[Report 1898] / Medical Officer of Health, Pontypool Local Board / U.D.C.

  • Pontypool (Wales). Local Board.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: [Report 1898] / Medical Officer of Health, Pontypool Local Board / U.D.C. Source: Wellcome Collection.

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    PONTYPOOL URBAN DISTRICT COUNCIL JVIedical Officers Annual Hepopt, 1898. Denham House, Pontypool, Mon. January, 1899. Gentlemen—I beer to place before you my 21st annual report relative to the sanitary condition of your area for the past year ending- December 31st, 1898. The boundaries of your district remaining- exactly the same as at the time of my last annual report leaves me nothing to say respecting the geological formation, or configuration, further than I reported then, and is as follows: Description of Area.—It lies upon the carboni¬ ferous system, dr more particularly the millstone grit, or farewell rock, or the lower portion of the true coal measures, and forms the eastern outcrop of the South Wales coal field. 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 Avon Llwyd river. It comprises the angular portion of land formed by the above-named streams. The ground rises or slopes up in a northerly, north¬ westerly, and westerly direction from the before- mentioned streams, and lies at an elevation of from 400 feet to 700 feet above the mean sea level, and comprises an area of 234 acres. Atmospheric Changes.—The year began with a fine mild month in January, with very little rain, and, consequently, a moderate amount of sickness, fol¬ lowed by a very damp February, with influenza be¬ ginning about the 24th, and becoming epidemic by the 28th, continuing all through March, and moderating somewhat at the end of the month. April was remarkably mild and fine, but the spring¬ like influences were checked by a cold, damp May. June, July, August, and up to the middle of Sep¬ tember were more or less hot and summerlike. Sometimes intensely hot, the end of September was very wet, and brought about diarrhoea and a heavy death rate. The remaining months of the year were wet, unseasonably mild, and generally unhealthy, but, taking the year all through, it cannot be said to have been a sickly year by any means. By a strange coincidence the same number of persons died during the past year as in the year im¬ mediately preceding, viz., 91—44 males, and 47 females—giving a death rate for the year of 14 5 per 1,000 of the estimated population. This is the death rate of persons actually dying in your district, but it can be corrected up to 15-8 per 1.000 per annum by reckoning in eight persons who died in the Union Workhouse, but who, probably, would have succumbed in your district had they not been con¬ veyed to the Union. On the other hand, several persons have died in your district belonging to other districts ; these, if eliminated, would again reduce the death rate. At the same time, I consider the death rate a very favourable one, considering all things, and compares well with former years, inas¬ much as the rate for 1893 was 17 6; ’94, 16 4; ’95 14T ; '96, 11*8; and 1897, 14-6—this gives a mean death rate for the past 6 years of 14-8 per 1,000 per annum of the estimated population. During the same period there were 172 births—90 males and 82 females—the birth rate being 27-4 per 1,000 per annum of the estimated population. There is a falling off in the birth rate. In ’93 it was 35 7 • 94,34-8; ’95,34-6; 96,26*8; *97,30*8; and 1898,27^ I cannot account for the falling off, unless the disastrous coal strike had 6ome influence on the marriage rate, although it might be considered too early to feel the effects of the strike in this direction, yet there is a possibility that in view of the strike, young men did not enter so freely into the marriage state during the past year. The death rate per 1000 born is less this year, viz., 151J. I am glad to record a reduction here, as in the year immediately preceding it reached the high figure of 163 2. Referring to table A, it will be seen that 26 children died under 1 year of age, and 12 between that age and 5 years—making a total of 38 deaths under 5 years of age, compared with 46 under 5 years in 1897. The death rate from the seven principal zymotic diseases was -31 per 1000 per annum, but the' death rate from all zymotic diseases, including diarrhoea, was 1’43, this rate does not point to a very insanitary condition, especially when it is observed that most ot the cases going towards making it occurred from diarrhcea during September, which was duly re¬ ported on at the time. For your convenience I have iqrmulated the several rates as under for the oast Six Years— 1 1893 35-7 17-6 1894 34-8 16-4 1895 34-6 14 1 1896 26-3 11-8 1897 30-8 14-6 1898 27-4 14-5 150’2 2-5 19-7 142-8 2-1 18-4 142-1 -8 19-7 128-3 2-4 13-1 163-2 20 15-6 151-1 1-43 158 For the year I am now reviewing the various rates are satisfactory, and especially so when it is taken into consideration that 172 persons were born, and Jl persons died, including 26 under 1 year of age. Xour population has a nett gain of 81. Table A supplied by the Local Government Board epitomises the mortality from all causes as under : Deaths under 1 year of a-e. 2d; 1 year and under 5 years, 12—38 under 5 years of age; 5 and under lo years, 0 ; 16 and under 25 years, 4 ; 25 and under Oo years, 23 ; Ou and upwards, 26—53 over 5 years of age ; total, 91 at all ages. y CAUSES OP MORTALITY—TABLE A. Under 5 years Five years of age. and upwds. Diphtheria. 1 0 Puerperal fever . 0 1 Whooping cough. 1 0 Diarrhoea and Dysentery 13 2 Phthisis. 0 3 Bronchitis, Pneumonia, and Pleurisy. 6 9 Heart disease . 0 5 Influenza .. 0 6 Injuries . 0 2 All other diseases . 17 25 38 53 It is interesting to notice there is an increase in the deaths of persons over 65 years of age, and a decrease in the infant mortality ; by that I mean persons appear to be living longer and dyino- at a greater age, as the following table for the past six years will illustrate :— Died Died under 5 over 65 years of age. 47 45 42 36 46 38 years of age. 14 17 22 13 16 26 This is one of the great aims of sanitarians—to reduce the infant mortality and add to length of years. By looking at Table A it will be seen that if children can be got over 5 years of age, there is some chance of their reaching adult life, for bv the table for the year under review no single death oc¬ curred between 5 and 15 years of age. After 15 years of age, they become exposed to different influ¬ ences, and run risks by entering the field of labour and then the thin end of the wedge of mortality commences. It ie well known among medical men that the greatest amount of their work consists in attending children under the age of 5 years, and also the younger they are below thut a;re tile greater is the liability of a fatal issue, and at the same time the majority of illnesses in children occurring in those tender years is brought about by some laxity of care. No one except the profession knows the amount of sickness leading to fatal results that springs from exposure to damp and cold, and I ven¬ ture to say that there is no subject that medical men issue so many warnings about to mothers, but I am afraid in most instances the advice falls on barren ground. Another requirement of the Local Government Board, Table B, explains at a glance census, births and new cases of infectious sickness. Pontypool Urban District Council. — Population at all ages census 1891, 5,842; population estimated to the middle of 1898, 6,255; registered births, 172, INFECTIOUS SICKNESS. Under 5 Over 5 Scarlatina.. Diphtheria. Membranous croup. Enteric or typhoid fever... Puerperal fever . Erysipelas. years of age. 0 2 2 0 -t , 8 16 Number of such cases removed to iso¬ lation hospital . o The above are all notifiable diseases, and come t the knowledge of the medical officer of healt through the Notification Act, which was adopte by the Local Board in 1891, January lsl and which has proved itself of great service i- allowing the officers of your Council to be in formed of every fresh outbreak of infectious dis ease to which the Act refers. Scarlati?ia.—During the year there has been n death from this disease, although there have been separate outbreaks. They were all over 5 years o age, and consequently stood a better chance of re sisting the attack. I am glad to be able to say tha since 1892, the year after the adoption of the Noti fication Act, this. disease has been declinin in your area In 1892, 100 cases were notified • ‘9:- 47 ; ’94,15 ; 95,12 : ’96, 22 ; ’97, 22 ; and 1898, 5. am sanguine enough to think that notification ha 4? 1° with this> and there is n doubt that the attacks are milder. I also begin t- think that persons in charge of patients sufferin' from the disease can see the neei of isolation am care in the prevention ot the spread of the conta gmn. Diphtheria.—I received 5 notifications of thi disease. One case proved fatal. This case was im ported into your district from a family sufferin' from the disease. All the cases occurred sine October, comcidently with the wet weather, and a this time bad throats, independent of diphtheria were very common. There is no doubt but that tb infection of diphtheria is more persistent in a dis trict in which is has taken a hold than scarlatin: contagion. The infection of diphtheria is not s. rapidly diffusible or explosive as scarlet fever I appears to take after the character of enteric o typhoid fever in hemp- a very preventible disease depends a good deal on domestic sanitation am individual care —dirt, overcrowding, and povert- being the foster parents of ,the disease—and unlik influenza, measles, whooping cough, and scarlatina is more amenable to sanitary control. Membraneous Croup.—Two cases of this disease have been notified, and no death has taken place from it. This disease, like the forementioned one, is of the same class, and it is often difficult to say where croup—that is membraneous croup—ends and diphtheria begins. Puerperal Fever.—One case of this disease oc¬ curred in January and proved fatal. There was no apparent cause for the infection, the subject was a very delicate woman. There was no spread of the disease. Enteric or Typhoid Fever.—There have been 4 cases of this disease notified, 1 in April, the remain¬ der in December. There has been no fatal result. In the first case no cause could be found for the outbreak. In the second there was evidence of in¬ fection from a vitiated atmosphere in which the subject frequently spent some hours at work, to¬ gether with a very low state of health. The third was of a very doubtful character, and although assuming many of the distinctive features of the disease there were complications leaving an element of doubt. It was, however, carefully subjected to all sanitary precautions, and ultimately did well. The last case was sent into your district from Newport, and from a house in which the disease existed. The great difficulty in treating these cases from a sani¬ tary point of view is in finding a suitable means of disposing of the excreta—burning it appears to be the only safe means of dealing with it. In the cases above mentioned your inspector has taken every precuation to prevent any infection getting into the drains or sewers, and the excreta has been carefully disposed of. Erysipelas.—This disease has been cropping up all through the year. In all, 7 mild cases were notified, and no fatal result supervened. There was no specific insanitary cause to be assigned in any of the outbreaks, unless the damp condition of the atmosphere could be considered as such. Measles.—There has been no particular outbreak of this disease during the past year. A few spo¬ radic cases have occurred, but as this disease is not included in the schedule of notifiable diseases, I have no means of knowing how many. Several sanitary districts have included this disease in the schedule for a limited period as an exoeriment. but I do not think they are yet in a position to say how far it has been successful in diminishing the spread of the infection. There has been no fatal case in your area. Whooping Cough.—There has been no particular outbreak of this malady during the past 12 months. One child over 5 years of age died of it, and during the earlier months of the year a few cases came under observation, but at no time did it become general. Diarrhoea and Dysentery.—Diarrhoea has been more than usually prevalent during the period under review ; 15 deaths were registered as due to it in one form or another. It was particularly preva¬ lent in September. I then made a special inquiry into the cause, and made a report to the Council on the subject, a copy of which I sent to the Local Go¬ vernment Board. It was thought the water supply had something to do with it, but a subsequent exa¬ mination of a sample taken by myself from the Company’s mains did not bear out this supposition, and whatever might have been the cause of the out¬ break, resulting in 9 deaths in September, my im¬ pression was that the system of artificial feeding of infants by the bottle largely contributed to it. Phthisis.—This disease of the lungs proved fatal in three instances. I am surprised that more tuber cular disease does not exist in your district, inas¬ much as so much damp and moisture prevails, but as a set-off against this, your district is so situated that it rapidly drains away, and with improved drainage and sewers the subsoil water is kept low. The subject of tuberculosis is engaging the attention of sanitarians all over the country, and the Local Government Board, I am given to understand, will take some definite action bofore long with regard to its control, and seme extended system of sani- toria will doubtless be instituted at convenient places for the treatment of the disease in its earlier stages, when it is very amenable to remedial mea¬ sures and often curable. As a word of warning is expected from medical officers of health, the public at large should understand that any person suffer¬ ing from lung disease, or more properly termed con¬ sumption, should be as far as possible isolated, should sleep in a bed alone and in a separate room, should never expectorate except into a spittoon con- tainingsome disinfectant, or into a Japanese paper handkerchief which could be immediately burnt. No person shewing the tendency to tuberculosis should be employed as a teacher or engaged in employ¬ ment where they have to mix or come into close contact with others, especially young persons. Social and domestic sanitation can do a great deal to lessen the dangers of the disease where it exists, and also in preventing the spread of it to others. Bronch itis, Pneumonia, and Pleurisy.—These dis¬ eases claimed 15 victims, the result of much sickness running through the whole year. These diseases are nearly always with us, and at times assume an epidemic form, especially broncho-pneumonia, I have pointed out on many occasions how by care on the part of parents these diseases may be controlled or prevented, but as long as mothers will expose their tender children to the damp cold night atmos¬ phere, and be otherwise careless of them in the matter of catching cold, so long will these diseases predominate. It is comparatively rare to find broncho-pneumonia in the homes of the respectable tradesman class, inasmuch as they take more care of their offspring. Influenza.—This disease was quite epidemic in March, and 6 cases proved fatal; all through the year it has been cropping up more or less. It is fre¬ quently the forerunner of pneumonia and other chest affections, and in some instances leaves very serious affections of the nervous system. Tne Queen Victor ia's Inst itute of Nurses continues to do good service in your district. During the year 119 cases have been nursed and 2,783 visits paid by the lady representing that useful institution, and the greatest fault one can find with it is that tile staff is so meagre. Work could be found for several more, and if funds are needed to procure this de¬ sideratum the District Council might, as an aid to health, ask for subscriptions. Vaccination,—‘Since my last report the law with respect to this important subject has been consider¬ ably altered, the vaccination station has been abolished, also vaccination from arm to arm. The public vaccinator has now to visit every child in his district who has attained the age of 4 months and is unvaccinated, and offer to perform the operation with calf-lymph. Under antiseptic precautions he is also required to attend the child afterwards, free of charge, if the parents so desire, in case the vac¬ cination does not go right. All this will add con¬ siderable expense to the ratepayers, but the object of the legislature is obviously to make this operation as perfect as possiblej and at the same time not to interfere with its efficiency. So far this will be met. The one great blunder in this Act is the Conscience Clause. This spreads over the country thousands of unprotected children, and should be remedied by not allowing any child to enter a scfiool, public or private, who has not been properly vaccinated, in the same way that most public bodies will not accept men into their service who have not been recently vaccinated. When parents refuse vaccination to their children they little think of the danger they are exposing them to, and my opinion is that a parent has as much right to pro¬ tect his child against smallpox as he would protect it from fire, or being run over in the street, or other calamity. If medical science could find out some other form of vaccination which would protect the individual from consumption, typhoid, and many other scourges, what a blessing it would be, and yet in a few years after these diseases had been beaten down, the wise public would begin to say vaccina¬ tion was useless. The Water Supply has been severely taxed during the past twelvemonths, the heat and drought of the summer brought the inhabitants face to face with a very short service—your district was not alone in this respect. The quality has been good. Your Council felt some misgivings on this point, and in October caused an analysis ; this was reassuring, the water was found to be organically pure, with no trace of pollution, but the analyst thought the fil¬ tration not sufficient, in consequence of the presence of diatoms aud algie. I believe the Council have approached the Gas and Water Company on this subject. The Meat Supply to the district has been ou the whole good, and prices low, and it has not been necessary to condemn any sample this year. In reviewing the health of the district for the past twelve months, I am of opinion that your area h is been fairly healthy. No epidemic has invaded it except influenza. The lamentable coal strike, which lasted five months, brought about a good deal of poverty, but not so much sickness as would be im¬ agined. one thing favourable to this end was the exceedingly fine summer-like weather which pre¬ vailed most of the time. The number of fresh cases of pauper sickness was 408 for the twelve months ending December 31st, 1898. Compared with 375 in the previous year, this is not so great an increase as was anticipated. It has been suggested by a member of the Council to plant trees in various parts of the district suit¬ able for the purpose. I should like to endorse the recommendation, as I believe it would add to the appearance of the district, and at the same time be beneficial to the health of the inhabitants. During the year under review the common lodg¬ ing-houses, dairies and cowsheds, slaughter-houses, balcehouses, and sugar-boiling shops have all beeri regularly inspected, and the recommendations of your officers have been promptly complied with. In my last annual report I recommended the ex¬ isting exit pipes of the sewers emptying into the Afon Llwyd be carried further into the stream. This has been done, aud I am sure it will have a beneficial effect; also, the various impedimenta lying about the stream have been removed, so as to give a free and unobstructed flow to the stream. Your inspector reports the removal and abatement of the following nuisances: Defective closets, 12; foul closets. 41 ; defective drains, 53; defective closet drains, 33 ; defective dwellings, 5 ; overcrowding, 1; back area not paved, 1. General nuisances arising from defective rain¬ water pipes, depositing ashes or house refuse, or for allowing any offensive or noxious matter to run, lodge, or accumulate in the gutters or surface of the street, and also from the accumulation of manure, 280; on these noticesi were served, and promptly complied with. Two new houses have been added to your district. I beg to recommend that the Albion-road sewer running at the back of the Albion-road be extend jd as far as the Albion Inn, and that the houses up to that point be connected with it. I am, Mr Chairman and Gentlemen, Yours obediently, S. Butler Mason. M.R.C.P., &c, Medical Officer of Health.