BOARD FO HEALTH.

Press, Volume XXXVIII, Issue 5324, 21 October 1882, Page 2

BOA RD FO HEALTH.

BonflM iiutbiu kill ffilttiti iftMui at 3 o'elocfc- Present —VT. Vincent (chMrmml, Messrs W. White, J. B. Parker, and W. V. Hnbbard. The report of the medical offiear (Dr. Nedwill) wee read aa follow* : — Cbristohuroh, October , 1883. Sir,—l hate the honor to submit to you my report on the health, of the district for the quarter «n'iJTig September 30th. ... The following are the number of oases of »fections diseases reported for the toe months •- Christdinrch... 3 ~ 17 l< 4 Sydenham ... 8 10 SI Atoj. « 4 * O Seathcote ... O 8 1* • Biocsrton ... 0 0 0 0 Bpreydon ...' 1 I 1 ft SkAlbans ... jtt M _c Jt 7 00 43 10=119 land aooordisg to the months ttwyware distributed th.ua:— *~ Trphold XHph- Somrlet Ferer. therU.r'eTOT. Measles. July 0 15 23 5 Aognst 4 IS 10 2 September ... 3 S3 9 S The numbers reported fox the oorrespoßding , three months oUBBI were—

Typhoid Fever. Diphtheria. Scarlet Fever. Measles. 43 14 a iia . The mortality within the city was per 1000 of the population monthly—July, 0.70; August, 141} September, 1.47 ; and for the correapondißjr months of. 1881—tJoly, 1.58; Ansrast,. 1.05; 1.81. The mortality, in Sydenham wae—July, 0.79; August, 0.68: Septembor, 1.12; and for the oorreaponding period of last year—July, 1.18 j August, L 43; September. 2.24. ■ Zymotio diseases caused 80 deaths during the quarter: 8 from diphtheria; 5 in St. Albass, 1 in Sydenham, and, 3 iv. Christchur oh; I from typhoid fever in Sydeixham; a from diarrhoea, lin Heathoote and 1 in St. Albans; 1 from scarlet fever in St. Albani; 7 from erysipelas, 1 in Sydenham, 2in Heathcote, lin Spreydon, and 3- in the Christchurch Hospital'; tad 1 frem puerperal fever in Heathcote. ■

Judging from the number of deaths, reoorted from erysipelas this disease seems to have been far from afLoomUon in the district daring the quarter.' Its chief interest from a pnblio health point of view depends oa its having caused three deaths in the Christchuroh Hospital. Erysipelas in the wards of a fixed hospital is a yery serious thing., Thatjßich an'infeotifyiß disease should hive ocfffirred. itt the Christohujfoh Hospital hu probably arises from cases being received, which, in the absence of tin infections diseases hospital,' could not easily be refused admission. Vor some time it will require the strictest care on the part of the authorities to make their surgical wards safe for the treatment of open wotmds. . ■-.< ~ ■ - .On glancing over the statistics which I have furnished, it will be observed thai both scarlet fever and diphtheria have been mote than usually pssTalent during this qnaxter. The caees of scarlet lever have been confined to no particular part ol the district. That they have been of a very mild type ia evident from the fact that only on* death was registered as having oocorredfrom this disease, although forty-two cases were reported. .In many of the cases the disease was ascertained to hare been caused by -visitimr houses where it wae known that edarletfererexietOfL

It will be interesting to enquire into the cause of the increased number of cases of diphtheria which hare occurred daring the three months

under review. In. my report to the Board for the quarter ending Jane the 30th I stated that it was a ," feigniflcant fact that of 26 houses in St. Albans from whioh esses of diptheria have bean reported-only , 2 tot them, are connected with a sewer, 17 *r# Iα ■sreefs in which no aawer has bees laid, aad the remaining 7 houses are in streets. in which tiere -«b Hewers, but the owners have not connected:"' la other worde, bad in sanitary condition* were tlja enirounding circumstances. Bat I also stated that" the pnbho school was mainly responsible for disseminating the disease." Here the question occurs whether the emanations arising from the flltb. sodden ground belonging to the cottages in Si. Albana wonld not in ell probability predispose children to attacks from diphtheria when exposed to ite contagion in tha public school. At no less than 35 of the houses in the combined district from which diphtheria and scarlet fever have been reported neglect of common sanitary precautions was painfully noticeable—oossjite were not abolished, leaky pans allowed the boards of closets to be saturated with filth. -There were no

.house drains to carry slop water, or the drinking water was not protected from contaminationf from soakage. ' -The particular kind of nuisance which was disclosed in connection with, these cases of infectiona diseases differed somewhat according to the park *f the district. In Christchurch bad house drain-' age was the distinguishing feature, while in Sydenham, St. AihuTiM, and PhQlipstown, in addition to defective drainage,-there was the usual absence of proper closet aocommodatioa. Towards the latter end of the quarter diphtheria was reported from ten houses where obildren had been in attendance at the infant school on the South town belt. - . '

Fortunately the first cases -were promptly reported by the medical men in attendance, or there can be no doubt a very serious epidemic wonldhave been tke result. Only four cases were reported when I succeeded in getting tke school closed. At this early stage there could be no reasonable doubt that the school was the source from which the ' disease was being spread. Probably the first case came from a house in Martin street, a small street between Colombo and ! Manohoster streets, a locality where two years ago I\ found the back yard knee deep in water, and the occupants unable to reach the closet. On my recent visit to this house I found the yard damp and dirty and the closet filthy. At several of the other honees subsequently visited fcygienio conditions were at fault. The evidence, however, obtained at one house where matters sanitary were duly attended to pointed oleaily to the school aa the focva ef the mischief. A strong healthy child ' from a clean house had only joined the school a few days when it was taken ill. At another house I was informed that notwithstanding that ono child had been 111 in bed a week with diphtheria, two other children of this family ware still permitted to attend the school. On visiting the schiaol.l ascertained that it was not only badly ventilated, but, what was worse, that none of the windows had been made to open. I therefore advised that the school should be dosed, and that before it was again opened it should be thoroughly disinfected, and the windows so altered that it would be possible to get a current ef freak air to permeate the building. The precautions which were taken seem to have arrested the progress of the disease, bnt not, unfortunately, until five deaths were registered, the type of the complaint having been, evidently severe.

Schools are bo frequently the cause of spreading infectiona diseases, that grave responsibilities zest on committees and on sohoolmasters as well as on parents. The committees should see that their schools are"so constructed thai free ventilation can be secured, that cloak-rooms form no part of classroom*, and that they also be well ventilated. The schoolmasters should immediately, after school hours, open all the doors and windows, and thus produce strong currents ef air through every part of the buildings. They should satiety themselves as to the nature of any illness which aecessitatos the absence from school of any child, and they should be on their guard against admitting children excluded from other schools on account of infections sicknees. Parents should on no account send children te school from infected houses, for although not ill themselves, they may carry infection in their clothes. The~Bbara of Health, should try to make arrangements for notifying to priaripsJs of schools the occurrence of such cases, and it should see that disinfection is properly carried out. , -

Aβ Infections Diseases Hospital and proper disinfecting apparatus should be prorided with, the least delay possible. As to school vaccination, it appears that nothing short of * Tisitation of smallpox will be likely to move the Govenuneut. It is a most snomsJons I position for & Board of Health to occupy not to be able to ascertain the names of anvaccinated children attending the public schools in its district. The leg- J process to follow is so easy that one is astonished at the painfol backwardness of the authorities. AH that is necessary to be done is to instruct the public vaccinator to visit the schools without prerioas notice, so as to get the names of all anvaccinate-l .children In attendance, j This information l&ejbg secured, the public vaccinator or vaccination inspector should eerro notices oa the parents of such children to have Yaecination performed. If they fail to comply with the jprovisioas of the law they can then be summoned before * a magistrate. Should smallpox be introduced into the district grave responsibility will rest with the Government for having taken no action in this important matter. Aβ an instance of the delay which occurs in Weil' lington in sanitary matters, I would point out that more than twelve months ago, as the then pnblic vaccinator fox this district, I recommended the Government to forward to all public vaccinators in. Hew Zealand the instructions leaned by Mr Jobs Simon to public vaccinators in England. I was asked by Government to let them have a copy o? those instructions for circulation, but altkongh X complied with the request, I have never vet heard of the instructions being forwarded to public vaccinators.

I fear there is c gnat deal of misappretenaion in the district with regard to the intentions of the Board with reference to connection* with the sewers for disposioff of slop water and water closet dejecta. I trctri Ism right in assuming thai while the Board is, very properly, anxtoos to see noaae cocnectione made with the sewers tot carrying away filthy household water, it will sot permit any Dewon to use a wnter closet tmtfl he Batagflaa tha Drainage Board that he tea an nnfutTiwy gof&cigncy of water propetly tar fiasUnc; that hie water,otoiwlußQf oavof m ajpreTed ldad,lwt

ftsai la a proper place and w*n vntfUted, and that all pipee and traps are properly flashed and ventilated, and disconnected Don the main hooaa drain. To neglect those precautions •will certainly Iμ to bring discredit on tin system, andM endanger, tho public health. It appears to mc #P»' cleafc thatnatil an additional water supply» obtained the number of householders will be com#»rftti»ely •mall that canjrf&h safety bo peiffltfted t&tae t. c It is true tttßlifcnm aswers caafie flashed at anytime with theOßteefenwolls byiasrelr turning on tap*; bnt house draw; being <ia a much higher level In many porta otMa flashed by natural oTerflow roSa the arfeasiftns. C<JDBid«i> able caretnlne**.in,-TOijpping waster ot, considerable ffirtenaitnre for ildsia*. wftter bjr machinery to a nfefrw lerel, ma;f enable some to comply with the oonditions which It will be necessary to enforce; but both in Chriatchnrch and ita •ttbuibs the pan eyetem of eiciitttemoTel, with or without admixture of a disinfectant, such as dry earth or ashen, will hare to be, for years with lome, and perhaps for erer with others, the one on which they 4nust depend. ... .. It Iβ to be regretted tbat this eystem, even in Christchurch where it has been best, attended to, has been carried ont in a most barbsxona and dieyufftine fashion. The pans should have had close fitting lids to be used during removal, and when one pan wns removed another, perfectly dean, should hare token its place, Bnt eron wtuxont these precautions the system might have been rendered considerably less unhealthy and offensive if any attempt had been made to nee earth or ecreened ashea; whether in town or country, one or the other oould hare been easily proenred. The use of either would have prevented deooinpositioß (and consequently treqttently disease), would have removed offensiveness, and would hate Bared people from being cltssifled with those whom IST John Simon considers gnUty ot " otter boaetiality of neilect," One of the most common and Injurious nuisances which can exist in any community Iβ the hole dog Into!! Slftuui for ine WmAto Hie eotiooa luvre been eomplLoS. eioept «= fifteen instances. But altbooeh pans n&Te taVftn their place, the public nightman's work has not been increased.

The great argument In farorof the fpan system is that it admits of the frequency of romoTalctf deposited, excrement. If by neglect these pens am not emptied More decomposition sets in. the main object to be accomplished in bringing them into os 4 will not be gaioea. I» «» a"" ot isol**** l hOTiaoa with plots of ground, if earth or aahes are used in mc pang tl)o contents can eafely tie got rid of in'&taraena. ' I wonlcU hoverer. etronjjly re- . oommmd «ba£ i= »Tif tJiioVly popnliit«»iJiMfaoin « Sydenham, St. Albans, Woolston, and linweoo, it etould be made oomfalgory to employee public scavenger. Neither in Christohnrch nor in the wipuloob suburbs should houeeholclerabe permit? M to accumulate dost tin refuse. Ite remoTal wwuy also should be contracted for, and should not &> pend on the caprice of householders. In places where slops cannot be disposed of by connecting with s> sewer, instead of running them into a roadside ditch, or throwing them orer the ground *i back doors, where they create intolerable nuisances, they might be eaeUy conveyed into gardens trom boxes outside the house harm* sheet iron pipes to distribute them into holes. Aβ soon as one hole ia f nil it coald be covered with earth. Another Hole being then dug and the end of the pipe shifted. . ' . I see by the public papers that the qtteation hns arisen whether the Board has power to compel householders to dispose of their slops by oonnecting with a sewer. This Iβ a most important point, for the Board. If the Board has not this power it cannot possibly prevent many nuisances from arising, as the only way to abate them ie by eonnectinff. Bat it coald of course go on weefby week issuing , summonses until connections were made. As (he negotiations for altering the constitution of the Board of Health hare broken down I would suggest that the recommendations Which I made on the subject of appointing a chief inspector for the whole district should be carried out. One death from diphtheria jln Christchurou has recently been registered, bnt no report of the case has been forwarded to the Board. As the certifylog practititioner in this case has been repeatedly of late notifying to the Board the occurrence of infectious cases in his practice, I have little doubt "but that some satisfactory explanation can be giren of the omission. It has been represented to mc by a Cfcristohurch practitioner that in thee Tent of a case of infections sickness not having been reported by the medical man in attendance it would be well for the medical bffloer of the Board to ask from him an explanation before submitting his name to a publio report. This suggestion I mean to follow ia the future provided the Board appxWTes of it. . , Mr ferker said there wee oae matfezreferred to in fke report which deserved attention, and that was tho apatbetio way ia wbiohtheGevernment acted m regard to vawtsJation, Alter the last report of the medical officer tufl Board represented the matter to , the mejnber of the Goverament, who was at the Bead of the dejjartmenV concerned, tot' they had beea quietly snubbed a»d raoeived no e»Hsfaction, tta Gorernment simply stating that it Was too late in the session to bring in s jßillonthe anbjant He mo?ed—"Thivt the Gorwnmeafc Setentten to with reepict to TacclaaHoß ia Bchpola, Inqnlrißgwhat a etsps, if aay, have beea taken to esforee Tacclflation where ceeessary hy the nuolic Vaccinator, and to carry ont jnepeotion in order to ssoertsia what ohildren are aow anTftocinated" '■ ■■•■■- ■' '- ";;..-. j." . The motion was seconded by Dr. Doyle end carried. ~- . ... .;;: , ■.- j In. ansirer to D?. Doyle, the Chairman said 1 nothing definitei h»a bean done ye* is the matter ot establisbiag q sep&rate hospital for infeetiooe diseaaea. . : ■„» ■ .The furtuG? coßßiderateon of the medical dficex-'s report was deferred uatil nest meeting. Dr. Doyle took exception to the practice of a me&eal atan in reporting eases as " Malignant Bore throat." That was not legally an infectious diiease, and the fees should not be pai£. It waa very wrong that a doctor nhonld mislead the friends of the patients by describing casea of diptaeria as " malignant sore throat," and such a practice was calculated to encourage the spread of disease. "Malignant sore throat" should be reported under the head of the sptjcifio disease of which it was apart. Bβ wonld more --'That only those oases reported onder the head of infections diseases according to the Act be paid for.: , ' V , Mr Hnbbard eeconded, and the motion was .'carried, ... .;'"V ' t . ■ Afteraehort disenwion, : he folio wise oorrespondenoe was read :— From the town clerk of Pydeaham, Kqueatinj that with a wew of providing more effectually agaiastthfr spread of oontagionsdiseftie through the medium ef tfae Sydenham borough sohool, the Biard would cause all such coses to be reperted to tEe head master of the sohoel as seen as possible. Consideration deferred until the mfdioal ofEcer'e report was aider disoaMioa. From the town clerk of the City Council, stating that the resolutions paired by the obnf erenoe of local bodies on health questions had been considered by the Council and disapproved of.

From the town clerk of Sydenham to a similar effect. ■• ■ " *'■•"■■ ■■ '■ ■ '■■"- ■'

From the cletk of the Sprejdon Bead Board on the same subject, stating that the Board was satkfted with the present state of things ac to the management of the Board of Health, From Mr John Brightlintf, square, denying that the dry rnbbish. deposited in bit gravel pits was " off entiira matter," as reported by the medical offioer, and asking the Boatd to inspect ibe'um _ . „ „ : From W. Parkeraoß, Begisirar of Births, Beaths. and Marriages, acknowledging receipt ef map of district, and stating that he had received instructions to meat the views of the Board so ac to enable its officers to obtain information of deaths, Ad, eecnrring in certain cub-districts. Hβ would bo glad to furnish any information repaired. * From T. 8. foster, heed msster of the West) Ghristehurch School, asking that oases of infactious disease occurring in houses from whiob children attended either the Christchuroh Wes% Seheol or the side sohool at Addington, mipht be reported, and stating that boys from the South Beftßoaool had attempted to obtain admiuion to hie eohool by repreeenting that they bed been attending the Normal Bchool. Eβ deemed it right to draw attention to this Tery objectionable praetioe. ff»m Dr. Nedwill, the medical officer, dated the 35th September, stating that since Saturday oases of diphtheria from five different houses had been reported, where the evidence pointed strongly to the infant school on tite south belt being the canseof disseminating the disease. The school oonusittee had consented to close the school at ones. Hβ advised that it should be thoroughly disinfected and the ventilation improved. Hβ woold again urge upon the master the importance of preventing children from infected houses attending school nntn they received a certificate that it was cafe -to do bo. A letter, fa reply, was read from the Secretary o£ the %ard of Edaeatioa, storing that the architect had been instructed to inspect tee schoolroom on tee South belt, and report cc to the best means of imptovwa the- TOntilatien. With regard fe> the Normal Sehoel, none cculd be more parUcfoLa than the principal end teachers fa preventing the attendance of children from infected hoaaes, bat nalsse the parents and doctors isf onaed the school attthodties of every snoh instanoe they coold not be aware of their exiitenco. In the eouta belt farther attesda&ee of the jmildren had beea prohibited until the prodoctioa of the medical certificate. Tram the inspector of mdnasseß coder the Prain&ge Board, forwarding a list of notices to abolish privy cesspools and provide pass vhiob had net bsen complied with. 'Xhe list consprjaod fear persons. It was decided to compel eoapliaaoe is ftU cases, and the obaimaa was empowered to take proceedings if necessary. Account* were passed far piymeat Iβ ifca ameontof J944*6d. ; ■ - ..■•■■