Dr. Thorne Thorne's report to the local government board on the sanitary condition of the Dewsbury registration district, with special reference to the prevalence of infectious diseases in the district.

  • Thorne, Richard Thorne.
Date:
1878
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Licence: Public Domain Mark

Credit: Dr. Thorne Thorne's report to the local government board on the sanitary condition of the Dewsbury registration district, with special reference to the prevalence of infectious diseases in the district. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    263 Causes of the limitation of the disease in Raven s- thorpe. Conclusion as to the cause of the epidemic. Difference of the incidence of t he disease in Bailey as compared with Dews- bury and Heckmond- wike. Remedial measures. 52 to which he attributed the epidemic then prevailing in Dewsbury. In short, the differ- ence of medical opinion as to the prevalence or not of enteric fever in Ravensthorpe was mainly due to the use by different medical men of a different nomenclature. At the same time, however, it is quite evident that if enteric fever was produced in Ravensthorpe under the same circumstances as those which led to its epidemic pre- valence in Dewsbury, Batley, and Heckmondwike, its prevalence in the former place was far more limited and of much less intensity than in the other towns. This I think may be accounted for in two ways. In the first place the water-supply for Ravensthorpe being taken from the tail end of a main, the chances of any specific pollution reaching that one point in an extensive system of mains were small, and secondly, the very great im- provements which had been made, amongst other things, in the means of sewerage and drainage in Ravensthorpe, and which had efficiently prevented the escape of sewer air into the dwellings, had produced results which tended to prevent the spread of this disease by means of one of its most common channels of communication. I have therefore arrived at the opinion that the circumstances of this epidemic warrant the conclusion that by some means, which were no longer apparent at a distance of 16 months from the commencement of the epidemic, some pollution of the joint water-supply for the four districts did take place, which led to the development of the extensive prevalence of enteric fever under consideration. This view is confirmed by information forwarded to me by a medical man practising on the border of the area to which this water is distributed, to the effect that during the earlier stage of the epi- demic, that is, prior to the date at which infection may have become somewhat general through the various means of excremental poisoning of air obtaining in the locality, the disease was strictly limited to those houses receiving this water-supply, all others escap- ing. And previous experience of somewhat similar outbreaks is to the effect that the comparatively small number of attacks to persons drinking the water does not of itself operate against such a view. It is also quite possible that any pollution of the general supply may have been an isolated occurrence, or at least one which did not frequently recur, a view which receives some support from the fact that where, as in Ravensthorpe, certain sanitary measures had been adopted which tend to prevent the spread of such a disease as enteric fever, the outbreak was limited; whereas in the other three districts where the sanitary circumstances are such as to favour the spread of this disease, when once in existence, it became widely prevalent. It is, however, noteworthy, that whereas the mortality from the epidemic for the first four months of 1877 was at the rate of 36*0 per 10,000 living in Dewsbury, and 32T per 10,000 in Heckmondwike, it was only 243 per 10,000 in Batley, the more so since this difference can hardly be accounted for by any marked absence in Batley of those con- ditions favourable to the spread of enteric fever. Some allowance may perhaps have to be made on the ground that these calculations are made on an estimate only of the population, and that the numbers in question are not large, but even after this has been taken into consideration there would appear still to be a difference in favour of Batley. Now if the view I have expressed as to the origin of this epidemic be a correct one, this difference may be in part at least accounted for by the circumstance that in Batley the water from the works of the joint Authorities was during the whole course of the epidemic somewhat freely mingled with that from its own independent works. •I would here further observe that after the investigation of the works belonging to the Dewsbury, Batley, and Heckmondwike Waterworks Company, when the means which favour the pollution of their water-supply were discovered, I was assured that immediate steps would be taken to prevent the possibility of any such occurrence in the future, either at the gathering ground or along the course of the conduit. In conclusion, I desire to acknowledge the courteous and ready assistance which throughout the course of a somewhat lengthened inquiry has been rendered to me by the members and officers of the various Sanitary Authorities concerned in it. R. THORNE THORNE. September, 1878. RECOMMENDATIONS. I.—Relating to the Urban Sanitary District of Dewsbury. 1. No unnecessary delay should be allowed to occur in securing for the district a constant high-pressure water service. Means should be adopted to provide for the free