THE OUTBREAK OF TYPHOID FEVER.

New Zealand Herald, Volume XXV, Issue 9032, 19 April 1888, Page 6

THE OUTBREAK OF TYPHOID FEVER.

CONFERENCE BETWEEN THE LEGAL COMMITTEE .. AND THE HON. MEDICAL STAFF.

The Conference in regard to the recent outbreak .of typhoid fever, especially in Ponsonby Ward, was continued at the City Council Chambe. s last night. The members of the Legal Committee present were His Worship the Mayor, Messrs. Gairatt, Holland, Atkin, Hewson, and Lennox. The medical gentlemen present were Drs. Stockwell (Health Officer of the city), McKellar, Beale, Lewis, Erson, Hooper, Haines, McMullen, and Bond. Mr. Pond, Colonial Analyst, was also present.

The Mayor opened the proceedings by stating that the report in the morning paper gave an accurate idea of what had taken place on the previous night, and the objects for which they had met, and he gave a synopsis of his remarks at the opening of the proceedings. He reminded them that this was a committee meeting, and at its conclusion a report would be prepared for the Council as to the origin and causes of the outbreak of typhoid.

Dr. Beale said he had paid no particular attention to the outbreak at Ponsonby, but the causes were twofold, the deranged state of the system of the person exposed to the noxious causes being the chief one. He believed the noxious gases from the tramway stables and from factories were causes for the outbreak.

In reply to the Mayor, Dr. Beale said he hail attended cases in Pompallier Terrace and other places in Ponsonby, but had not been able to detect the apparent cause. The main causes of typhoid were imperfect drainage and impure water. In one case water was being used from an old well in Edinburgh-street, Newton, in the family of McHugh. It was a bad case, and was sent to the Hospital. Another cause was impure food and impure air from overcrowding. He had noticed noxious smells from Cox's Creek blowing across Ponsonby— very bad smells indeed. The best sanitation would not stay disease unless the people were themselves careful. McHugh was a sailor, and he did not know how long he resided in Newton.

Dr. Stockwell said they had particulars of this case. In reply to the Mayor, Dr. Be ale said typhoid was nob contagious but was infectious. and the system had to be deranged before the outside fever could take effect. That accounted for some people escaping and others beingaffected. The Mayor : Edinburgh-street is a welldrained street. Dr. Erson said he noticed while there was an advance of sanitation, there was a collateral advance in the death-rate, and he pointed out that those 114 cases in the city should not exist at all, and the best thing they could do was to take steps in this direction. They had an epidemic in Newmarket last year ; now they had it in Ponsonby. Dr. Stockwell had discovered the cause in Ponsonby, and when the cause was removed the epidemic was removed. It was admitted that typhoid was preventible, and was due to certain causes. It was due in Ponsonby to the state of the tramway stables, ana it was due in other places to open side-channels, broken pipes and wooden drains, which formed little cesspools. Only yesterday he saw an instance of this in Eden Terrace. The Mayor said that was outside the , city. What they wanted to get at was the | cause of the outbreak at Ponsonby. Dr. Erson also said he had seen cases in which earth was not used in the closets. Up to the Three Lamps the roads were formed and drainage made, but beyond that nothing was done. The Mayor : We have not the means.

Dr. Erson : What, then, is the use 6f calling us together if you cannot adopt the remedies wc suggest. He continued that a great fault was imperfect plumbing—the traps being bad. If they had typhoid, and a water supply without proper drainage, the flushing would only tend to spread the disease. He had been unable to trace any cases directly to the milk supply; but diarrhoea and diphtheria, ana kindred diseases, may be caused by this. With regard to the local remedy he should suggest regular periodical inspection of premises and of buildings. The Mayor : That is remedied now. We have a new inspector and a new bye-law. Dr. Erson : Then landlords should be compelled to see after the closets, and be made responsible. The Mayor : That can only be done by legislation. Every ward foreman is a sanitary inspector, and is doing good work. Dr. Erson ; The fact of these tram stables and closets being allowed to exist showed the necessity for inspection, and the fact brought out by Dr. Stockwell, that the men in the tram stables had insufficient accommodation, showed deficiency of inspection. Dr. Erson poiuted out several places where drainage in the suburbs was defective, and said that only by centralisation in sanitary matters could a proper health system be established. If they had no power over persons building houses, then they were helpless in regard to sanitary laws. There should be a health officer with the inspector directly under his control. It was impossible for a general practitioner to undertake the duty, for the reason that even if he had time he was in danger of carrying contagion to his patients. He had in the press suggested that a Central Board of Health should supervise the drainage system throughout the province. He also pointed out the necessity for more ventilation for the sewers. _ There should be expert authority or nothing could be done. In answer to the Mayor, Dr. Erson said typhoid was not contagious, but was infectious. Dr. Beale said that was nob his experience. Dr. Erson said he had made a study of sanitary matters when he spent twelve months in Canada and the United States. In regard to cases which had not been reported all his cases were reported, and he sent two to Mr. Goldie from Newmarket, which were torn up, being out of his district.

Dr. Mackellar said that he had not much knowledge of the cases at the tram stables, except that the greater number of the cases were sent to the Hospital, and he found that they were mainly due to the defective closets, and the overcrowding aided and abetted. That was his whole experience as to this outbroak. I 'The Mayor asked him to name a remedy, for the remedy which would be effective there would be effective elsewhere.

Dr. Mackellak said he was informed the closets were faulty, and that sufficient earth was not used. Some of the boxes in use were not only not water-tight but not excreta-tight. The Mayor : Is typhoid contagious or infectious ?

Dr. Mackkllar : I can only give my own definition. • Taking contagion in the sense of being acquired by touch, it is contagious; and by infection I mean the microbes being acquired through the air, that is improbable. In answer to other questions he said the main cause of the outbreak at Ponsonby was the state of the closets at the tram stables. There may have been other causes.

In answer to Dr. Stockwell, Dr. Mackellar said he had no local knowledge, and could not say whether this was the pause of the outbreak in other places. Some of the patients who were in the Hospital worked in the stabler although not living in them. Men working in the stables might infect other closets. If a child attended school with typhoid developed, and used the closets, the homes of the children would be exposed to a certain risk, but there was no certainty as to infection. If a disease broke out in a boarding-school it was apt to spread, if in a day-school not so much so. The stables were more in the class of a boarding-school. He certainly thought the defective air space in the sleeping accommodation was a cause or accessory. Dr. Haines said he had no personal knowledge of the cases from the tramway stables, but the state of the closets as described was enough to spread typhoid through the whole district. People could contract this disease from the emanations from those who are diseased.

In answer to the Mayor, he said that the effluvia from the soap works was injurious to health, but not likely to cause typhoid. Dr. MacMullen said that, like Dr. Haines, he had no personal knowledge of the outbreak at Ponsonby, bub, from what had been stated, he believed ib arose from defective closets. He had experienced the smells from the soap works, etc., and they were certainly injurious to the public

health. As to whether typhoid was more or less severe this year, he thought it about the same. Dr. Hooper said his experience was that there were five cases at the Western Springs, near the abattoirs, on the lull "facing Richmond Road, in the house of a slaughterman. Two of the children had to be sent to the hospital, and the others were treated at home, and he could only attribute those cases to the city abattoirs. Other cases came under his notice that evidently resulted from slaughtering sheep and pigs at the back of butcher's premises. There were three cases at Epsom, and it was not denied that sheep had been slaughtered there, and the offal buried in the garden. j Otherwise the district was very healthy. The man said he buried the offal deep, but it was peculiar that there were three cases in that house, two of which proved fatal. Another instance in Mount Eden : Two brothers took ill on the same day, one of pneumonia, and the other of typhoid, but he did not know whether in this case there was any slaughtering. As far as his experience went he never found any case of typhoid fever arising from stable manure, and he differed from the opinion expressed that this was a cause. In fact the contrary was the case, and the large stables of Crowther and Dignan had not developed typhoid. There was very little doubt in his mind that the want of using earth in closets and defective drainage was the cause of typhoid. His attention had been called to an open drain in Sheehan-street, Ponsonby, which drew the sewage from a large area, and no doubt in summer weather this drain becamo stagnant. In regard to a question put about children in public schools not spreading typhoid, it may be answered in this way, that children may not use the closets every day ; and again with typhoid developed the children would be too ill to go to school.

In answer to the Mayor, Dr. Hoofer said the noisome smells from Warnock's factory would be injurious to delicate people, but would not produce typhoid. He had felt sick himself when passing it. He should not like to live there himself.

Dr. Bond corroborated the previous opinions that the outbreak of typhoid in Ponsonby was caused by the defective and foul state of the tramway closets. He had not experienced the noisome smell complained of. He was only once down by the soap works, and did not experience it then. Dr. Stock well said that when he visited the tramway stables with Mr. Goldie, he was not aware that any change had taken place, and it was nob until afterwards that he ascertained the closets had previously been burnt and renewed. Mr. Pond (Colonial Analyst) said that the earth closet system, if perfect, was a good system, but leaky closets, no matter how often emptied, were dangerous, especially in a place like Ponsonby, where there was a clay soil. It was during the hot summer of January that the disease broke out. He had noticed, in many instances, that a large number ot boxes were porous, and that earth was not used as it should be, and ashes being used largely was injurious, for dry earth was deodorising, while ashes created ammoniacal odours, and one of the worst features of this sorb he could refer to was the urinal at the Opera House. He regretted the change that had been made by the City Council in regard to the x duat boxes, as people were now induced to evade the tax by hiding away the dust in their own or their neighbours' yards. One other point regarding milk. He had the unpleasant duty of going round the dairies the summer before last with the inspector, and so much unpleasantness he never experienced, and it was to be regretted the Council had nob power to deal with the delinquents. But they had the power of the press, and the names of the delinquents should be published. With regard to the water supply, he could not speak in higher terms than he had done. Ib was the purest he had ever found, but it required to be jealously guarded. He also suggested that notice be taken of those using wells in the ! city, and that every effort be made to prevent it.

In answer to Dr. McMullen, Mr. Pond said he considered the risk of the Springs being affected by typhoid in the neighbourhood very slight. The water was taken direct from the Springs for the greater portion of the year, and the pressure was outward, but if a man suffering from the typhoid drowned himself in the Springs, he should not like to drink the water.

Dr. Macka asked if typhoid always required a case to start it, or could it arise de novo from dirt.

Dr. Haines said the general opinion was that the case did not arise de novo.

Dr. Mackellak said there were authorities which stated that it might arise de novo or from the system of the individual itself. ;

Dr. Ekson gave an instance of two children in the country developing typhoid from the smell of a pool around which they were playing. Dr. Haines said that in many cases similar to those instanced by Dr. Erson the poison had been traced. Microbes could be carried from long distances and form a centre. Then there was the susceptibility of the individual to typhoid where the health was lowered, and so they became susceptible to the first microbe that came their way. Dr. Stockwell said no explanation had been offered of the outbreak of typhoid at sea, where condensed water was used, and where all emanations went direct into the sea.

Dr. Erson* said he gob typhoid himself on board ship from a patient whom he was attending, and was very bad, but he attributed it to the bilge water. Dr. Beale said the case he had referred to in his evidence was in West-street, not in Edinburgh-street. The Mayor said that closed the inquiry, so far as the medical gentlemen were concerned, and he thanked them for their attendance.