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0fe4e7c0-3344-4448-b130-bf82a276ae17 | 2 15 6 24 2 Scarlet Fever 2 1 3 4 β 10 3 3 1 β Diphtheria 2 8 7 2 4 2 5 5 8 28 Whooping Cough 9 13 3 6 25 5 17 5 21 β Typhoid Fever β 1 1 β 3 4 2 2 2 2 Diarrhoea and) Dysentery 10 12 18 24 34 60 17 44 37 80 Puerperal Fever β β β β 1 6 4 2 β β Total number of deaths from 7 Zymotic Diseases 24 60 43 45 91 89 63 67 93 130 Deaths from other causes 282 377 298 368 334 396 330 411 371 373 Total Deaths 306 437 341 413 425 |
ef2ccff2-ea80-44a7-998f-b0e51ba39ca5 | 486 393 478 464 503 D'th rate from 7 Zymotic diseases per thousand 1.09 2.8 1.9 1.8 3.6 3.4 2.2 2.4 3.1 4.1 D'th rate from other causes per thousand 12.9 16.1 12.0 15.3 13.4 15.2 12 14.8 12.6 11.8 General death rate per thou- sand 13.99 18.9 13.9 17.1 17 18.6 14.2 17.2 15.7 15.9 In London the Zymotic Death rate was 2.58 per thousand. 9 NOTIFICATION OF INFECTIOUS DISEASES. There were 221 notified, as against 259 in 1896. |
45e539e9-c986-43cc-8e75-1d72cfea611a | The following table gives the number reported each year since the Act came into force. 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. Small Pox β β 13 7 2 β β β Scarlet Fever 108 63 74 192 86 67 193 93 Diphtheria. 14 8 27 41 22 32 23 89 Membranous Croup 4 β 13 1 β β β 4 Typhoid Fever 13 13 15 19 15 28 14 10 Continued Fever β β β 1 β β β - Puerperal Fever 1 β 1 2 1 3 3 β Erysipelas 22 18 37 77 41 31 26 25 162 102 180 340 167 161 259 221 SMALL POX. |
76884b77-6d20-4af0-81e3-25d21b1a3a31 | No cases have been notified since 1894, and no deaths have occurred in the district during the last thirteen years. It is very probable that great changes will shortly be inaugurated by the Local Government Board with reference to the system of Vaccination. We shall have the use of humanised lymph prohibited, and vaccine lymph derived from the calf exclusively used for both primary and secondary vaccination. In Germany the system of Vaccinating direct from the Calf has been abandoned as completely as that from Arm to Arm, the use of Glycerinated Calf Lymph having become general throughout the Empire. 10 Ur. Copeman in this country showed some years ago that glycerinated lymph possessed many advantages; but the German Government have extended his investigations, and have turned the results to practical account. |
3be0d2ca-42ea-4e62-8bb6-a6e851b22f78 | It has been proved by competent bacteriologists that, by the admixture to Calf Lymph of 50 per cent, solution of pure Glycerine in sterile water, and storage of the lymph material in tubes, under proper precautions for a term of several weeks, the preparation remains quite active as vaccine, yet all disease producing micro-organisms which may be in the lymph are destroyed or rendered harmless. SCARLET FEVER. Ninety three cases were notified, but not a single death occurred. In 1896 we had only one death. This is a remarkably low death rate, and is highly satisfactory. DIPHTHERIA. Eighty nine cases were notified, and twenty one deaths occurred during the year. Most of the cases were of a purely sporadic form, viz.:β attacking only one or two in a house, and not spreading. In a few of the houses where deaths occurred defective drainage was found and .at once rectified. |
13e7f916-9875-4a2e-8640-7d1c80f6805f | The long continued inhalation of diluted sewer air tends to produce a general loss of health, especially in children; shown in various ways, and one of these symptoms may be sore throat; or there may be only a condition of depressed vitality, which offers slight resistance to attacks of acute disease. Occasionally a severe form of tonsillitis attacks the occupants of a badly drained house; this form is generally recognised as " Sewer air Throat." These throats are contagious and 11 directly transmissible from person to person, and without a bacteriological examination is made of the membrane on the tonsils or throat, it is difficult to say that these cases are not true Diphtheria. What is more common is to find in these throats not the true bacillus of diphtheria but a microbe that plays an important part in preparing the throat for Diphtheria, by weakening it so that the throat offers less resistance to the action of the specific organism. |
40d531be-1974-43fe-b311-75106aba7f22 | Dampness and moisture in the air of a house is also a strong predisposing factor in the production of Diphtheria outbreaks. MEASLES. In the early spring I caused the following Leaflet to be circulated amongst the poorer class, and it has produced a very beneficial result, as although we had a distinct epidemic in the Autumn there were only two deaths recorded during the year. Instructions to the Public as pegapds Measles. Leaflet Issued by the Sanitary Authority of Acton. VERY IMPORTANT TO PARENTS. In order that you may take steps to prevent Measles becoming prevalent here during the coming Spring, it is important that you should know the following facts :β Measles is a dangerous disease and must not be neglected ; it is also most contagious from the commencement of the attack, and remains so for four weeks. Measles begins with symptoms of a severe cold, watering of the eyes, running of the nose, pain in forehead, and irritable cough. |
10396602-e472-40bc-9a65-f10e4297bfc7 | At this stage, before the rash appears, the disease is extremely Catching. 12 Look upon all colds with suspicion just now, and keep any child with the above symptoms in a warm room to himself. Send at Once for Medical Assistance. It is dangerous for parents to trust to household remedies. On the fourth day a rash appears, first on the forehead and face, in the form of minute dots of a dull red or raspberry colour, many of the spots join together.) The great danger in Measles is the tendency of the cold to spread to the lungs. So All Exposure to Cold Must be Avoided. The Infection of Measles is easily conveyed by the clothing of persons not themselves attacked by the disease. Should you have the disease in your home, forbid your house to ALL, and let nobody from your house go into any one else's. Clothing and bed clothes should be disinfected by being well boiled in water. |
b7e2e37c-0b32-45b0-be00-0d7e4dc01223 | Any articles which will not bear toiling should be thoroughly washed with Carbolic Soap, and then freely exposed to the out-door air. G. A. GARRY SIMPSON, East Acton, W. Medical Officer of Health. TYPHOID FEVER. Ten cases were recorded, and two deaths occurred. It will be noticed that we have had only eight deaths from Typhoid Fever during the last four years. 13 PUERPERAL FEVER. No cases were notified. There were 973 confinements during the year. WATER SUPPLY. No complaints reached me during the year. An analysis was made of a sample on October 9th, and the report was satisfactory. DRAINAGE. The only sewers laid down during the year were short lengths in Bedford Park and Acton Lane. NUISANCES. Reference to the subjoined report of your Sanitary Inspector will show the various classes under which these have been treated. |
09c421c6-3067-468f-afe9-9540faa45e54 | 14 REPORT OF SANITARY INSPECTOR For the year ending December 31st, 1897. Visits to ensure continued isolation of infectious patients 511 Rooms, &c., disinfected by fumigation (Improved method) 146 Lots of Bedding, Clothing, &c., disinfected by Steam 110 Public school rooms, lavatories, &c., disinfected 2 Private school rooms, dormitories, lavatories, &c., disinfected 7 Disinfectant supplied (exclusive of supplies at the office) bots. 206 Number of dwellings inspected 380 Found more or less insanitary 320 (The large proportion of insanitary dwellings is accounted for by the fact that inspections, as a rule, followed complaints or private information). |
f679ea41-aee6-4a3c-a0e2-c0f4d381985c | House drains and sanitary fittings tested (dwellings) 130 Re-tested (these do not include the water testing of reconstructed drains) 42 House drains taken up and reconstructed 81 Ditto partially reconstructed or repaired 28 Visits to ascertain whether notices were being complied with, and to inspect sanitary work in progress 987 Soil pipes provided with ventilation 73 Intercepting traps and air inlets fixed 69 Soil pipes taken outside house walls 18 Scullery sink waste pipes disconnected from soil drains and made to discharge in the open air over trapped gullies 37 15 Rain water pipes disconnected from soil drain (dwellings) 30 Insanitary closets replaced by sanitary apparatus 84 New water waste preventers fixed for flushing closets 17 Defective roofs made good 12 Defective guttering replaced or repaired (dwellings) 40 Dilapidated walls, ceilings, &c. |
a6d716f8-5cfa-47c7-a263-773c870a5ca2 | cleansed and repaired (houses) 40 Complaints registered 135 Notices served (supplemented by letters & personal interviews with owners and agents) 317 School Inspections 25 ORDINARY NUISANCES ABATED. Smoke 4 Manure, offal, and other deposits 22 Choked drains 50 Overcrowding 24 Cellar flooding 6 Animals, poultry, &c. 12 Pig keeping suppressed 2 Dust bins provided 82 Other nuisances not included in the above 41 GENERAL INSPECTIONS. Bakehouses 26 Cowsheds, milk shops, and dairies 95 Slaughterhouses 140 Piggeries 182 Brickfields 14 16 ARTICLES OF FOOD CONDEMNED. 6 Trunks of Plaice 1 Trunk β Haddock 5 Kits β β 1 Case β Cod Fish 1 β β Pocket Fish 1 Trunk β Soles 2 Bushels β Whelks About 60-lbs. |
ed249ec6-2c0a-43e5-8f62-c5145f16d917 | of Butter β 70-lbs. β Cheese WILLIAM T. BOVEY, Sanitary Inspector. ' * β |
d45971bc-3ff1-48f0-ac6d-2a36be394f0b | BSX 1/18 A.R. 332 ACT 6 THE Urban District Council of Acton, ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR, 1898. by G. A. GARRY SIMPSON, M.R.C.S., L.S.A., Fellow of the Royal Institute of Public Health, Medical Officer of Health, Acton, W. ACTON: Printed by J. Knowles, 5 and 6, Market Place. 1899. THE Urban District Council of Acton. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR, 1898. by G. A. GARRY SIMPSON, M.R.C.S., L.S.A., Fellow of the Royal Institute of Public Health, Medical Officer of Health, Acton, IV. ACTON : Printed by J. Knowles, 5 and 6, Market Place. 1899. The Urban District Council of Acton. |
fd759902-4730-4487-aaa6-17db25df9393 | ANNUAL REPORT OF THE MEDICAL OFFICER for the year 1898. To the Chairman and Members of the Acton District Council. Gentlemen, The year 1898 was remarkable, from a meteorological point, for the persistent absence of rain, the mild conditions which generally prevailed when cold should have been experienced, and the phenomenal heat of September, which equalled the highest record of this century, viz. 92.1 shade temperature. During the quarter ending September 30th, the infant mortality was 124*2 per 1,000 registered births. The majority of deaths was due to causes which are recognised on all hands to be, in a measure, preventable; for they were practically restricted to the children of the poorer class and were largely due to parental ignorance and neglect of the laws of health and disease. |
ea155ccd-eadf-4164-85f7-bebe24c8dd21 | The question of educating the public as regards infant feeding and the ordinary rules of hygiene, wilt I trust, ere long be taken up in earnest by the Government and those responsible; for it is truly lamentable that one-fourth of the whole mortality in the British Isles is among children under one year of age. Our system of education should concern itself with teaching every scholar those ordinary principles of hygiene, which are of the first importance to the individual and the community, even to the sacrifice of other matter which is now taught. 4 The building trade has been very active during the year, and in these enlightened times, the strict supervision of the erection of dwellings is a matter of the highest importance, for a damp and badly built house is responsible for much suffering and often death. The Mr. Passmore Edwards Cottage Hospital was opened in May, and is doing most useful work. A Public Library and Fire Station are also in process of erection. |
eaa297de-1636-4548-8a78-bc29b2b65b8e | I am pleased that you purpose erecting a "Destructor Furnace" with as little delay as possible, and that the question of providing means for Isolating Infectious Cases will not be long in abeyance; both these matters are, as you know, of vital importance, especially now that the population is so rapidly increasing. I take this opportunity of strongly advising you to adopt the Housing of the Working Classes Act, 1890. Part I. of the Act enables you to deal with unhealthy areas. Part II., with unhealthy or obstructive buildings. I have dealt with the vital statistics under the various headings, and will only briefly allude to one or two points. With regard to the population, it will be noticed that I still adhere to the method adopted for many years, viz. |
b085e49b-5061-4d1f-a93d-7c2cb627cf0a | : to allow six persons for each occupied house; but the correct way to obtain a local census, is to allow six for each occupied house, and one for each unoccupied house, so as to allow for caretakers, &c.; by this means you get a better estimation of the population. In future, I would suggest this latter method. Our annual death rate is again satisfactory, as is also our birth rate. I am, Gentlemen, Your obedient servant, G. A. GARRY" SIMPSON. 5 POPULATION. In the middle of 1898, the number of inhabited houses was 5,427; allowing as usual six persons for every occupied house, the population is 32,562, an estimated increase of 930 compared with 1897. The following table shows the number of the population and the inhabitated houses at the four preceding censuses:β Year. Inhabited Houses. Population. 1861. |
be332ab6-b961-4e9e-8a5a-b266929f44b4 | 610 3,151 1871. 1,568 8,306 1881. 2,844 17,110 1891. 4,084 24,207 BIRTHS. The total number registered was 995 (475 boys, 520 girls). The birth-rate per 1,000 persons living was 30.5 The following table shows the births since 1890:β Year. Number of Births. 1890. 704 1891. 772 1892. 763 1893. 831 1894. 834 1895. 874 1896. 894 1897. 973 1898. 995 Birth-rate for London 29.5 per 1,000 persons living. MORTALITY. |
0a27f5da-2e09-4ef6-aaa9-f537838740be | General Mortality.β There were 507 deaths registered of parishioners who were resident in the Parish, and 10 of parishioners who died in Public Institutions outside the Parish, making a total of 517 deaths. 6 The recorded general death-rate is therefore 15.8 per 1,000, as against 15.9 in 1897. The London death-rate was 18.7 per 1,000 living. This ordinary death-rate cannot be taken as a true index of the healthiness of the Parish, nor can it be justly compared with other sanitary districts, unless some allowance is made for the relative proportions of males and females at different ages in the districts compared. Death-rates vary according to the nature of the population of the respective districts; for instance, in a district containing a large number of very young or very old people, the death-rate would be considerably higher than in a district consisting of middle-aged people. |
82312f6b-a7b7-4787-b723-ef8287a1db41 | Thus in this country the mean annual death-rate is as follows:β Males. Females. Under 5 years of age 68.1 58.1 10 to 15 β 3.7 3.7 25 β 35 β 9.3 8.6 35 β 45 β 13.7 11.6 45 β 55 β 20.0 14.6 Over 75 β 169.1 155.8 It will thus be seen that the death-rates of different districts cannot be compared with one another, unless they are reduced to a common standard. What preventive measures against disease have achieved during the last 50 years, despite the increased strain of the struggle for existence, is shown from a consideration of the difference in the average number of years lived by each individual. |
f49b16d0-871e-4ca6-9aa4-bd353cbe12bb | From 1838 to 1854 the average lifetime was 39.9 years for males and 41.9 for females (Farr); from 1871-80, it was 41.4 years for males and 44.6 for females (Ogle); and from 1881-90, it was 43.7 years for males and 47.2 for females (Tatham). 7 The following table shows the various ages at which death occurred in the district:β Under 1 year 181 Under 5 268 1 year and under 5 87 5 years and under 15 11 Over 5 239 15 β β 25 11 25 β β 65 116 65 β and upwards 101 507 507 The following table compares the death-rate of children under one year per 1,000 registered births, and the birth-rate for the last twelve years:β Birth-rate per Thousand. Deaths of Children under 1 year. |
4a46113b-8366-4f76-9fd2-4ccb6227ba23 | Per Thousand Registered Births. 1887. 28.7 147 1888. 31.1 182 1889. 34.1 175 1890. 28.3 151 1891. 30.8 146 1892. 30.5 185 1893. 31.9 192.5 1894. 30.2 160.6 1895. 31.6 168.1 1896. 30.3 168.9 1897. 30.7 198.3 1898. 30.5 181.9 8 It will thus be apparent that our infant mortality, though high, is an improvement on the previous year. I have frequently alluded to the causes of a high infant mortality, and I purpose drawing up a leaflet giving simple instructions with regard to infant feeding. |
12016523-adb6-42e9-940c-3154f0127cf8 | These leaflets will be supplied to the Registrar of the district who will give one to each person who registers a birth. In the latter part of the year a warning was issued to parents and guardians as to the dangers attending the use of "Condensed Separated" and "Condensed Skimmed" milks for the feeding of infants and young children. "Condensed Separated" milk is milk condensed after the fat has been separated by a centrifugal machine. "Condensed Skimmed" milk is milk condensed after the cream has been skimmed off. I may note here that Nestles Condensed Milk contains the whole of the original solid matter of the milk. The amended Infant Life Protection Bill came into force on the 1st of January, 1898. It is a matter of regret that the clause allowing a woman to receive one child for hire and reward without coming under the Act is still partially retained. |
04abac1a-782a-435e-8c62-1e20abae7968 | Those women who receive childrenβmostly illegitimateβand adopt them, one child at a time, for a sum down, do not come under the Act, providing they receive payment exceeding Β£20. Thus they are not affected by the provisions of the Act if they receive Β£20 and is. This is too small a price for the disposal of an illegitimate child to ensure that some women will not continue, by accepting one child at a time, to rid themselves of their charges by ill-feeding and exposure. ZYMOTIC DEATH-RATE. The total number of deaths registered from Zymotic diseases was 78. 9 The Zymotic death-rate for the year was 2.3 per 1,000 of the population. In the following table the death-rate and Zymotic death-rate are so arranged that comparison can be made for the last eleven years:β 1888. 1889 1890. 1891. 1892. 1893. 1894. |
d3040135-d0f1-4b57-9630-4e94e365a21b | 1895. 1896. 1897. 1898. Small Pox - - - - - - - - - - - Measles 1 25 11 9 24 2 15 6 24 2 6 Scarlet Fever 2 1 3 4 β 10 3 3 1 β 3 Diphtheria 2 8 7 2 4 2 5 5 8 28 8 Whooping Cough 9 13 3 6 25 5 17 5 21 β 10 Typhoid Fever β 1 1 β 3 4 2 2 2 2 β DiarrhΕa and Dysentery 10 12 18 24 34 60 17 44 37 80 50 Puerperal Fever - β β β 1 6 4 2 β β 1 Total number of deaths from seven Zymotic |
a6de7473-3def-4ddb-a4cc-0e53fb305563 | Diseases 24 60 43 45 91 89 63 67 93 130 78 Deaths from other causes 282 377 298 368 334 396 330 411 371 373 439 Total Deaths 306 437 341 413 425 486 393 478 464 503 517 Death-rate from seven Zymotic Diseases per thousand 1.9 2.8 1.9 1.8 3.6 3.4 2.2 2.4 3.1 4.1 2.3 Death-rate from other causes per thousand 12.9 16.1 12.0 15.3 13.4 15.2 12 14.8 12.6 11.8 13.5 General deathrate per thousand 13.99 18.9 13.9 17.1 17 18.6 14.2 17. |
4171ebb7-d1e0-4011-95a9-77779a71af18 | 2 15.7 15.9 15.8 In London the Zymotic death-rate was 278 per 1,000. 10 NOTIFICATION OF INFECTIOUS DISEASES. There were 234 notified, as against 221 in 1896. The following table gives the number reported each year since the Act came into force:β 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. 1898. |
18ced648-3fa1-4c9a-ab6a-3c84a13ca87c | Small Pox β β 13 7 2 β β β β Scarlet Fever 108 63 74 192 86 67 193 93 167 Diphtheria 14 8 27 41 22 32 23 89 35 Membranous Croup 4 β 13 1 β β β 4 β Typhoid Fever 13 13 15 19 15 28 14 10 9 Continued Fever β - β 1 β β β β β Puerperal Fever 1 β 1 2 1 3 3 β 1 Erysipelas 22 18 37 77 41 31 26 25 22 162 102 180 340 167 161 259 221 234 SMALL-POX. No cases have been notified since 1894, and no deaths have occurred during the last fourteen years. |
57dda64a-7aeb-48dc-8b3f-5acf6d49cc4a | "The Conscience Clause" has practically reduced the Vaccination Act to a dead letter, and many foresee a revival of the terrible scourge of small-pox. The opinions arrived at by the majority of the Royal Commission on vaccination I have summarised in the form of questions and answers:β Q. Has small-pox diminished since the introduction of vaccination ? A. Yes! Q. In those households attacked, does the disease differentiate between the vaccinated and the unvaccinated members? A. Yes ! The vaccinated escaped and the unvaccinated suffered out of all proportion to their respective numbers. 11 Q. In an affected community, does small-pox make the same differentiation as in infected households ? A. Yes! Q. Are those classes who are re-vaccinated, i.e., postmen, policemen, nurses, specially protected as compared with the rest of the community? A. Yes! |
2f62e9ad-2e1e-48fd-b77e-23e71e995ae4 | Q. Small-pox in pre-vaccination days claimed 80 per cent, of its victims among children, but since infantile vaccination was inaugurated, has the mortality been very largely transferred to the latter periods of lifeβwhen the protective power of infant vaccination has largely worn out ? A. Yes! Q. Among those attacked, do those who have been vaccinated have milder attacks and furnish fewer deaths than those who have not been vaccinated? A. Yes! Q. Does vaccination, properly performed, afford greater protection from small-poxthan vaccination insufficiently or ill-performed? A. Yes! The above report constitutes a tower of evidence which is quite impregnable. Writing to me on the subject, one of our greatest Sanitarians says: "No eloquence of mine will make those believe in vaccination who resolutely refuse to listen to argument. |
9c43d2b8-c1ec-4577-a934-e4202c3ff9c1 | They wilfully shut their ears or misuse their understandings, and nothing short of an epidemic of Smallpox will cause them to recognise facts as they really are." SCARLET FEVER. One hundred and sixty seven cases were notified during the year. The seasonal curve of comparative prevalence was at its minimum in March, and maximum in October, when it assumed an epidemic 12 form. I made frequent visits to the schools in the district, and received valuable help from Mr. Bovev and the School Board Officers, Messrs. Lambert and Shute. HOW THE DISEASE IS SPREAD. 1. Sometimes the disease is kept a secret, no Medical Practitioner being called in. 2. The disease may be so mild as to escape the notice of the relatives, and their attention is only called to the child when desquammation has set in. 3. |
f52a9b2c-c3f7-48ae-9110-c2f29bebcc80 | Ignorance of the parents as to the nature of the illness and neglect to call in medical advice. 4. In three or four instances children were found peeling freely and playing in the streets with other children, and in one case a child had been sent to Sunday School peeling freely. On being censured the parents invariably pleaded ignorance as to the nature of the illness. 5. Return Cases.βDuring the year there were good grounds for belief that the infection in two instances was communicated by patients who had been'recently discharged as free from infection, from the Willesden Isolation Hospital. This is a rare occurrence, for every possible effort, in my belief, is taken to prevent it, but the circumstance is worthy of note by parishioners, who will always do well to isolate children for at least a few days after their return home. |
22e100ea-73e3-40ca-8076-f9797ec9a2b0 | In my report of November, 1898, to the Council on these return cases, I mentioned that possibly the micro-organism that caused the disease might remain in the throats of the patients after apparent convalescence. The following is Dr. Klein's report to the Local Government Board, which I have copied from the British Medical Journal of January 21st, 1899 " Microbes Association with Scarlatina.βDr. Klein makes a further report on the streptococcus, named S. scarlatinas or conglomeratus, isolated by him from the throat and nasal discharge of patients suffering from scarlatina. It is not found in the desquammating skin, urine, or aural discharge. Dr. Klein expresses the opinion that it is the persistence of this organism in the throat of patients discharged as cured which gives rise to the 'return cases.' |
7dd3f509-110f-4516-95ed-685fd00806c7 | " 13 Some people regard Scarlatina as a disease which does not demand the same strict precautions against spread as Scarlet Fever; and many parishioners have expressed great surprise on being informed that Scarlatina is essentially Scarlet Fever of a mild type. It would be a gain if all medical practitioners referred to all such cases, not as Scarlatina but as mild attacks of Scarlet Fever. DIPHTHERIA & MEMBRANOUS CROUP. Thirty five cases were notified, and eight deaths were recorded. As to the efficacy of Diphtheria Antitoxin, good reports upon its employment come from all parts of the globe, but, unfortunately, the remedy is too generally used as a "dernier resort." In the latter part of the year I forwarded the following circular letter to the practitioners in the district:β 9th December, 1898. |
40849a67-2d01-4d47-8d82-373057345ec8 | Dear Doctor, I am pleased to inform you that I have made arrangements with the Jenner Institute of Preventive Medicine to keep me supplied with Diphtheria Antitoxin, which will enable me to let you have the same at any hour of the day or night. I also keep by me a special Syringe recommended by the Institute with full directions as to its use, and the dose recommended. I need not remind you of the satisfactory results that are obtained by the early use of Diphtheria Antitoxin, and I feel sure this arrangement will meet with your hearty approval. The cost of the Antitoxin will be 2/6 for 2000 units. Believe me, Yours faithfully, G. A. GARRY SIMPSON, Medical Officer of Health, Acton. 14 Five cases that were notified as Diphtheria, turned out to be cases of Ulcerated sore-throat caused by slight escapes of coal gas from defective pipes and burners. |
fa4efdb6-ab12-4a50-92b2-7fa2767718cb | MEASLES. Measles becomes epidemic every two years, and 1898 followed the rule, but we had few deaths compared with previous epidemic years, and there can be no doubt of the value of the leaflet which I distribute in the spring and autumn. TYPHOID FEVER. Nine cases were notified, but no deaths occurred. Typhoid is generally conveyed by water or milk, and, when there is already a case in the house, by infected hands, linen and food. In almost all the cases notified insanitary conditions were found, but we must not conclude haphazardly, that insanitary defects are the actual cause of the disease. Sewer gas produces a lowered state of vitality, and renders the inmates more prone to disease in almost any form. The Bacillus Typhosus must be either inhaled with specifically infected sewer air, or swallowed in food or drink. |
d35c037b-ac65-4b0b-8a9e-524cbfc29046 | I have made arrangements to apply Widal's Typhoid Serum Reaction, to assist the diagnosis of any doubtful cases. PHTHISIS. Under the above heading I have included all the deaths due to Tubercle Bacilli, and they number 48. About one half were registered as Tabes Mesenterica or Consumption of the Bowels, the remaining cases were due to Tuberculosis of the Lungs and Tubercular Meningitis. The year 1898 will ever be remembered for the inauguration of the National Society for the Prevention of Consumption and other forms of Tuberculosis. The object of the Society is to educate the Public that Tuberculosis is a preventible disease, and to establish Open 15 Air Sanatoria for the Treatment of Patients. It is now clear that Tuberculosis is due to neglect of the simplest sanitary precautions. The idea that Consumption is an inherited disease and could not be escaped, has now been disposed of. |
812d3774-9921-49e1-a90e-e2581f82f582 | Persons may inherit a certain delicacy of constitution, and cultivate it further by all sorts of insanitary living, sins against hygiene and the like. The chief predisposing causes are those that lower the vitality of the individual, such as bad air (consequent on overcrowding), damp dwellings, insufficient food, and intemperance. The immediate or existing cause is the Tubercle Bacillus, which can only be obtained from some other human being or beast affected by Tuberculosis. This Bacillus may gain an entrance into the body by being inhaled with dust, or by being swallowed with food and drink. From 30 to 40 per cent, of cows suffer from Tuberculosis, so that unboiled milk is the chief offender, and infants and young children frequently get Tubercular Disease of the glands of the Intestines. The measures required for the Prevention of Tuberculosis, are:β I.βBy Individuals. (a.) |
0eb9b804-5700-4cf4-90e3-29d8ffd482d1 | The careful disinfection of all expectoration from a consumptive patient. (b.) The disinfection of all milk consumed as food, by boiling, or by " Pasteurisation," viz.: heating the milk in a special apparatus to a temperature of 158 deg. F, keeping at that temperature for 30 minutes, and rapidly cooling. (c.) Choice of a house, which should be situated on pure, dry, and well-drained soil. II.βBy Local Sanitary Authorities. (a.) Control of buildings, especially with regard to site, soil, subsoil, drainage, dryness, cubic space, &c. (b.) Prevention of overcrowding. (c.) Notification of Tuberculous Disease. 16 (d.) Disinfection of rooms, houses, and of clothing, bedding, &c., which have been used by consumptive patients. (e.) |
9f8c9db3-8413-4ca5-b4a8-1bd4536040fe | Registration of all cow-sheds, milk-shops, dairies, &c., with regulations as to site, space, lighting, ventilation and cleanliness. (f.) Systematic inspection of all cow-sheds, dairies and milk shops, by competent inspectors. (g.) Exclusion and isolation of all animals affected with Tuberculosis, by the "Tuberculin Test. (The "Tuberculin Test" can be easily applied by Veterinary Surgeons. It is made by the injection of a small quantity of "Tuberculin" into an animal, and a rise of temperature from three to nine degrees would prove the animal was affected with Tuberculosis.) (h.) Construction of public slaughter houses, in which all animals shall be inspected before and after slaughter. HOSPITAL ISOLATION. The following patients were admitted into the Willesden Isolation Hospital during the year:β Name. Admitted. Discharged. Died. Disease. |
090ed6da-0ce5-489a-9327-d0b375736a5c | A. F. C. Jan. 29, 1898 Jan. 30. Diphtheria. J. N. Mar. 8, β Mar. 9. Diphtheria. C. S. B. April 6, ,, June 10. Scarlet Fever E. M. S. June 15, β Sept. 1. β M. C. β 21, ,, Aug. 18. β G. W. July 16, β Sept. 8. β c. s. Sept. 6, β Dec. 22. β F. E. S. β 6, β Nov. 24. β W. F. β 18, β ,, 24. (sent to Stanmore.) β J.W. Oct. 14, β β 24. β E. W. β 14 β β 24. β D. F. |
478e332a-d991-4eaf-ad04-22d935de4816 | β 28 β Dec. 29. β 17 SANITARY WORK PERFORMED DURING THE YEAR. As will be seen by Mr. Bovey's Report, a great deal of sanitary work has been performed during the year 1898. I personally visited the dairies and cow-sheds, and distributed a leaflet, showing the legal responsibilities of cow-keepers, dairymen, &c. WATER SUPPLY. I have, from time to time, made an analysis of the water supply, which I have always found satisfactory. I should be pleased if householders would take their water from a draw-off tap straight from the rising main. Cisterns should only be used in case of the water being on the intermittent system. SICK NURSING. The importance of good nursing in the treatment of disease can scarcely be exaggerated, and a great and good work has been done by the two district nurses connected with the Cottage Hospital. |
c1f302da-8908-42f3-a9be-4a7d314662b6 | During the five months that the hospital has been opened they have nursed no surgical and 64 medical, making a total of 174 cases. Nurse Dawkins has been most assiduous in her duties. The following is a summary of her work during the year:β Cases Nursed.-Diphtheria 6 Scarlet Fever 19 Typhoid 1 26 Visits paid to Diphtheria and Scarlet Fever cases, 46. Patients taken to Hospital, 5. The following is the ANNUAL REPORT of the SANITARY INSPECTOR, For the Year ending December 31st, 1898, By WILLIAM T. BOVEY. 19 Sanitary Inspector's Report for the year ending, 1898. |
ede28237-86f9-4f76-935a-0f92c174f7d2 | A brief review of the sanitary work accomplished in the Acton district during the past year, indubitably demonstrates that genuine progress has been the undeviating rule, which, in the aggregate, amounts to an important sum; and it is interesting to note the ameliorative influence that keeps pace with improved sanitation, as is evidenced by the gradual reduction of intensity in zymotic diseases. Much however remains to be done. "War to the knife" has yet to be declared against damp, dirt, and overcrowding; as this trio of health destructors might fairly be accredited with a large proportion of the tuberculous and kindred diseases which swell our annual death-roll. The Sanitary Inspector, were he an Hercules, would fail to clear his districts of the Augean evils, as long as the public maintain a position of carelessness or apathy. |
a8b8f848-a52d-4f3f-b7a6-25d459a61b0e | Happily there are signs in our social horizon of an early awakening; when public opinion is aroused, a solution of the difficult problem how the evils of damp, dirty, and overcrowded dwellings may be dealt with, and abolished, will doubtless be discovered. INFECTIOUS DISEASES. Visits to ensure continued isolation 644 Beds, Bedding, &c., disinfected by steam 82 Rooms, &c., disinfected by fumigation (improved method) 123 Disinfectants supplied (exclusive of supplies from the office) bots. 452 HOUSE INSPECTIONS. Number of dwellings inspected 214 Found more or less insanitary 188 (Inspections as a rule followed complaints only) House drains and Sanitary fittings tested 93 Ditto retested 24 (These do not enclude the water testing of reconstructed drains) House drains taken up and reconstructed 77 Ditto partially reconstructed 41 Visits to ascertain whether notices were being complied with, |
27e82624-c140-4c14-96a1-9ebb9542dbcd | and to inspect work in progress 542 Soil pipes provided with ventilation 34 Intercepting traps and air inlets fixed 31 20 Soil pipes taken outside house-walls 4 Scullery sink waste pipes disconnected from soil drains and made to discharge in the open air over trapped gullies 37 Rain water pipes disconnected from soil drains (dwellings) 18 Insanitary closets replaced by sanitary apparatus 56 Waste preventors provided or made good 32 Defective roofs made watertight 9 Inspection chambers constructed 41 Defective guttering repaired or replaced (dwellings) 7 Dilapidated walls, ceilings, &c. cleansed and repaired (houses) 13 Dwellings permanently closed (unfit for habitation) 6 Complaints registered 128 Notices served (supplemented by personal interviews with owners and their agents, also by letters) 148 Damp courses added to house-walls (dwellings) 7 ORDINARY NUISANCES ABATED. |
227d3c4a-50b6-4e36-b349-a7312d117d01 | Smoke 7 Manure, offal, and other filth deposits 34 Choked drains 45 Overcrowding 8 Cellar flooding 3 Animals, Poultry, &c., 22 Dust bins 9 Cesspools abolished 3 Waste gully inlets raised above ground level (dwellings) 6 Other nuisances not included with the above 44 GENERAL INSPECTIONS. Schools 8 Bakehouses 42 Cowsheds, milkshops and dairies 89 Slaughter houses 97 Piggeries 115 Dust shoot in contractor's brickfield 33 Stabling 53 ARTICLES OF FOOD CONDEMNED. 4 Trunks Skate 2 Cases " Kipper Herrings " 3 Trunks Haddock. 2 β Hake. WILLIAM T. BOVEY, Sanitary Inspector |
66d116c4-24a1-4459-8017-380b7a26ead8 | ACT7 THE Urban District Council of Acton. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1899. BY G. A. GARRY SIMPSON, M.R.C.S., L.S.A, Fellow of the Royal Institute of Public Health, Medical Officer of Health, Acton, W. ACTON: Printed by J. Knowles, 5 and 6, Marker Place 1900 THE Urban District Council of Acton. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 1899. by G. A. GARRY SIMPSON, M.RC.S., L.S.A., Fellow of the Royal Institute of Public Health, Medical Officer of Health, Acton, W. ACTON: Printed by J. Knowles, 5 and 6, Market Place. 1900. The urban District Council of Action. ANNUAL REPORT OF THE MEDICAL OFFICER for the year 1899. |
2452bdc6-6fe5-4093-a968-87303d243d63 | To the Chairman and Members of the Acton District Council. Gentlemen, MANY measures of sanitary importance have occupied your attention during the year. The Plans for the Isolation Hospital have been forwarded to the Local Government Board for approval, so there is a reasonable hope that this much needed Institution will soon be in evidence. Permission to raise a loan for the erection of a Destructor Furnace has been granted. A New Mortuary is shortly to be built. Several Dust Carts and Waggons have been purchased. The carts are tipped by mechanical means, are covered with special covers of iron and have a capacity of 3 cubic yards for carts and 3Β½ cubic yards for the waggons. The carts are of very great improvement on the old ones used by the late contractor, and will be a means of improving the health of the district. The question of building dwellings for the working classes has also been discussed. |
9447f88a-802e-4795-967d-0741157a311c | 4 I regret that forty-six cases of Enteric Fever were reported during the year, but one must not lose sight of the fact that Enteric Fever was generally universal, and that instances are recorded of outbreaks after a hot and dry summer followed by much rain, both of which climatic conditions we experienced. In this report I have fully discussed the disease, and the measures which should be employed to prevent it. I am pleased to again record a lowered Death Rate, which when we consider the large Infant population, is satisfactory. I am, Gentlemen, Your obedient servant, G. A. GARRY SIMPSON. s POPULATION. The number of occupied houses in the Parish in the middle of 1899 amounted to 5,614, and the number of occupants to each house averaged about six; the population estimated in this way would be 33.684. The above computation is about correct, and is selected in this report for the purpose of drawing out the mortality-rates of the Parish. |
d606a2f4-d3b1-423f-b3e5-3eefe96d2a06 | The following table shows the number of the population and inhabited houses at the four preceding censusefs;β Year. Inhabited Houses. Population. 1861. 610 3.151 1871. 1,568 8,306 1881. 2,844 17,110 1891. 4,084 24,207 The number of the population and inhabited houses since 1896. Year Inhabited Houses. Population. 1896. 4,909 29,454 1897. 5,272 32,632 1898 5,427 32,562 1899. 5,614 33,684 The natural increase of population by excess of births over deaths during the year, amounted to 459, as against 488 in the preceding year, and 470 in 1897. BIRTHS. |
68584c0c-7f61-4933-937e-a4b3e3644305 | During the year 1899 there were 1,068 births registered in the Parish: of these 535 were males, and 533 were females. The birthrate per 1,000 persons living was therefore 317. 6 The following table shows the Births since 1890:β Year. Number of Births. 1890. 704 1891. 772 1892. 763 1893. 831 1894. 834 1895. 874 1896. 894 1897. 973 1898. 995 1899. 1,068 Birth-rate for London 29.4 per 1,000 persons living. MORTALITY. General Mortality.βThere were 509 deaths registered. The recorded general death rate is therefore 15.1 per 1,000, as against i5.8 in 1898 and i5.9 in 1897. |
b4088768-56d7-49cf-b8d1-d07b5d597d5d | The London death-rate was 19.8 per 1,000 living. Death-rates vary according to the nature of the population of the respective districts; for instance, in a district containing a large number of very young or very old people, the death-rate would be considerably higher than in a district consisting of middle-aged people. Taking into consideration the number of children in the parish, we have in comparison with other districts a low death-rate. Senile Mortalityβ Of the 509 deaths 91 were of persons over 65 years of age, 36 over 70 years of age, 16 over 80 years, and 3 over 90 years. The mean age at death of 56 Inhabitants was 78 years. These figures denote an exceptionally high proportion of deaths from Senile decay. |
3abade57-4baa-4b0c-a548-b197096e3b9c | 7 Infantile MortalityβThere were 200 deaths registered of Infants under 1 year of age, as against 1,068 births; the proportion which the deaths under 1 year of age bear to 1,000 births is, therefore, 187.2 as against 181.9 in the preceding year. Prior to the commencement of the fourth quarter of 1899, the deaths of children under one year were below the average for the preceding year, but the mortality from diarrhΕa caused an unexpected rise. Summer diarrhoea must be thought of as something quite apart from the diarrhoea which figures as a cause of death all the year round. There are sufficient reasons for believing that the essential cause of the complaint resides in the soil, from which it issues under favourable meteorological conditions (more especially of temperature) to gain access to air, water, and food. It is especially important, therefore, in the summer months to take every possible means of ensuring the freedom of these necessities of life from contamination. |
af53b6b1-72c4-4509-ae87-69e606a07569 | Infants fed artificially for the first nine months of life, suffer much more from the complaint than those fed naturally from the mother's breast, and where such artificial feeding is necessary, very much mortality would be prevented if parents would give nothing but well boiled diluted cows' milk for the first nine months of life, and by keeping all milk vessels and feeding bottles scrupulously clean. For the neglect of these simple precautions, the infants of these islands alone are paying a yearly toll of many thousands of deaths. An increasing and distinctly preventable cause of Infantile Mortality is from overlaying or from suffocation in bed. I am pleased to state that no inquests were held during the year on "overlaid "children, which is a record for this parish as far as I can ascertain. The Coroner writes to me "They used to be of frequent occurrence, and never a year has passed without 3 or 4 such cases." |
6dea45cc-3904-4a54-844a-df79199a7411 | In England the number of deaths from overlaying steadily increases, the highest on record being (or 1896, when they reached 1,941; of these 1,740 were under one year of age. Nearly every coroner, at all events in London, has lamented this increase, and has stated that the deaths were largely preventable. As they mainly take place on Saturday night (two to three times as many as on other nights), the stupefaction of drink must be held largely accountable for the mothers' carelessness; Monday is the next worst. The rate of deaths from suffocation in bed has steadily increased from 130 per million births in 1881 to 174 in 1890, and is now even higher than that. |
8deacb07-3b79-4c27-9657-015b65a0d576 | That this black list might easily be abolished is proved by the experience of Germany, where, though infantile mortality as a whole is high, this particular form of death has now been almost abolished, since it renders the parent liable to a fine; drunkenness being no excuse, as it is with us, for the child's death, but rather an aggravation. In AustroHungary also parents are forbidden to have infants in bed with themselves. In my health addresses I fully enter into the subject, and give simple instructions to the mothers, with so far very satisfactory results. MEANS EMPLOYED FOR LOWERING THE INFANT MORTALITY. (a) The following Leaflet is given to each person registering a birth, by the Registrar. THE DISTRICT COUNCIL OF ACTON. IMPORTANT ADVICE TO PARENTS. 1. For the first seven or eight months of life the Infants' Food should be restricted to Mother's Milk, which is the natural food. |
03a6ea83-ae85-45a2-8741-1fee7ab93264 | Starchy foods, such as Potatoes, Sago, Tapioca, Rice, Bread, Biscuits, &c., must on no account be given, as the juices for digesting them are not formed till the seventh or eighth month when the teeth begin to appear. 9 2. If the infant be brought up by hand, cow's milk, previously boiled and properly diluted should be given. For the first two months give twice as much water as milk. From two to three months give equal parts of milk and water. From three to six months give one third part water. Each bottle should be sweetened with a little sugar. 3. The amount of food to be given at each meal and the intervals between meals, should be as follows:- Age. Interval of Feeding. Average Amount at each Feeding. Average Amount in 24 hours. |
de7d5a26-8c9d-4599-bf08-5b85f0085f58 | 1st week 2 hours 1 ounce 10 ounces 1st to 6th week 2Β½ ,, 1Β½ to 2 β 12 to 16 β 6th to 12th week and possibly to 5 th or 6th month 3 ,, 3 to 4 ,, 18 to 24 β At 6 months 3 ,, 6 β 36 ,, At 10 months 3 ,, 8 β 40 β NoteβOne ounce is equal to two tablespoonfuls. 4. When eight month's old, a healthy baby may be allowed, in addition to the milk diet, a little boiled bread and milk, rusks soaked in milk, yolk of egg and milk, beef tea, mutton broth (Β½1b. of the meat to a pint of water), fine oatmeal, Mellin's or Benger's Food, Wheaten flour, Savory & Moore's Food, Allen & Hanbury's Food. |
3492ddc0-97f4-4029-a39b-616c727acc8c | Never give Wine, Beer, Spirits, Tea or Coffee, Cake or Sweets. 5. Condensed Milk is never so good for infants as fresh milk, but if it is used at all it must be Condensed Whole Milk. Never give 10 condensed milk to an infant from a tin which has the words "skimmed" or "separated" upon the label, for such milk has been robbed of nutriment, and a child cannot thrive on it, however much is taken. 6. Feeding bottles should be kept very clean, the best form is the boat shaped bottle with a short teat; don't use the bottle with a long india-rubber tube. Two bottles should be used alternately, they should be placed in boiling water after use along with the teat or tube attached to them. Neglect of this precaution is responsible for hundreds of deaths each year from Diarrhoea. 7. |
ea80f13a-10fa-411a-ba0e-b6edd6b0176c | A flannel bandage should be worn round the stomach and abdomeu next to the skin. The band should be sufficiently wide to cover the whole belly from the hips to the waist, and long enough to go twice round the body. 8. Healthy Infants should be taken into the fresh air whenever the weather permits. THE MEDICAL OFFICER OF HEALTH. B. The free distribution of leaflets on Measles, during the spring. I have now done this for three successive years, and for the first time on record there was not a single death attributed to this complaint. C. Health Lectures at Mothers' Meetings. I have been convinced for some years that the only way to lower Infant Mortality is by educating the Mothers by Leaflets and Health addresses on Infant Feeding and Home Hygiene. During 1899,1 gave nine lectures, and had an average attendance of 50 women to each lecture. At Christmas an examination was held, and prizes given to the three most successful candidates. |
79315db6-e85a-467a-b6c5-d06677fc6627 | I was most encouraged by the results of these addresses, and shall hope to continue them during the coming autumn and winter months. 11 The following table compares the death-rate of children under one year per 1,000 registered births, and the birth-rate for the last thirteen years:β Birth-rate per Thousand. Deaths of Children under 1 year. Per Thousand Registered Births. 1887. 287 147 1888. 31.1 182 1889. 34.1 175 1890. 28.3 151 1891. 30.8 146 1892. 30.5 185 1893. 31.9 192.5 1894. 30.2 160.6 1895. 31.6 168.1 1896. 30.3 168.9 1897. 30.7 198.3 1898. 30.5 181.9 1899. |
71d0d182-4f00-4cd6-884d-9a82f0f61cd8 | 31.7 187.2 The following table shows the various ages at which death occurred in the district:β Under 1 year 200 | Under 5 265 1 year and under 5 65 5 years and under 15 17 -Over 5 15 ,, ,, 25 22 25 ,, ,, 65 114 244 ) 65 ,, and upwards 91, 509 509 12 THE MORTUARY. During the year 22 bodies were deposited in the Public Mortuary; of these 14 were males and 8 were females. Post Mortem examinations were performed upon 14 of these cases, and 20 inquests held. The Zymotic death-rate for the year was 2.5 per 1,ooo of the population. In the following table the death-rate and Zymotic death-rate are so arranged that comparison can be made for the last twelve years:β 1888 1 1889 1890 1891 1892 1893 |
9ca9ee30-99e3-4e05-8633-97ab0296f8c6 | 1894 1895 1896 1897 1898 1899 Small Pox β β β β β β β β β β β β Measles 1 25 11 9 24 2 15 6 24 2 6 β Scarlet Fever 2 1 3 4 β 10 3 3 i β 3 2 Diptheria 2 8 7 2 4 2 5 5 8 28 8 7 Whooping Cough 9 13 3 6 25 5 17 5 21 β 10 14 Typhoid Fever β 1 1 β 3 4 2 2 2 2 β 7 Diarrhoea and Dysentery 10 12 18 24 34 60 17 44 37 80 50 56 Puerperal Fever β β β 1 6 4 2 β β 1 β Total number of deaths |
f80e5ea6-58b5-4507-a274-9885451e885d | from seven Zymotic Diseases 14 60 43 4S 91 89 63 67 93 130 78 86 Deaths from other causes J 282 377 298 368 334 396 330 411 370 373 439 423 Total Deaths 306 437 34 1 413 425 486 393 48 464 503 517 509 Death-rate from seven Zymotic Diseases per thousand 1.9 2.8 1.9 1.8 3.6 3.4 2.2 2.4 3.1 4.1 2.3 2.5 Death-rate from other causes per thousand 7 12.9 161 12.o 15.3 13.4 15.2 12 14.8 12.6 11.8 13.5 12.6 General death. |
3202d95b-63ae-40d7-8ad9-a106caa2e7e8 | rate per thousand 13.99 18.9 13.9 17.1 17 18.6 14.2 17.2 15.7 15.9 15.8 15.1 In London the Zymotic death-rate was 2.48 per 1,000. 13 INFECTIOUS DISEASES AND THE MEASURES TAKEN TO PREVENT THEIR SPREAD. It will be seen from the following table that 239 notification certificates of Infectious Illness were received from medical practitioners, as against 234 during the preceding year. In most instances disinfection was performed by the Sanitary Authority, and in other cases by the householders, to the satisfaction of their medical attendant. A visit was paid to every house; thus, apart from the measures that have been taken to prevent the spread of infectious illness, the notification of such illness was the means during the year of bringing about a sanitary inspection of various premises. |
60ed3108-3e45-48c5-bb9b-7affedb5bb04 | The following table gives the number reported each year since the Act came into force. 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 Small Pox β β 13 7 2 β β β β β Scarlet Fever 108 63 74 192 86 67 193 93 167 111 Diphtheria 14 8 27 41 22 32 23 89 35 49 Membranous Croup 4 β 13 1 β β β 4 β β Typhoid Fever 13 13 15 19 15 28 14 10 9 46 Continued Fever β β β 1 β β β β β β Puerperal Fever 1 β 1 2 1 3 3 β 1 β Erysipelas 22 18 37 77 41 31 26 25 22 31 162 102 180 |
130e1678-191c-4bce-b7af-e5e808d539ae | 340 167 161 259 221 234 239 DISINFECTION. The employment of sulphurous acid for the surface disinfection of rooms is still employed, but I take this opportunity of informing you that I shall shortly advise the use of Formic Aldehyde. There are no greater difficulties or inconveniences attending its use than those which apply to the use of Sulphurous Acid, and it possesses the great advantages that it is more certain in its disinfectant action and does not injure any article of furniture or ornamentation exposed to it. All bedding &c. is disinfected by super-heated steam as before. 14 HOSPITAL ISOLATION. The following patients were admitted into the Willesden Isolation Hospital during 1899:β NAME. ADMITTED. DISCHARGED. AMOUNT CHARGED FOR MAINTENANCE L. W. Jan. 27, 1899 Mar. 27, 1899 Β£ s. d. |
0fbb84ef-a96f-4162-bda3-279bae5ccbde | 26 ii 0 H. P. April 10, ,, June 1, β 23 8 0 F. S. May 25, ,, July 13, β 22 1 0 W. B. July 31, β Aug. 31. β 13 19 0 W. A. P. Sept. 13, β Nov. 2, β 22 10 0 G. P. Sept. 27, β Dec. 7, β 31 19 0 Β£140 8 0 In addition five patients suffering from Enteric Fever were treated in the Acton Cottage Hospital, four at the West London Hospital, Hammersmith, and one at Isleworth. One patient convalescent from Scarlet Fever was sent to the Mary Wardell Home, Stanmore, during the year. Four little patients were taken at a moment's notice to the West London Hospital, suffering from Diphtheria. Such cases as these give great anxiety. |
26b1db82-873e-43ab-b87d-5f12cfe0af8a | One is suddenly called, often late at night, to find a child dying from laryngeal obstruction due generally to Diphtheritic Membrane; to save the child's life the operation of Tracheotomy has to be performed without delay, yet to attempt the operation without skilled nursing and proper surroundings is fatal. The West London Hospital has kindly come to my aid, often opening a ward specially for the patient. Three patients recovered out of four on whom the operation of Tracheotomy was performed, although two had practically stopped breathing on arrival at the hospital. Cases such as the above point to the great want of an Infectious Hospital. 15 SICK NURSING. The importance of good nursing in the treatment of disease can scarcely be exaggerated, and a great work has been done by the nurses in connection with our Cottage Hospital. They have had under treatmen 265 patients and paid no less than 5,473 visits. |
0e5f2b6a-be26-4b85-9b15-49b008690db9 | Nurse Dawkins has paid 1,090 visits, nursed 18 cases of Scarlet Fever, 16 of Diphtheria, and 13 of Enteric. She has given out 609 bottles of disinfectant, and superintended the removal of 14 patients to various Hospitals. She has also in her spare moments delivered about 800 Leaflets on Measles and Infant Feeding, &c. SCARLET FEVER. One hundred and thirteen cases were notified against 167 in 1898. There were only two deaths. It is important that no children should be allowed to return to school for some little time after desquamation has ceased, as the micro-organism that causes the disease, remains in the throat sometime after apparent convalescence. DIPHTHERIA. Forty-nine cases were notified aganist 35 in 1898. There were seven deaths. |
e155d28f-2088-48c7-b713-655da1a89725 | Most of the Medical Practitioners avail themselves of the Diphtheria Antitoxine which I always keep ready for immediate use. The following statistics should convince the most sceptical as to the value of the Antitoxine treatment. MORTALITY STATISTICS OF THE CITY OF PARIS, from 1894 to 1898. 1894 1,008 deaths. 1895 Diphtheria Antitoxine used 423 β 1896 β β 454 β 1897 β β 301 β 1898 β β 255 β 16 The above figures justify the regular employment of antitoxine. Yet hundreds of poor children in London die of Diphtheria, who have never had the benefit of this remedy. The default is sometimes due to the fact that the medical practitioner is not convinced as to the value of the agent. There can be no gainsaying that the continued prevalence of this disease is determined to some extent by school attendance. The Medical Officer of Health (Mr. |
d10022ef-a14e-4f94-add9-d3a4b12b3b28 | Shirley Murphy), of the London County Council, has placed the matter upon a solid statistical foundation. He has shown that the increase in Diphtheria has mainly affected the ages 3β10, and that the relative increase of the mortality at the ages 3β10 commenced with the operations of the Elementary Education Act of 1870. The effect which the closing of the schools during vacation periods has in reducing the incidence of the disease is also susceptible of statistical demonstration. In view of these facts, and seeing the part schools play in the dissemination of other infections, the precautions taken in the interest of the scholars are in my opinion unsatisfactory. The Medical Officer of Health should be kept promptly posted up as to those who are absent through illness; he should possess the power of examining any scholar or scholars at any time when he has reason to think such action desirable in the public interest; and he should also have the power of arranging for a medical inspection of all the scholars, when he considers such a step advisable. |
8d429d65-2889-47e1-9a18-c5feb2781491 | Short of the adoption of these measures compulsory education will continue to be linked in some measure with compulsory disease. Medical Officers of Health have been for some time pressing for such powers, but they can only be granted by Act of Parliament. TYPHOID FEVER. The immunity which we have hitherto experienced from this disease was unfortunately broken during the year. 57 Forty-six cases were notified and there were seven deaths. As I have already fully reported the result of my investigations, I need not repeat the matter. A report also went to the Local Government Board. The Nature and Causes of Typhoid Fever. At the present time between 30,000 and 50,000 people suffer from typhoid fever every year, and between 5,000 and 6,000 people die from it in England and Wales alone. And yet typhoid fever is pre-eminently a preventable disease. |
5bee3448-d562-4d36-bd37-1ef504320236 | If we were to make full and proper use of the knowledge which we have gained with regard to the causes of typhoid fever, and the means of preventing it, we mightβin England and Walesβ save nearly 5,000 lives a year, and prevent the prolonged sickness and suffering of some 30,000 to 50,000 individuals. In fact, we might in time exterminate the disease altogether. Typhoid feverβaccording to our best Authoritiesβis caused by living creatures named typhoid bacilli: creatures so small that they can be seen only with the most powerful microscopes; so small that millions of them may be crowded together into a few drops of fluid, or a few grains of soil. From a patient suffering from typhoid fever the typhoid bacilli are given off in countless myriads; chiefly in the discharges from the bowels, but also in the urine. |
abdefe17-bf27-4353-86d8-75ab1b7cd09f | If these bacilli are allowed to find their way into the .surroundings or the food of manβsuch as the soil, or water or milk,β they can multiply with marvellous rapidity. If they, again, find entrance into the body of man they can multiply in the same way, and produce the disease which we know as typhoid or enteric fever. 18 Ways in which Typhoid Fever may be Conveyed. The bacilli may be conveyed from the patient to other individuals in various ways:β (1) Through the handling of the body, clothing, bedding, utensils, or other things which have been polluted with the discharges of the typhoid fever patient. (2) Through the air coming either from drains,cesspits and other deposits which have been contaminated with the discharges from typhoid fever patients, or from soil so contaminated. |
35b55428-61dc-4359-9568-683c3ce87246 | (3) Through ordinary food (especially drinking water and milk), which has been exposed to air contaminated in the ways mentioned above; or has been directly polluted by deposits, leaking cesspits, sewers, drains, &c., containing discharges from typhoid fever patients. The poison of typhoid fever is also sometimes conveyed through ices, and probably through watercress, and various other food materials which have been in contact with polluted water, and have not been cooked before being eaten. Prevention of Typhoid Fever. DUTIES OF THE NURSE. The honour and the responsibility of holding and guarding the first line of defence against invasion by typhoid fever belongs to our nurses. |
5d5e12e9-01bb-4fd4-ac58-1e623f92c21f | When the living typhoid bacilli, contained in the discharges and urine of a typhoid fever patient, have once been allowed to escape into the outer world it becomes almost impossible to detect them again, or to learn what becomes of them; whilst the difficulty of protecting human beings and their surroundings from them becomes increased to an incalculable extent. It is the duty of every nurse to recognise the great responsibility incurred in nursing a typhoid fever patient, to realise the power which she possesses, and to neglect 110 precaution by which she may kill the living poison before it can escape. 19 Difficulties of Thorough Disinfection. In the process of disinfection it must be remembered that the object is to destroy all traces of the living poison. When heat is applied as a disinfectant, every article of the poison should be heated to the required temperature. |
88ef36d4-41ea-4e62-86ed-1ed55176e660 | Consequently linen, or solids, or liquids containing any solid articles should be boiled for at least half an hour; since it takes some time to raise the temperature of every part of the linen or solid particle up to that of the boiling water. When disinfecting solutions are used, the solution must be of sufficient strength and must be applied for sufficient time to ensure complete destruction of all the living bacilli. For this reason it is necessary to soak infected linen for at least four hours in the disinfecting solution, since the solution does not penetrate the whole of the linen for a considerable time. For the same reason it is necessary to soak discharges from the bowel, containing even small particles, with the disinfecting solution for at least three hours before emptying these discharges into the drain. Any solid lumps in the discharges should be broken up and well mixed with the disinfecting solution : for which purpose two pieces of stick may be used ; and these pieces should be burnt immediately after being used. |
13446c49-715b-46c9-859c-ccb0160fe04a | Thorough disinfection of the hands is extremely difficult. It is not sufficient merely to dip them in disinfecting solution. In addition to this the hands, and more especially the spaces under the nails, must be thoroughly scrubbed with soap and water. TUBERCULOSIS. Forty deaths were attributed to Phthisis or Tuberculosis. This disease which causes the tremendous mortality of 60,000 per annnm in England and Wales is very largely preventable, and attention has been drawn to the urgent necessity which exists for adopting measures that are calculated to diminish this appalling waste of health and life and the misery and expense which it entails. 20 The expectoration of patients suffering from consumption is loaded with the germs of the disease, and when this dries it mingles with the dirt of the compartment, gets lifted up by air currents, and if inhaled by a susceptible individual he probably falls a victim to the complaint. Unboiled milk is another fertile source of Infection, as from 40-50 per cent. |
c128b4fc-b12b-452a-ba02-e9a74f456717 | of milk cows suffer from Consumption. In my annual report for 1898 I entered fully into the subject, but I take this opportunity of suggesting that the following measures be sanctioned by the District Council, with a view of preventing the spread of consumption through the infection derived from previous human sufferers. (1). That all the medical practitioners in Acton be informed that the District Council is prepared, on application, to disinfect (free of charge) all rooms which have been occupied by patients suffering from consumption immediately upon such rooms ceasing to be occupied. (2). That whenever a death from tubercular disease is certified in the parish a visit shall be paid to the house in which the death occurred and an offer made to disinfect free of cost. (3). |
5e890154-ddbf-4751-8a2b-8304766c7a5d | That handbills of information as to the nature of the disease, the ways in which it may be contracted, the necessity for the adoption of certain precautions, and the willingness of the District Council to undertake gratuitous disinfection, be sent to the ministers of religion, district visitors, school teachers, etc., with a request that they will circulate these as opportunites present themselves. MEASLES. There were no deaths from Measles during the year, which is a record according to these reports. 21 WATER SUPPLY An analysis of the water supply was made at regular intervals. DRAINAGE. Sewers laid during the year:β Park Road East about 187 yards. Park Road North β 120 β Osborne Road ,, 144 β Across Acton Green,, 133 β Several estates have been opened up, Roads formed and sewers laid, viz.: Acton Green Estate about 3,000 yards. |
2fed9d15-e574-4007-a532-0a42759ae192 | Brookfield Road β 300 β Esmond Road (extension) 450 ,, The following is the ANNUAL REPORT or the SANITARY INSPECTOR. For the Year ending December 31st, 1899 By WILLIAM T. BOVEY. 23 Sanitary inspector's Report for tHe pear ending, 1899. INFECTIOUS DISEASES. Visits to ensure isolation 376 Rooms, &c., disinfected by fumigation 120 Ditto Wards of the Cottage Hospital 4 Beds, Bedding, &c., disinfected by Steam (lots) 108 Disinfectants distributed in infectious cases go gallons Ditto Carbolized Oil in Scarlet Fever cases about 5 gallons INSPECTION OF DWELLINGS. Dwellings inspected on complaint 217 Found more or less insanitary 184 House drains tested 106 Ditto do. re-tested 66 HOUSE INSPECTIONS. |
ddaa43cc-e888-44c3-b43e-15471b752542 | Working Class Dwellings 236 More or less Insanitary 115 House drains taken up and re-constructed 54. Ditto partially re-constructed 70 Visits to ascertain whether Notices were being complied with, also to inspect work in progress 700 CONSTRUCTIVE SANITARY WORK. |
91786e80-3543-462e-addc-8381c44336f9 | Soil pipes provided with ventilation 33 Intercepting traps with air inlets fixed 11 Inspection chambers provided 40 Soil pipes taken outside house walls 6 Scullery sink waste pipes disconnected from soil drain 26 Bell and lip traps replaced by proper trapped gullies (dwellings) 15 Rain water down pipes discontinued from soil drains (dwellings) 18 Insanitary closets replaced by sanitary apparatus 62 Waste preventors provided or made good 25 Defective roofs made watertight 18 New cisterns provided 3 Defective guttering replaced or made good (dwellings) 9 Walls, ceilings, &c., cleansed or repaired (dwellings) 6 Yards, paved 15 24 FACTORIES AND WORK SHOP ACTS. Laundries, on complaint H.M. Inspector of Factories 43 Complaints registered 102 Notices served (supplemented by tetters, also personal interviews with owners or their representatives) 107 ORDINARY NUISANCES. |
819a3a69-c394-4c25-bd35-bd9f7eda0f6b | Smoke 9 Manure, offal and other filth deposits 30 Overcrowding 7 Cellar flooding 5 Animals, Poultry, &c. 9 Dust bins 8 Cesspools abolished 2 Stopped up House Drains 111 Gas escape in sleeping apartments (dwellings) 14 Other nuisances not included with the above 23 GENERAL INSPECTIONS. Schools 5 Bakehouses 34 Milk shops and dairies 37 (Found insanitary) 5 Slaughter houses 77 Piggeries 99 Stabling 37 Brickfields 10 Mineral Water Factory 3 ARTICLES OF FOOD CONDEMNED. Considerable quantity of diseased Beef. Several lots of tainted Beef and Pork. Large parcel of Tomatoes. 2 Trunks Codlings 1 Trunk Whiting 1 β Haddock 1 Barrel Skate 1 Trunk β Signed, WILLIAM T. BOVEY, Sanitary Inspector. |
ed652abe-e699-4537-8a34-eaff5c86ba67 | ACT 2 THE Urban District Council of Acton. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THF. YEAR 1900. BY G. A. GARRY SIMPSON, M.R.C.S., L.S.A. Fellcnv of the Royal Institute of Public Health, Medical Officer of Health, Acton, W. ACTON: Printed by J. Knowi.es, 5 and 6, Market Place. 1901. THE Urban District Council of Action. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the YEAR 900. BY G. A. GARRY SIMPSON, M.R.C.S., L.S.A., Fellow of the Royal Institute of Public Health, Medical Officer of Health, Acton, W. ACTON: Printed by J. Knowles, 5 and 6, Market Place. 1901. The Urban District Council of Action. |
5d0cf79b-d761-4b3c-b051-4a077c36c640 | ANNUAL REPORT OF THE MEDICAL OFFICER for the year 1900. To the Chairman and Members of the Acton District Council. Gentlemen, I beg to submit to you my Annual Report on the Health and Sanitary Condition of Acton during 1900. The population shows a marked increase compared with preceding years; and our death rate of 137 per 1,000 is remarkably low, taking into consideration the number of children resident in the district. The neighbourhood is being rapidly built upon, and new estates are being opened up; this, together with the improved method of locomotion by means of electricity will make Acton one of the most accessible and desirable suburbs of London. |
d42ccb3b-d677-4b9a-a1bf-5a70aa824c55 | The chief works of Sanitary interest during the year have been:β The experiments in connection with the Bacterial Treatment of our Sewage; the Building and Opening of a most perfect and up-to-date Mortuary; the determination of the Council to erect Baths; and preliminary arrangements have been made for the purchase of an 4 extensive and suitable site, on high ground North of the town, for our much needed Isolation Hospital. I am now, in conjunction with your surveyor, considering sketches for the construction of the same. A long-felt want has been supplied by the erection of sanitary conveniences for both sexes in the park. Similar arrangements are badly wanted in the centre of the town, and I trust this matter will soon engage your attention. I am pleased to state that the work of the Sanitary Department is being carried on in a satisfactory manner. I have received most valuable help from your Sanitary Inspector Mr. Kinch, and also from Nurse Dawkins, to both of whom I tender my sincere thanks. |
e8cfc25f-8b93-4a29-9e98-4c9455e188fb | I am, Gentlemen, Your obedient servant, G. A. GARRY SIMPSON. 5 POPULATION. Every year as we move onwards from the census of 1891 all vital calculations become more and more doubtful; but it is only a question of a few months, and we shall once more have a correct estimation of the population of Acton. Adopting the usual method of allowing six persons to each occupied house, the population is assumed to be 38,406. It will be interesting to see how far these figures coincide with the true census which will shortly be taken. The number of inhabited houses in the middle of 1900 was 6,401. The following table shows the number of the population and inhabited houses at the four preceding censuses:β Year. Inhabited Houses. Population. |
2c57b0b0-d8c3-464b-a4cf-5e74479090a3 | 1861 610 3,151 1871 1,568 8,306 1881 2,844 17,110 1891 4,084 24,207 The number of the population and inhabited houses since 1896. Year. Inhabited Houses. Population. 1896 4,909 29,454 1897 5,272 32,632 1898 5,427 32,562 1899 5,614 33,684 1900 6,401 38,406 The increase of population by excess of births over deaths during the year amounted to 552; as against 459 in the preceding year, and 488 in 1898. 6 BIRTHS. During the year 1900 there were 1,080 births registered: of these 542 were males, and 538 were females. The birth rate per 1,000 persons living was 28.1. |
8820a355-f430-44ae-bd72-7e12910045fe | The London birth rate was 28 6. The following table shows the births since 1890. Year. Number of Births. 1890 704 1891 772 1892 763 I893 831 1894 834 1895 874 1896 894 1897 973 1898 995 1899 1,068 1900 1,080 DEATHS. General Mortality.βThere were 528 deaths registered. The deaths comprised 237 males, and 291 females. The recorded general death-rate was 137 per 1000. The London death-rate was 18.3. The following table gives the causes of, and ages at, death during year 1900. 7 CAUSES OF, AND AGES AT, DEATH During Year 1900. Cuases of Death. deaths inwhole district at subjoined ages. deaths in localities (at all ages). |
684ce6f1-2366-473e-80c8-32f29d72a6a5 | Deaths in Public Institutions. All ages. Under 1 1and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards Acton South Acton Acton Green East Acton Bedford Park Willesden Measles 16 4 12 β β β β 8 7 1 β β β β Scarlet fever 6 1 3 2 β β β 4 2 β β β β β Whoopingcough 4 2 2 β β β β 2 2 β β β β β Diphtheria and membranous croup 4 β 3 1 β β β 2 1 β β 1 β β Fever:β Enteric 4 β β β 1 3 β β β 1 β β β 3 Continued 1 β β β β β 1 β β β β 1 β β Influenza 30 4 3 β 1 13 8 |
52b880d1-d203-4ab9-9253-b2f339122fbf | 14 10 2 1 1 1 1 Diarrhoea 50 40 8 β β β 2 19 18 11 β 2 β β Enteritis 8 7 β β β 1 β 1 6 β β 1 β β Puerperal fever 1 β β β β β β β β β β β β 1 Septic diseases 3 β β 1 β 2 β β β β β 1 β 2 Phthisis 25 1 β 1 3 19 1 14 2 5 2 β 2 β Other tubercular diseases 16 6 7 β β 2 β 7 4 3 1 β 1 β Cancer, malignant disease 31 β β β 1 18 12 16 4 5 2 2 2 β Bronchitis 59 23 10 1 β 9 16 21 18 14 β 4 |
9f1e5f64-654f-47af-a117-f0d42437a905 | 2 β Pneumonia 40 9 19 β 2 8 2 13 14 10 β 1 β 2 Pleurisy 1 1 β β β β β 1 β β β β β β Other diseases of Respiratory organs 1 β 1 β β β β β 1 β β β β β Alcoholism Cirrhosis of liver 5 β β β β 4 1 3 1 β 1 β β β Premature birth 20 20 β β β β β 8 8 3 β 1 β β Diseases and accidents of parturition 3 β β β 2 1 β 1 2 β β β β β Heart diseases 36 2 β 2 3 17 12 22 2 7 1 3 β 1 Accidents 8 4 β β 1 3 β 4 2 1 β β β 1 All other causes 156 58 15 5 |
bd6e2972-e458-4285-9821-b0ef554c6a0b | 2 35 4i 67 42 23 6 12 2 4 All causes 528 182 83 14 17 135 97 227 146 86 14 30 10 15 In the following table the death-rate and Zymotic death-rate are so arranged that comparison can be made for the last thirteen years:β 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 Small Pox β β β β β β β β β β β β β Measles 1 25 11 9 24 2 15 6 24 2 6 β 16 Scarlet Fever 2 1 3 4 β 10 3 3 1 β 3 2 6 Diphtheria 2 8 7 2 4 2 5 5 8 28 8 |
ae99345f-9180-4afd-a5d0-c6a146e88004 | 7 4 Whooping Cough 9 13 3 6 25 5 17 5 21 β 10 14 4 Typhoid Fever β 1 1 β 3 4 2 2 2 2 β 7 4 Diarrhoea and Dysentery 10 12 18 24 34 60 17 44 37 80 50 56 50 Puerperal Fever β β β β 1 6 4 2 β β 1 0 1 Total number of deaths from 7 Zymotic Diseases 24 60 43 45 91 89 63 67 93 130 78 86 85 Deaths from other causes 282 377 298 368 334 396 330 411 371 373 439 423 443 Total deaths 306 437 341 413 425 486 393 478 464 503 517 509 528 |
a1931998-7428-4b7d-8ef8-c7b5ad31606a | Death-rate from seven Zymotic Diseases per thousand |1.9 2.8 1.9 1.8 3.6 3.4 2.2 2.4 3.1 4.1 2.3 2.5 2.2 Death-rate from other causes per thousand 12.9 i6.1 12.0 15.3 13.4 I5.2 12 14.8 I2.6 11.8 13.5 12.6 11.5 General Death-rate per thousand 13.99 18.9 13.9 17.1 17 18.6 14.2 17.2 15.7 15.9 15.8 15.1 13.7 In London the Zymotic Death-rate was 2.19 per 1,000. |
cd0e50ca-d4d5-43b3-8fc4-52e21d4ba7cb | 9 Infantile Mortality.βThere were 182 deaths registered of Infants under 1 year of age as against 1,080 births; the proportion which the deaths under 1 year of age bear to 1,000 births is therefore 168.5, as against i87.2 in the preceding year. The following table compares the death-rate of children under one year per 1,000 registered births, and the birth-rate for the last fourteen years:β Birth-rate per Thousand. Deaths of Children under 1 year. Per Thousand Registered Birth. |