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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    house. The fifth case had complained of stinks from an untrapped opening in a drain close to the door of her house. The sixth was using a w.c. into which the stools of one of the first two cases were taken without disinfection. The seventh case was in a cottage which is immediately opposite to the house of one of the first two cases, and in which the accommodation was a water-closet in a small pitch-black recess in the wall of the ground-floor room ; there was, moreover, no ventilation of the soil-pipe, which opened directly into the sewer into which the slops from one of the first two cases were thrown. Though the foregoing conditions were in some degree peculiar to the houses that became attacked early in the outbreak, the cases would seem, with rather better show of reason, to be attributable to the water. Thus :—The first five families which were affected between August 1st and October 6th took the same water (the above described Birchcliffe water) ; they had no relations with one another; they worked at some distance from one another; they were scattered over three contiguous streets, an adjoining square, and a square a short distance away; and the direction of their drains would not serve to explain the spread from one to another. Six families were affected between October 6th and October 15th; these all took the Birchcliffe water, though possibly the infection in these cases may be explained by the condition of their drains and the mode of disposal of the slops and stools of those previously affected. Eour families were attacked between October 15th and November 1st, none of which took the Birchcliffe water, but the first patient of one family was companion of one of the above, that of another was sister to one of the above, and visited her prior to her illness, and that of a third was using the Bridge Lane water, a water open to direct leakage from an old privy. Six families were attacked between November 11th and November 23rd, four of them in one row of houses in which only one case had occurred previously. The stools of the latter were, moreover, disinfected and deposited in pails and removed. Among these cases there were five children of one family in one house all ill within a week, three working at three different mills, one at school, and one at home ; evidence of a common and probably of a local cause. Each of these six families took the Birchcliffe water. There was but one patient in the next family. Here the Local Board water was used, but the patient had had dealings with a previously affected family. Then a family using the Birchcliffe water fell ill. The four succeeding families affected were about a mile away, and in some the disease is attributable to local causes. The next family was using the Local Board water. Then one of a family using the Bridge Lane water fell ill, and the next case, the last for the year 1884, was using water open to sewage contamination. Therefore, of the first 21 tenements affected there were but four in which the Birchcliffe water was not used, viz., in order of attack, the 12th, 13th, 14th, and 15th, and in two of these four there was exposure to the local conditions of previously infected houses. The patient in the 22nd tenement did not use the Birchcliffe water, but had been in relations with the people of an infected house ; and the patient in the 23rd tenement did use the Birchcliffe water. The incidence of fever upon houses on the Birchcliffe system has now to be compared with its incidence on houses using the Local Board’s water. The former number 135, and during the epidemic period 20 of them were invaded; the latter are 473 in number and, at the outside, three of them were invaded during the same period. Then as to the portion of the Birchcliffe system most concerned in the distribution of the fever : 70 of the 135 houses derive their supply from the White Lion cistern; of these 70, only one house was invaded : 65 receive their supply from other cisterns ; and fever appeared in 19 out of these 65. The evidence seems therefore to point strongly to water pollution as essentially the means of spread of the fever. The specific pollution must have principally affected some one or two Birchcliffe cisterns. I am not prepared to say whence this pollution was originally derived; but it is noteworthy in this connexion, that during the last two weeks of June 1884 the water from the Birchcliffe springs was directed into another course to allow of haymaking on the fields over which the water naturally flows, and the higher cisterns became almost empty ; it was turned again into its natural channels early in July, and the cisterns filled in the course of three or four days. The rainfall at Todmorden in June was 1 * 1 inch, that of July was 4 -99 inches. The fields therefore in June were dry. In July they were inundated with the spring water (now re-directed