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The Hobart typhoid epidemic of 1887–88
Sm. SC;. Med. Vol. 29, No. 8, pp. 953-958, 1989 Printed in Great Britain. All rights reserved
THE HOBART Department
of Geography,
0277-9536189
$3.00 + 0.00 Press plc
Copyright 0 I989 Pergamon
TYPHOID
EPIDEMIC
OF 1887-88
R. G. KELLAWAY University of Tasmania, Hobart, Tasmania, Australia 7001
Abstract-Typhoid fever records for Hobart during the nineteenth century are examined and the summer of 1887/88 identified as the second year of a S-year epidemic cycle. Three factors are used to explain the change from endemic to epidemic typhoid in the 1880s. Firstly, there was a sequence of hot, dry summers that affected water quality and the amount of water available for the cleansing of the street gutters. Secondly, there were changes to the system of disposal of excrement from cesspits to poorly organized pail and single-pan schemes which led to the casual disposal of sewage in the street gutters. Thirdly, the population increase of the 1880s followed 25 years of stagnation and led to overcrowding in existing, often deteriorated, buildings and the placement of new dwellings on small internal allotments. Key words-Hobart,
Tasmania, typhoid epidemic, sanitation, historic reconstruction
A terrace of six houses is located on the north side of Davey Street between Anti11 Street and Watch-house Lane. This building dates from at least 1841 and in recent years has been maintained with sympathy for its role as an element in Hobart’s colonial townscape with pastel paint on the external walls and a period picket fence. This terrace presented a rather different impression to the passerby in 1888; it was dirty and dilapidated. The Central Board of Health was calling upon the landlord to clear away the rubbish, whitewash the walls, pave the yards and repair the drains [I]. The Board also reported that the terrace was overcrowded. Forty-four persons lived in the five occupied houses. The sixth house was untenanted. The average of 8.8 persons for each of these small terrace houses was well above the city average of 5.5 persons per dwelling. Overcrowding was exacerbated by the fact that some of the rooms were unfit for habitation. The building was also unhealthy. The attention of the Central Board of Health had been drawn to this terrace by an outbreak of typhoid. Ten cases had occurred within this building in 1888. Four cases proved fatal. A further five cases including one fatality were to occur in the following year. The Central Board of Health, the Local Board of Health, and even the Women’s Sanitary League had no hesitation in identifying the inadequate drainage of this terrace and the block in which it stood as one of the main problems affecting the health of the city. Typhoid had become a major problem in Hobart only in 1887. Records of typhoid mortality for the city begin in 1838 (Fig. 1). The data for 1838-67 are derived from a table prepared by the Colonial Statistician in 1891 and printed without explanatory footnotes in the Tasmanian Official Record 1892. The number of deaths from 1868 onwards are contained in the annual statistics of the colony. Cumpston and McCallum [2] claimed that the pre-1868 data were only a record of deaths in the Hobart hospital. The deaths of convicts, a not inconsiderable portion of the city’s population in the 184Os, and civil deaths elsewhere in the town were probably not included. Nevertheless, Fig. 1 defines three aspects of the
typhoid situation in nineteenth century Hobart. Firstly, typhoid was endemic in the Hobart environment. Each year would see about 10 deaths. Secondly, typhoid fever had been relatively stable for almost 50 years. Only on four occasions had the death toll reached 20. Alternatively, the disease was in decline if the earlier records had seriously underestimated the extent of typhoid in the town. Thirdly, the incidence of typhoid fever had accelerated upwards in 1887 when 70 deaths were registered in the Hobart district. There were a further 37 in 1888 and 41 in 1889. While only 17 were reported in 1890, the toll in 1891 was 57. Some 222 lives had been lost in Hobart during the course of a S-year epidemic cycle. Another 122 deaths had occurred in Launceston and 92 in country districts. The typhoid mortality rate in Hobart averaged over the 5 years, 1887-1891, was 13.9 per 10,000. In the period from 1870 to 1886, the rate had averaged 3.7. This increase had implications for society that went beyond the loss of life from what was known to be a preventable cause. The principal concern was that this epidemic hit disproportionately severely at the adult population. In 1887, males between 15 and 45 yr accounted for 59 of the 112 typhoid deaths in the colony. Females in the same age bracket accounted for 35 deaths. There were only 12 deaths of persons under 15 yr and 6 over 45 yr. The pattern was the same in 1888. Typhoid fever, according to the Central Board of Health, was selecting “. . . its victims chiefly from those who are in the full vigour of life-those whose lives within their own circle are the most precious” [3]. The loss of ‘breadwinners and domestic managers’ created widows and orphans whose support would have to be taken over by charitable agencies. Furthermore, there was a concern about the loss of income. Each death was believed to represent about 10 cases of sickness. Each case in turn would represent the loss of a month’s wages and the possible impoverishment of a family. The estimated 1000 cases and 112 deaths in the colony in 1887 was alleged to have cost the community f60,OOO [4]. Finally, there was the threat to the tourist trade. Cabmen complained that visitors 953
954
R.G.
KELLAWAY
YEAR
Fig. 1. Deaths from typhoid fever in Hobart. were no longer coming to the colony on account of the typhoid [5]. Hobart’s reputation as a refuge from the heat and fevers of Melbourne had been destroyed. The Central Board of Health believed that the authorities, particularly in Hobart had learned nothing from the 1887 epidemic [l]. Therefore, it began a systematic monitoring of the disease situation from the beginning of 1888 in the theory that ameliorative action could be undertaken if local concentrations could be identified. The principal method of investigation was the map. The Parliamentary Papers of the period contain many disease maps. Some unravel the interaction between disease and the urban environment through plotting the point distribution of cases of epidemic diseases and the incidence of infant mortality. These exist for Hobart on a more or less regular basis from 1888 to 1902. Other maps examined the topographic situation. One example was the plan of the Davey Street/Anti11 Street block that contained the terrace [3]. It showed buildings, outbuildings and garden layouts at a scale of 1 in. to 60 links (1:475). The map of disease locations during the first 6 months of 1888 is of particular interest [l]. It was the first of the point distribution maps. It had the handicap that the three types of epidemic disease-typhoid, scarlet fever and diphtheria-were located by the same symbol. However, this map is uniquely useful [6]. It contained a choropleth overlay that divided the city into areas that were below average, above average and very much above average in terms of the total epidemic disease rate. Alfred Mault, the Secretary, Engineer and only paid official of the Central Board of Health had divided the city into 21 ecological units based on common housing characteristics. The resident population, the average rated value of housing, and the mean height of each district appeared in a table in the accompanying report. Case numbers and rates had also been calculated for the individual diseases. The original case location data has been remapped (Fig. 2) along with a morbidity map for typhoid fever (Fig. 3). Three districts had an above incidence of typhoid fever during the summer and autumn of 1888. The
highest rates were in South Hobart. The Davey Street/Anti11 Street block was located on the ridge that ran towards Mt Wellington while the remainder of the district occupied slopes that overlooked the Hobart Rivulet. The character of the housing was extremely mixed though of a generally low value. The second highest rate was in North Hobart, an area of narrow streets and mean housing while Wapping, the notorious slum between the town centre and the Old Wharf was slightly in excess of the urban average. The official explanation involved the interaction of poor drainage and low quality housing. The problems of Wapping, for instance were described in the following terms:
. . overcrowded conditions and circumstances combine almost all the elements of unhealthiness-damp, dirt, dilapidation, overcrowding, unpaved and undrained yards, floors flush with or even below the adjoining soil; and all this on made up ground only three or four feet at most above the tide and liable to be flooded in wet weather [7]. However, the relationship between typhoid and poverty is not as clear cut as statements of this type would suggest. It may have been that the apparent correlation between low value housing and typhoid fever was a result of incomplete data. One hundred and twenty-nine cases were reported to the authorities in the first 6 months of 1888. Almost all were of persons who were treated at the hospital. Few doctors in private practice met their obligation to notify infectious disease. Extrapolation of the case-fatality ratio in the hospital to the overall situation would suggest that only half of the actual cases had been reported. Mault himself regarded this data as hopelessly compromised and subsequently reviewed the pattern using deaths from typhoid rather than cases [7]. This revealed that the average rated value for houses in which typhoid deaths occurred during 1888 and 1889 was f31/10/0. This was slightly above the city average. Typhoid was a disease of dirt rather than poverty per se. It affected “. . . all classes, rich and poor: the law, the civil service, the banking and commercial interests suffering, if anything more severely than their poorer neighbours” [4]. There also
The Hobart typhoid epidemic of 1887-88
TY,“O,D D,F”r”E*,A 6CA6LET lOTAL 0
Metro6
FEVER
- 120
- 16 FEVE” - 66 - 166
600
Fig. 2. Location of epidemic diseases in Hobart, January to June 1888.
seemed to be random, local factors at work. The problem in North Hobart may have involved the permission given to a local dairyman to continue to sell milk even though there was fever in his household [S]. There were reservoirs of typhoid throughout the town that awaited the heat of summer to revivify and infect the community. The actual pattern of the outbreak would vary from year to year. Typhoid would appear in one district, run its course and re-emerge in another. Five years of case-location data from the 1890s showed that the South Hobart areaalthough exposed to the ‘exhalations’ given off by the Rivulet and containing some of the poorest housing in the city-had below average case rates. The same was true for Wapping. Other areas, such as the now forgotten course of the Murray Street Rivulet and the lower end of Liverpool Street, were major foci for outbreaks in the 1890s. Nevertheless, the data collected in 1888 for the Davey Street/Anti11 Street block are of importance in evaluating the reasons for the transition from en-
demic to epidemic typhoid in the 1880s. Three factors lay behind this change. Firstly, there was the stress caused by a series of years with hot, dry summers. These began in 1886/87. Summer rainfall (DecemberMarch) was just below normal but its effectiveness was reduced by the abnormally warm temperatures and the concentration of much of the rain into January. There was no doubt about the summer of 1887/88. The rainfall was only 53.3% of normal. Temperatures in December were hot (17.9”C compared with 153°C mean); January and February were normal while March was relatively cool. Rainfall in the summer of 1888/89 was also below normal. It was claimed that the summer of 1887/88 was the driest for 50 or 60 years (91. It is not possible to check this allegation as the Hobart gauge before 1882 was located at several places. However, the records sug gest that the last full year that could be called dry-a rainfall of less than 500 mm-had occurred in 1871. Dry weather interacted with typhoid through the water supply. In spite of allegations to the contrary, Hobart had a sound system of water supply. Tests
R.G.
956
CASES
0 I
KELLAWAY
PER THOUSANO
htetres 500 1
Fig. 3. Incidence of typhoid fever in Hobart, January to June 1988.
revealed no problems with the quality of the water as it left the reservoir [lo]. However, there were weaknesses in the distribution system. The water pressure was low in many areas and it was possible that contaminated surface water could enter the pipes through leaks or at the fire plugs [I I]. There were also problems with the amount of water available during a dry summer. In a normal season, the city used two million gallons a day. Fifteen percent of this was required to clean the street gutters [12]. The gutters were used for the disposal of household waste water. The only alternative in the absence of any system of drainage was to run sullage into the yard where it would eventually soak into the soil. Slops from the kitchen, washhouse and laundry were inevitably joined by urine and faeces. These, mixed with horse manure and street rubbish, formed an obnoxious stew. The gutters were vile creating smells that would “. . . pervade the street and enter every house” [12]. The council employed scavengers to sweep the gutters. In a normal year, rain would assist
in keeping the gutters clean. In a drought year, there would be no natural cleansing and the amount of water that could be used for washing the streets would be restricted. The gutters of the typhoid block were noted by the City.Surveyor to be among “. . . the most objectionable and unhealthy” in the city [13]. The washing water of typhoid patients was also alleged to have been dumped in the gutter on Davey Street to I‘. . . run 500 yards along the street exposed to street traffic and in front of shops until falling into a grating” [ 11.This was vigorously denied by the doctor attending [14]. Whether or not this was true will never be known. What was undeniable was that these gutters were cobblestone rather than freestone. It was impossible to keep this type of gutter clean as the ‘slush’ lodged between the rocks. The Central Board called for the council to undertake the proper drainage of this block. This meant underground sewers. The council thought that Sewers were an impossible luxury and responded with a plan for the
The Hobart typhoid epidemic of 1887-88
street gutters in the vicinity to be tarred for easier cleaning. This was the policy adopted after a prolonged and public argument between the two bodies. Street gutters had become a more serious health problem in the 1880s owing to changes in the system for disposal of excrement. The city until 1883 had been served by cesspits. These had been progressively closed with the plan that all should have been filled in by the beginning of 1887. A house to house survey revealed the slow rate of progress of this plan. There were still 1293 cesspits remaining in October 1886 though most were scheduled for closing within the next few months [15]. Cesspits were an obvious health risk. Many had been poorly constructed and they were emptied at “. . . very uncertain intervals” [16]. Dr Edward Giblin, Medical Officer of Health for the Local Board believed that old cesspits were the major problem of the typhoid block [17]. They had been very dense in this area and were believed to be still poisoning the soil even though they had been closed for 2 years. The alternative provided by the council was a nightcart service that collected pails from each household on a weekly or fortnightly basis. This option was used by 298 1 households in 1886. The pail system was both obnoxious and unhealthy and was regarded as a temporary measure until a single-pan system could be introduced. The pails were rarely ever washed [ 181 and many were inadequate for the purpose for which they were intended. Landlords often provided nothing more than a kerosene tin [19]. The pail system interacted with the climate to intensify the health risk. There were incentives for the illegal disposal of the contents. Many households in poorer areas had no access to dry soil to deodorize the pail and could avoid the quarterly charge for collection by dumping the contents “. . . in a manner objectionable to the public” [20]. Giblin had called for more frequent washing of the gutters following the outbreak of typhoid in 1887. The gutters, he said, “. . . could easily become infected with typhoid germs by the filthy habits of some persons who under the cover of night empty their pans into the gutter” [21]. This problem had not existed with the cesspit system though water closets, of which there were 533, had not been blameless in this respect. There was no system of public underground sewers. Private sewers could legally terminate only in the Hobart Rivulet which had been defined as a common sewer by Act of Parliament. Many terminated in other streams which had the legal status of common drains and which had no system for flushing. Others terminated in odd places. The Army Barracks was one notorious example. A barrel drain was led to the boundary on Davey Street where it discharged into the street gutter [22]. The third factor that explains the transition to epidemic conditions was the timing and pattern of urban growth. The population in 1870 was 19,092. This was 357 fewer than had been recorded in 1861 and the stagnation of Hobart’s economy was reflected in the large number of vacant houses around the town [23]. No fewer than 504 of the city’s 3890 dwellings were unoccupied and many had fallen into disrepair. Economic growth resumed in 1875 and the population began to increase. The census of 1881 recorded
957
a population of 21,118. However, the addition to the city’s total housing stock was just 207. This was insufficient to cope with an increase of 2026 persons. Many semi-abandoned houses were re-occupied. Population increase continued through the next intercensal period. By 1891, Hobart had a population of 24,905. The number of houses was now beginning to increase but it was still not sufficient to prevent the number of persons per occupied house rising from 5.29 to 5.48. Deteriorated housing presented health risks. In 1886, the Medical OfFicer of Health and the City Building Surveyor examined old buildings in the city. The problem that they stressed was the physical danger of these structures. Many were in’ imminent danger of collapse. For instance, 36 Melville Street may “. . . at any time collapse and cause loss of life” [24]. Routine inspections looked at conventional health problems viz: dirty yards, broken drains and inadequate privy accommodation. The latter problem was especially pertinent to typhoid. Examples could be found from virtually every part of Hobart. One inspection of housing in Wapping found seven tenements in Rileys Lane with only two privies, five tenements in Wilcox Yard with two, six in Shades Row with two and six in Morlings Lane with two [25]. All of these houses were long overdue for demolition. The detailed plan of the Davey Street/Anti11 Street block put forward a scheme for sewers and placed one privy near‘each dwelling [7]. It is not possible to state whether these were actually in existence. However, other features found on this block typified the essential problem of the 1880s-of how to absorb population growth in a city that lacked effective public transport. Dwellings had begun to appear in interior blocks or in tenement yards behind existing houses. These were particularly noticeable in the area that is now the parking lot of the Wheatsheaf Hotel. There were 14 dwellings on four lots; more importantly there were 11 on only two lots. This type of intensification was not seen on the plan of the city prepared for the Intercolonial Exhibition of 1866. The decline of typhoid back to its normal level in the 1890s may be due to the development of a tram system. This allowed the dispersal of the population into new suburbs where technological developments within the building industry provided cheap but spacious weatherboard homes. Alternatively, it could have been what The Mercury newspaper had hoped for on 1 January, 1888-a return to normal Tasmanian summer weather. REFERENCES
1. Central Board of Health: Interim Report 1888. Journals and Printed Papers, Tasmania Paper 118, 1888189. 2. Cumpston J. H. L. and McCallum F. The History of Imestinal Infections (and Typhus Fever) in Ausfralia 1788-1923. Government Printer, Melbourne, 1927. 3. Central Board of Health: Annual Report 1888. Journals and Printed Papers, Tasmania Paper 96, 1889. 4. Central Board of Health: Annual Report 1887. Journals and Printed Papers, Tasmania Paper 102, 1888189.
5. Mercury Hobart, 22 November, 1887. in McQuilton J. and 6. Kellaway R. Introduction MacCulloch J. Guide io the Maps in rhe Tasmanian Parliamentary Papers. Sydney, 1984.
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R.G.
KELLAWAY
7. Central Board of Health: Annual Report 1889. Journals and Printed Papers, Tasmania Paper 25, 1890. 8. Local Board of Health (Hobart). Archives Office of 9.
10. 11. 12. 13. 14. 15. 16.
Tasmania LA 26/4-l, 19 March, 1888. Mercury Hobart, 28 February, 1888. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 19 ‘March, ‘1988. Local Board of Health (Hobart). Archives Office of Tasmania LA 2614-l. 18 March. 1889. Report on the Sewerage and Drainage of the City of Hobart. Journals and Printed Papers, Tasmania Paper 9, 1896. Hobart City Council Records. Archives Office of Tasmania MCC 16/56-l, 16 June, 1888. Hobart City Council Records. Archives Office of Tasmania MCC 16/48, 11 May, 1889. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 25 October, 1886. Drainage and Sewerage of the City of Hobart.
Journals
17. 18. 19. 20. 21. 22. 23. 24. 25.
and Printed Papers, Tasmania Paper 47, 1886. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 15 April, 1889. Local Board of Health (Hobart). Archives Office of Tasmania LA 2614-I. 27 Seutember. 1888. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 25 October, 1886. Mercury Hobart, 3 December, 1887. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 21 March, 1887. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 27 August, 1887. Blainey G. Population Movements in Tasmania 1870-1901. Tasmanian Hist. Res. Ass. 3, 62-70, 1954. Hobart City Council Records. Archives Office of Tasmania MCC 16/58, 2 April, 1886. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 14 November, 1887.
THE HOBART Department
of Geography,
0277-9536189
$3.00 + 0.00 Press plc
Copyright 0 I989 Pergamon
TYPHOID
EPIDEMIC
OF 1887-88
R. G. KELLAWAY University of Tasmania, Hobart, Tasmania, Australia 7001
Abstract-Typhoid fever records for Hobart during the nineteenth century are examined and the summer of 1887/88 identified as the second year of a S-year epidemic cycle. Three factors are used to explain the change from endemic to epidemic typhoid in the 1880s. Firstly, there was a sequence of hot, dry summers that affected water quality and the amount of water available for the cleansing of the street gutters. Secondly, there were changes to the system of disposal of excrement from cesspits to poorly organized pail and single-pan schemes which led to the casual disposal of sewage in the street gutters. Thirdly, the population increase of the 1880s followed 25 years of stagnation and led to overcrowding in existing, often deteriorated, buildings and the placement of new dwellings on small internal allotments. Key words-Hobart,
Tasmania, typhoid epidemic, sanitation, historic reconstruction
A terrace of six houses is located on the north side of Davey Street between Anti11 Street and Watch-house Lane. This building dates from at least 1841 and in recent years has been maintained with sympathy for its role as an element in Hobart’s colonial townscape with pastel paint on the external walls and a period picket fence. This terrace presented a rather different impression to the passerby in 1888; it was dirty and dilapidated. The Central Board of Health was calling upon the landlord to clear away the rubbish, whitewash the walls, pave the yards and repair the drains [I]. The Board also reported that the terrace was overcrowded. Forty-four persons lived in the five occupied houses. The sixth house was untenanted. The average of 8.8 persons for each of these small terrace houses was well above the city average of 5.5 persons per dwelling. Overcrowding was exacerbated by the fact that some of the rooms were unfit for habitation. The building was also unhealthy. The attention of the Central Board of Health had been drawn to this terrace by an outbreak of typhoid. Ten cases had occurred within this building in 1888. Four cases proved fatal. A further five cases including one fatality were to occur in the following year. The Central Board of Health, the Local Board of Health, and even the Women’s Sanitary League had no hesitation in identifying the inadequate drainage of this terrace and the block in which it stood as one of the main problems affecting the health of the city. Typhoid had become a major problem in Hobart only in 1887. Records of typhoid mortality for the city begin in 1838 (Fig. 1). The data for 1838-67 are derived from a table prepared by the Colonial Statistician in 1891 and printed without explanatory footnotes in the Tasmanian Official Record 1892. The number of deaths from 1868 onwards are contained in the annual statistics of the colony. Cumpston and McCallum [2] claimed that the pre-1868 data were only a record of deaths in the Hobart hospital. The deaths of convicts, a not inconsiderable portion of the city’s population in the 184Os, and civil deaths elsewhere in the town were probably not included. Nevertheless, Fig. 1 defines three aspects of the
typhoid situation in nineteenth century Hobart. Firstly, typhoid was endemic in the Hobart environment. Each year would see about 10 deaths. Secondly, typhoid fever had been relatively stable for almost 50 years. Only on four occasions had the death toll reached 20. Alternatively, the disease was in decline if the earlier records had seriously underestimated the extent of typhoid in the town. Thirdly, the incidence of typhoid fever had accelerated upwards in 1887 when 70 deaths were registered in the Hobart district. There were a further 37 in 1888 and 41 in 1889. While only 17 were reported in 1890, the toll in 1891 was 57. Some 222 lives had been lost in Hobart during the course of a S-year epidemic cycle. Another 122 deaths had occurred in Launceston and 92 in country districts. The typhoid mortality rate in Hobart averaged over the 5 years, 1887-1891, was 13.9 per 10,000. In the period from 1870 to 1886, the rate had averaged 3.7. This increase had implications for society that went beyond the loss of life from what was known to be a preventable cause. The principal concern was that this epidemic hit disproportionately severely at the adult population. In 1887, males between 15 and 45 yr accounted for 59 of the 112 typhoid deaths in the colony. Females in the same age bracket accounted for 35 deaths. There were only 12 deaths of persons under 15 yr and 6 over 45 yr. The pattern was the same in 1888. Typhoid fever, according to the Central Board of Health, was selecting “. . . its victims chiefly from those who are in the full vigour of life-those whose lives within their own circle are the most precious” [3]. The loss of ‘breadwinners and domestic managers’ created widows and orphans whose support would have to be taken over by charitable agencies. Furthermore, there was a concern about the loss of income. Each death was believed to represent about 10 cases of sickness. Each case in turn would represent the loss of a month’s wages and the possible impoverishment of a family. The estimated 1000 cases and 112 deaths in the colony in 1887 was alleged to have cost the community f60,OOO [4]. Finally, there was the threat to the tourist trade. Cabmen complained that visitors 953
954
R.G.
KELLAWAY
YEAR
Fig. 1. Deaths from typhoid fever in Hobart. were no longer coming to the colony on account of the typhoid [5]. Hobart’s reputation as a refuge from the heat and fevers of Melbourne had been destroyed. The Central Board of Health believed that the authorities, particularly in Hobart had learned nothing from the 1887 epidemic [l]. Therefore, it began a systematic monitoring of the disease situation from the beginning of 1888 in the theory that ameliorative action could be undertaken if local concentrations could be identified. The principal method of investigation was the map. The Parliamentary Papers of the period contain many disease maps. Some unravel the interaction between disease and the urban environment through plotting the point distribution of cases of epidemic diseases and the incidence of infant mortality. These exist for Hobart on a more or less regular basis from 1888 to 1902. Other maps examined the topographic situation. One example was the plan of the Davey Street/Anti11 Street block that contained the terrace [3]. It showed buildings, outbuildings and garden layouts at a scale of 1 in. to 60 links (1:475). The map of disease locations during the first 6 months of 1888 is of particular interest [l]. It was the first of the point distribution maps. It had the handicap that the three types of epidemic disease-typhoid, scarlet fever and diphtheria-were located by the same symbol. However, this map is uniquely useful [6]. It contained a choropleth overlay that divided the city into areas that were below average, above average and very much above average in terms of the total epidemic disease rate. Alfred Mault, the Secretary, Engineer and only paid official of the Central Board of Health had divided the city into 21 ecological units based on common housing characteristics. The resident population, the average rated value of housing, and the mean height of each district appeared in a table in the accompanying report. Case numbers and rates had also been calculated for the individual diseases. The original case location data has been remapped (Fig. 2) along with a morbidity map for typhoid fever (Fig. 3). Three districts had an above incidence of typhoid fever during the summer and autumn of 1888. The
highest rates were in South Hobart. The Davey Street/Anti11 Street block was located on the ridge that ran towards Mt Wellington while the remainder of the district occupied slopes that overlooked the Hobart Rivulet. The character of the housing was extremely mixed though of a generally low value. The second highest rate was in North Hobart, an area of narrow streets and mean housing while Wapping, the notorious slum between the town centre and the Old Wharf was slightly in excess of the urban average. The official explanation involved the interaction of poor drainage and low quality housing. The problems of Wapping, for instance were described in the following terms:
. . overcrowded conditions and circumstances combine almost all the elements of unhealthiness-damp, dirt, dilapidation, overcrowding, unpaved and undrained yards, floors flush with or even below the adjoining soil; and all this on made up ground only three or four feet at most above the tide and liable to be flooded in wet weather [7]. However, the relationship between typhoid and poverty is not as clear cut as statements of this type would suggest. It may have been that the apparent correlation between low value housing and typhoid fever was a result of incomplete data. One hundred and twenty-nine cases were reported to the authorities in the first 6 months of 1888. Almost all were of persons who were treated at the hospital. Few doctors in private practice met their obligation to notify infectious disease. Extrapolation of the case-fatality ratio in the hospital to the overall situation would suggest that only half of the actual cases had been reported. Mault himself regarded this data as hopelessly compromised and subsequently reviewed the pattern using deaths from typhoid rather than cases [7]. This revealed that the average rated value for houses in which typhoid deaths occurred during 1888 and 1889 was f31/10/0. This was slightly above the city average. Typhoid was a disease of dirt rather than poverty per se. It affected “. . . all classes, rich and poor: the law, the civil service, the banking and commercial interests suffering, if anything more severely than their poorer neighbours” [4]. There also
The Hobart typhoid epidemic of 1887-88
TY,“O,D D,F”r”E*,A 6CA6LET lOTAL 0
Metro6
FEVER
- 120
- 16 FEVE” - 66 - 166
600
Fig. 2. Location of epidemic diseases in Hobart, January to June 1888.
seemed to be random, local factors at work. The problem in North Hobart may have involved the permission given to a local dairyman to continue to sell milk even though there was fever in his household [S]. There were reservoirs of typhoid throughout the town that awaited the heat of summer to revivify and infect the community. The actual pattern of the outbreak would vary from year to year. Typhoid would appear in one district, run its course and re-emerge in another. Five years of case-location data from the 1890s showed that the South Hobart areaalthough exposed to the ‘exhalations’ given off by the Rivulet and containing some of the poorest housing in the city-had below average case rates. The same was true for Wapping. Other areas, such as the now forgotten course of the Murray Street Rivulet and the lower end of Liverpool Street, were major foci for outbreaks in the 1890s. Nevertheless, the data collected in 1888 for the Davey Street/Anti11 Street block are of importance in evaluating the reasons for the transition from en-
demic to epidemic typhoid in the 1880s. Three factors lay behind this change. Firstly, there was the stress caused by a series of years with hot, dry summers. These began in 1886/87. Summer rainfall (DecemberMarch) was just below normal but its effectiveness was reduced by the abnormally warm temperatures and the concentration of much of the rain into January. There was no doubt about the summer of 1887/88. The rainfall was only 53.3% of normal. Temperatures in December were hot (17.9”C compared with 153°C mean); January and February were normal while March was relatively cool. Rainfall in the summer of 1888/89 was also below normal. It was claimed that the summer of 1887/88 was the driest for 50 or 60 years (91. It is not possible to check this allegation as the Hobart gauge before 1882 was located at several places. However, the records sug gest that the last full year that could be called dry-a rainfall of less than 500 mm-had occurred in 1871. Dry weather interacted with typhoid through the water supply. In spite of allegations to the contrary, Hobart had a sound system of water supply. Tests
R.G.
956
CASES
0 I
KELLAWAY
PER THOUSANO
htetres 500 1
Fig. 3. Incidence of typhoid fever in Hobart, January to June 1988.
revealed no problems with the quality of the water as it left the reservoir [lo]. However, there were weaknesses in the distribution system. The water pressure was low in many areas and it was possible that contaminated surface water could enter the pipes through leaks or at the fire plugs [I I]. There were also problems with the amount of water available during a dry summer. In a normal season, the city used two million gallons a day. Fifteen percent of this was required to clean the street gutters [12]. The gutters were used for the disposal of household waste water. The only alternative in the absence of any system of drainage was to run sullage into the yard where it would eventually soak into the soil. Slops from the kitchen, washhouse and laundry were inevitably joined by urine and faeces. These, mixed with horse manure and street rubbish, formed an obnoxious stew. The gutters were vile creating smells that would “. . . pervade the street and enter every house” [12]. The council employed scavengers to sweep the gutters. In a normal year, rain would assist
in keeping the gutters clean. In a drought year, there would be no natural cleansing and the amount of water that could be used for washing the streets would be restricted. The gutters of the typhoid block were noted by the City.Surveyor to be among “. . . the most objectionable and unhealthy” in the city [13]. The washing water of typhoid patients was also alleged to have been dumped in the gutter on Davey Street to I‘. . . run 500 yards along the street exposed to street traffic and in front of shops until falling into a grating” [ 11.This was vigorously denied by the doctor attending [14]. Whether or not this was true will never be known. What was undeniable was that these gutters were cobblestone rather than freestone. It was impossible to keep this type of gutter clean as the ‘slush’ lodged between the rocks. The Central Board called for the council to undertake the proper drainage of this block. This meant underground sewers. The council thought that Sewers were an impossible luxury and responded with a plan for the
The Hobart typhoid epidemic of 1887-88
street gutters in the vicinity to be tarred for easier cleaning. This was the policy adopted after a prolonged and public argument between the two bodies. Street gutters had become a more serious health problem in the 1880s owing to changes in the system for disposal of excrement. The city until 1883 had been served by cesspits. These had been progressively closed with the plan that all should have been filled in by the beginning of 1887. A house to house survey revealed the slow rate of progress of this plan. There were still 1293 cesspits remaining in October 1886 though most were scheduled for closing within the next few months [15]. Cesspits were an obvious health risk. Many had been poorly constructed and they were emptied at “. . . very uncertain intervals” [16]. Dr Edward Giblin, Medical Officer of Health for the Local Board believed that old cesspits were the major problem of the typhoid block [17]. They had been very dense in this area and were believed to be still poisoning the soil even though they had been closed for 2 years. The alternative provided by the council was a nightcart service that collected pails from each household on a weekly or fortnightly basis. This option was used by 298 1 households in 1886. The pail system was both obnoxious and unhealthy and was regarded as a temporary measure until a single-pan system could be introduced. The pails were rarely ever washed [ 181 and many were inadequate for the purpose for which they were intended. Landlords often provided nothing more than a kerosene tin [19]. The pail system interacted with the climate to intensify the health risk. There were incentives for the illegal disposal of the contents. Many households in poorer areas had no access to dry soil to deodorize the pail and could avoid the quarterly charge for collection by dumping the contents “. . . in a manner objectionable to the public” [20]. Giblin had called for more frequent washing of the gutters following the outbreak of typhoid in 1887. The gutters, he said, “. . . could easily become infected with typhoid germs by the filthy habits of some persons who under the cover of night empty their pans into the gutter” [21]. This problem had not existed with the cesspit system though water closets, of which there were 533, had not been blameless in this respect. There was no system of public underground sewers. Private sewers could legally terminate only in the Hobart Rivulet which had been defined as a common sewer by Act of Parliament. Many terminated in other streams which had the legal status of common drains and which had no system for flushing. Others terminated in odd places. The Army Barracks was one notorious example. A barrel drain was led to the boundary on Davey Street where it discharged into the street gutter [22]. The third factor that explains the transition to epidemic conditions was the timing and pattern of urban growth. The population in 1870 was 19,092. This was 357 fewer than had been recorded in 1861 and the stagnation of Hobart’s economy was reflected in the large number of vacant houses around the town [23]. No fewer than 504 of the city’s 3890 dwellings were unoccupied and many had fallen into disrepair. Economic growth resumed in 1875 and the population began to increase. The census of 1881 recorded
957
a population of 21,118. However, the addition to the city’s total housing stock was just 207. This was insufficient to cope with an increase of 2026 persons. Many semi-abandoned houses were re-occupied. Population increase continued through the next intercensal period. By 1891, Hobart had a population of 24,905. The number of houses was now beginning to increase but it was still not sufficient to prevent the number of persons per occupied house rising from 5.29 to 5.48. Deteriorated housing presented health risks. In 1886, the Medical OfFicer of Health and the City Building Surveyor examined old buildings in the city. The problem that they stressed was the physical danger of these structures. Many were in’ imminent danger of collapse. For instance, 36 Melville Street may “. . . at any time collapse and cause loss of life” [24]. Routine inspections looked at conventional health problems viz: dirty yards, broken drains and inadequate privy accommodation. The latter problem was especially pertinent to typhoid. Examples could be found from virtually every part of Hobart. One inspection of housing in Wapping found seven tenements in Rileys Lane with only two privies, five tenements in Wilcox Yard with two, six in Shades Row with two and six in Morlings Lane with two [25]. All of these houses were long overdue for demolition. The detailed plan of the Davey Street/Anti11 Street block put forward a scheme for sewers and placed one privy near‘each dwelling [7]. It is not possible to state whether these were actually in existence. However, other features found on this block typified the essential problem of the 1880s-of how to absorb population growth in a city that lacked effective public transport. Dwellings had begun to appear in interior blocks or in tenement yards behind existing houses. These were particularly noticeable in the area that is now the parking lot of the Wheatsheaf Hotel. There were 14 dwellings on four lots; more importantly there were 11 on only two lots. This type of intensification was not seen on the plan of the city prepared for the Intercolonial Exhibition of 1866. The decline of typhoid back to its normal level in the 1890s may be due to the development of a tram system. This allowed the dispersal of the population into new suburbs where technological developments within the building industry provided cheap but spacious weatherboard homes. Alternatively, it could have been what The Mercury newspaper had hoped for on 1 January, 1888-a return to normal Tasmanian summer weather. REFERENCES
1. Central Board of Health: Interim Report 1888. Journals and Printed Papers, Tasmania Paper 118, 1888189. 2. Cumpston J. H. L. and McCallum F. The History of Imestinal Infections (and Typhus Fever) in Ausfralia 1788-1923. Government Printer, Melbourne, 1927. 3. Central Board of Health: Annual Report 1888. Journals and Printed Papers, Tasmania Paper 96, 1889. 4. Central Board of Health: Annual Report 1887. Journals and Printed Papers, Tasmania Paper 102, 1888189.
5. Mercury Hobart, 22 November, 1887. in McQuilton J. and 6. Kellaway R. Introduction MacCulloch J. Guide io the Maps in rhe Tasmanian Parliamentary Papers. Sydney, 1984.
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KELLAWAY
7. Central Board of Health: Annual Report 1889. Journals and Printed Papers, Tasmania Paper 25, 1890. 8. Local Board of Health (Hobart). Archives Office of 9.
10. 11. 12. 13. 14. 15. 16.
Tasmania LA 26/4-l, 19 March, 1888. Mercury Hobart, 28 February, 1888. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 19 ‘March, ‘1988. Local Board of Health (Hobart). Archives Office of Tasmania LA 2614-l. 18 March. 1889. Report on the Sewerage and Drainage of the City of Hobart. Journals and Printed Papers, Tasmania Paper 9, 1896. Hobart City Council Records. Archives Office of Tasmania MCC 16/56-l, 16 June, 1888. Hobart City Council Records. Archives Office of Tasmania MCC 16/48, 11 May, 1889. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 25 October, 1886. Drainage and Sewerage of the City of Hobart.
Journals
17. 18. 19. 20. 21. 22. 23. 24. 25.
and Printed Papers, Tasmania Paper 47, 1886. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 15 April, 1889. Local Board of Health (Hobart). Archives Office of Tasmania LA 2614-I. 27 Seutember. 1888. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 25 October, 1886. Mercury Hobart, 3 December, 1887. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 21 March, 1887. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 27 August, 1887. Blainey G. Population Movements in Tasmania 1870-1901. Tasmanian Hist. Res. Ass. 3, 62-70, 1954. Hobart City Council Records. Archives Office of Tasmania MCC 16/58, 2 April, 1886. Local Board of Health (Hobart). Archives Office of Tasmania LA 26/4-l, 14 November, 1887.