cases of erysipelas are mostly removed to the Infirmary of the Wandsworth and Clapham Union, situated on St. John's Hill, within the parish, as also cases of puerperal fever, other hospitals not providing accommodation for these two diseases. It will be observed that the several localities and institutions have populations assigned to them. |
e27db562-fda7-4c40-914b-d8c6e3c12ddb | The out-door districts of East and West Battersea have populations based upon the ascertained increase of population during the last inter-censal period, while the institutions have the census populations of 1896 given. Table B of Population, Births, and of New Cases of Infectious Disease coming to the knowledge of the Medical Officer of Health, during the Year 1898 in the Metropolitan Sanitary District of Battersea, Classified according to Diseases, Ages and Localities. Names of localities adopted for the purpose of these statistics. Public Institutions being shown as separate localities. Population at all ages. Registered Births. Aged under 5 or over 5. New cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Number of such Cases removed from their homes in the several localities for treatment in Isolation Hospital. |
e53d4f28-36e7-4c02-bf9b-8189643981bd | 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Small Pox. Scarlatina. Diphtheria. Membranous Croup. FEVERS. Cholera. Erysipelas. Small Pox. Scarlatina. Diphtheria. Membranous Croup. FEVERS. Cholera. Erysipelas. Last Census. 1896. Estimated to middle of 1898. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. East Battersea 71,730 73,792 2, |
4eda9e33-8d5a-472e-85c3-c7988f5e7eeb | 424 Under 5 . 86 133 8 . 3 . . . . 10 . 65 92 4 . 2 . . . . 2 5 upwards 2 206 308 5 1 39 . . 4 . 103 1 156 215 3 . 30 . . 1 . 13 West Battersea 91,928 96,460 2,733 Under 5 . 139 108 4 . . . . . . 10 . 108 71 . . . . . . . . 5 upwards 2 370 223 . . 51 . . 6 . 51 . 285 94 . . 26 . . 2 . 7 Wandsworth and Clapham Union Infirmary 708 708 . Under 5 . . . . . . . . . . . . . . . . . . . . . . 5 upwards . . . . . . . . . . |
6b3c194b-0d78-471a-bc56-1c85177c42e4 | 4 . . . . . . . . . . . Bolingbroke Hospital 39 39 . Under 5 5 upwards Westminster Union Schools 183 183 . Under 5 5 upwards 3 2 3 2 Masonic School, Battersea Rise 316 316 . Under 5 5 upwards 2 1 2 1 Emanuel School, Wandsworth Common 211 211 . Under 5 5 upwards 3 3 Totals 165,115 171,709 5,157 Under 5 225 241 12 3 20 173 163 4 2 2 5 upwards 4 584 533 5 1 91 10 . 158 1 449 311 3 57 3 20 29 TABLE X. Infectious Sickness and Mortality, 1898. No. of Cases notified. No. ot cases removed to Hospital. Deaths at home. |
4c0eabb5-c957-438a-a908-88ae628472cb | Deaths at Hospital. Total Deaths. Small Pox 4 1 ... ... ... Scarlatina 809 622 6 22 28 Diphtheria and Membranous Croup 791 481 45 75 120 Typhus Fever 1 ... ... ... ... Enteric and Continued Fevers 94 59 7 8 15 Relapsing Fever ... ... ... ... ... Puerperal Fever 10 3 4 2 6 Cholera ... ... ... ... ... Erysipelas 178 22 12 6 18 totals. 1887 1188 74 113 187 This Table takes the place of Tables X and XI in former reports, and shows plainly any difference in results between home and hospital treatment. |
588ca330-df05-41b4-92b6-852f6e907a37 | It must not be forgotten that the more severe and necessitous cases find their way to the hospitals, which are principally those of the Metropolitan Asylums Board, with the exception of Puerperal Fever and Erysipelas, for which diseases no provision is made by that Authority, and cases of those diseases have to be sent to the Union Infirmary. 30 TABLE XI. Below will be found a synopsis of the notifications received during the year, with removals to hospital:— Notified. Removed to Hospital. |
ca09f73d-2a8d-4bce-acc3-d9ab677dc7fe | Small Pox 4 1 Scarlatina 809 622 Diphtheria and Membranous Croup 791 481 Typhus Fever 1 ... Enteric and Continued Fever 94 59 Relapsing Fever ... ... Puerperal Fever 10 3 Cholera ... ... Erysipelas 178 22 1887 1188 Ages:— Under 5 years 501 344 5 years and upwards 1386 844 1887 1188 Where occurring:— East Battersea 908 584 West Battersea 964 593 Union Infirmary 4 ... Westminster Schools 5 5 Masonic School 3 3 Emanuel School 3 3 1887 1188 31 TABLE XII. Particulars of the Prevalence of Notifiable Infectious Disease in the several Sanitary Districts. Sanitary Districts. Cases NotifiedContinued Fever Relapsing Fever . Cases Removed to Hospital. |
ae7798c3-942d-4e00-b406-33d89b139b44 | Small Pox Scarlatina Diphtheria and Membranous Croup Typhus Fever Enteric Fever Puerperal Fever Cholera Erysipelas Totals Small Pox Scarlatina Diphtheria and Membranous Croup Typhus Fever Enteric Fever Continued Fever Relapsing Fever Puerperal Fever Cholera Erysipelas Totals No. 1 1 69 131 . 14 . . 1 . 34 250 1 61 73 . 13 . . 1 . 2 151 „ 2 1 123 234 1 16 . . 1 . 39 415 . 82 156 . 10 . . . . 4 252 „ 3 . 132 141 . 12 . . 2 . 29 316 . 94 79 . 7 . . 2 . 5 187 „ 4 1 130 55 . 12 . . |
ce491d89-ed34-44b4-8f65-5c5f9c6be9e8 | 1 . 21 220 . 111 40 . 9 . . . . 3 163 „ 5 . 74 55 . 11 . . 2 . 24 166 . 57 42 . 9 . . . . 4 112 „ 6 1 175 82 . 10 . . 1 . 15 284 . 127 54 . 6 . . . . 4 191 „ 7 . 55 42 . 14 . . . . 8 119 . 32 21 . 5 . . . . . 58 „ 8 . 51 51 . 5 . . 2 . 8 117 . 58 16 . . . . . . . 74 Whole Parish 4 809 791 1 94 . . 10 . 178 1887 1 622 481 . 59 . . 3 . 22 1188 32 Table XII. |
968cb142-251e-4978-b638-45be8b4c62c6 | is a table shewing the incidence of notifiable disease in the different sanitary districts, and, taking into consideration the numerical differences of population, the numbers are more equal than may appear at first sight. Small-Pox. Four notifications of this disease were received during 1898. Three of these were not true cases of Small-Pox. The only true case of Small-Pox which occurred in the parish, was in the person of a man who had been working at the erection of a temporary Small-Pox hospital at Middlesboro', where an epidemic of the disease had broken out. The patient was at once removed to hospital, and the necessary disinfection performed, with the result of no second case occuring. In June notices were received from the Port Medical Officer of Southampton that two persons were proceeding to this parish from Cape Town, passengers by s.s. Briton, on which cases of Small-Pox had occurred. They were kept under close observation and did not contract the disease. |
3ff80d4c-3413-4907-9ed8-2dfd4a125e3a | As there have been complaints that persons suffering from infectious diseases have been conveyed in public conveyances, the following notice has been issued to those concerned, such as cabmen and conductors of tram cars and omnibuses. The Vestry of the Parish of St. Mary, Battersea.—Notice to owners of public conveyances, drivers, &c.—The Vestry of the Parish of St. Mary, Battersea, desire to draw the attention of the public to sec. 70, of the Public Health (London) Act, 1891, which enacts that it shall not be lawful for any owner or driver of a public conveyance knowingly to convey, or for any other person knowingly to place in any public conveyance a person suffering from any dangerous infectious disease, or for a person suffering from any such disease to enter any public conveyance, and if he does 33 so he shall be liable to a fine not exceeding £10; and if any person so suffering is conveyed in any public conveyance, |
b8d956c0-9b61-4076-a5c9-13b5c162b38f | the owner or driver thereof as soon as it comes to his knowledge shall give notice to the Sanitary Authority, and shall cause such conveyance to be disinfected, and if he fails to do so he shall be liable to a fine not exceeding £5, and the owner or driver of such conveyance shall be entitled to recover in a summary manner from the person so conveyed by him or from the person causing that person to be so conveyed a sum sufficient to cover any loss and expense incurred by him in connection with such disinfection. A chamber has been provided at the Vestry's Depot, Culvert Road, where conveyances can be disinfected free of charge. The Metropolitan Asylums Board will remove in one of their ambulances any person suffering from infectious disease to places other than the Board's hospitals upon application and payment of the sum of five shillings. |
5601fe54-e424-466f-87d0-860180458ebb | In the case of inability to pay such sum application should be made to the Public Health Department of the Vestry, by whom such removal will be effected. Chicken-Pox. Judging from the number of notices received from Head Teachers of Schools, this disease appeared to be very prevalent during the month of June. In every case enquiries were made at the houses as to whether the patients were under medical attendance, lest the cases should be those of unrecognised Small-Pox. The largest number of notices received was from No. 1 District, and suggests that the outbreak was more prevalent in that locality. Scarlet Fever. Eight hundred and nine notifications of this disease were received, and six hundred and twenty-two of the less effectively isolated cases removed c 34 to hospitals of the Metropolitan Asylum Board, and to the London Fever Hospital, &c., leaving one hundred and eighty-seven which were treated at home. |
7e5e5f2e-c8fc-4b07-b186-a004d44169f3 | The deaths in hospital, to which the worst type of cases is generally removed, were twenty-two or just 3.5 per cent. of cases, while of the cases treated at home, the majority of which were of a very slight nature, involving perhaps only scarlatinal sore throat, 3.2 per cent. died. One thing is certain, that the generally improved sanitary conditions, including early removal of cases which could not be effectively isolated, have reduced the mortality of this disease to a remarkable extent. Diphtheria and Membranous Croup. Seven hundred and ninety-one cases of this disease were notified during the year, four hundred and eighty-one were removed to hospital, the remainder, three hundred and ten remained at home. Of the cases removed to hospital, seventy-five died, giving a hospital mortality of 15 per cent., the worst and most urgent cases being removed thereto. |
892b2146-2deb-463a-a730-9016e60d2428 | Of the cases remaining at home, forty-five died, being at the rate of 14 per cent. Some of these cases were of a doubtful nature, being probably cases of ordinary sore throat. A glance at Table XIII will show the number of fatal cases of Diphtheria at home during the last eleven years. They were in 1888, twenty-two; 1889, twenty-one; 1890, twenty-seven; 1891, thirty-five; 1892, twenty-eight; 1893 ninety; 1894, sixty-seven; 1895, sixty; 1896, fifty; 1897, fifty-two; and in 1898, forty-five or just half the mortality from this disease in 1893. In the report for 1897 I observed "This disease appears to have become endemic in London. It has a tendency to shift from locality to locality," and in consequence of the incidence of a number of cases in No. |
fbad099d-213b-4518-8c72-b61f93b932cf | 2 Sanitary district, I was directed to report thereon, and subsequently upon the undue incidence of this disease in districts No. 4 and 6. 35 In order that the prevalence of Diphtheria in Battersea may he seen, I have here added a table of the notifications of this disease yearly from 1890, the first complete year when notification became obligatory. These numbers include Membranous croup from which Diphtheria is undistinguishable clinically. Year. No. cases notified. 1890 349 1891 260 1892 366 1893 682 1894 504 1895 411 1896 426 1897 614 1898 791 As the sanitary districts have been altered in number and area several times during these years, I am unable to locate the disease for these years in districts. The summer and autumn of 1898 were very hot and dry, there being practically no rainfall for many weeks. |
49eccd22-773e-4ac5-b909-45cf57ef1cd8 | During this period an excessive incidence of diphtheria in No. 2 sanitary district occurred. In my report I stated that diphtheria could be spread in many ways, by direct personal infection at school or elsewhere, by sewer gas, by water, milk or other food. There were at this time, numerous complaints of offensive effluvia from the sewers, by the gullies, surface ventilators, &c. The Schools were closed for most of the period, and the milk supply was so varied that it was clearly not the cause of the outbreak. A very detailed examination of the sewers convinced me that to their condition must the outbreak be in great measure ascribed. The Surveyor reported fully on the subjects, showing numerous defects in the sewers, gullies, ventilators, &c., and the Chief Sanitary Inspector made a detailed report to the same effect. |
5abc23fe-fe33-462f-a949-acd01cf42374 | 36 The Health Committee and the Vestry adopted this view, and works to amend the defects were ordered, many of which have been carried out at the time of writing. Subsequently an outbreak was found to exist in No. 4 and 6 sanitary districts, the latter especially. It was found that most of the cases were attending the infant's department of the Plough Road School, and further investigations showed that a child suffering from diphtheritic sore throat had been attending school, without the true nature of her illness being suspected, and it was not until other cases occurred in her family and in the same house that she was medically examined, and found to have just recovered from diphtheria. |
db9633c0-fc6e-46fd-a5ac-aead8850a010 | I examined the school, and found that the whole of the children from the different class rooms assembled together in the main hall, and therefore recommended the Vestry to close the whole of the infants' department for three weeks; an order was made to that effect, and the schools closed and disinfected, with the result that there has been no recurrence of the disease. Another cause of diphtheria infection is the return of children from hospital still in an infectious condition, generally in my opinion, from the nasal cavities still containing the bacillus causing the disease. A case occurred in Henley Street, where a child was prematurely returned, subsequently six persons were attacked and sent to hospital from the same house, together with the original patient, for treatment. On June 14th the Committee had under consideration a report to the effect that a child whilst suffering from diphtheria had been taken to St. |
f6754ad6-f270-4967-bc1c-e4c17e1247ba | George's Hospital in a perambulator, thereby contravening Section 68 of the Public Health (London) Act, 1891. It was alleged that the parents had acted under the advice of one of the Medical Staff at the Hospital. A letter was directed to be sent requesting that the hospital authorities would exercise care in seeing that a proper ambulance was in future provided. 37 On one occasion only during the year has any difficulty been experienced in obtaining hospital accommodation for cases of this disease. This was on the 20th October, and was quite temporary. To meet such contingencies the Metropolitan Asylums Board have now made arrangement that when hospitals are full and cases unable to obtain admission and require treatment with Anti-toxic Serum, a supply of the Serum may be obtained at the Health Department of the Local Authorities, the Authorities' supply being obtained upon presentation of the necessary warrants at the Examination Hall of the Royal College of Physicians and Surgeons, Victoria Embankment. |
17820f64-2b74-4b9b-98e8-704cdfc0000c | The forms for obtaining a supply of Anti-toxin by the Vestry's Medical Officer, and from him by the Medical Practitioner are appended. It has not been necessary to obtain a supply, as all cases have been speedily removed to hospital. METROPOLITAN ASYLUMS BOARD. To the Director of Laboratories, Royal College of Physicians and Surgeons, Examination Hall (near Waterloo Bridge), Victoria Embankment, S. W. 189 Dear Sir, Please let me have by bearer doses of Anti-Toxin -—of 4,000 units each—for distribution amongst those Medical Practitioners in my district who may have diphtheria patients awaiting admission into the Hospitals of the Metropolitan Asylums Board. Please also let me have warrant forms for such Medical Practitioners to sign. Yours faithfully, Medical Officer of Health, Parish or District Board. 38 METROPOLITAN ASYLUMS BOARD. Warrant for Anti-Toxic Serum. |
4273f13f-055e-43d5-a37f-1bb73ffe600b | In Exchange for this Warrant and the subjoined Certificate, the Bearer is entitled to receive one bottle of Anti-toxic Serum, for use in the treatment of the Patient named in the said Certificate, who cannot be immediately received into one of the Board's Hospitals. (By Order) T. Duncombe Mann, Clerk to the Board. Certificate of Medical Practitioner. To the Medical Officer of Health for (on behalf of the Metropolitan Asylums Board.) I hereby certify that I require one bottle of Anti-toxic Serum for use in the treatment of a Patient under my care residing at , who is suffering from Diphtheria, and who cannot immediately be received into one of the Hospitals of the Board. I undertake to use the Serum so supplied to me exclusively for the treatment of the above-mentioned case, and for none other and I further undertake to return forthwith the Serum should the Patient (or responsible relations) object to its use. (Signed) Name and Address of Medical Practitioner. |
157132d7-3ea6-4c6e-a149-e0f650b41405 | Dated 189 39 Enteric and other Fevers. Ninety-four cases of Enteric Fever were notified during the year in addition to one of Typhus and and ten of Puerperal Fever. Of the Enteric cases fifty-nine were removed to hospital with a mortality of eight equal to thirteen per cent. Of the thirty-five cases treated at home, seven died equal to a mortality of twenty per cent. The difference in favour of hospital treatment lies in the fact that the diet is strictly regulated there, many deaths arising at home from injudicious feeding with solids before the bowels are fitted for their reception, ulceration of the bowels being usual in this disease. Last year in consequence of the prevalence of Enteric or Typhoid Fever in the Metropolis and in this parish I prepared a special report shewing the action taken upon the notification of Typhoid Fever. |
28a83b80-1ff1-4b43-852d-3f5575076081 | Upon the receipt of such notification a disinfector is immediately despatched to the infected premises with a supply of disinfectants and apparatus tor flushing of house drains. The District Sanitary Inspector visits the premises and ascertains whether sufficient means of isolation are provided, and if n-ecessary adopts measures for the removal of the patient to hospital, makes investigations as to whether patient has in any way subjected himself to infection, examines and tests drains and sanitary appliances, inspects the cistern and water fittings, and makes enquiries as to the source of milk supply, and as to schools attended by children in the house or places and nature of employment of adults. Notices of the case are immediately forwarded to the headmasters of the schools attended. Disinfection of the bedding and premises is carried out after the removal of the patient or at the termination of the case. |
7675bf6c-25e8-4dc6-b4af-0bebeece71b2 | 40 During the last five years there has been a steady decrease in the number of cases of Enteric fever in the parish, as the following will shew:— 1898 94 1897 95 1896 110 1895 135 1894 153 Typhus. There was but one case of this disease during the year, the patient, a nurse, had been in attendance upon several cases of sickness at Wellingborough. The case recovered. Erysipelas. For some reason this disease has increased during the last few years in the Metropolis. During 1898 one hundred and seventy-eight cases were notified, of these twentytwo were removed to hospital, of whom six died. Of the one hundred and fifty-six remaining at home twelve died. Those removed were admitted into the Wandsworth and Clapham Union Infirmary in the majority of instances. |
132501c6-33c5-4e3c-8889-af4e6a23747b | The term Erysipelas covers so many degrees and forms of inflammatory affections, that no further discussion of the subject would be profitable. Diarrhœa. One hundred and sixty-five fatal cases were registered from this cause alone, the majority being hand-fed infants. To reduce this mortality the Health Committee has for some years issued the following handbill during the hotter months, when disorders of the digestive tract are most prevalent. It is hoped that much good has been done and many lives saved by this means, as a notable diminution in the number of fatal cases has always been manifest after its issue. No case was notified as Asiatic Cholera. 41 PRECAUTIONS AS TO DIARRHŒA. |
aac280b9-9cba-41df-b97a-dec2049ef531 | In consequence of the prevalence of Diarrhoea amongst young children, more especially those brought up by hand, the Vestry as the Sanitary Authority acting under the advice of their Medical Officer of Health, beg to direct the attention of Parents and others having care of young children to the great advisability of boiling all water and milk used for feeding such children. Care should be taken as to the sound condition of every article of food for children, anything not fresh being withheld. Fruit especially should not be given if in the slightest degree decomposed. Cleanliness of person and dwellings with frequent flushing of house drains is of the greatest value. Disinfectants in case of illness are supplied free of charge on application to the Public Health Department, Town Hall Road, between the hours of 9 a.m. and 5 p.m., and on Saturdays, between 9 a.m. and 1 p.m. Measles and Whooping Cough. |
9a88ee9c-9336-4724-a3b4-23f924e715cb | The number of cases which occurred during 1898 cannot be ascertained, as these, the most fatal of all zymotic diseases, still remain non-notifiable. I reported relative to the prevalence of Measles, and the number of fatal cases becoming grave I was directed to re-issue a bill giving the public instructions asto the necessary precautionsto beobserved during an epidemic of this disease, and they are here appended. One hundred and nineteen fatal cases of Measles were recorded during the year, the number during 1894 having been one hundred and fifty-one, during 1895 ninety-nine, in 1896 one hundred and eighty-five, and in 1897, seventy-six. |
a455d617-2cb9-4258-91a7-292d67807b4a | At a Meeting of the Health Committee in April, a letter was considered from the London County Council, enclosing copy of a communication from the London School Board, asking the Council 42 to include Measles in the term "dangerous and infectious diseases" and enquiring whether the Vestry would be in favour of the extension to Measles of the provisions contained in section 68 of the Public Health (London) Act 1891, which was agreed to by the Committee and reported to the Vestry. PRECAUTIONS TO BE OBSERVED DURING THE EPIDEMIC OF MEASLES. The Vestry, as the Sanitary Authority for the Parish, and as advised by the Medical Officer of Health, desire to direct the attention of parents and others to the importance of checking the spread of Measles, which is now prevalent in an epidemic form and is causing much mortality by complications, such as Bronchitis and Pneumonia. |
3e68d921-e6e7-42ba-9498-f13dc7e5407e | All children suffering from Measles, even in the earliest stage, before the eruption appears, should be isolated from others. The first symptoms of Measles are running at the eyes and nose, with repeated sneezing and a puffy appearance of the face and eyelids and, a few days after, the appearance of the rash which is raised and red or purplish in colour. The child should be kept in bed from the first appearance of the symptoms until the rash has finally disappeared, in order to avoid the danger of lung complications, which are the real causes of death, uncomplicated measles not being usually fatal. Medical aid should be sought in every case where difficulty of breathing is observed. Disinfectants in a dilute form should be freely used in every case of measles in a warm bath at the onset and termination of the disease, and to sponge the face and other parts during the illness. |
de79ab05-8748-4825-b9ae-578c82993eb7 | 43 In case of inability to obtain suitable disinfectants the same will be supplied, free of charge, on application to the Public Health Department, Town Hall Road, Lavender Hill. The epidemic of measles was accompanied and followed as usual by deaths from various respiratory disorders. From Whooping Cough seventy-one deaths were registered, a large majority complicated by Measles. Thus from the two diseases combined one hundred and ninety deaths occurred, comparing unfavourably with a total of one hundred and eighty-seven deaths from all the notifiable zymotic diseases an unanswerable argument in favour of the compulsory notification of all infectious diseases, they, in the prenotification period, being said to be equally intractable to supervision and modification, an idea which the present greatly diminished case mortality demonstrates to be incorrect. Influenza. This disease assumed grave proportions during the earlier months of 1898, an immense number of people being prostrated by it. |
9ed80fa1-8790-48b8-8fb0-8ee97ae78b1d | Seventy-six persons were certified as having died directly from influenza, but there can be no doubt that the enormous number of deaths from diseases of the respiratory organs was largely due to influenza, as also affections of the brain, nerves, digestive organs &c., there being no organ or part of the body exempt from its influence and probably many cases of suicide without any adequate motive, have been committed under temporary brain stress, brought about by this disease. When the disease has been unusually prevalent, the Health Committee has issued the following PRECAUTIONS AGAINST INFLUENZA. / The Vestry of the Parish of St. |
71ca7d76-b02c-4f45-ac62-6d2f58ca17ec | Mary, Battersea, as the Sanitary Authority and as advised by the Medical Officer of Health, in consequence of the renewed prevalence of Influenza, 44 desire to direct the attention of the public to the extremely infectious character of the disease, and to point out that to the exposure of those in an infective condition from Influenza, by neglect to isolate themselves during the period of such infective condition, the spread and maintenance of the disease is chiefly due. It is probable that the breath of those so affected is the principal medium by which infection is conveyed. The early symptoms of Influenza are chiefly chills and shivering, accompanied by great muscular weakness and prostration, often amounting to inability to stand or move, with pains in the spine or other parts of the body. |
a93109ae-8272-4564-9835-77fd17bfdfe1 | It is desirable that persons thus affected should at once go to bed and there remain until convalescence is established in order to avoid the dangers of Pneumonia or Bronchitis, which are the chief complications to be feared, as likely to lead to fatal results. Early recourse to medical assistance is desirable in every case, both for the determination of the real nature of the disease and for the prevention of the more serious complications. A most important memorandum was issued in 1895 by the Medical Officer of the Local Government Board, and was produced as the result of questions in Parliament, addressed to Ministers, on the subject of a very fatal outbreak at the end of 1894 and beginning of 1895, and is here set out. |
f0d5ba32-a80d-4a92-8590-5d9b2d457ff2 | Influenza became epidemic in England in the winter of 1889-90; it recurred in epidemic form in the spring of 1891, and was maintained up to June of that year; a third epidemic took place in the winter of 1891-92, and after a minor recrudescence in the spring of 1893, a fifth prevalence on a wide scale took place in the winter of 1893-94. England is now passing through a sixth epidemic period. Two detailed reports have been issued by the Board on the subject. The first was Dr. Parsons, "On the Influenza Epidemic of 1889-90," with an introduction by Sir 45 George Buchanan, M.D., F.R.S., the Board's Medical Officer at that date. The second was a "Further Report on Epidemic Influenza, 1889-92," by Dr. |
c44868b5-c5b5-41d5-9ad2-b522789d5f51 | Parsons, with papers on the Clinical and Pathological aspects of the Disease, by Dr. Klein, F.R.S., and an introduction by Sir R. Thorne Thorne. A "Provisional Memorandum upon Precautions advisable at times when Epidemic Influenza threatens, or is prevalent," was also drawn up in January, 1892, and was issued by the Board to local sanitary authorities. The further study made by the Medical Department as to the natural history of Influenza, and as to its clinical and bacteriological characteristics, goes to show that it is a disease against which it is most difficult to apply measures of prevention with any substantial prospect of success. |
1ebf97d0-18b2-455e-b01b-151b928a6a9a | Influenza is highly infective from person to person; its infectious quality is often manifested before the disease is fully recognised ; its incubation period is one of the shortest of all infectious diseases; it varies so much in intensity that many cases are never diagnosed at all; one attack confers no marked immunity against another; and the infection is largely eliminated by means of the lungs, the sputa of the sick being invariably charged, during the acute stage of the disease, with its pathognomonic micro-organism. The disease calls primarily for measures of isolation and of disinfection, but there are difficulties in making any such measures universally applicable. Wherever they can be carried out, the following precautions should, however, be adopted:— 1st. The sick should be separated from the healthy. This is especially important in the case of first attacks in a locality or a household. 46 2nd. |
9d791997-b3e3-4d04-b0fe-b6353e204f32 | The sputa of the sick should, especially in the acute stage of the disease, be received into vessels containing disinfectants. Infected articles and rooms should be cleansed and disinfected. 3rd. When Influenza threatens, unnecessary assemblage of persons should be avoided. 4th. Buildings and rooms in which many people necessarily congregate should be efficiently aerated and cleansed during the intervals of occupation. It should be borne in mind that the liability to contract Influenza, and also the danger of an attack, if contracted, are increased by depressing conditions, such as exposure to cold, and to fatigue whether mental or physical. Attention should hence be paid at epidemic periods to all measures tending to the maintenance of health, such as the use of clothing of suitable warmth, and a sufficiency of wholesome food. |
5bdfa868-da0e-4e93-9b2a-11508ab90e2d | Persons who are attacked by Influenza should at once seek rest, warmth, and medical treatment, and they should bear in mind that the risk of relapse, with dangerous complications, constitutes a chief danger of the disease. It will be perceived that the contents of the above memorandum are in accord with the precautions issued by this parish early in 1894, and now re-issued for the guidance of the public. Infectious Disease at Cowsheds, Dairies, &c. In the event of an outbreak of infectious disease occurring at the premises of a milk-purveyor or dairyman, the London County Council who undertake the registration of such premises are at once communicated with: all milk upon the premises is destroyed, and business is suspended 47 until disinfection of the premises and all trade utensils has been carried out, and a certificate thereof granted by the Medical Officer of Health, after the termination of the case or the removal of the patient to hospital. |
2061ddcf-6594-4bf9-a989-d43541966f53 | With a view to uniformity throughout the Metropolis, the London County Council has adopted a form of certificate authorising the resumption of the sale of milk, a copy of which is appended and is now in general use for that purpose. In the Administrative County of London. In the matter of the Dairies, Cowsheds and Milkshops Orders ot 1885 and 1886, and in the matter of The Regulations thereunder of the London County Council, being the Local Authority for the Administrative County of London. I, the undersigned, being the Medical Officer of Health of the undermentioned District, in pursuance of No. |
34b28db4-b8b2-4734-b9b1-26a8afeb717e | 29 of the aforesaid Regulations, do hereby declare that the building or premises known as in the said District, in which building or premises an outbreak of infectious or contagious disease to wit occurred on or about the day of 189 , and in which building or premises milk is purveyed or sold by one have been disinfected, and that the said building or premises are in my opinion free from infection. As witness my hand this day of 189 . Medical Officer of Health of the District of Battersea, in the Administrative County of London. 48 Closing of Public Elementary Schools. A memorandum, prepared in the Medical Department of the Local Government Board on the circumstances under which the closing of Public Elementary Schools or the exclusion therefrom of particular children may be required in order to prevent the spread of disease was issued in July, 1897. |
579f6b5d-970d-46c4-9358-4e320fc351d2 | This gives information derived from the reports of the Board's own Medical Inspectors, and of local Medical Officers of Health, respecting school closure and exclusion from schools as precautions against infection, with a view to indicating the best means of preventing the spread of disease by school children, while avoiding any unnecessary interruption of the work of education. The regulations of the Education Department (Art. 88) prescribe, as one of the general conditions required to be fulfilled by a Public Elementary School in order to obtain the grant, that the managers must at once comply with any notice of the Sanitary Authority, acting on the advice of the Medical Officer of Health, requiring them for a specified time, with a view to preventing the spread of disease, or any danger to health likely to arise from the condition of the school, either to close the school, or to exclude any scholars from attendance, but provides for their appeal to the Department, after complying, if they consider the notice unreasonable. |
a7a16fe7-2a50-4a18-ae40-1f779de1fa7e | It has subsequently been found necessary to make use of this provision for the closing of the Infants' department of the Plough Road school. It has generally been found so far sufficient to exclude scholars from infected houses from attendance for that purpose, daily returns being forwarded to the Head Masters of Schools notifying the existence of infectious disease at the residences of scholars attending such schools. Table XIII. illustrates the epidemic or zymotic mortality for the past eleven years with the resulting death rates. The 49 number of deaths from each class of disease is shewn. The zymotic death rate for 1898 was 3.0 per thousand persons. TABLE XIII. Comparative Table of Zymoiic Mortality during the past II years. 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 Small Pox . . . . . . . . . . . |
0dc9290b-23fa-46c7-a40b-c2e6dc15b95f | Measles 87 104 159 37 90 90 151 99 185 76 119 Scarlet Fever 25 12 10 10 15 17 5 10 5 7 6 Diphtheria 22 21 27 35 28 90 67 60 5° 52 45 Enteric, &c. |
b386c7f3-a3b0-40a9-958e-c82cf9bb8e44 | Fevers 13 15 21 19 8 14 13 15 11 8 8 Whooping Cough 119 81 146 104 100 115 77 52 137 82 71 Epidemic Diarrhœa 75 112 121 104 99 120 93 151 169 141 154 Other Zymotic Diseases 22 21 59 89 133 118 62 104 45 25 114 Total Deaths from Zymotic Diseases 363 366 543 398 473 564 468 491 602 391 517 Zymotic Death Rate 2.6 2.5 3.6 2.6 3.0 3.5 2.8 2.9 3.6 2.3 3.0 Death-rates from all Diseases 15.7 15.6 19.3 17.3 17. |
40e04861-b74a-4c24-9eb6-ffc7c9b3ba5c | 4 17.8 15.4 17.8 17.7 15.5 16.0 TABLE XIV. Comparative Table of all non-zymotic causes of Deaths during the past 11 years. 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 Tubercular, including Phthisis 342 334 320 285 237 355 304 353 374 355 376 Of Brain, Nerves, &c. |
c5644c97-9bfb-46e3-b7ec-aaa2866f7b25 | 223 212 261 195 259 213 211 334 211 241 181 Of the Heart, &c. Of the Respiratory 113 108 148 141 183 159 173 213 182 189 164 gans,excluding Phthisis 474 391 618 572 635 653 471 623 531 439 383 Of Digestive Organs 113 100 118 122 112 127 197 114 154 202 168 Of Urinary Organs 24 39 34 49 72 60 57 56 88 69 75 Of Organs of Generation 6 14 15 16 15 14 12 7 22 14 16 Of Joints, Bones, &c. 9 3 4 7 2 3 6 — 5 6 2 Premature Birth, Low Vitality, Malformation, &c. |
07b627fd-b22b-417f-b889-b94306140764 | 175 205 206 238 256 295 273 332 298 286 288 Of Uncertain Seat Cancer, Syphilis, Dropsy, &c. 79 96 70 89 233 130 114 108 122 141 131 Age 57 52 71 74 122 103 118 128 207 150 317 Violence 56 60 77 60 81 102 70 102 117 118 122 Constitutional ... ... ... 2 12 23 20 40 28 19 22 Total 1671 1614 1942 1850 2219 2237 2026 2410 2339 2229 2245 D 50 Non-Zymotic Diseases. |
19e09a63-9d6e-4284-9e10-4f1f2ff1cc81 | It will be seen by Table XIV that, considering the great increase of population during the eleven years included in the table, the Non-Zymotic deaths have not increased in proportion to the number of residents, but have diminished, in almost the same proportion as the Zymotic deaths. On former reports this has been attributed to the fact that improved sanitation reduces the death rate of both classes of disease, and consequently suggesting that many of the so called non-zymotic diseases will in time be transferred to the zymotic class. A notable example of this tendency is to be found in the case of Tuberculosis, also known as consumption of the lungs, water on the brain, tabes or consumption of the bowels, scrofula, &c. This disease is without doubt communicable under certain circumstances, probably to persons predisposed constitutionally to contract the disease. |
2d8799a3-fe3f-42fd-9f22-fd60a9f80de2 | Public attention has been much directed to this aspect of the question of late and large meetings have been held on the subject, by which the attention of those having control of the public health has been aroused, and in many of the districts of the Metropolis and elsewhere the local authority has issued handbills, giving the public information as to the precautions to be observed against this disease. Such handbill has been drawn up by me, and adopted by the Health Committee and the Vestry, and is here appended. PRECAUTIONS TO BE OBSERVED against TUBERCULOSIS OR CONSUMPTION. The Vestry, as the Sanitary Authority for the Parish, and as advised by the Medical Officer of Health, desire to direct attention to the importance of adopting measures to prevent the spread of Tuberculosis, which is also known as consumption of the lungs or bowels and also as water on the brain, scrofula, &c. |
815dfd74-8f44-486c-b362-d1c14b26cd8d | 51 The disease is caused by a special germ or microbe which may be taken into the system in several ways. Amongst others it is generally contracted in otherwise healthy persons by inhalation of the dust containing the germ or microbe of the disease derived from the dried expectoration or phlegm of persons suffering from consumption. All persons suffering from consumption should expectorate either into the fire or a vessel containing disinfectants such as carbolic acid or into rags or paper which should be afterwards burned. They should especially abstain from expectorating phlegm or spitting on the floors of houses or vehicles or in public places. The disease may also be contracted by partaking of meat or milk of tubercular animals especially of the cow, therefore all meat should be properly cooked and all milk, including condensed milk, boiled before being given to children in every instance. |
4a3c3c91-5ebe-4285-83e9-841c15c6f637 | Milk so treated is as nourishing and palatable as new milk, and it need only be brought to the boiling point for a minute, prolonged boiling being unnecessary. A further mode of contracting the disease is by sleeping in a room which is or has been inhabited by a person suffering from consumption. Therefore if possible all persons suffering from this disease should have a separate bedroom, the windows of which should be kept open as long as possible daily. After the death or removal of a person suffering from consumption the room should be disinfected, the wall paper stripped and the ceilings whitewashed. Disinfection will be performed in such cases by the Vestry's staff, free of charge, upon application at the Public Health Department, Municipal Buildings, Town Hall Road, where disinfectants will also be supplied to the poor, without charge, in cases where the same cannot otherwise be obtained. 52 Social Position of Persons Dying During 1898. N umber. Per Cent. |
2c73588d-bbb9-4bd3-9c34-c6b3568333dc | Nobility and Gentry 15 0.5 Professional Class 25 0.9 Middle and Trading Class 211 7.6 Industrial and Labouring Class 2,486 91.0 2.737 100.0 Steam Disinfection. On several occasions during the last few years the Health Committee has considered as to the advisability of carrying out steam disinfection without the intervention of a contractor. In November, 1895, a letter was received from the Metropolitan Asylums Board, recommending that Sanitary Authorities provide their own steam disinfectors, and have the work carried out by their own officials. The subject was at that time adjourned for three months, when the Committee recommended the renewal of the contract. |
7b3a9b5c-60a7-4f58-86b8-ad5e9051fed1 | In July, 1897, the Committee again considered the matter and a Sub-Committee was appointed, who visited several of the Metropolitan Disinfecting stations, but decided to again adjourn the matter until it could be ascertained what steam would be permanently available for the purpose of a steam disinfector, either in connection with the Electric Lighting Works at the rear of the Town Hall or elsewhere. During the year the Vestry has again renewed the contract with Mr. W. G. Lacy to carry out this work. Inquests. During the year 1898, 333 deaths were referred to the Coroner. In sixty-six instances he decided that no further inquiry was necessary, and they are therefore marked in the Registrar's Returns as "submitted to Coroner," which is sufficient to authorise registration. |
fcdaaa4b-079e-45de-b477-ee047ca35f60 | 53 In the other 267 cases inquests were held with the following verdicts:— From Natural Causes 145 From Accidental Causes:— Poisoning 1 Burns 12 Falls 32 Run over 3 Suffocated 7 Suffocated in bed with parents 18 Scalds 3 On Railway 3 Drowned 1 Want of attention at birth 1 Fractured Skull 1 Strangulation 1 Hæmmorhage 1 — 84 From Suicidal Causes:— Cut throat 5 Drowning 3 Poisoning 4 Hanging 1 Railway 1 — 14 From Homicidal Causes:— Suffocation 2 Neglect 1 — 3 Open Verdicts:— Drowned 8 Injuries 7 Poisoned 2 54 Suffocated 2 Alcoholism 1 Hæmmorhage 1 — 21 Total 267 Eighteen deaths were due to suffocation whilst in bed with parents, |
bfafddd8-770e-4443-98c5-e438d34b1d91 | the dates and days of the week being as follows: 18th January Tuesday 19th June Sunday. 3rd February Thursday 2nd August Tuesday. 20th ,, Sunday 17th „ Wednesday. 11th March Friday 12th September Monday. 31st ,, Thursday 5th October Wednesday. 8th April Friday 2nd November Wednesday. 29th Friday 4th Friday. 15th May Sunday 21st December Wednesday. 13th June Monday. 26th ,, Monday. Classified according to days of week:— Sunday 3 Monday 3 Tuesday 2 Wednesday 4 Thursday 2 Friday 4 Saturday 0 18 55 Water Supply for London. This most important subject, more especially with reference to the health and sanitary condition of the inhabitants of this vast metropolis, among whom of course are included the many thousands of persons who are inhabitants of Battersea, is now engaging general attention. |
3d7d75ec-0800-478d-bf78-c8846ef64df3 | In my report for 1895 the subject was very fully discussed, and as the matter is one involving as it does the expenditure of many millions of the public money as well as the health and lives of the community, and in which every public man should take a strong personal interest, a condensed account of the present position of the question is again given. The water supply for London has been under consideration by a Royal Commission which sat during 1892 and 1893. The Chairman was Lord Balfour of Burleigh; Sir Archibald Geikie, Professor Dewar, Dr. Ogle, Mr. Mansergh, Mr. Hill, and Sir George Bruce constituted the Committee, all men of eminence and selected for their intimate knowledge of the subject. No Commissioner was in any way connected with either of the London Water Companies, and Mr. Mansergh is the Engineer who is now bringing water to Birmingham from Wales, while Mr. |
aa2b32a6-6da2-4a56-9210-0ddde08a7eab | Hill is supplying Manchester from Thirlmere. The witnesses examined include nearly one hundred of the leading sanitarians and engineers, together with representatives' of the great public bodies of the Metropolis and elsewhere, the Local Government Board, the London County Council, the Corporation of London, and the various Water Companies and others having interests in the Water Supply of the Metropolis. Briefly reviewing the inquiry, the main question referred to and considered by the Commission was whether the water of the Thames and Lea Valleys was good, and whether enough of it could be obtained for the London of the future without injury to the interests of other districts in those watersheds. |
0a7a9578-e5e0-4a5d-8647-45f8f54e4423 | They find, as the Companies always maintained, that " the water as supplied 56 to the consumer in London is of a very high standard of excellence and of purity, and that it is suitable in quality for all household purposes," and also that the Thames and Lea Valleys may, without prejudice to the claims or material injury to the interests of districts outside the area of Greater London, be made to supply more than double the present population of the Metropolis with 35 gallons per head daily. The Commissioners recommend that the inspection of the River Thames should be more thoroughly done than it is at present, and that increased provision should be made, in the form of reservoirs for avoiding the taking in of water while the river is in a state of flood. Of all the sites that have been suggested to them as suitable for reservoirs they consider none in the Thames Valley so reliable as can be found upon the London clay, only a short distance above the Hampton intakes. |
e4b57c3e-2dac-46fa-92ca-9fdd8f10a164 | From the Thames, when required, may be taken 300,000,000 gallons a day; from the Lea, 52,500,000 gallons; from wells in the Lea Valley, 40,000,000 gallons; and from wells in the Kent Company's district, 27,500,000 gallons, besides a further considerable quantity, should it ever be wanted, from the Valley of the Medway and the country to the east of it. The Commission, as might be expected, deal with the question broadly, without committing themselves to details. It would be going beyond the duty of useful criticism to discuss some of the interesting scientific, though minor, points upon which the Commissioners adopted views adverse to those of some of the distinguished witnesses who appeared before them. There are, however, in the enquiry two points which rather hang upon one another, and about which we wish the Commission had told us a little more. |
bdf3356c-b088-481c-b31e-c39a0860b514 | These are:— (1) The effect which might be expected upon the Thames of taking double the present quantity of the water from the river during periods of drought. 57 (2) The amount of storage space to be provided above the intakes in order to make the taking of any more of this water unnecessary. The conclusion of the Commission is most distinct that there is ample supply of water derivable from the River Thames and Lea, from wells in the chalk in the Lea Valley, and also in the district of the Kent Water Works Company, which will be sufficient to meet the requirements of London for fifty years to come. As to the purity of these supplies, the chemical and bacteriological evidence of Dr. Frankland, Dr. Odling, Professor Crookes, Professor Ray Lankester, Dr. P. F. Frankland and others, is most satisfactory; and no evidence submitted as to impurity could stand the test of the investigations and inquiries of the Commissioners. |
ec595f16-1b79-44f8-b15e-400908deaee2 | In their report, however, they very properly advise that further efforts shall be made to keep pollution of all kinds out of the Rivers, and maintain their purity in every possible way. The Commissioners then state that— "We are strongly of opinion that the water as supplied to the consumer in London is of a very high standard of excellence and of purity, and that it is suitable in quality for all household purposes. We are well aware that a certain prejudice exists against the use of drinking water derived from the Thames and the Lea, because these rivers are liable to pollution, however perfect the subsequent purification, either by natural or artificial means, may be. But, having regard to the experience of London during the last thirty years, and to the evidence given to us on the subject, we do not believe that any danger exists of the spread of disease by the use of this water, provided that there is adequate storage, and the same is efficiently filtered before delivery to the consumers. |
07b4bff2-101d-4de2-94f1-c19fd868d521 | "With respect to the quantity of water which can be obtained within the watersheds of the Thames and the Lea, we are of opinion that, if the proposals we have recommended are 58 adopted, a sufficient supply to meet the wants of the Metropolis for a long time to come may be found without any prejudice to the claims, or material injury to the interests of any district outside the area of Greater London. We are of opinion that an average daily supply of 40,000,000 gallons can be obtained from wells and springs in the chalk of the Lea Valley without affecting any material interests, but that, if this quantity be exceeded, it is probable that the springs and wells in the parts of the Valley immediately adjacent to the wells and all the districts farther down the Valley may be injuriously affected. "From wells in the chalk area on the south side of the Thames, in the district of the Kent Company, we are of opinion that a daily average supply of 27,500,000 gallons may be obtained. |
2d128d7d-0ade-4e24-aa89-9b6ebfccd339 | We think it of very great importance that distinct obligations should be laid upon any company or Local Authority which is allowed to pump water from the chalk for purposes of public supply to keep accurate observation of the effect of their operations on the level of the water in the wells from which they pump, and return the results to the Water Examiner under such regulations as may be framed. "The great difficulty which we have had to encounter has been in getting accurate and reliable information as to the actual effect of the operations now carried on. The importance of procuring this will increase each year as the limit of what can be taken from any district with safety is gradually being reached. From the River Lea we are of opinion what with adequate additions to the present system of storage 52,500,000 gallons may be taken daily. |
a7e4f7e0-2f7c-46e2-953b-61215cc1286f | We are of opinion that, by the construction of storage reservoirs in the Thames Valley, at no great distance above the intakes of the Companies, it will be possible to obtain an average daily supply of 300,000,000 gallons without taking in any objectionable part of the flood water. The average daily flow of the Thames at Teddington Weir, adding the water taken 59 by the Companies, is about 1,350,000,000 gallons per day. |
4b072b7d-8baf-486b-92ca-a38d53d5bc40 | It will thus be seen that, when 300,000,000 gallons are taken, there will be left to flow down into the tidal portion of the river an average daily quantity of not less than 1,000,000,000; and we think that regulations could be framed under which the quantity we suggest could be taken, not only without reducing the flow of the river on the rare occasions of exceptional drought to the present minimum, but in such a way as to secure that the volume of water left in the river at these times should be substantially greater than it is under existing conditions. "To our minds, one great advantage of such a scheme of storage reservoirs is that it can be carried out progressively to meet the increasing demands for water; and should the population not grow so rapidly as we have thought it right to contemplate, the extensions may be from time to time deferred as successive decennial enumerations reveal that the ratio of increase is remaining stationary or even falling. |
f5bfe70c-1383-4956-aaee-1391b148d76c | From the sources and by the methods we have mentioned, a daily supply of 424,000,000 gallons can, in our opinion, be obtained. This is a sufficient quantity to supply 35 gallons per head to a population of 12,000,000 persons, which is about three-quarters of a million in excess of what the total population of Greater London, together with the outlying parts of Water London, will have become in 1931 even if the ratio of increase in the last decennial period from 1881 to 1931 is fully maintained. We are further of opinion that a large supply of water might be obtained from the chalk area east of the Kent Companies' district in the basis of the Medway, and in the district further east, without any risk whatever of damage to that area." The London County Council and its Views upon the Water Supply. |
0d4ca1e9-bfb0-4601-a7c6-a4fc6b89c299 | Of these witnesses examined whose evidence was directly adverse to the reservoir and storage schemes put forward by the 60 Companies, that of Sir A. R. Binnie, M. Inst., C.E., Chief Engineer to the London County Council, was the most important. Sir A. R. Binnie's evidence was to the effect that the supply that could be drawn from the Thames and the Lea was wholly insufficient to meet the future wants of Greater London; and he stated that, in his opinion, deeper storage reservoirs in the Thames Valley were impracticable, and, further, that any large increase in quantity pumped from the chalk formations would only ultimately diminish the amount of surface water in the various contributory streams, and therefore could not be reckoned on for increasing the supply. |
97ea3ac2-c3f7-4075-9a0f-d24788e18e39 | The Water Committee of the London County Council issued a memorandum by its Chairman and a series of reports by the principal officers of the Council on the report of the Royal Commission on the Metropolitan Water supply by which it will be seen that the conclusions of the Royal Commission are controverted to a certain extent. An admirable synopsis of the views of the London County Council and its chief officials appeared in the British Medical Journal, which is here closelv followed. Mr. Basset Hopkins, the Chairman of Committtee, in his memorandum, insists strongly on the narrowness of the scope of the inquiry by the Royal Commission, and points out that mischievous consequences may follow, and the Council may be grievously hampered in its action if people accept the idea that the report was the result of an all-embracing investigation of the general subject. The real question which is of most interest to Londoners is—what is the best course for London to pursue under the circumstances? |
6492638e-d943-4b40-becb-1819ed369903 | But this never entered into the reference to the Commission, and in considering their report it has constantly to be borne in mind that whatever they say in support of the prospective sufficiency (for forty years only) of the watersheds on the Thames and Lea has no bearing on the real question whether new gathering grounds ought not to be sought for outside that area altogether. 61 Considerable stress is laid on the shortness of the term of forty years to which the Commission have limited their forecast. The capacity of the Thames and Lea watersheds as sources of supply may be expected to have reached, or nearly reached, their limit about the year 1931, and then it will be impossible any further to delay turning to some outside source. By that time, however, the best gathering grounds in the country, which "are already being rapidly taken possession of by other municipalities," may be lost to us. |
57e3745f-f355-46aa-b398-4be46e667b58 | In regard to this, one has to bear in mind the long time which is required for the execution of the vast works necessary in large water schemes, and the Council's chief engineer says plainly that the people of London, "will at some not very distant date (probably twenty years hence) have to contemplate the exhaustion of the supplies which can be obtained in the Thames Valley," and the necessity of looking elsewhere for an increased supply. "One of the greatest blots upon the finding of the Royal Commission" is that "it can in no way be considered a final settlement of the case." This limitation of forecast to forty years is all the more curious in view of the fact that two members of the Royal Commission. giving evidence before the House of Lords on the Birmingham water scheme, gave much longer periods as the time for which estimates should be made, Mr. G. H. Hill stating that provision for a large town should be for a period of not less than 50 years, and Mr. |
1f0d7f58-4812-49f5-922b-a7636ba81e5f | James Mansergh, the engineer to the scheme, indicating that he calculated his supply for some sixty-four years, and on that basis laid out the works which the Corporation of Birmingham are now carrying out. Sir A. R. Binnie shows in a striking way the difference between averages and actualities in regard to the flowofwater down a river bed. The Royal Commissioners contemplating taking 300 million gallons from the Thames daily, trusting to the fact that the average daily flow at Teddington weir is about 1,350 million gallons; but he shows that during certain dry months the 62 total average flow would often only slightly exceed the amount of water required by the Companies, and in such a case as that of September, 1893, the total flow would not come up to the requirements. If the extreme minimum flow per twenty-four hours is taken, the difficulty of providing a supply both for the River and the Metropolis is still more apparent. |
7fc0687e-351f-46d6-ae1b-605df31573f6 | There is a good deal of common sense in some of the remarks in the reports about the safety, or otherwise, of polluted waters. Sir A. R. Binnie draws attention to the fact that " the Royal Commissioners received, although they do not quote it, some very strong evidence from one of the highest authorities, namely, Sir G. Buchanan, M.D., F.R.S., late Chief Medical Officer to the Local Government Board." This evidence was to the effect that neither chemical nor bacteriological tests were to be relied on as to the purity of water, that we did not know how small an amount of morbific material, if it gained access to the water, might set up disease, and that the way to gain information as to purity and safety was to search out the conditions surrounding water courses and water services. Asked what would be his treatment of the water if it were found to be polluted, he could only answer that " there was nothing for it but either to boil the polluted water, or else to leave it alone." |
82c269bc-03fd-4cdb-aece-80f707e87922 | In face of such evidence from such an authority we turn with interest to the paragraphs in Sir A. R. Binnie's report summarising the pollutions of the Thames water, which the Commission thinks good enough for London. It seems that at the census of 1891 there was a population of 1,056,415 persons draining into the river above the intakes, and that in the last thirty years this population had increased from 816,814 to its present number. That, however, gives but a poor idea of the increase which is going on in the urban population living on the banks of the Thames and its Tributaries, many of these towns having more than doubled their size in thirty years. "Besides this human population there are probably 1,600,000 animals inhabiting the 63 above area." Consequently it is cleat that if the Thames is to be retained as a source of water supply, the people of London must drink the more or less clarified excreta of this vast population. |
1802e9a3-fcc9-4d46-99ba-81137c45f506 | Mr. Shirley Murphy, Medical Officer of the London County Council, confines his observations to that portion of the report of the Royal Commission which relates to the quality of the present sources of supply. The Royal Commission had before it evidence, he says, which showed that the rivers from which the Water Companies draw their supplies, receive from the towns situated on their banks at varying distances above the intakes, sewage effluents, which, after treatment of the sewage, either by filtration through land or by chemical processes, enter smaller rivers. In addition to these, numerous pollutions from smaller populations discharging into cesspools and ditches reach, untreated, the streams at times of heavy rainfall. Such sewage must not infrequently contain the excremental matter of persons suffering from typhoid fever and may not improbably in the future, contain from time to time the excreta of persons suffering from cholera. |
41f6b0c0-94d9-4428-8cdb-c33f9a885f60 | The virus of both these diseases has been found by past experience to have been disseminated by water and to have produced fatal results in persons drinking such water. Not only are these diseases known to be waterborne, but experience has shewn that a very small amount of the excremental matter of persons suffering from them is capable under favourable circumstances of infecting vast volumes of water. In the present state of knowledge on such matters we are driven back to much the same opinion as that held by the late Sir George Buchanan, who said that he did not think that it was possible, either by chemical, microscopical, or bacteriological processes, to say when a water was or was not injurious, and that there was no way of arriving at a solution of this question except by inspecting the sources of supply, and seeing if they 64 were or were not pollutted. According to this criterion London river water stands absolutely and hopelessly condemned. |
d8afd552-386f-4112-8a74-76d91c4b0ed2 | Although very little is definitely said on the subject, the impression which the perusal of the report leaves upon the mind is that the whole control of the water supply, from the sources to the final delivery to the consumer, should be in the hands of one authority, and that the time has arrived when competing companies, the result of private enterprise, should no longer be left in possession of a monopoly of the primary necessity of existence. At the time of writing the London County Council have introduced a Bill into Parliament, empowering it to bring a supply of water from South Wales. The Bill failed to pass the second reading. It is certain that some further source of supply other than the Thames and Lea must before many years be found. The Vestry has ordered that monthly samples of water for the purposes of analyses be taken from the supplies of the water companies in the Parish. Public Health (London) Act, 1891. |
81ba2a36-6293-4689-8aa7-a5a06fe59b98 | The procedure of the Public Health Department is almost entirely based upon the provisions of the Public Health (London) Act, 1891, which consolidated and amended the various Acts under which the Sanitation of London has been previously carried out. It contained also many valuable provisions which had hitherto only been extra Metropolitan and contained in the Public Health Act, 1875, under which provincial Sanitary Authorities had effected great improvement in the Sanitation of their districts. A condensed synopsis of its provisions here will be useful for reference. Sec. 1 provides for house to house inspection by the Sanitary Authority, for which additional Inspectors with separate and smaller districts have been appointed within the last few years. Sec. 2.—A nuisance must be abated that is dangerous or likely to be dangerous to health. Under the Metropolis Management and other Acts it was necessary to prove actual injury tohealth. 65 Sec. |
c7b60f4b-b30a-4c46-99f4-20bcb2139619 | 3 provides that information of a nuisance may be made to the Sanitary Authority, who shall serve intimation to parties responsible. Sec. 4—The most essential difference between the procedure under the Public Health (London) Act, 1891, and the various other preceding Acts, is that formerly if a notice to abate a nuisance from the Sanitary Authority was not complied with, proceedings had to be commenced before a justice and evidence produced to satisfy him that a nuisance injurious to health existed, when, if satisfied that such nuisance existed and was injurious to health an order would be made for the abatement of the same. If this order was disregarded and the necessary works not executed it was necessary to commence fresh proceedings to recover penalties. The Sanitary Authority under this section itself considers the matter and makes orders, if necessary suing for penalties for non-compliance therewith. |
8e8ba3c3-2e45-4cd2-a68c-3a6b5b51bcd9 | Absence of proper water-fittings is constituted a nuisance under section 4, and by section 5 a house may be closed for this reason. The authority can specify works and insist upon the carrying out of the same under the latter section, and now does so in a large proportion of cases. Secs. 5, 6 and 8 contain provisions for orders, penalties and appeals, and enables the Sanitary Authority itself to carry out necessary works in default of responsible owners, &c. Sec. n provides for recovery of expenses and costs consequent thereon, and Sec. 13 enables the Authority to take action in the first instance in the higher Courts should it think fit. Under Sec. 14 an important proviso is introduced, as a Sanitary Authority has power to take proceedings for the abatement of nuisances arising in the district of another authority should the nuisance injuriously affect the inhabitants of their own district. E 66 Sec. |
3f1b2168-3b86-4fa4-9873-4e607fb081b3 | 15 renders liable to a penalty of £5 any person wilfully injuring or destroying any closet or sanitary apparatus, and will probably be useful in restraining persons from wantonly damaging fittings. Bye-laws are to be made by the authority for the prevention of nuisances or keeping of animals so as to be a nuisance or injurious to health, and as to paving yards. The London County Council has made Bye-laws nnder the following sections which are now operative:— Sec. 16-1.—Removal of fcecal matter. ,, Removal and disposal of refuse. ,, Cleansing and filling up of cesspools and privies. Sec. 39-1.—Water closets and soil pipes. „ Ashpits. ,, Receptacles for dung, cesspools, &c. The Vestry has made Bye-laws under the undermentioned Sections of the Act:— Sec. 16.—Prevention of nuisances. ,, 39.—Keeping of water closets. |
35ca519d-c90d-4843-a9d8-5931a8e7fc94 | ,, 50.—Cleansing of cisterns. ,, 94.—Houses let in lodgings. These are in active operation, and can be obtained at the office of the Public Health Department by any ratepayer desiring a copy. There are other bye-laws which may be made by the Sanitary Authority. They are:— Sec. 66. Removal to hospital of infected persons. This is now effected under the provisions of the various acts and regulations of the Metropolitan Asylums Board. 67 Sec. 88. Bye-laws for the Mortuary. Regulations are in existence for the control of the Mortuary-keeper under which the Mortuary has hitherto been regulated. Sec. 95. Tents and vans. Bye-laws were made by the District Board some years since, under the Housing of the Working Classes Act, 1885, which have been acted on until the present time. By Secs. |
8c54baa7-9819-4ec8-afeb-20f78617ad0a | 23 and 24 the control of smoke nuisances other than in private dwellings is placed under the Sanitary Authority instead of the Police, and has considerably increased the work of the Public Health Department, it being necessary in many cases to keep observation throughout the night. Work-shops, Work-places and Factories are also placed under the supervision of the Sanitary Authority with certain duties as to giving notice to the Factory Inspector when children, young persons, or women are employed. It is also the duty of the Authority to see that proper and separate accommodation is provided for each sex. Sec. 47 provides that a medical officer of health or sanitary inspector shall examine all articles intended for the food of man if unsound, and shall seize the same and obtain an order from a Justice for its destruction. |
c839f0ad-a8b3-4247-9649-b57e9eadeed2 | The fine is raised to a maximum of £50 for every animal or parcel of food condemned, and should a person be so convicted twice in twelve months the Court may order a notice of the facts to be affixed to his premises for a period not exceeding twenty-one days. Should a person find himself in the possession of unsound food he himself may give notice to the Vestry, who must remove the same as trade refuse and this procedure would seem to relieve him of the penalties mentioned. Sec. 48 contains the important provision that a newly-erected dwelling-house must not be occupied until a certificate has been obtained of the Sanitary Authority to the effect that a proper and 68 sufficient supply of water exists. This section seems to be now more generally understood and imposes much work on the Public Health Department. The following sections 49, 50, 51, 52, 53 and 54, apply inter alia to water supply generally. Secs. |
e138402c-9a80-46b7-ac14-4dd809a07ec5 | 55,56 and 57 re-enact, as elsewhere stated, the provisions of the Infectious Disease (Notification) Act. Secs. 59, 60 and 61 require the authority to make provisions for the disinfection of clothing, &c., which provision has been duly made by the Vestry. The subsequent sections provide that Infectious refuse shall not be treated so as to be dangerous to the public health, and prescribe penalties on persons letting houses or apartments in which infectious disease has occurred without having the same properly disinfected and obtaining a certificate thereof, which certificate is given to applicants free of charge on application to the Public Health Department. Other important provisions for the prevention of the spread of infectious disease follow in subsequent sections; but they have long been in operation in this parish. In fact, it may be said generally that the methods of Sanitary procedure which may have gradually evolved in this parish during the last twenty years, were adopted by the framers of the Act as its basis. |
28f69c15-e474-4910-a50d-9846c1d78aff | Provision is made for Mortuaries and post-mortem examinations; such have existed in Battersea for many years. The Mortuary accommodation is, however, becoming somewhat inadequate for the needs of this ever increasing parish, and it is proposed to provide a new Mortuary with Coroner's Court. The present Mortuary, originally said to be the best arranged in London, in a commendable spirit of emulation, other parishes have improved upon, until we are at the present time somewhat short of the standard of excellence. The plans of the Surveyor, when carried out, will provide a building far in advance of the majority of Metropolitan Mortuaries. There was a difficulty in deciding as to the most suitable site, but one adjacent to the Public Baths in the Latchmere Road has been finally determined upon. 69 The following Table shews the number of bodies admitted into the Mortuary during the past eleven years, together with the number of post-mortem examinations and inquests held. |
98cb5e5f-0de2-49d0-a001-306c1646509d | Table shewing number of Bodies removed to the Parish Mortuary during the past ii Years. *No. of bodies received. No. of post-mortem examinations. No. of inquests. 1888 134 106 134 1889 140 118 140 1890 199 148 194 1891 176 139 169 1892 193 163 187 1893 243 200 237 1894 224 197 208 1895 259 210 232 1896 293 242 278 1897 289 246 273 1898 294 238 267 * Includes bodies of infectious dead and cases removed for sanitary reasons. Customs This Act, which is simply an extension of the Revenue provisions of the Customs and Inland Revenue Act, Act, 1891. |
790b4194-5333-49f2-b055-9245f25aa6a1 | 1890, exempting houses structurally fitted in the opinion of the Medical Officer of Health for occupation as 70 separate tenements at an annual rental not exceeding £10 from the liability to house duty. The 1891 Act raised the amount to £4.0 annual rental. These Acts have added much to the duties of the Medical Officer, as personal inspection; is imperative and certain forms of certificate have to be sent by him to the Surveyor of Taxes. Many hundreds of tenements have been inspected and certified since the Act came into force in January, 1891, and many flats are now being built and converted in the parish in order to obtain exemption or abatement of the house duty. |
1f6ea9d1-d084-4e1e-b393-61271af23932 | The numbers inspected yearly from 1890, in which two hundred and forty-three were inspected, and after the execution of necessary works re-inspected and certified were for 1891, one hundred and nineteen; for 1892, one hundred and sixty-five; for 1893, two hundred and one; for 1894 and 1895, each ninety-one; during 1896, one hundred and twenty. During 1897 forty-three applications were made and certificates given in twenty-seven cases. In 1898, eighty-two certificates were granted after personal inspection of the premises. The Act requires that in order that a certificate may be granted by the Medical Officer of Health, the house be so constructed as to afford suitable and separate accommodation for each tenement. In connection with the granting of these certificates, the following recommendations have been adopted by the Metropolitan Branch of the Incorporated Society of Medical Officers of Health. |
85d59f62-a258-4c65-ac2e-395dfbefdbba | I. That in no case should a Medical Officer of Health examine a house with a view to giving a Certificate under these Acts, until he is absolutely satisfied— as advised in the letter from the Local Government Board, dated the 15th August, 1892—that the house in question comes within the sections of the Acts. 71 2. That a Certificate under these Acts should state that the following requirements are complied with : (a) A definite minimum height and superficial area for living and sleeping rooms, as defined by the London Building Act, 1894. (b) That there is a sufficient and available supply of water on each floor. (c) That there is at least one water-closet, properly supplied with water for every twelve occupants (or less) on each floor. (1d) That the drainage of the premises is in accordance with the regulations recognized by the Authority in whose jurisdiction the house is situated. |
b4a6c8c8-3d5a-412a-b3c4-3220975d6842 | (e) That accommodation for clothes washing is provided, sufficient for the number of persons inhabiting the house. At the end of 1897 certificates were outstanding in regard to applications for 10 premises, and have during 1898 been granted, the works required to be carried out to satisfy the requirements of the Medical Officer of Health having been attended to. During 1898 seventy-two fresh applications were received, and in all cases certificates were granted. Applications 72 Certificates granted 82 Deaths Cases Battersea OTHER DISEASES. Deaths Cases Battersea ZYMOTIC OR EPIDEMIC DISEASES. TABLE XV. Sickness and Mortality amongst the Parish Poor dining the year 1898. 8 109 Diseases of the Tubercular Class. ... ... Small-Pox. 4 211 Of Brain, Nerves, &c. 2 57 Measles. 2 124 Of Heart. ... 14 Scarlatina. |
a7848150-2f46-454a-b0ec-56a498d57403 | 21 861 Of Respiratory Organs. ... 7 Diphtheria. 1 201 Of Digestive Organs. 1 17 Whooping Cough. ... 10 Of Kidneys. ... 3 Enteric & other Fevers. 1 3 Premature Birth, Low Vitality, Malformation, &c. ... 16 Erysipelas. 4 139 Age. ... 4 Puerperal Fever or Metria. 1 123 Violence. ... 147 Diarrhoea, Dysentery, or Cholera. 7 2231 All other Diseases. 6 156 Influenza. 49 4012 Total. ... 3 Other Zymotic Diseases 9 424 Total. 58 4436 Grand Totals of Cases and Deaths from all Diseases. ZL 73 TABLE XVI. Batternea Vaccination Returns, January to December, 1898. |
00cddf0c-4436-490c-a957-45085ad07130 | Registration Sub-District. Number of Births returned in the Birth List Sheets—1898. Nos. of those births duly entered by the 31st j anuary, 1899, in Cols. 10, 11, and 13, of the Vaccination Register, (Birth List Sheets), viz.:— No. of Births which on, the 31st March, 1899,remained unentered in the Vaccination Register on account. Number of those Births remaining on 31st January neither duly entered in Vaccination Register (Col. 3, 4, 5. and 6 of this Return) nor accounted in the Report Book. Col. 10, successfully vaccinated. Col. 11, Insusceptible of vaccination. Had Smallpox. Col. 13, Dead unvaccinated. Conscientious Objection Certificates received. Postponement by Medical Certificate. |
b2f34caf-4bbe-4459-bbd6-db5d855fb6a0 | Removed to Districts the vaccination officers of which have been apprised. Removed to places unknown. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) east battersea 2433 912 11 ... 268 49 189 18 292 694 west battersea 2755 1088 6 ... 248 57 164 17 294 881 totals 5188 2000 j7 ... 516 106 353 35 586 1575 Vaccination In the Annual Report for 1896 a very copious resume of the report of the Royal Commission on Vaccination was given. It will not be necessary to reproduce the body of the report, but the conclusions of the majority report as well as that of the min6rity are epitomised and here given as well as the new Vaccination Act. |
88d9064c-b4cc-4f35-9a33-643c6387d2b8 | After setting out at great length the advantages and disadvantages of arm to arm vaccination the report goes on to say that it is obvious that the employment of calf-lymph only would wholly exclude the risks as regards both Syphilis and Leprosy. Respecting the latter disease, however, there appears to be reason to doubt whether any risk exists, and at any rate it 74 does not concern the British population. Even in Leprosy districts the employment of English human lymph would be, so far as Leprosy is concerned, as safe as that from the calf. The risk of Syphilis, although real, is an exceedingly small one, even when humanized lymph is employed, and may probably be wholly avoided by care in the selection of the vaccinifer. As regards all the other dangers, whether of severe illness or temporary inconvenience, the two forms of lymph appear to stand on the same level. |
9bd42398-3676-407f-a78f-cfff87aa54cf | The instances of inflamed arms, of Erysipelas, of Vaccinia Maligna, and Eczematous eruptions are not more common after the use of human lymph than after that from the calf. Some of the best qualified witnesses who have afforded us their assistance have expressed a deliberate preference for armto-arm vaccination, believing that the advantages of calf-lymph are more imaginary than real. A careful examination of the facts which have been brought under our notice has enabled us to arrive at the conclusion that, although some of the dangers said to attend vaccination are undoubtedly real and not inconsiderable in gross amount, yet when considered in relation to the extent of vaccination work done they are insignificant. There is reason further to believe that they are diminishing under the better precautions of the present day, and with the addition of the further precautions which experience suggests will do so still more in the future. |
2b73a6b9-f79f-42f4-a36d-8328c603df25 | We put the use of calf-lymph in the forefront because, as we have said, this would afford an absolute security against the communication of Syphilis. Though we believe the risk of such communication to be extremely small where humanized lymph is employed, we cannot but recognize the fact that however slight the risk, the idea of encountering even such a risk is naturally regarded by a parent with abhorrence. We think, therefore, that parents should not be required to submit their children to vaccination by means of any but calf-lympth, but this should not preclude the use of humanized lymph in case they so desire. 75 So long as the state, with a view to the public interest, compels the vaccination of children, so long even as it errlploys public money in promoting and encouraging the practice, we think it is under an obligation to provide that the means of obtaining calf-lymph for the purpose of vaccination should be within reach of all. |
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