Reports and papers on cholera in England in 1893 / with an introduction by the Medical Officer of the Local Government Board.

  • Great Britain. Local Government Board.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Reports and papers on cholera in England in 1893 / with an introduction by the Medical Officer of the Local Government Board. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    17/374 (page 11)
    Order on September 6th. Both these Orders are reproduced in Appendix A., No. 17. The regulations embodied in the Orders required the division of each of the urban sanitary districts into sub-divisions,” the appointment of medical visitors and assistants in each sub-division, the daily visitation of localities inhabited by the poorer classes, the gratuitous supply of medicines, medical aid, and nursing, the isolation in hospital or otherwise of the sick, the speedy burial of the dead, together with the adoption of measures of cleansing and disinfection wherever these were needed. Choleraic diarrhoea as well as cholera was, for the purposes of the regulations, declared to be a notifiable disease, and a daily record giving particulars as to cases of these maladies was ordered to be transmitted to the Board. These Orders remained in operation until January 8th, 1894. The beginning of cholera in Grimsby and Cleethorpes is involved in considerable obscurity. With a view to its elucida- tion, Dr. Reece traced the antecedents of a number of persons by whom the disease might have been imported by sea during the first days of the month of August, but the materials collected failed to afford any satisfactory solution of the difficulty. When, however, notification of “diarrhoea” was instituted by the Grimsby and Cleethorpes Sanitary Authorities, it was found that this disease, under the designation of which certain fatal attacks, which must be regarded as cholera, were registered, had become very widely prevalent in both places. “ Diarrhoea ” was also causing a large mortality. Indeed, the diarrhoea death-rates of Grimsby and of Cleethorpes during the third quarter of 1893, were out of all proportion to those of the large towns and cities of England during the same period, and they very greatly exceeded the corresponding rates which had obtained in those districts in antecedent years. And when the details of fatal “ diarrhoea ” in Grimsby came to be examined more minutely, it further transpired that the excess of death registered under that heading had commenced about mid- July ; that 29 fatal attacks had occurred in the four weeks ending August 5th ; that in the next five weeks, during which cholera was most prevalent in the borough, no less than 81 deaths were ascribed to diarrhoea; and that taking the period August 5th to October 14th, during which period disease of the nature of cholera attacked 127 persons and caused 35 deaths in Grimsby, there were 89 fatal attacks assigned to “ diarrhoea.” Thus, pre- valence of cholera both in Grimsby and in Cleethorpes occurred simultaneously with an epidemic prevalence of diarrhoea; and, in Grimsby at least, it was preceded by an ominous increase of mortality referred to that cause. This is but a repetition of that which has so often occurred before in the history of cholera; and it can hardly be doubted that cholera had made its way into Grimsby and Cleethorpes sometime before the fact was recognised, and that the disease secured a footing in those towns, for want of the adoption of adequate measures of prevention at an early stage. Such measures as were carried out during the month of August, came too late to prevent