Mr. W. H. Power's report to the local government board on diphtheria at Hern Hill, in the Faversham rural sanitary district ; on the sanitary state of that district ; and on administration by the rural sanitary district.

Power, W. H.

Date:: 1880

Credit: Mr. W. H. Power's report to the local government board on diphtheria at Hern Hill, in the Faversham rural sanitary district ; on the sanitary state of that district ; and on administration by the rural sanitary district. 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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$who came together at the school, and among other members of the same family. Subsequently the disease spread widely in the village and the increasing number of foci of infection increased at once the facility of its spread and the difficulty of accu- rately tracing it. 3. My inquiry was limited to the earliest cases in November. There was nothing at the homes of the children Smith and Stubbs that could be accused of giving rise to the disease. Their dwellings lay on opposite sides of a brancli road that leads up from the lowest part of the village to the higher level of the araljle land. There seemed good reason to think that the children had contracted the disease at the school, for attendance at school was, as far as was known, the only condition common to the first five or six cases. In this direction inquiry was somewhat at fault, for the old lady who kept the school had since died, and information regarding it coukl only be obtained from the neighbours. The house stands near the bottom of a steep row of half-a-dozen cottages rising from the road. The privies and ashpit belonging to the row are placed at the top, and the ground is so steep that there appears to be some risk of soakage from them into the soil under the cottages. Up to the time of the outbi'eak there had been, it was stated, a nuisance immediately in front of the door of the school, arising from a choked drain, and accumulation of slops on the surface. The old lady who kept the school had become so infirm that she could not walk so far as the closet at the top of the roAV. The result Avas a retention of stools in a chainber A^essel, A\ffiich was kept in the room where the little children, eight or ten in number, Avere gathered for schooling. A neighbour described the smell in the school-room as so bad that she could not stay in it. The house Avas unoccupied and locked iq? Avhen 1 visited the place, but looking in at the windoAV I could see that the school-room Avas A^ery small, OAily about 8 feet sq\iare. 4. On further inquiry I learned that there had been cases of throat disease, occurring in adults, in two other houses in this same roAV, a month or tAvo before any of the school-children were attacked. It is not certain that the throat disease Avas diphtheria though the relation in respect of locality, betAveen those earlier cases of throat disease, and the later cases of pronounced diphtheria Avas exceedingly suspicious. Nothing Avas knoAvn of any importation of the infection. The origin of the disease must, 1 fear, remain doubtful; but it is difficidt to escape the impression that its fatal incidence upon little children attending the dame-school Avas in some Avay dependent upon, or determined by, the foulness of the atmosphere in Avhich the children were assembled. 5. Up to the 16th of February there had been 54 cases of diphtheria, of which live had ended fatally. 6. The arrangement above described of privies placed close at the top of the roAV of dwellings to which they belong, appears to be usual in Ilaunds. There is evident danger of the house foundations and basements becoming soaked Avith fluid from the privies and polluting the air in the dAvellings. CLITHEROB. « [Registrar-General’s Quarterly Return, 1879, Fourth quarter.—District, Clitheroe; Sub-district, Chipping. Population, 3,301. Eleven deaths registered from diphtheria. (Registrar’s note, “ Diphtheria prevalent in the townships of Chipping and Thornley.”)] 1. The locality affected by this outbreak of diphtheria was the village of Chipping, at the foot of the Bleasdale Moor, and the neighbouring hamlets of Hesketh Lane and Thornley, in the wide Amlley that lies between Bleasdale Moor and Longridge Hill, in Lancashire. Longridge Hill is composed of millstone grit; Bleasdale Moor of mountain limestone ; and the intervening A'alley slopes are formed of the debris of the hills around. The soil is less clayey than that of most localities in AAdiich diphtheria is found to prevail; but some of the houses in which the disease had occurred Avere in notably exposed situations. 2. The Medical Officer of Flealth, Mr. W. P. Counsellor, of Whalley, near Clitheroe, placed at my disposal all the information he had obtained relating to the outbreak. The first intimation that he received of the occurence of any case of diphtheria was toAYards the middle of December, Avhen he heard from the Registrar of tAvo deaths from that disease in the neighbourhood of Chipping, on the 25th and 30th of November. His first visit to the infected district was on December 14 ; and on his recommendation the schools at Chipping and Hesketh Lane AAmre closed frou] that day B o O$