Dr. Gresswell's report to the Local Government Board on the prevalence of enteric fever in the registration sub-district of Hebden Bridge / [D. Astley Gresswell].

  • Gresswell, D. Astley (Dan Astley)
Date:
[1885]
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Gresswell's report to the Local Government Board on the prevalence of enteric fever in the registration sub-district of Hebden Bridge / [D. Astley Gresswell]. Source: Wellcome Collection.

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    In 1883 there was no death from fever in the urban district, and there were only two in the rural. In the first half of 1884 there was none, hut in the second half there were 14 in the two districts, i.e., not far short of half of the total deaths from fever since the beginning of 1878. Fever, then, has continually prevailed here more or less, but prior to 1884 there had been no outburst for 12 years approaching in deadliness to that of the second half of 1884, during which time four deaths occurred in the rural and 10 in the urban district. While seeking the cause of the continued prevalence of fever, the facts above mentioned concerning the sanitation of the place present themselves in all their fever-abetting reality. Overcrowding, defective ventilation, habitations drawing sewer air through sink-pipes, through soil-pipes, and from filth-sodden soil, water open to pollution on every side ; these afford conditions favourable enough for the prevalence of the disease. The fever has frequently been attributed to polluted water. Dr. S. T. Steele, while Medical Officer of Health, repeatedly drew attention to the pollution of the water, and to the facility with which typhoid fever could be traced up the hills to farm above farm, the water supply of the lower farm being polluted on the farm above. He condemned the Bridge Lane water as being the cause of typhoid fever, of which in 1875 he wrote saying that it had been endemic in Bridge Lane for the previous 10 years. He likewise ascribed the large number of typhoid cases which occurred some 12 years ago in Foster Mill Lane to pollution of the water. He also condemned the Birchcliffe water. Dr. Lawson, who succeeded Dr. Steele in 1878, and who still holds the office, has repeatedly spoken to the same effect. Let us now turn to the outbreak of last year. That it was one of enteric fever is evidenced by the record of rose spots, diarrhoea, intestinal haemorrhage, and relapse. The first two cases occurred in March and July respectively, in a short isolated row of cottages at the west end of the town, in which cases of typhoid fever are reported to have occurred in the previous year. They were attributed to the drinking of a local spring water polluted by leakage from a privy used by the occupants of these cottages. Then, on July 15th, a woman died, it is said, of typhoid fever near to the centre of the town. She had shivering, lumbar pain, headache, and vomiting, but she continued to keep about for a week or so; she then took to bed and died on the fifth day afterwards of “ asthenia.” Her stools were not disinfected, and her husband says that he had not the slightest idea that she was suffering from fever. The sink-pipe communicated directly with the sewer. The water used wTas that of the Local Board. The milk supply-is not suspected. It is probable that she did not communicate typhoid fever to the next cases, because the next two cases, which occurred simultaneously in the first week of August (a fortnight after this woman’s death), were living in two different though contiguous streets at some distance from her house, and they had had no relations with her. Ten tenements were affected between August 1st and October 15th, in one small portion of the town. Later four tenements in other parts of the town were affected, and still later six tenements, all within the small portion of the town in which the above ten had already been affected. It will be necessary to examine carefully the cases in the tenements which were first affected. I have said that they were not probably due to infection from the woman whose case has been described; they could not, moreover, be traced to the March and July cases. They cannot be ascribed to the milk because (1) the first two tenements which were affected almost simultaneously, had different milk supplies ; (2) the third had yet another milk supply; (3) the four next, all of which were affected almost simultaneously in two different streets, had four different milk supplies; (4) each of the milkmen who supplied the above, supplied also very many other tenements which were not affected. They would possibly be ascribed by some to the insanitary state of the dwellings in which they occurred. Thus:—of the first two simultaneous cases, one had suffered from “ stinks” from his water-closet which had not been properly flushed owing to scarcity of water, and the other had been boiling tripe, and had allowed his cellar to get into such a filthy and stinking condition that the next tenant “ could not stand the smell.” The third case had his house-drain blocked so that the main culvert sewer had to be opened up, and he had suffered from stinks in the house. The fourth case occurred at a distance, and is not apparently explicable on the ground of uncleanliness in the