[Report 1895] / Medical Officer of Health, Pontypool Local Board / U.D.C.

  • Pontypool (Wales). Local Board.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: [Report 1895] / Medical Officer of Health, Pontypool Local Board / U.D.C. Source: Wellcome Collection.

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    MEDICAL OFFICER’S REPORT. PONTYPOOL URBAN! DISTRICT COUNCIL Denham House, Pontypool, January 18th, 18%. Mr Chnirman and Geatlemen,—I have great plea¬ sure in laying before you my eighteenth Annual Report relative to the sanitary condition of your district for the year ending Deeember 81st, 1895, to¬ gether with information as to the births, deaths, and sickness for the same period ; also a summary of the action taken in order to comply with the regulations of the Local Government Board appli¬ cable to tbe sanitation of the area under your con¬ trol. The geological formation of your district remains as it was at the time of my last annual report. It lies upon the carboniferous system, or more parti¬ cularly the millstone grit, or farewell rock, or the lower portion of the true coal measures, and forms the eastern outcrop of the South Wales coalfield. The strata dip, or slope, about three inches per yard in a south-westerly direction. Configuration.—The surface of the district is ex¬ tremely irregular and hilly, and lies to the north of the Trosnant Brook, and to the west of the. Afon Llwyd River. It comprises the angular portion of land formed by the above-named streams. The ground rises of slopes up in a northerly, north¬ westerly, and westerly direction from the before- mentioned streams, and lies at an elevation of from 400 to 700 feet above the mean sea-level, and com¬ prises an area of 229 acres. The year began very cold and winterly. January. February, and up to the last week in March being frosty, with heavy snows and east winds. During the early part of February the thermometer regis¬ tered very low readings ; this was especially noted on the night of February 6th, 84 degrees of frost being indicated near Newport. April. May, and June were warm and summerlike : July and part of August damp and cool: and then began a second summer, which continued till the commencement of October. The remaining three months of the year were wet. cheerless dull months, the amount of daylight during December being very scanty. Notwithstanding the amount of rain that has fallen your district has not suffered from excessive moi6t, ture, as the natural fall of the surface carries it all away, and the sewers at the same time get well flushed. During the past twelve months 86 persons have died—56 males and 3 females, the annual general death rate being 141 per 1,000 per annum of the estimated population. This death rate, as it ap¬ pears, is fallacious, as 14 persons were removed from your district and di> d in the Union Infirmary. Had these persons succumbed to their la*t illnesses' and died in your district the death rate then would have been 19 7 per 1,000 per annum ; but it must be remembered and taken into consideration that many of those removed to the Union Infirmary were not actual parishioners belonging to you. but tramps coming casually. Of those removed to the Union eight were over 60 years of age, destitute and diseased, and quite unable to take care of themselves. The births during the past year were 211—103 males and 108 females, the birth’rate being 34*6 per 1,000 per annum of the estimated population The rate of infant mortality per 1,000 births registered was 142*1. The death rate from zymotic diseases, as per Notification Act, 18S9, including diarrhoea, '8 per 1,000 per -nnuin. I have estimated your population as 6,082, for the purpose of calculating statistics of births and deaths, adopting my usual custom of adding Go to the previous year, as the increase to the popula¬ tion. At the same time I do not consider the inha¬ bitants of your district so numerous now as at this time last year, in consequence of so many families having gone away in search of work, several col¬ lieries and works in the immediate vicinity having been closed through want of trade and other pecu¬ niary reasons. The death rate of 141 per 1,000 per annum is a low death rate, and I attribute this chiefly to the decrease in the number Of children dying from cheat affections '.he number of children that died under 1 year of ige last year being quite equal to the number dying n previous years yet there is scarcely half the eaths from bronchial affections that have been re- lstered in previous years. In 1887—the Jubilee ear—the rate of infant mortality per 1,000 births ra« 12.) 0, and it is just worth while emarkmg that it was a season notorious “'i* dry summer; the general eai 1 late chat year waB 14-3 l,er 1.000 per annum nd although the year we have recently closed was i no sense to be compared with 1887 as regards in- jnse heat and drought, still a comparison can be rawn.tor in the year under review we were favoured nth two summers, and before and after each an ex- essive amount of moisture, and there is no doubt a umid state of the atmosphere tends to bronchial nections in all persons, and especially children I the general death rate in 1894 was 16*4 per 1 000 iaP? the infantile death rate 142‘8per 17°K°nn^r?i«vod inj1893 the corresponding rates were LWb IV? ?’ and neXcr 8ince ,KS7 has the infantile Meath rate been so low. Still there has been a / years7 decrease in lnfant mortality for several o^a Pa8fc year 211 births were registered as agamst 210 in 1894, and 218 in 1893, the general be,nK 348 Per 1*000 of thepopnlation! The birth rate is influenced by the marriage rate JL® «™at Extent. I have no means of giving the marriage rate. In my annual report for 1894 I considered that the bad trade of the district had so influenced the mar¬ riage rate that the birth rate was declining, how¬ ever, the past year has been bad indeed for trade, but the births have exceeded the former year by 1. For the period under consideration the births exceeded the deaths by 125, of these 30 died during the first year of life, consequently there has been a net gain to your population of 95. and this is 14 more than were added to you in 1894. This is most satisfac¬ tory, and rather inclines me to think that greater care is being exercised over infant life. Still there is great room for improvement in this respect. When the fact is taken into consideration that about one- fifth of the total deaths in the United Kingdom are under 1 year of age, and in our own district very nearly one-third of the deaths occur during the same period of life, and during the year under re¬ view one-half the deaths occurred under 5 years of age, this looks like a terrible slaughter of the innocents, yet who is to blame ? On analysing the 30 deaths at 1 year of age and under, I find that 26 were children of the labouring classes, and the remaining 4 belonged to persons in trade, 6 died from the effect of chest atf ce- tions, 6 from convulsions and brain diseases, 6 from immaturity and accidents incidental to birth, and 12 from troubles traceable to improper feeding and diseases of the intestinal canal and organs con¬ nected therewith. The probability is that many children not tabulated by me in the 12 were the vic¬ tims of improper feeding to such an extent that their powers of life were reduced so low that they could not withstand disease. The artificial feeding of infants is to be blamed very much for the lowered state of vitality among young children, so many children noware bottle-fed instead of breast-fed. In Berlin, the death certi¬ ficates of children under 1 year of age must state whether the infants were brought up at the breast or upon artificial foods, and this would be a valuable addition to our English system of certifying deaths. The markets are flooded by innumerable foods— pancreatised this and peptonised that—every one specially vaunted tor some worthless peculiarity, which often acts as a starch poison to the unfortu¬ nate infants, raising irritation and giving no nou¬ rishment ; so that the victim is as much starved as though food was withheld. Every mother should be warned that “ jVo farinaceous food (and that includes bread, biscuit, gruel, arrowroot, cornflour, maizena. rice. >ago, potato, fc.) should under am} circumstances be given, to a child until It lias full dentition, unless it has bent precious!g malted, fgr the Simple reason that Nature has not provided the necessary digestive organs to break up and assimi¬ late such starchy foods until the eruption of teeth. I frequently see children in arms suffering from the most unaccountable symptoms, and on inquiry find that they are fed “ on a little of whatever is going.” Many mothers cling obstinately to the belief tlTat the sooner their babies receive solid food the quicker they will grow. The result is, the food acts as an irritant producing indigestion and non-nutrition as much as though they had been fed on cocoa-nut hbre or cinders. It is no uncommon thing to find children under 12 months old suffering from worms. This is ar other result of improper feeding. In the absence of the mother’s milk, good cow’s milk is the best, the newer the better, and it should be had from healthy cows, and purchased from a vendor known for his cleanliness and honesty in the non-adulteration of the real article. The habit of milk-vendors using drugs or preservatives to their milk is a pernicious one. and is in some places carried on to an alarming extent. New, good, fresh cow’s milk is the ideal food for voung infants. It should be kept in a covered vessel, and given to the child as it is. If it gets a few hours stale, it should be boiled for 40 minutes, not in a saucepan, but in a jug placed in a saucepan of water. Table A, supplied by the Local Government Board, epitomises the mortality from all causes as under:— Deaths under 1 year of age.30 ) 42 under 5 1 year and under 5 years 12) years 5 » 15 ,, 4) m 25 „ 2 I 44 over 5 yrs 25 ,, 60 „ 16 of age 60 and upwards .22J Total. 86 Causes of Mortality, Table A. Under 5 years. 5 years and upwards Membraneous Croup . 1 y Measles . 0 j Diarrhoea and Dysentery ... 3 . . . u Rheumatic Fever. u j Phthisis ... . 1 .’’’’’’ j Bronchitis, Pneumonia, aud Pluerisy . 7 g Heart Disease . 2 g Injuries . o 4 All other disease s.28 26 Total. 42 44 Table B.—Another requirement of the Local Government Board refers to new cases of sickness census, Ac. PONTYPOOL URBAN DISTRICT COUNCIL. Population at all ages, Census 1891. 5.842 Estimated to middle of 1895 .’’’ 6,082 New cases of infectious disease coming to the knowledge of the Medical Officer of Health during the year 1895:— Under 5 years of age. Over 5 years of age. Scarlatina. 6 6 Diphtheria . 0 4 Membraneous Croup . 2 0 Typhoid Fever, or Enteric Fever . 0 11 Erysipelas . 0 4 Measles. 3 j Total. 11 26 The Notification Act of 1889, after adoption, came into operation in your district January 1st) 1891, and has been very effective in localising places in your district requiring special sanitary precautions. Notwithstanding the fact that it had been well advertised, one householder pleaded igno¬ rance of it, when found to have four children under his roof suffering from scarlatina. In my monthly report for August I brought this case before your Council, and I felt it my duty to do so, as another family had become infected with the disease through playing with the children from the infected house. The Council very properly determined to prosecute the offender, and he was found guilty and fined 5s and costs by the Pontypool Bench, the Council, by their clerk, asking for special leniency towards the offender, as this was the first case. If Notification is worth anything at all, it must be done well. In the case of a person acting as hi* own medical adviser, and failing to regard several cases of scar¬ latina as a serious matter and a danger to the public health, it behoves the Authority to mark their sense of duty. In the instance quoted above several children living next door to the infected premises caught the disease, and were placed in imminent peril for several weeks, Sentiment must stand aloof when such inconsiderate acts tend to spread a dangerous disease, and give rise to an epidemic. It should be clearly known to everyone that the following diseases must be notified to the Medical Officer of Health for the district, viz., scarlatina or scarlet fever, smallpox, diphtheria, membraneous croup, typhus fever, typhoid or en¬ teric fever, cholera, erysipelas, relapsing, continued, or puerperal fever. Asa rule it may be safely left for the attending practitioner to do, but in case there is no medical man in attendance, the duty of informing the medical officer of health devolves upon several persons, for instance, “ The head of the family to which such inmate (patient) belongs, and in his default the nearest relatives of the patient present in the building, or being in attendance on the patient, and in default of any such person, the occupier of the building shall as soon as he become aware that the patient is suffering from an infec¬ tious disease to which this Act applies, send notice thereof to the medical officer of health for the dis¬ trict.” And it is only by every householder acting the part of a good citizen in this respect, that we can hope to benefit by the Notification Act. Scarlatina.—During the first 3 months of the year 4 cases of this disease occurred—in August, 6’; in October, 1, and December, 1 ; in all, 12 cases. The majority of the cases were mild, and all recovered. Diphtheria.—This disease attacked 4 persons, 2 were in the same house, the others in separate parts of the district, in all cases the drainage was found to be at fault, and your inspector of nuisances had the requisite improvements carried out to prevent recurrence. Membraneous Croup.—'Two children suffered from this affection, in 1 it proved fatal. Erysipelas.—Four persons were affected by ery¬ sipelas—3 in April, and 1 in June. As far as I could judge 3 of the sufferers caught it by means of a chill, and in the 4th it supervened on a scalp wound. They all recovered. Typhoid or Enteric Fever.—All through the year this disease has been cropping up, 11 cases have been notified. In January 3 children were affected in a house in John-street, the cause was an untrapped drain in the basement. One case occurred in the Albion-road close to the former, a defective gully trap connected to a drain leading to the w.c. was found opposite the back door In September one adult had this disease who lived over the slaughter¬ house. I reported at length to your Council on this case at the time, pointing out the dirty state of the pig pens. In November a man became ill of the disease at the top of George-street, and afterwards his two children; the house was found to be very dirty, a hole had been made in the floor to take the waste water and was connected with the drain, un¬ trapped. In this case the personal cleanliness of the family was absolutely neglected, and the nurse was quite a fortnight before she could get the skin of the adult clean, these cases were afterwards re¬ moved to the infectious disease ward at the Union. In December there was one case each in Dauncey’s Court, Coedcae, and Crumlin-street; in each case defective drains and untrapped w.c. were discovered. In all cases the greatest sanitary precautions were taken and improvements made in the defective traps and drains. Phthisis.—Only 2 deaths were due to consump¬ tion—this is an improvement on former years. In 1891, 9 deaths were registered, and in 1893, 6. This is quite in keeping with a marked decrease in affec¬ tions of the chest during the year now closed. Bronchitis, Pneumonia, ami Pleurisy,—There has been a marked decrease in the mortality from these diseases during tbe period under review, but 15 deaths were registered, as compared with 33 in 1894 and 41 in 1893. There appears to have been an average number of children sick with these ail¬ ments. Thirteen of the deaths occurred in the early months of the year, and, since May. the remaining 2. I am very much inclined to believe the decrease in mortality to be due to the more efficient nursing, as certainly the climatic conditions have been against all cases. Influenza has shown itself occasionally during’ the year, particularly in March, when it assumed an epidemic form. There has been no death directly assigned to it, yet, I have no doubt, it has been the foundation of many ailments. In reviewing the health of your district tor the past year, I can come to no other conclusion than that there has been a marked improvement, and a decrease in the aggre¬ gate of sickness. Among the artizan and labouring classes, the amount of poverty has been above the average, in consequence of so little employment being available; pauperism has extended, and numbers have had to seek parish relief that hitherto could maintain themselves. The sickness among these latter has been greater than usual and of a lower type, such as would be expected where great destitution and privation prevailed. This fact has been well demonstrated by the rapidity by which these persons recovered after a more nutritious diet. Vaccination in your district has not been carried out so vigorously as it should be. During the past year, 11!) children have been taken to the public vaccination station, as against 146 in 1894. For several years the vaccination has been badly looked after. I have now hopes of great improvement, as a new vaccination officer has been appointed. It is a matter of great regret that the public do not embrace the blessings bestowed on them by vacci¬ nation more freely. As a preventive to small pox, no sane person could doubt its efficacy, and it is to be regretted that more diseases cannot be warded off by so simple a measure, a F01^ intluest8 have been held, and verdicts of Accidental death ” returned in each case. The water supply has been good, and a great impro¬ vement has been made in the service, and the conve¬ nience of consumers consulted and considered in the matter of turning on and off for repairs. The meat supply has been abundant, good, and cheap, and no sample of suspicious meat has been brought to me for examination. As a matter affecting the health and welfare of the inhabitants of your authority I take this oppor¬ tunity of placing on record the fact that through tbe instrumentality and munificence of Mr J. C. Hanbury, J.P.,of Pontypool Park, a trained district nurse, from the QueenVictoria’s Jubilee Institute of Nurses,has been supplied to work in your district; her services are of the greatest value and much appre¬ ciated by the sick poor and medical profession alike, inasmuch as since her arrival on May 14th, 1895, to the end of the year she attended 96 patients and paid 2,111 visits. I understand the Council have come to no final decision as to the disposal of the sewage of the dis¬ trict, but that the matter is still before them ; also- is the scheme for a cattle market, slaughter-house, and place to hold the fairs still under consideration. It would be a most useful procedure if the Council could arrange to have a proper place to hold the various fairs instead of holding them in the streets, which is not not only an insanitary but a dangerous practice. Your inspector of nuisances reportshaving served 183 notices of various kinds during the year, viz.: To remedy insanitary, defective, and dangerous buildings. 10 For the removal of swine. 9 For the cleansing of foul cesspits. 9 For the cleansin? of foul w.c.’s. 23 For the repair of defective drains. 37 For improving defective closet accommodation 26 For the cessation of overcrowding . 2 For the removal of manure and other filth . 67 Total. 183 Inspections and recommendations for the removal of nuisances arising from defective down pipes, filthy condition of houses, and throwing slop water into the streets 130. The common lodging-houses, factories and work¬ shops, and slaughter-houses have all been periodi¬ cally inspected; also the cowsheds, 2 in number, and dairies have received attention. The erection of new buildiDgs and houses and the alteration of old ones have been regularly inspected, 6 new houses and shops have been added to your number, and 2 old houses and shops remodelled. The old pig market has been entirely swept away and new pens havejbeen fixed, paved with Stafford¬ shire blue bricks, set in best cement and laid on a bed of concrete, which makes it quite impervious to soakage. properly channelled, and all gulleys trapped. This is an improvement in Market-street which has widened the roadway from 22 to 30 feet, I am, Mr Chairman and Gentlemen, Yours obediently, S. B. Mason, M.R.C.P., &c., Medical Officer of Health.