|The Rushden Echo, 28th March, 1913, transcribed by Gill Hollis
Medical Officer’s Report for Rushden
A Low Death-Rate - Heavy Infantile Mortality
Dr. Morris, medical officer of health for Rushden, in the course of his annual report, presented to the Rushden Urban Council, says :-
The estimated population is 13,658, and the number of inhabited houses 2,932.
The majority of the inhabitants are engaged in the manufacture of boots and shoes and processes incidental thereto.
There were registered during the year 287 births (142 males and 145 females), giving a birth-rate of 21.01 per 1000 of the estimated population, viz., 13,658, as compared with 281, or at the rate of 20.08 per 1000, last year. One transferable birth was received, and eight births were illegitimate.
The deaths from all causes numbered 121, or at the rate of 8.8 per 1000 of the population, as compared with 126, or at the rate of 9.3 per 1000, last year. Of the deaths registered 16 were transferable, one of which had only resided in your district for about three weeks.
Twenty-four of the deaths recorded were of children under one year of age, giving a rate of 83.6 per 1000 registered births, as compared with 28 deaths at the rate of 99.6 per 1000 registered births last year.
While the general death-rate has been steadily declining throughout the country, there has been no corresponding diminution in the mortality of infants under one year of age. As a rule the mortality is greater with industrial conditions.
The real causes are chiefly centred in two factors the nature of the food supply of the child, and the income of the parents, and, therefore, the diet and nutrition of the mother. If the mother is healthy, well fed, and comfortably housed, and can, and does, nurse her own offspring, the chance of the infant in the first year of life is increased three or four times. Nothing can take the place of the mother’s milk, and it would indeed be wiser and more economical to feed the child through the mother.
Ninety-eight cases were notified thirty-seven in the first, twenty in the second, fifteen in the third, and twenty-six in the fourth quarters respectively. The disease was generally of a mild type, no death having been returned from this complaint.
Scarlet fever has in recent years increased enormously throughout the country, and is practically endemic in this and many other industrial centres. Mistakes in diagnosis and delay in notification naturally add to its continuance and extension.
It was found necessary during the year to take legal proceedings against the parents of some children for failing to notify their children who were found running about the streets in the peeling stage.
Another case which came under my notice was of a boy who was at home unwell. This boy was sent for by the School Medical Officer to be examined, and on presenting himself at the school was found to be in an advanced stage of peeling. On these premises being visited by your Inspector it was discovered that the boy had been allowed to play about the house and two more notifications were subsequently received.
Several other cases were found to be in the advanced stage on notification being received, and it is hoped the legal proceedings taken will act as a warning to parents and impress upon them the need and duty of early notification and isolation.
I am pleased to again report there has been no necessity to use the Small Pox Hospital during the year.
The suggestion to use this Hospital for Consumptive Patients appears to be a good one, and I trust the County Authority will see their way clear to adopt these premises for that purpose and thus benefit some of the persons notified in your district.
Diphtheria and Membranous Croup
Twenty-two notifications referring to diphtheria were received during the year, as compared with thirty-eight in the previous year, and forty-three in the year 1910. In fifteen cases bacteriological examination was obtained, and of these, nine gave a positive result, and six negative. It is to be regretted that this is not done in every instance, as, in accordance with the provisions made by the Council, no charge is made to the medical practitioners or the patients.
The free supply of Anti-toxin to suitable cases is still available, and it was procured for most of the cases, a supply being kept at the Council Offices for that purpose.
Two deaths are returned from this disease, both being transferable, one between five and fifteen, and one between twenty-five and forty-five years of age.
I am pleased to report that no cases have been notified from this disease during the year.
Only two deaths are reported from this complaint, both of which were of children under one year of age, as compared with nine deaths in the previous year.
This complaint is not notifiable in the district; no deaths have occurred.
One death has been returned from this disease of a child under one year.
Bronchitis and Pneumonia
Two deaths have occurred, both of which were under one year of age.
Sixteen deaths have been returned from this disease, as compared with nine in 1911, and fourteen in 1910; one between one and two, two between five and fifteen, seven between fifteen and twenty-five, and six between twenty-five and sixty years.
Other Tubercular Diseases
Six deaths have been returned; one under one year, one between two and five, two between five and fifteen, one between fifteen and twenty-five, and one between twenty-five and forty-five years respectively.
Cancer and Malignant Disease
The deaths again show a decrease on the previous year, only seven deaths having occurred, as compared with nine in 1911, and fifteen in 1910. Five deaths were of persons between the ages of forty-five and sixty-five, and two over sixty-five years.
Accidents and Suicides
One death has been registered as the result of accident, and two from suicide.
Two cases were notified from this disease, with one death.
Seven cases were notified from this disease, as compared with nine last year. No deaths have been registered.
Tuberculosis and Consumption
Sixteen deaths, one being a child under two years of age, were attributed to pulmonary consumption; Two deaths were between five and fifteen, seven between fifteen and twenty-five, five between twenty-five and forty-five, and one above sixty-five years of age.
In the campaign against tuberculosis the year will always stand out with special distinction, and have far reaching results, and which indeed will in all probability, make, in a comparatively short period of time, this a rare disease.
The systematic housing inspection of the district has again received attention during the past year, and a number of houses have been inspected and their sanitary conditions and surroundings inquired into and entered in the register provided for that purpose. This branch of special duties takes up a considerable amount of time, and involves a large amount of re-inspection work, which is carried out by your Sanitary Inspector.
Special attention has been given to the sanitary requirements of these premises; in some instances shallow wells have been closed and the town water laid on to the houses, new glazed stoneware sinks have been fixed in a number of houses in place of insanitary and defective quarry sinks, several houses of the “back to back” type have had their ventilation improved, either by fixing windows in their blank walls, where possible, or by carrying a shaft through the ceiling.
During the year twenty-six houses were specially reported upon. Five houses, which on inspection were considered to be in such a state as to be unfit for human habitation, have been closed, the remainder either having been repaired or are receiving attention at the time of writing.
There are a good number of houses in the district with a large number of occupants, but these do not come under the legal definition of over-crowding, but are certainly occupied by more people than is desirable.
Four cases of over-crowded rooms were discovered during the year, but as the Housing Accommodation at present is heavily taxed, owing, no doubt, to the exceptionally busy state of the staple industry, it is difficult to deal with over-crowding when discovered; although, taking the town generally, I do not consider there is much over-crowding to be complained of.
The National Insurance Act, 1911, provides for the appointment of Insurance Committees in Counties and County Boroughs and gives them and other bodies among other powers, authority to allege, if they think fit, excessive sickness in any district to be due to the bad housing, insanitary conditions, or neglect on the part of Sanitary Authorities, and to apply to the Secretary of State or to the Local Government Board for an enquiry. The person holding such enquiry, if satisfied of this, will have power, under certain conditions, to apportion blame and to penalise local authorities or owners of property for neglect, and to award costs.
The tendency of legislation in recent years has been not merely to largely increase the actual work of the Medical Officer of Health, but to add generally to his responsibilities in every direction, without providing for any commensurate remuneration.
Sanitary Inspector’s Work in Rushden
Mr. Allen’s Yearly Report - House To House Inspection
The Sanitary Inspector for Rushden (Mr. F. J. Allen) has presented his annual report to the Rushden Urban Council, from which we take the following extracts :-
I beg to present to you my second Annual Report upon the work done in my department.
During the year ending December 31st, 1912, the number of written notices served on owners or occupiers for the abatement of nuisances was 135, whilst 88 letters were written in respect of nuisances, and 141 verbal notices given. Each notice sets forth fully in detail the work required to be done to abate the nuisance existing. I may mention that wherever possible verbal notices are given and every required explanation made, thus saving a good deal of trouble and delay.
A good deal of attention and time has been given to the condition of house drains and sanitary fittings, and in 86 premises the drains have been repaired or re-laid. This work being so very important, a considerable amount of time, therefore, is taken up, as numerous visits are made in each case whilst the work is in progress. All the drains laid or repaired are tested with water before being covered up, and all soil-pipes and ventilating shafts that are repaired or renewed tested with the smoke machine.
Whenever time permitted a systematic inspection of your district was carried out, in compliance with the Order of the Local Government Board, with a view of discovering any nuisance that might exist, or any breach of the town bye-laws. In all, 168 premises were inspected under this head, and an inventory of the apparent condition of the sanitary arrangements taken and entered in a special book for that purpose. Particular attention was given to the flushing of w.c.’s, purity of water supply, nuisances from overcrowding, disconnection of waste pipes of sinks and baths, as well as rain water down pipes from the drains, and the state of the houses and surroundings generally.
There are seven licensed and registered slaughter houses in the district, three of which are subject to an Annual Licence, as well as one Knacker’s Yard Premises. These premises have been regularly inspected and received the same careful attention as in the past. The floors and yard paving of two of these premises have been improved during the year and the lime-washing of all the premises regularly carried out.
During the year three carcases of sheep were seized and destroyed as being unfit for the food of man, one of which was disputed by the owner, but as your Medical Officer of Health certified it to be unfit for the food of man and a Magistrate’s Order having been obtained, the carcase was destroyed in the usual way. No unsound fruit or other food was seized, but continual observation is kept where necessary.
Sale of Food and Drugs Acts
I am indebted to the Clerk to the County Council (H. A. Millington, Esq.) for the following items of work done under the above Acts :-
During the year 23 samples of milk, viz., twenty-two New and one Skim Milk have been purchased. Two new milks were adulterated, each to the extent of 5 per cent. deficient in fat. Two other new milk samples taken informally were very poor, being only just to the minimum standard.
Dairies, Cowsheds, and Milkshops Order
There are forty-five milk vendors, dairymen, and cowkeepers on the register, and their premises were periodically inspected. The dairies were for the most part well and cleanly kept; only in one instance was it found necessary to give instructions as to the storing of milk. In the case of the milk sellers, a number of them practically never store any milk, but convey it direct from the farmer to their customers.
Where outworkers are employed in certain trades mentioned in the Factory and Workshops Act, lists of such outworkers have been kept on the prescribed forms, copies of which were sent to the Sanitary Department. The prescribed forms are supplied by the District Council. The dwellings of the outworkers have been mostly inspected and in several instances it was found necessary to warn the occupier about the insanitary condition of the premises.
Notification of persons suffering from a dangerous infectious disorder were received during the year from eleven houses occupied by outworkers where wearing apparel was received. The articles were thoroughly disinfected before being returned to the factory, and the homework stopped by order of the Medical Officer of Health until a certain time had elapsed after fumigation.
A total of one hundred and thirty cases of infectious diseases were notified during the past year. Disinfectant fluid and soap were supplied to these cases when applied for. These houses were kept under observation until certified to be free, and the premises sprayed and fumigated.
One hundred and fifteen houses and rooms have been sprayed and fumigated after infectious disease, and two hundred and seventy-five visits and inspections have been made.
Fifty-seven cases of pulmonary tuberculosis were notified to your Medical Officer of Health. The majority of houses occupied by these cases have received attention and their sanitary conditions and surroundings inquired into.
Fifteen lots of bedding have been destroyed after deaths from consumption, and twenty-six consumptive homes have been thoroughly sprayed and fumigated. Compensation in respect of bedding destroyed was given in several cases, it being found necessary to destroy such bedding owing to the want of a suitable disinfecting chamber.
Disinfecting fluid, powder, and soap were again distributed to families applying for same, also a number of pocket spittoons were supplied to consumptive patients.
The free use of anti-diphtheria serum was again supplied to cases where the medical attendant applied for same, a supply being kept at the Council Buildings for that purpose.
It was found necessary during the past year to take legal proceedings against the parents of some children who were found, on inspection, to be in an advanced stage of peeling, some of whom were still attending school, and, although warnings and advice were given, they were ignored, and the children were allowed to run about to the danger of the inhabitants in the neighbourhood.
The magistrates, after hearing the case, imposed a fine which it is hoped will act as warning to others, as during the year several cases were found to be in an advanced stage of peeling before being notified.
Factories and Workshops
During the year these premises have been periodically inspected. Several additions have been made to the sanitary conveniences. A list of the additions and defects found and remedied is included in this report.
There are no underground bakehouses in use in the District within the meaning of the Act. All bakehouses have been limewashed twice during the year. It was found necessary on six occasions to draw the occupiers’ attention to the date of limewashing, which was duly complied with. No drain openings or w.c.’s were discovered inside or in direct communication with any bakehouse; in two instances the floors and ceilings were repaired, and in one instance the town water was laid on inside premises.
All the public elementary schools have been regularly sprayed and disinfected, and special attention having been given to the sanitary conveniences and outhouses. It was also found necessary to disinfect one of the private schools, owing to an outbreak of Scarlet Fever occurring on the premises.
The number of written notices sent to the day schools by the Medical Officer of Health’s instructions, either requesting the head teachers not to allow children to attend school or informing them that the houses were free from infection, was 138.
The number of complaints received and registered were one hundred and thirty seven, which is an increase of sixty-six as compared with 1911. These were promptly attended to and investigated, which absorbed a good deal of the time that would otherwise have been spent in the systematic inspection of the district. Several requests were received for the application of the smoke and water test to the drains and sanitary fittings of houses, some of which were referred to private tradesmen to carry out under the supervision of this department.
Backyards and Passages
These have again received attention during the past year, and a large number of yards where the paving was worn and unsuitable have had their surfaces repaired. An attempt has been made to get the backways and common yards to several properties put in a more suitable condition, and in several instances they have been repaired, but as these cannot be brought under the heading of yards attached to the houses, I find there is a difficulty in getting the conditions improved without the local authority having to put their powers in force under the Private Street Works Act. I think it would certainly be better and more economical to the owners if they were to combine and make these backways more passable for the tenants, as in their present condition it is impossible for the tenants to keep their houses in a clean and sanitary condition during the bad weather.
During the year one hundred and eighty-seven houses have been supplied with galvanised iron dust bins in place of insanitary tubs, boxes, etc. Whilst these bins are a decided improvement on the wooden receptacles, they soon become foul unless the tenant does his duty and keeps the receptacle in proper condition. It has been found necessary to draw the tenants’ attention to this fact in many instances, owing to the insanitary state the receptacle has been allowed to get in.
From the report of your Surveyor (Mr. W. B. Madin) I have obtained the following details:-
The average daily consumption of water was 12.24 gallons; 10.68 gallons for domestic purposes, and 1.56 gallons for trade purposes.
The greatest consumption in any one week was the second week in May, when the consumption averaged 217,714 gallons per day, and the lowest was during the second week of January, with an average of 163,571 gallons per day.
The rainfall for 1912 was 27.06 inches. The heaviest day’s rainfall during the year was on August 26th, when 1.61 ins. were registered in twenty-four hours.
Average Rainfall for the Past Five Years
The rainfall for 1912 exceeded the previous year by 9.96 inches.