Dr. Gresswell's report to the Local Government Board on the sanitary condition of Cradley in the rural sanitary district of Stourbridge, and on the recent prevalence of enteric fever there / [D. Astley Gresswell].

  • Gresswell, D. Astley (Dan Astley)
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Gresswell's report to the Local Government Board on the sanitary condition of Cradley in the rural sanitary district of Stourbridge, and on the recent prevalence of enteric fever there / [D. Astley Gresswell]. Source: Wellcome Collection.

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    It will also be observed that the numbers of yearly deaths from infantile diarrhoea in Cradley (all but two of the deaths from diarrhoea recorded in the table having occurred at ages under five years) have been on some occasions excessive. In Lye and Wollescote parishes, with a total population in 1881 of 9,382, adjoining Cradley; and like it forming parts of the Rural Sanitary District of Stourbridge, the following with other deaths were registered for the period from the beginning of 1879 to the end of 1888, viz., 67 from typhoid or enteric fever, 16 from febricula, 1 from continued fever, 2 from typhoid pneumonia, 1 from acute gastritis, 6 from enteritis with or without peritonitis, 1 from typhlitis, 9 from meningitis (simple or tubercular), 1 from meningo-eneephalitis, 7 from cerebro-spinal meningitis or cerebro¬ spinal fever, 4 from cerebritis, 4 from tubercular peritonitis, 6 from acute peritonitis, 2 from infantile remittent fever, 1 from vermicular fever, 1 from dysentery, and 81 from diarrhoea. At Pensnett, Bromley, Brockmoor, and Wordsley, also in the Rural Sanitary District of Stour¬ bridge, there were 16 deaths from enteric fever in the year 1888, a matter which formed the subject of some notes to the Board by Dr. Parsons in November of that year. It may be remarked also that in five parishes near to Cradley, viz., Hill, Halesowen, Lapal, Hasbury, and Hawn, with a total population in 1881 of 8,630, there were among persons under 5 years of age 25 deaths attributed to diarrhoea, gastric, gastro-enteric, and enteric catarrh in the period from May 27, 1888, to May 9, 1889. Quite possibly the circumstance that the children of Cradley and of the surrounding districts are so commonly infested with “ round worms ”—the fact as to which is attested by each of the medical practitioners with whom I was brought into communication—is, in a measure, the result of the foul condition of outdoor premises. The filth heaps and the sewage swamps, on and about which the children spend much of their playtime, must contain exceptional numbers of the ova of this parasite, which in dry weather could be carried by almost every gust of wind into the dwellings, and so get abundant opportunity of lodgment in food. The Enteric Fever Outbreak. Special attention has now to be given to the recent outbreak of enteric fever in Cradley. For a knowledge of the cases I am indebted to the medical men of the district, who were good enough to give me full information concerning the persons whom they had attended. It is perhaps needless to say that there must have been persons in many households, who, though in all probability suffering from typhoid fever, received no medical advice. Taking cognizance of all cases that came to my know'ledge as having occurred between the date of inspection (June 10th, 1889), to as far back as December 11th, 1887, prior to which for three years there had been no death from this disease in Cradley itself, it appears that 52 dwellings were invaded; out of the 316 inmates of these dwellings, 113, or 35*7 per cent., manifested symptoms of the disease, and 16 of the latter, or 14*1 per cent., died. The incidence of the disease on several age-groups is shown thus :— Of the inmates of the 52 invaded dwellings— 38 were under 5 years of age; of these 4 were affected, i.e., 10'50/o, and none died, i.e., 0’0°/o 46 99 5 to 10 „ 22 99 47'8°/0, and 2 » 9-0 °U 47 99 10 to 15 „ 27 99 57*4°/0, and 4 » 14-8 °/c 38 99 15 to 20 „ 18 99 47-3°/c, and 1 » 5 5°/o 147 99 over 20 „ 42 99 28-5°/0, and 9 » 2l*4°/0. The gravity of the disease in relation to age of the patient was that usually observed in epidemics of enteric fever. And similarly, the customary preva¬ lence of the disease in relation to season was duly observed, the number of households invaded in different months having been as follows :— 1887. —December, one. 1888. —February, one; March, one ; May, one; July, one; August, two ; September, three ; October, three ; November, sixteen ; Decem¬ ber, eight. 1889. —January, nine ; February, three ; April, three; May, none. As regards localization of the disease, the following facts are worthy ol notice. In Cradley proper 47 dwellings were invaded; 104 of their 283 inmates were affected, and 12 died. In the rest of the district 5 dwellings were invaded; 9 of their 33 inmates were affected, and 3 died. Again in the outbreak in 1877 and 1878 the deaths in Cradley proper numbered 14; and those in the rest of the district 7. Hence in the recent out¬ break the proportion of deaths in Cradley proper to the total of enteric fever deaths in the parish was 80 • 0%; and in the earlier outbreak it was