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PUBLIC HEALTH AND POOR LAW. many of those dying in the suburbs may have The Vartry water the disease in the city. contracted is practically exonerated by the committee, though they draw attention to the manner in which contamination of the water may occur in polluted cisterns. The committee, after considering all the usual methods of the spread of typhoid fever, were led to regard the contamination of the subsoil by polluted subsoil water as the chief agent in the origin and -dissemination of the disease ; they look, in fact, upon the polluted subsoil water as forming a suitable medium for the growth of typhoid bacilli, and they insist upon the importance of efficient subsoil drainage. In order to ascertain the levels and fluctuations of the subsoil water in several parts of the city wells were made and the levels observed. The result, in so far as the limited observations made went, was to show that the subsoil water was highest in the more elevated parts of the city and lowest in the lowlying portions near the river, this unexpected result being due, it appears, to the fact that the upper portions of the. city are on clay and the lower on gravel. The fluctuations of the subsoil water in the trial wells varied from two inches and a half to three feet ten inches. It will be extremely interesting to observe the effect of the subsoil drainage, not only upon the prevalence of typhoid fever, but also upon that of phthisis. Whooping-cough and measles were added to the list of notifiable diseases in May, 1893, but in regard to theformer disease Sir Charles Cameron observes that, the uselessness of its notification having been experimentally demonstrated, it has now been removed from the list.
presumably
Public Health
and
Poor Law
LOCAL GOVERNMENT DEPARTMENT. REPORTS OF MEDICAL OFFICERS OF HEALTH.
St. Pancras Urban Sanitary District.-The general and infantile mortality in the several subdistricts in St. Pancras is well shown in the accompanying table :-
his report a very interesting and concise outbreak of scarlet fever which occurred in October, 1893, amongst the consumers of milk from a certain farm at Hendon. The milk in question was supplied to the VITAL STATISTICS. customers by a milk vendor at Highgate, who obtained his milk from two sources other than the Hendon farm. It was HEALTH OF ENGLISH TOWNS. possible, however, by a careful inquiry as to the distribution of the several supplies, to exonerate all but the Hendon milk IN thirty-three of the largest English towns 7072 biiths from blame; and it appears that before Dr. Sykes’s visit to the and 4901 deaths were registered during the week ending farm the county veterinary inspector had ordered the milk of Jan. 12th. The annual rate of mortality in these towns, five cows with sore teats to be withdrawn from the common which had been 18-0 and 18’9 per 1000 in the preceding two supply, and the cows themselves to be isolated. The story which weeks, further rose last week to 20’1. In London the Dr. Sykes tells gives a good idea of the great difficulty and rate was 19’3 per 1000, while it averaged 20 8 in the thirtydelay occasioned by having to procure a magistrate’s order two provincial towns. The lowest rates in these towns were prior to inspecting the suspected dairies. Before being able 14-6 in Derby, 16-8 in Bradford and in Croydon, 16-9 in to obtain an order to inspect the Hendon dairy Dr. Sykes Leicester, and 17-4 in Cardiff ; the highest rates were 22’7 in called on no less than five magistrates in the district in Newcastle-upon-Tyne, 23’9 in Manchester, 24-1 in Blackburn, which the dairy was situated, and he also experienced con- 25-7 in Huddersfield, and 28-9 in Liverpool. The 4091 deaths siderable delay before being able to legally enter the High- included 363 which were referred to the principal zymotic gate dairy. It seems that antecedently to the outbreak there diseases, against 385 and 399 in the preceding two weeks; had been at the Hendon farm one, if not two, cases of scarlet of these, 109 resulted from measles, 68 from whoopingfever among those having to do with the cows, so that in cough, 66 from diphtheria, 45 from diarrhoea, 39 from this instance there was apparently illness both of cows and "fever" (principally enteric), 33 from scarlet fever, and 3 milkman. from small-pox. No fatal case of any of these diseases Dublin Urban Sanitary District.-The corrected general occurred last week in Swansea or in Norwich; in the other death-rate of Dublin for 1893 was 28’2 per 1000, a rate towns they caused the lowest death-rates in Biightop, which, as Sir Charles Cameron points out, is 4’88 above the Leicester, Burnley, and Nottingham, and the highest rates mean rate for the thirty-three large towns of England and in Manchester, Salford, Portsmouth, Wolverhampton, and Wales for the same period. The rate is, however, slightly Gateshead. The greatest mortality from measles occurred in below that of -)Ianchester and Preston and considerably -Portsmouth, Derby, Halifax, Leeds, Sheffield, and Gateshead;.-, lower than that of Liverpool. The high death-rate of from scarlet fever in Wolverhampton ; from whoopingDublin is attributed by Sir Charles Cameron chiefly to the cough in Birkenhead, Huddersfield, and Sunderland ; and poverty and environment of a large portion of the population; from diarrhoea in Gateshead. The mortality from "fever" and in illustration of this point he observes that one-third of showed no marked excess in the other large towns. Th& the population live in single room tenements, and that in 66 deaths from diphtheria included 34 in London, 6 in 1893 no less than 33’2 per cent. of the total deaths in Dublin West Ham, and 3 each in Bristol, Wolverhampton, Biroccurred in public institutions frequented by the poor, a mingham, and Sheffield. Three fatal cases of small-pox percentage considerably in excess of that observed in London were registered in Liverpool, but not one in London or and other English towns. There were eleven deaths from in any other of the thirty-three great towns. There typhus fever in Dublin during 1893, a disease which, Sir were 28 cases of small-pox under treatment in the MetroCharles Cameron remarks, was once very prevalent in politan Asylum Hospitals and in the Highgate Smallpox that city. Diphtheria caused in the city a very small Hospital on Saturday last, the 12th inst., against 15, 16, and mortality, there being but 12 deaths. On the other 23 at the end of the preceding three weeks ; 8 new cases hand, phthisis, a disease always prevalent in Dublin, were admitted during the week, against 1 and 8 in the caused a death-rate of 3’9 per 1000. The deaths, too, frompreceding two weeks. The number of scarlet fever typhoid fever were in excess of those during any previouspatients in the Metropolitan Asylum Hospitals and in the year, prolonged drought and heat being, Sir Charles CamerotLondon Fever Hospital at the end of the week was 1713, thinks, chiefly responsible for the excess. The report upor1against 1931, 1890, and 1779 on the preceding three Saturthe prevalence of typhoid fever in Dublin, which was drawIdays; 130 new cases were admitted during the week, against up by a committee under the auspices of the Dublin Sanitar’ 116 and 126 in the preceding two weeks. The deaths referred Association, is referred to at seme length by Sir Charlesto diseases of the respiratory organs in London, which had Cameron. After pointing out that the death-rate froi3been 332 and 319 in the preceding two weeks, rose again last typhoid fever is higher in Dublin than in any other tomweek to 389, but were as many as 454 below the corrected in the United Kingdom save Belfast, the committee con average. The causes of 82, or 2-0 per cent., of the deaths sider in detail the causes instrumental in maintaining ; in the thirty-three towns were not certified either by a, this high rate. The disease seems to prevail not only in theregistered medical practitioner or by a coroner. All the city of Dublin itself, but also in the suburbs, although causes of death were duly certified in Portsmouth, Bristol,
Dr.
Sykes gives in
account of
an
.