Dr. Blaxall's report to the local government board on the sanitary condition of Plymouth.

  • Blaxall, F. H.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Blaxall's report to the local government board on the sanitary condition of Plymouth. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    words, there would have been an increase of 2,669 deaths. With reference to the given streets, I would further point out that while the high mortality from all causes is undoubtedly attributable to the general unwholesome conditions that prevail, the excessive fatality from “ fever ” and, perhaps, from diarrhoea, may he regarded as the results specially of excremental nuisances; and in like manner the very high death- rates from diseases of the respiratory organs may he connected more particularly with dampness, overcrowding, and other unwholesome conditions tending to vitiate the atmosphere of the dwellings. It is noteworthy that scarlatina and its allied disease diphtheria are the only diseases in respect of which the given streets do not compare very unfavourably with the rest of Plymouth. With regard to the visitations of epidemic disease to which Plymouth is subject, it may he premised that the character and circumstances of the town are such as expose it in a peculiar degree to the introduction of dangerous infectious disease, forming as it does a great naval and military centre, also being an important market town, and one of the chief sea ports whence numerous emigrants annually embark ; circumstances which combine to invite continual influx of visitors and strangers from all parts, rendering the town liable to importations of disease. And it may be pre- sumed that some special risk is run through the arrival in the port of vessels having infectious disease on board; hut this probably does not count for much. Again, should any infectious disease appear amongst the emigrants at the depot awaiting em- barkation, such cases are at once sent off to “ lodgings,” with the exception of small-pox and “ fever ” cases, which are said to be removed to hospital. To mention a case in point that happened during the present inquiry, a child attacked with scarlatina at the depot was, together with her family removed to the said lodgings, where they remained from the Sunday to the Tuesday, thereby affording ample opportunity of communi- cating infection to others. The lodgings, it should be stated, are situated in a crowded part of the town, and partake of the character of a common lodging house. The epidemic of ivhooping-cough, which has added exceptionally to the mortality of the present year, may be considered to date from September 1877, when two deaths were registered from this cause. From this date the disease gradually increased till the following February, when it reached its highest fatality, causing 39 deaths. It continued very fatal throughout March, but afterwards gradually declined, and ter- minated in June, resulting in all in 178 deaths, of which 67 per cent, occurred in children under two years of age. The epidemic was fatal to females to the extent of one fourth more than to males. The disease was chiefly confined to the poorer class, and its spread would appear to have been due, as usual, to the unrestricted communication that obtained between the infected and healthy children of careless people. The special intensity of the recent epidemic has no doubt been related to the comparative immunity of the town for some time previously from the disease. For two and a quarter years (from June 1875 to September 1877) Plymouth had had little whooping-cough, only 27 deaths having been registered in the whole of that period. Hence, in all probability, there were more sus- ceptible children on the occasion of the disease resuming epidemic proportions. According to the testimony of the medical men the deaths bore a high proportion to the number of attacks. I have failed to connect this fatality with meteorology, but inquiry goes to prove that it was influenced by the unwholesome atmospheric con- ditions under which the patients had been placed. Doubtless the mortality ascribed to whooping cough might *in part be put to the account of measles, which was epide- mically coexisting. In this connection it is noteworthy that bronchitis and pneumonia, diseases of the respiratory organs, were very generally the immediate cause of death. With regard to typhoid fever: This disease is so closely associated with excre- mental nuisances as to have obtained for it, par excellence, the very pertinent title of “ the filth disease; ” and there is abundant evidence to prove that its persistent presence in Plymouth is due to such unwholesome conditions. Besides the evidence to that effect arising out of the experience of Dr. Littleton, the Medical Officer of Health, as expressed in his report to the Sanitary Authority (to be presently referred to), I may illustrate this position by similar experiences obtained in respect of certain cases of typhoid fever that came under my own observation :— (1.) A house in Cobourg Street, inhabited by a widow, two daughters, and a son. While one of the daughters was ill of typhoid fever, I visited the house and learned that the family had lived there about 10 years, during which time they had been more or less out of health, suffering from headache, nausea, and other ailments, the widow stating that they always felt better after being away from home for a few days, but soon relapsed into the i 488. n *1.