Medical Officer of Health reports, 1891 - Angus (Forfarshire)

Page Transcription
HH62/1/FORFAR/1 REPORT BY THE MEDICAL OFFICER OF THE COUNTY, For the Year 1891. MY LORDS AND GENTLEMEN, The Bye-Law No. 11 recommended by the Board of Supervision, and adopted by the County, requires me to make a Yearly Report to the County in the following form:- I. - "A General Account of the Sanitary state of the County, and the Measures which in his Opinion should be adopted for its Improvement." The state of the County from a sanitary point of view is fairly satisfactory. The condition of the houses of the working classes varies much. In some instances the houses are everything that can be desired; in others they are old, damp, delapidated, and indeed past mending. Ashpits, privies, pigstyes, and dung-heaps, especially in villages, are often found too near dwelling-houses and wells, and are the source both of discomfort and sickness. I think it desirable that in villages, where necessary, public conveniences should be erected, and that in all cases the Local Authority should provide for the periodical emptying of all privies and ashpits in such villages, as I find that often the possessor of the ashpit is not to blame for its condition, but that the person who has undertaken to empty it has failed to do so.
HH62/1/FORFAR/3 [Page] 2 A better supply of water for domestic purposes is required in many places, and when at all practicable should be provided. II. - "A Statement of his Inquiries and Proceedings and of the matters in regard to which he has given advice or taken action during the year." I visited all the Parishes in the County during the year, and have paid particular attention to the sanitary arrangements of the schools, and, when I found it necessary, gave instructions as to better ventilation and greater cleanliness. I enquired into the following outbreaks of disease in the County:- Typhoid Fever in Edzell, which did not spread. An epidemic of Scarlet Fever, also in Edzell, which was of a mild type, and confined to a limited area. Three cases of Typhoid Fever in the parish of Kinnettles. Typhoid Fever in the parishes of Inverarity and Newtyle. I sent a report regarding these to the County Council, to which I beg to refer. I certified Wood's Yard, Craigie, in the neighbourhood of Dun- dee, a nuisance. I reported, along with Mr Anderson, County Sanitary Inspector, on the Kingennie Manure Depot, and visited and inspected, along with him, several of the most unhealthy houses in the various districts. I have given advice as to the quality of many samples of water in various districts in the County. III. - "A Statement of the causes, origin, and distribution of Diseases in the County, and the extent to which the same have depended on, or been influenced by conditions capable of removal or mitigation." Speaking generally, much of the sickness in the County is due to dampness, either as to situation or construction of houses, want of ventilation, to bad drainage and impure water, to exposure to cold, especially in the case of young children without proper clothing, the want of proper precautions to prevent the spread of diseases which [Page] 3 are known to be infectious. This is specially the case with Pulmonary Consumption, which is the most fatal disease in the County, and which is now universally allowed to be infectious. I would recom- mend that instructions as to the best mode of managing such cases should be printed, and distributed by the District Sanitary Inspectors, where such disease was known to exist. An epidemic of Influenza visited the County in the end of the year. It seemed to attack the towns on the coast first, and to spread inwards. In the rural parts of the County, although very extensive, it was not serious when uncomplicated, and comparatively few of the deaths in the rural part of the County were in any way attributed to it. I append a Tabular Statement of the mortality from this disease in the County and its several Districts. IV. - "A Summary of the action taken to prevent the Outbreak and Spread of Infectious Disease, and an account of the Hospitals or other means of isolation existing within the County." By the adoption of the Infectious Diseases (Notification) Act, the Dundee and Brechin Districts have taken the best, and indeed the only efficient way to prevent the spread of Infectious Diseases, and it is necessary for the best interests of the whole County that the other Districts should also adopt it. Whenever a case of infectious disease was known to exist, the patient was isolated, and when necessary the other members of the family remained from school till such time as it was certified safe for them to return Thorough disinfection was carried out to the satisfaction of the Sanitary Inspector. In some instances the cases were at once removed to hospital. The County is well supplied with hospitals, though they do not belong to the County Council. In the Dundee District the Dundee Local Authority receive cases from the County to their epidemic hospital on certain conditions. The Arbroath District have acquired a right to send patients to the epidemic hospital in that town. This
HH62/1/FORFAR/5 [Page] 4 hospital contains two large wards with 14 beds in each, and two small wards, and is in every way suitable for the treatment of infectious cases. The Brechin District have also made arrangements with the Infirmary Directors of that city, by which patients are admitted to the fever wards, and these wards are in every way suitable for the treatment of such cases. The Forfar District have no agreement with the Directors of the Forfar Infirmary, but infectious cases from the District are freely admitted to that institution. There are infectious wards in connection with the Montrose Infirmary, but I understand the Local Authority of that town object to infectious cases being brought within the burgh, so that negotia- tions which were being carried on between the Brechin District Committee and the Managers of the Montrose Infirmary have had for the time to be suspended. V. - "A Tabular Statement of the Sickness and Mortality within the County, embodying the Information con- tained in the Reports which the Medical Officers of Districts, or parts of Districts, are required to send to the County Council." The population is that of the rural portions of the County exclusive of the Burghs, and the various statistics apply solely to the rural portion. The population of the County is 52,866. There have been 1487 births during the year, giving a percentage of 28.108 per thousand, and 872 deaths, equal to 16.494 per thousand. I append a tabular statement of the sickness and mortality within the County, embodying the information contained in the Reports which as Medical Officer for the District I have already furnished to the County Council. In this Report, and also in my Reports to the several districts, I have abstained from giving particulars regarding the water supply and drainage of the various districts of the County, as this is [Page] 5 required of the Sanitary Inspector by the Bye-Laws of the County, and has been very fully reported on by him. I have also abstained from giving any statistics, except those belonging to the County, for the present year. Those who are interested in previous Census returns and tables of mortality will find them in the reports of the Registrar-General. In conclusion, I would draw the attention of the County Council to the desirability of having an office in the various districts, where the Sanitary Inspector's books should be kept, and where he might be seen by appointment at any time. I have the honour to be, My Lords and Gentlemen, Your Most Obedient Servant, A. McL. WEDDERBURN, M.D., County Medical Officer. March, 1892.
HH62/1/FORFAR/7 [Page] 6 [Table inserted] [Page] 7 Density of Population, Birth Rate, Infantile, and other Death Rates. [Table inserted]
HH62/1/FORFAR/9 [Page] 8 Tabular Statement of Mortality from Influenza occurring in the several Districts of the County. [Table inserted] REPORT BY THE SANITARY INSPECTOR OF THE COUNTY For the Year 1891. To the Forfar County Council. MY LORDS AND GENTLEMEN, In terms of No. 12 Byelaw, which enacts that "the Sanitary Inspector shall annually prepare a Report for the year," I beg herewith to submit my first Annual Report, for the year ended 31st December, 1891:- (a) "A general account of the sanitary condition of the County, and the execution of the Public Health Acts therein." The sanitary condition of the County is in some respects fair, while in others there is room for improvement. Some of the villages are abundantly supplied with good water and provided with efficient systems of Sewerage Works. In other villages, the provision for water is neither sufficient in quantity nor quality. The same villages are without any proper system of drains. In none of the villages or rural parts is there a systematic mode of cleansing of ashpits, conveniences, or such like. Consequently, they are often in a filthy state, and detrimental to the health of the inhabitants. In the rural parts of the County, no provision has been made for drainage, except from the better-class houses, or houses of recent construction; hence all slops or other foul water are usually either deposited in ashpits or thrown into roadside ditches, and become nuisances. Where drains exist, they either discharge into streams or ditches, or cesspools, and the liquid overflowing therefrom generally finds its way to streams.
HH62/1/FORFAR/11 [Page] 10 The overflows from manure tanks and drains from cattle courts, in some instances, are carried to roadside ditches and cause nuisances. In both the villages and the rural parts, conveniences, pigstyes, and ashpits are often in close proximity to dwellinghouses, and even in erecting new conveniences, &c., there is a tendency to keep them close to dwellings - the occupiers objecting to have to go any distance from the door. At many of the schools, the conveniences are badly designed and objectionably near the school buildings, and are not so frequently cleansed as is desirable; in fact, the excrement in some cases is allowed to accumulate for a year in pits adjoining the erections. Some of the schools are deficient in ventilation. In the rural portions of the County, the water for domestic use is at great distances from the dwelling-houses in a number of cases, and in others, where the water is near the dwellings, ashpits, piggeries, and other sources of contamination are contiguous, which causes suspicion as to the quality of the water; the same objection not being applicable to the former. In addition to the distance and the doubtful quality, there is an alleged deficiency at different places. The purity of the rivers and other sources of water is a question of interest to the County. Some of the streams and rivers are greatly polluted by sewage, including sewage from villages outwith the County, and refuse from bleachfields and manufactories. At two villages settling tanks are constructed to receive the sewage, and the overflows therefrom are allowed to discharge into the stream or river without any effectual attempt being made to purify the sewage. In other villages the sewage from any existing drains finds its way to streams and rivers without the intervention of settling tanks. The sewage from the village of Downfield is utilized for irrigating a field of land in the vicinity, and this method, to my mind, proves a satis- factory way for the disposal of sewage from inland villages. The sewage from large houses in the County is sometimes allowed to enter streams and rivers without passing through a cesspool, settling tank, or filter of any description. Although cesspools or settling tanks may intercept the grosser or more solid parts of the sewage, the liquid portion remains deleterious and injurious to health. [Page] 11 There are manufactories where privies are placed over the lade, and the excrement drops directly into the water, and is carried into the stream or river. If the flow of the river is rapid and the bottom formed of rock or boulders, the water will to a certain extent be clarified, but in a slow flowing river, with a soft muddy bottom, the water will be polluted according to the bulk of sewage and water. The water from some of the streams and rivers is used for culinary and other domestic purposes. The washings and ley from the bleachfields are generally allowed to enter the rivers without any attempt being made to lessen their obnoxious feature, other than allowing it to pass through settling tanks, which at most will only intercept the grosser parts. The bothies, houses for the labouring classes, and even some farm-houses, are not in such a condition of repair as is desirable, and considerable improvements will have to be effected. The bothies are a very mixed lot as to repair - some all that can be desired, others bad, and a great number are kept in a filthy state. It is held by some persons that it is the duty of the farmer that the bothy be kept clean, while it is maintained by others that, if the bothy is provided, it is for the occupiers to keep it clean and in a healthy condition. Much can be said on both sides. Without entering upon controversial points, it may be stated that no bothy will be kept clean, however anxious and attentive a farmer may be, except the occupiers aid in doing so. The better-class bothies having a large living room, bedrooms for each occupier, pantry and coal_ house, or living rooms with one large bedroom, are little better as regards cleanliness. In many instances the beds are removed from the rooms intended for them and placed in the living rooms. The property is often damaged by acts of carelessness. In one particular case, it was observed, a first-class new bothy with living room and single bedrooms had the floor considerably destroyed before it had been occupied eighteen months. The dwellinghouse for the labouring class is a question difficult of solution. Most of the villages in the County have been built or formed as seats of the hand-loom weaving industry. In fact, the
HH62/1/FORFAR/13 [Page] 12 greater number of the houses have been specially built to contain a space for a loom - the room and stance being considered a necessary part of the house. It may be parenthetically stated that many of the houses in the rural parts erected thirty years ago are provided with a loom stance. Hand-loom weaving is now practically non- existent, and a person may pass through what was a busy village thirty years ago, and not hear what must have been the cheery click of the shuttle. The work having left the villages, and there being less demand for agricultural labourers, the workers have had to remove to larger centres, where employment could be obtained - hence, empty houses, reduced rents, general delapidation, and the owners unable to keep what had been tidy cottages in a comfortable and healthy state of repair. In the rural parts considerable improvements have in recent years been made on the cottages required for the use of farm labourers, but much remains to be done. Generally, little attention is given to repairing the houses occupied by those, who may be styled day- labourers, except the houses are in the vicinity of quarries or public works, and even at these places there are many exceptions. Since the introduction of agricultural machinery there is less demand for day-labourers, unless at special seasons. It is unfortunate that the labourers have had to remove in such large numbers to towns. There are many empty houses (976 in 1889), and those really let yield such a small rent as to discourage any expenditure by the owner. It is to be feared that the proprietors will allow the occupiers to remove elsewhere rather than incur expenditure for which there will be no return. As this Report only comprises the period of about one year, and as it may be said the Public Health Act has practically been in force only during that period, little can be said as to the execution of the Act, but there is an evident desire on the part of the District Com- mittees to enforce its provisions, and the authors of nuisances have hitherto been willing to remove or abate them. (b). "A Statement of any Sanitary Measures he may consider advisable." Several of the villages are without any proper system of sewerage [Page] 13 works or an adequate supply of water. The foul water and other offensive matters are generally disposed of by being deposited in ashpits. The water supply in the villages, other than those formed into special districts, is generally derived from springs, streams, and sunk or shallow wells. In instances, ash- pits, privies, and other sources of contamination are suspiciously near to the wells. The water supply in many parts of the rural districts is obtained from similar sources, and is under the same suspicion as to quality. It is desirable that the larger villages, such as Friockheim, Newtyle, &c., be formed into special districts and a proper system of sewerage works laid down where necessary; the same district to be a special water district and an adequate supply of water provided for domestic purposes. In the rural districts the water supplies, besides being of doubtful quality, are often at considerable distances from the houses - a fact which does not tend to promote cleanliness. Wholesome water should be provided, where practicable, to all inhabited houses within a reasonable distance. It is desirable that the Public Health Act should be amended to the extent of authorizing the formation of special districts for cleans- ing purposes. Villages will not be kept thoroughly clean without the aid of scavengers. Public conveniences should be erected in all villages of any importance. In regard to the cleansing of villages, the following quotations are from practical suggestions issued by the Board of Supervision, and are better than any recommendation of mine:- "Removal of Contents of Ashpits and Privies. - In scattered communities it is impracticable for the Local Authority to take charge of such matters, and they must be left in great measure to the inhabitants themselves. But in towns and villages all experience tends to show that the removal of refuse and excreta, when left to householders, is very inefficiently attended to. In localities where
HH62/1/FORFAR/15 [Page] 14 the houses have no sufficient area of ground attached to them, the Local Authority should arrange for the removal of domestic refuse and the contents of ashpits. A week is the longest period that refuse should be allowed to accumulate in the neighbourhood of dwellings. Where large masses exist, the evolution of deleterious gases takes place, and when the heaps are disturbed in the process of removal, sickening odours are emitted. In towns where the refuse has to be kept within the houses, removal should be effected daily. The practice of contracting with farmers for the removal of refuse is unsatisfactory, the work being frequently very inefficiently and irregularly performed. Local Authorities should themselves undertake the duty." "Where water-closets are not in use the Local Authority ought also to undertake the removal of the contents of privies and earth- closets. A week is the longest period that excreta can remain in the vicinity of dwellings without nuisance, unless it is mixed with dry earth or other deodorant. Where an efficient system of sewerage and water supply exists, and the houses are provided with water- closets, the Local Authority may properly discourage the use of privies by throwing on the householders the burden of cleansing them and removing their contents. Public privies and water-closets must in all cases be attended to by the Local Authority. In towns where the water supply and sewerage system is complete, public water-closets are frequently constructed on the trough system, flushing being periodically effected by automatic means, or by the servants of the Local Authority." (c.) "A Summary of his Proceedings during the year, and of the cases in which he has given advice or taken action." The most of the County has been generally inspected by myself, and the Districts of Dundee, Forfar, and Arbroath by my Assistants, the District of Brechin having been examined by the District Inspector. Advice has been given on several occasions as to water supplies and drainage, which has in all cases been accepted. (d.) "An account of the Sanitary Condition of all premises belonging to or under the control of the County Council, and of the condition and efficiency of all Water Supply and Drainage Works constructed under the Public Health Acts within the County." [Page] 15 The premises belonging to, or under the control of the County Council are in a fair condition, unless a few police offices. These are being gradually improved under the directions of the Joint Committee of the County. Drainage Works have been constructed under the Public Health Acts in the villages of Monifieth, Downfield, Edzell, and Southmuir, Kirriemuir. Those in the two first-named villages are efficient and in good condition. In Edzell and Southmuir the sewers, so far as can be seen, are in good condition, but in consequence of the absence of manholes or inspecting shafts, a proper examination cannot be made. No ventilators are provided, consequently there is great danger of the sewer gas being forced into the dwelling houses. A sufficient number of manholes, and lampholes, or inspection shafts should be introduced, having perforated cast-iron covers, to act as ventilators as well as admit of the examination of the sewers, as the sewers may be silted up without it being known to those in charge. The village of Ferryden has several short drains, side channels, and other improvements made under the Public Health Acts. These are in good condition. The villages of Ferryden, Edzell, and Southmuir, Kirriemuir, have been provided with a supply of water. The works are generally in an efficient condition. The water was slightly deficient during the early part of last summer in the two former villages, and owing to local causes is occasionally scarce in Southmuir. The defects are being gradually remedied. The villages of Monifieth and Downfield were provided with an abundant and wholesome supply of water under the Acts. These villages are now included within the compulsory Water Supply Area of Dundee, and the pipes and other works will in future be under the care and management of the Dundee Water Com- missioners. (e.) "A Statement embodying the information contained in the Reports which the Sanitary Inspectors of Districts or parts of Districts are required to send to the County Council."
HH62/1/FORFAR/17 [Page] 16 I. - INSPECTIONS. -- Number. Total Inspections under Public Health Acts, -- 4662 II. - NUISANCES. Nuisances dealt with, -- 473 Intimations to authors of Nuisances, -- 291 Nuisances abated by authors thereof, -- 229 Nuisances abated by Local Authority, -- 1 Scavengers, &c., employed by Local Authority, -- 1 III. - SLAUGHTER-HOUSES AND OFFENSIVE TRADES. Inspections of Premises, -- 30 Applications for consent under Section 30, -- 1 Applications granted, -- - Applications refused, -- - IV. - COMMON LODGING-HOUSES. On Register at 1st January, -- General Inspections Registered during year, -- General Inspections Inspections between 8 a.m. and 10 p.m., -- General Inspections. Inspections between 10 p.m. and 8 a.m., -- General Inspections. Intimations of Irregularities sent to Keepers, -- General Inspections. Unregistered Premises dealt with, -- General Inspections. V. - INFECTIOUS DISEASES. Cases ascertained, -- 91 Visits of Enquiry, &c., -- 115 Patients removed to Hospital, -- 4 Notices to School Boards and Teachers, -- 4 Houses or Premises disinfected, -- 38 Sets of Clothing, Bedding, &c., disinfected or destroyed, -- - VI. - BURIALS. Burials undertaken in terms of Section 43, -- 2 [Page] 17 VII. - DAIRIES, &c. On Register at 1st January, -- 155 Registered during year, -- 53 Inspections, -- 187 Contraventions of Orders or Regulations dealt with, -- 4 VIII. - UNWHOLESOME FOOD. Inspections under Section 26. -- General Seizures of Unwholesome Food, -- - IX. - SPECIAL DISTRICTS. Special Drainage Districts at 1st January, -- 5 Formed during year, -- - Special Water Supply Districts at 1st January, -- 3 Formed during year, -- - X. - LEGAL PROCEEDINGS. Cases in which Local Authority have taken legal proceedings, -- 1 I have the honour to be, My Lords and Gentlemen, Your most obedient Servant, JOHN ANDERSON, Assoc. Inst. M. C.E., County Santiary [Sanitary] Inspector. MONTROSE, MARCH, 1892.