Mr. W.H. Power's report to the Local Government Board on diphtheria in Pirbright, and on the influence of the school there in the behaviour of the disease / [W.H. Power].

  • Power, William Henry, Sir, 1842-1916.
Date:
[1883]
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Licence: Public Domain Mark

Credit: Mr. W.H. Power's report to the Local Government Board on diphtheria in Pirbright, and on the influence of the school there in the behaviour of the disease / [W.H. Power]. Source: Wellcome Collection.

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    Mr. W. H. Power’s Report to the Local Government Board on Diphtheria in Pirbright, and on the influence of the School there in the behaviour of the Disease. . j Friv.cOML £ WBRARY George Buchanan, Medical Department, April 28, 1883. This inquiry was instituted under circumstances as follows :— On the 27th November last the Guildford Rural Sanitary Authority applied to the Board through its Health Officer, Mr. Joseph Smith, for advice respecting diphtheria prevalence in Pirbright that was regarded as having had relation with the operations of the National School there. Mr. Smith stated that since May last this school had on several separate occasions been closed, and each time for several weeks, on account of diphtheria among the scholars ; and that diphtheria in the parish having undergone diminution or cessation during each interval of school closure, reappeared, and mainly among school children, each time that the school recommenced operations. Upon this evidence the Board directed the present investigation into the conditions of diphtheria prevalence in Pirbright. The parish of Pirbright is situated 4-6 miles from Guildford town, at the extreme north-west of the rural district. Except to the eastward it is coterminous with parishes in the Chertsey and Farnham districts. Geologically, it is wholly on the sands and loam of the Upper and Middle Bagshot beds, the land being poor and little cultivated, consisting largely of heath and common. Notwithstanding its sandy nature, the soil cannot be regarded as dry, water being commonly held up near the surface by an impervious stratum : the water is mostly impregnated with iron. The population of the parish is almost wholly of the labouring class, and it is essentially a scattered population. Near to the church on the east of the parish there is some considerable aggregation of dwellings constituting the “ village.” Here 30-40 houses are spread for several hundred yards along two converging highways, on one side only of each highway. Again, at Dawney’s Hill, north of the village, and about J mile distant, is another and smaller group of cottages near the national school. But generally the houses of Pirbright, occurring singly or in very small groups, are dispersed over several miles of country. The sanitary circumstances of the parish may be deemed above the average. Few dwellings are overcrowded, and almost without exception they have garden ground or other ample space about them. This, while sufficing for utilization (in each instance on the premises) of slop drainage and privy contents, has generally admitted of the tolerably safe disposition of the pit privy in reference to the dwelling and to the surface well which exists in most gardens. Recently the sanitary authority by adoption of watertight tanks for the collection and storage (in each instance away from the house) of slop refuse, has still further diminished risk to surface wells—such as had before arisen' by careless people casting foul slops on the ground near to wells. These matters have a bearing on the subject of inquiry as tending to show that there is not in the physical and sanitary circumstances of Pirbright any ready explanation of the diphtheria: that, for instance, from the wide dispersion of dwellings, households have had, for the most part, but little intercommunication, while as regards other sanitary circumstances they are commonly exceptionally distinct and separate one from another. Upon becoming associated with Mr. Smith, I quickly learned that, in addition to definite diphtheria, there had been in the parish a large prevalence of sore throat, much of which had not come under medical observation, and that commonly persons who had had what they or their parents regarded as trivial sore throat, suffered later on from paralyses of the sort that are apt to follow diphtheria. This had been specially noticeable in regard of school children, and Mr. Hill, the schoolmaster, was able to cite many children (some not known to have been ill at all) who, on their reappearance at school after one or another of the intervals of school closure, could hardly see large print, or had difficulty in articulating intelligibly. It became obvious, therefore, that inquiry would be incomplete that did not, beside diphtheria, take account of minor sore throat, and that a house to house inquiry was requisite for ascertaining more precisely what had been occurring in the parish. This was accordingly undertaken, and has included almost all the houses in the place, and, in addition, some half dozen houses A R 5438. Wt. 3843.