[Report 1896] / Medical Officer of Health, Pontypool Local Board / U.D.C.

  • Pontypool (Wales). Local Board.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: [Report 1896] / Medical Officer of Health, Pontypool Local Board / U.D.C. Source: Wellcome Collection.

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    PONTYPOOL URBAN DISTRICT COUNCIL. gttebtcol (Officer's Annual ftepoi-t, ) 896. Denham House, Pontypool, January ‘20th, 1897. Mr Chairman and Gentlemen,—I hepr to lay be¬ fore you my nineteenth annual report respecting1 the health and sanitary condition of your district for the twelve months ending December 31st, 1896. I regret my inabiliy to congratulate you on the extension of your area. Your district lies within the same circumscribed radius as heretofore, and may be described as follows It lies upon the carboniferous system, or more particularly the millstone grit, or farewell rock, or the lower por¬ tion of the true coal measures, and forms the eastern outcrop of the South Wales coalfield. The strata dip. or slope about three inches per yard in u south-westerly direction Configuration.—The surface of the district is ex¬ tremely irregular and hilly, and lies to the north * of the Trosant Brook and to the west of the Avon Llwyd River It comprises the angular portion of land formed by the above-named streams. The ground rises or slopes up in a northerly, north¬ westerly, and westerly direction from the before- mentioned streams, and lies at an elevation of from 400 to 700 feet above the mean sea-level, and com¬ prises an area of 234 acres. The atmospheric conditions affecting a valley are no criterion as to the same conditions existing in the country generally, and valleys are as a rule more often affected by moisture than more elevated regions. The consequence is that your district suffered from an excess of moisture during the year, but owing to the configuration of the ground it rapidly flows away. Yet stili the effects remain to a great degree, and are markedly shown by v ear and tear of the roads and the frequent short epi¬ demic like series of invasions of colds and influenza which attack the inhabitants. The first three months of the year were damp and mild. These were followed by dry in¬ tensely hot weather, April and May being characterised by frequent north-easterly winds, bringing to your district influenza and broncho¬ pneumonia. The remaining months of the year were rough, wet, and cheerless. This latter condi¬ tion has been detrimental to the health of young children, old persons, and weaklings, who, through poverty, are insufficiently clad and fed. Yet, not¬ withstanding many adverse circumstances, of which I may mention bad trade as the most poignant factor, and one affecting the majority of your inabitants as it has materially altered their pecuniary position, your district has not such a bad record for the period under review as it might have had. During the twelve months ending December 31, 1896, 73 persons—34 males and 39 females—have died in your district. This gives a death-rate of ITS per 1000 per annum of the estimated popula¬ tion. This is the lowest annual death-rate I have had to record since my appointment as medical officer. Since 1892 the death-rate has been gradually declining. This I will tabulate farther on. Thedi athrate as shewn above is the rate of persons actually dying within your Authority. There is a fallacy in this death rate, inasmuch as it includes the deaths of persons belonging to other districts, seve¬ ral of whom are known to me, and it does not in¬ clude persons belonging to your district who have died elsewhere. 1 am in a position to correct this death rate by including 8 persons who died in the Union Workhouse, who, under ordinary circum¬ stances, would havr died in your district. This will bring the death rate up to 13T per 1,000 per annum. As I have shewn, this is not the correct death date, because I cannot exclude those who died in your district belonging to another ; however, it will have to answer our purpose. And further than that, several of the deaths occurring at the Union Infirmary, although removed from your dis¬ trict, did not belong to it, as they were migratory persons, and sought parish relief here. During the past year the births numbered 162— 88 males and 74 females—the birth rate being 26*3 per 1,000 per annum of the estimated, population There is a eeriou3 falling-off in your birth rat-?’ Forty-nine children were withheld from your dis¬ trict as compared with last year. The prosperity of a country is reckoned by the number of marriages and by the birth rate. If your birth rate has gone down, I am glad to say there is a compensating advantage, for the rate of infant mortality per 1,000 born has decreased also. For the year under review it is 128 3 as compared with last year, when it was 141 2. The death rate from all zymotic diseases (as per Notification Act of 1889) was 2*4 per 1,000 per annum. I ought to point out that this increase of deaths from zymotic diseases is more apparent than real, as 11 children died from whooping cough ; but in only 3 cases did the child succumb from that di ease alone, but by other chest affections super¬ vening on the primary disease ; therefore it is rea¬ sonable to suppose that had no secondary affection complicated the whooping cough, the probability is that moBt of the 11 lives would have been spared. Cor- _ .. „ rected Deaths Zymotic death .u , Death under death rate Birth rate rate per 1 year rate per ner per 1,000 per 1,000 per per 1000 1000 per 1,000 -I goo &0nAno' born. annum, per an. 1892 ... 40'3 22*8 1764 5-4 24*$ 1893 3.V7 17 6 150 2 25 V)7 1894 ... 34 8 16-4 142 8 21 18*4 1895 34*6 14.1 1421 -g 19-7 1896 26-3 11-8 1283 24 131 From the above tabulated list you will see that for the past five years the general death rate has been getting lower ; and one important factor m bringing about an increased mortality, viz., the in¬ fantile death rate, has gradually come down so yery encouragingly,that I am inclined to think thatmore care is bestowed on the feeding and welfare of those under one year of age. The mean death rate for Pontypool Urban District for the five years. 1S92 to 1896, was 16*5. I think it will be easily seen that this is a very satisfactory death rate. The mean average death rate at all ages for the whole of England and Wales for 1S94 was 16*6 persons pei 1000 per annum, this being the lowest on record. From the above table it will be seen that the rate of infant mortality per 1000 births is declining; for the year under review it is 128*3. This, compared with other large towns, is highly satisfactory, especially when we consider the amount of poverty and privation existing among the labouring classes. The births for the past twelve months numbered 162—8S males and 74 females, the birth rate being 26 3 per 1000 per annum of the population. This, I regret to say. is a reduced birth rate—in fact, I believe it is the lowest birth rate I remember. The birth rate has been declining for several years, and I firmly believe that the disturbed condition of trade has had a marked, effect upon the marriage rate, although I cannot give statistics relative to the latter. Of the 162 children born in your dis¬ trict during the past year, 21 died before attaining one year of age, so that the net gain to your popu¬ lation is 89, that is, afler deducting the whole of the deaths. This number is a less gain than that of 1895 by six. On analysing the causes of death of the 21 children who died before reaching the end of their first 3ear of life, I find 11 succumbed to cbest affections, and the remainder to convulsions and gastro-intestinal troubles, more or less due to improper feeding. I am inclined to think that the feeding of infants is better understood and carried out among the labouring classes, but still I find some who persistently give gruel and other farina¬ ceous foods to very young children, whose digestive organs are only capable of digesting milk. Table A, supplied by the Local Government Board, epitomises the mortality from all causes as under:— Deaths under 1 year of age. 21 ) 36 under 5 ir and under 5 years 15 J j-ears of age. ” 2 -j 37 over i , - . years of age. and upwa maer 0 years i.. I ye; 35 „ 2-) » 25 „ 5 ( c :■ - 17 (5'K upwards. J3 ) Total. 73 Causes of mortality, Table A :— Under 5 years 5 years and age. upwards. Diphtheria .. 1 . q Typhoid Fever . 0 ... . 2 Whooping Cough . 11 . 0 Phthisis . 0 .” ...” ’’ 7 Bronchitis, Pneu-) ,, monia, A Pluerisy J 11 . 7 Heart diseaee 0 . 5 Injuries . . 1 . 0 All other diseases ... 12 .16 36 37 Table B, another requirement of the Local txoyernment Board, has reference to new cases of sickness, census, area, Ac. Pontypool Urban District Council. I opulationat all ages, census 1891. 5842 Estimated to the middle of 1896 . 6142 Under 5 years Over 5 years of age. of age. Smallpox. 0 . 3 Scarlatina ... 9 .13 Diphtheria . 2 ............ . ... 5 Membraneous croup 3 . 0 Typhoid fever . 0 . 6 Puerperal fever. 0 . 2 Erysipelas . 0 . 2 14 31 Ttifi?1?Sis °XSUC£ cases removed to isolation hos¬ pital from their homes : Smallpox, under 5 years or age. 0; over 5 years of age, 3. Typhoid fever under 5 years of age, 0 ; over 5 years of age. 2. The Notification Act has been of signal service in 5C3P«n,r t0 ni0t,ice t5 cases ot' infectious disease. Each case notified has been dealt with as it. arose and I believe in so satisfactory a manner that nothing assuming the proportions of an epidemic of any infectious disease has been allowed to crop JWfllik-This hM been the most general infectious disease during the year. Twenty-two cases have bevn notified. Commencing in May with one case it followed on through the year in the order here given :-June, one; July, one ■ x™USv. tWf ; Sept®“ber, one ; October/ eight; November, four ; and December, four. None of the cases were of a very serious type, and all recovered. Diphtheria. This disease attacked seven persons, four of the number having a mild form and made quick recoveries. The other three were of a more serious nature. The first, a child aged three years was sent from an infected house in London to avoid the disease, and immediately on its arrival in your district it developed rapidly, and proved fatal within 48 hours. As far as possibe all sanitary precautions were taken, yet, notwithstanding this, two adult females who had been in attendaoce upon the child developed the disease. Each had a severe attack but both recovered. Membranous Crimp —Three cases of this affection were notified : all recovered. Typhoid Fever.—There were six cases of typhoid notified during the year under review and two deaths, one of the latter having been notified the end or 1895. Five cases were in one family, all paupers. Two I sent to the Union infectious dis¬ ease ward, and in consequence of the determination of theGuardans to admit no infectious disease from outside the other three were treated at their homes. The first case of this batch was undoubtedly impor¬ ted, the family being made up of many members of various relationship, and wandering about the county as tin workers and usually camping out. In their usual way they had fixed their abode on the banks of a stream outside your district where only a few months previously I had a latal case of typhoid evidently from drinking the pollu¬ ted water. The first sufferer of the five admitted having drank of the stream. The four other cases were developed out of this one. All these cases occurred in January and February. Early in March another case was notified in the same neigh¬ bourhood but in a different family. I could not trace the cause of this and regret to say it proved fatal from perforation of the intestine. Since then your district has been free from typhoid fever. There is no doubt but that the recovery of this family of tinworkers was in a measure greatly due to the untiring efforts of the then district nurse, who was doing duty here, from the Queen Vic¬ toria’s Jubilee Institute of Nurses. Puerpeial Fever.—Two cases of this terrible disease were notified. I endeavoured to find out the causes leading up to the attack, in one case there is not a doubt in my mind but that it was introduced by the hands of a dirty midwife, in the other case the cause was not traceable. They both recovered. Smallpox.—Three cases of smallpox occurred and the victims were all tramps, and the 3 were un¬ vaccinated, and in each case they were located in a common lodging-house. Two occurred in January and the third in March. The 2 cases that occurred in January I had promptly removed to the infectious disease ward at the Union Infirmary, inasmuch as naving brought the usual parish order I considered that the Guardians had as much right to take charge of them as though they were ill with any other complaint, especially as they were destitute’and the disease having shown itself in a common lodging- house, and, further than that, there was no isolation hospital in your district, nor any where near. The third case came under my observation on March 29th. In my capacity as district medical officer I received a note to attend a man on behalf of the Guardians of the Union. I found him in bed in a room of the common lodging-house, the room containing S other occupied beds. I discovered he had smallpox badly and had come from Usk 4 days before. He was quite destitute, having but fifteen pence as his capital and that being due to the lodging-house keeper. Acting as your medical officer of health I immediately set about isolating the case, and to that end sent for the relieving officer to remove the case as he did the former cases to the Infectious Ward at the Union. This lie refused to do, having had orders from the Guardians to take no more intectious diseases to the Union Infectious Disease Ward. I then obtained temporary possession of a cottage close to the spot where I bad treated the 5 cases of typhoid, and late at night removed the case there, my object being to geo it out of the common lodging-house. The day being Sunday I was somewhat, hampered, but I vaccinated all the inmates of the lodging-house that would be done, thoroughly disinfected the whole building before midnight, and destroyed ail traces of the disease as far as that place was concerned. The next day I met a committee of your Board, and after laying the case before them, and they seeing the urgency of action, gave me permission to get a Netten Radcliffe hospital tent and erect it in the most suitable place I could find and remove the case there. This I did with the assistance of your in¬ spector of nuisances and relieving officer although there was a delay in getting the complete’fittingsof the tent for several days, owing to the canvas part going astray on the railway. I had the tent erected in a very airy meadow within your district and the case did well, we were enabled to keep up complete isolation, and had a pit dug to take all refuse on which a layer of earth and chloride of lime were thrown every day. As the case was getting well, I was able to receive a case from our Neighbours, the Abersychan Dis¬ trict Council. After very careful disinfection I was able to take down the tent and store it away. It has not been needed since, but I was so satisfied with it. that if any other case occurred at any other time of the year I should not hesitate to erect it and use it again, as it is very snu and easily kept warm. I may add that the'attendants were provided with an ordinary army bell tent. Phthisis. — There were seven deaths from this affection. I felt encouraged in 1895 at only bavin two deaths to record, but this is a disease very dif¬ ficult to control in a damp valley. Bronchit is, Pneumonia and Pluerisy.—1 here were but 18 deaths from these diseases, j hey occurred at no particular period of the year, but arose at in¬ tervals all through the past 12 months. Affections of the chest were more numerous during the year I am reviewing than in 1895, when but 15 cases of the above-named affections occurred as compared w th 33 in 1894 a nd 41 in 1893. I believe the inhabitants are more alive to the necessity of more careful nursing, and they certainly pay greater attention to the dietary of young children. Influenza.—This malady, although not so general as it has been in former years, has shown itself frequently during the past year. There has been no fatal case, yet many have buffered from its effects. In reviewing the health of the district for the past 12 months I most unhesitatingly can say that there has been a great improvement in your area. There is doubt but that th? lessened death rate, the lowered infantile mortality, the greater freedom from chest affections, especially in children, are all the outcome of an improved sanitary condition of your area. Speaking broadly the cause of a high death rate is dirt. Your officers have been untiring in their efforts to get clean air. clean soil, and clean food, and have lectured the inhabitants constantly on personal cleanliness, although this latter is the most difficult task. 'Jhe ready response of your inspector of nuisances to my suggestions for disin¬ fection and improvements anywhere and atall hours have assuredly led to making your district so healthy during the past year. Th<-‘ water supply has been universally good. During the drought of last summer the upper parts of the district were somev.hat short, but at no time were we placed as some districts were—without any at all. Everyone could get a supply if they only took the precaution to store it when it was turned on. The meat supply has been abundant, good, and cheap, and I am glad 10 say that no single sample of unsound meat has been seized. I regret to say that vaccination is not in so flour¬ ishing a state as it ought to be owing to the delay in the report of the Vaccination Commission, and the very vague and altogether misleading conclusion of their report. The public instead of embracing the blessings of vaccination are more negligent of it than ever, if jour district is to be kept clear of smallpox every infant must be vaccinated, and every adult re-vaccinated ; and 1 hope the legisla¬ ture will make laws during the coining j'ear insist¬ ing more fully than at present on the operation being well and thoroughly done. The welfare of your inhabitants, especially the poorer ones, has been carefully tended in their ail¬ ments and accidents by the district nurse. Yvur distiict has been fortunately placed the past two years by having the free services of a highly-trained nurse from the Queen Victoria’s .Jubilee Institute ot Nurses. This is a desideratum that cannot be too highly appreciated, and 1 believe 1 am right in saying that the boon conferred bjr the generosity7 of Mr J. C. Hanbury. J.P.,of Pontypool Park, is prized by the public and medical prolession alike. No definite decision has yet been come to by your Authority as to the disposal of the sewage. I am in a position to say that the drainage of the district is becoming more perfectevery year, old box drains and others of an obsolete type are being replaced with proper glazed sanitary pipes wherever found, and if some scheme can be arrived at to deal with thesewage a great work will have been accomplished. I had the pleasure of attending a convention on the subject brought about by the Monmouthshire County Council on the 15th of the present month, when the county surveyor brought forward a great scheme to dram the Eastern and Western Vailevs by a grand trunk tunnel emptying itself into the sea.’The idea commended itself to my mind, and if your Council can arrange to join in it I certainly consider it will be the best for all time. Your inspector reports having served notices for the removal and abatement of nuisances during the year as follows:— Insanitary, detective, and dangerous buildings 8 Defective and foul w.c.’s . 49 Defective drainage.40 Overcrowding ....!!.*!!!!!! 2 Removal of manure. Ac.jo General nuisances from defective down pipes, filthy dwellings, accumulation of ashes, filth, and washtubs, Ac., and the removal of swine . 180 Obstruction and throwing water in the street... 89 The above have all been properly dealt with. The common lodging-houses, workshops, dairies and cowsheds, slaughter-houses and bakehouses have all had regular inspections, and a ready com¬ pliance has been given to all suggestions from your officers. The erections of new buildings have been regu¬ larly superintended. viz., 4 houses'in Conway’s-lane, 2 in Gwent-street, and 1 in Coedcae. The churches and chapels in the district, the town Hall, Mission Hall, Assembly Rooms have all been disinfected, and all the schools disinfected twice during the year. I am, Mr Chairman and Gentlemen, Yours obediently, S. B. Mason, M.R.C.P., Ac., Medical Officer of Health.