TYPHOID FEVER AT STROUD

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Transcript of TYPHOID FEVER AT STROUD

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trict, these reservoirs being exposed, as the service reservoirs,to percolation from the river Lea. It was, finally, provedthat the river Lea near the reservoirs had, a short time pre-viously to the indraught from the uncovered reservoirs re-ferred to, received the ejections of cholera patients. It is afact demonstrated as clearly as such facts admit of beingdemonstrated that the ejections of cholera patients, whenswallowed in a certain state of decomposition, will communi-cate the disease. It is a fact equally demonstrated that whenthese ejections are mixed with other excrementitious mattersat a certain degree of temperature, their poisonous properties arerapidly communicated to those matters, or that those mattersform a medium for the rapid and indefinite development ofthe poisonous material. At the time of the particular in-draught from the uncovered reservoirs it is certain, if observa-tions and experiments go for anything, that the Lea opposite thereservoirs was in a state of choleraic fermentation (so to speak),and laden with cholera poison. Given a river thus specificallypolluted ; given two series of reservoirs liable to percolationfrom this river; given, further, an outbreak of cholera limitedto the particular area of water-supply derived from thesereservoirs, and which possessed no other condition in commonby which localisation of the disease could be explained,-theprobability that the cause of the peculiar intensity and locali-sation of the epidemic in the East district of London dependedupon the distribution of choleraic poison in its water-supplyamounts for all practical purposes to a demonstration.Of the elaborate investigations conducted respecting the

outbreak of cholera referred to, the writer in the SaturdayReview remarks :"The inquiry which was made two or three years ago in

consequence of an outbreak of cholera in the East of Londonproved, to the surprise of some of the men of science who tookpart in the investigation, that, after excluding the case oftainted wells, there was no assignable relation between thepurity of the water and the health of the consumers."

It is not surprising that, after this suggestive ignorance ofthe facts disclosed by the inquirers into the causes of the out-break in the East of London in 1866, this writer should dege-nerate into utter nonsense when he touches upon less patentsubjects. For example, as when he states that the " water-fanatics" have " undertaken to prove the connexion betweensolid matter in water and disease." And again: "If an epi-demic (!) breaks out in London, the evil is at once attributedto the water; while it is assumed that Manchester and Glasgowwould be even more unhealthy than at present but for thepurity of their supply."The indecent attack which the writer of the article makes

upon the Registrar-General and Dr. Frankland would placehim beyond the pale of literary courtesy, were it not for thepublic importance of the question he has ventured to discuss,and the influential journal in which his article has been

published. It may be that Dr. Frankland’s method of de-

termining the degree of pollution of water with excremen-titious matter is not unassailable, and that objection might betaken to the inference and term "previous sewage contamina-tion," if it rested upon that method alone, independently ofall other considerations. But the fact remains, that the deter-mination of defilement from this source is a cardinal point to beattended to in ascertaining the quality of drinking water; andthe Registrar-General deserves the thanks of the communityfor having fixed this point in a phrase which adheres tena-ciously to the mind, and for keeping it constantly before thepublic. The question at issue cannot wait, neither is it neces-sary that it should wait, until chemists have come to a uni.formity of opinion upon an analytical process. It is possiblefor an individual, like the writer of the article in the SaturdabReview, to convince himself that water which has once beencontaminated with sewage may nevertheless become wholesome ’but it passes comprehension that anyone should think such aprevious contamination desirable, or at least unobjectionable,

It is deeply to be regretted that the columns of the SaturdayReview should be the medium of diffusion of nonsense so ill.conditioned as that published in the impression of the 10thinst. on the Water-supply of Towns. A competent criticismof the question would have been a gain ; but a criticism whichbetrays in every section an incredible ignorance of the subjectis to be deplored and deprecated. "Leisurely and scepticalstudents " of the class of the writer of that article, should notbe permitted to blur questions which require energetic work tomaster. Leisurely study is not an equivalent for earnest andconscientious study. Moreover, there is a scepticism of

ignorance as well as a scepticism of knowledge; but the writerin the Saturday Review appears to have confounded the formerwith the latter.

TYPHOID FEVER AT STROUD.

AN outbreak of typhoid fever has made its appearance atStroud, in Gloucestershire, and, although it has not attained

any great severity, it well illustrates the conditions on

which such outbreaks depend. We have recently describedthe method in use at Stroud for the purification of sewage,but this method is, unfortunately, only partially employed.Many houses have cesspools, and many more drain into abrook which circles round part of the outskirts of the town,and is separated only by their own gardens from the houses ofa principal street. This brook is much polluted at a cloth-mill about two miles from Stroud, where it not only receivesthe excrement of a large number of workpeople, but also therefuse of some offensive preparations employed in the manu-facture. As it approaches Stroud it receives drains and sewersat various points, and becomes more horribly offensive thefarther it goes. Immediately behind the gardens of the housesof a principal street, and close to the drill-ground of the

Volunteers, this brook is dammed up to form a pond for theservice of a mill; and thus it is spread out to a considerableextent, leaving, when the dams are raised, an expanse ofblack mud, through which bubbles of pungent gas ascend andburst. The town is supplied with water by the local Board ofHealth, but the taking of this water has not been compulsory,and many houses, in all parts of the town, have pumps andpump-wells of their own. These wells are often close to cess-

pools in a porous soil, and a free interchange of the contents ofthe respective cavities takes place; so much so, indeed, thatthe occupants of an important public building were for a longtime restrained from allowing the water in their tea-kettles toboil, "on account of the stink of the steam." This particularwater was obtained from a well in the vicinity of the pollutedbrook already described, and was found, on analysis, to Le

largely contaminated by sewage. An early, if not the first,case of fever occurred in a neighbouring cottage, taking itssupplies from another well, the water of which was not offen-sive. But on analysis by Professor Church, of the RoyalAgricultural College, it was unequivocally condemned. Itcontained 69 grains of solid residue per gallon (or three timesas much as the natural water of the district), and nearly6 grains of common salt per gallon. These analyses becomingknown to the public and to the Board of Health, attractedvery general attention to the matter, and the Board caused the water of seven wells, in the streets where fever most prevailed,to be handed to Dr. Maier for analysis. There is a drearysameness in his report, which we extract from the StroudNews of the 3rd instant :-

" Dr. Maier attended the Board of Health with analyses ofthe samples of water from wells in the town, and the followingreport was read by him :-

" ’ 1. Water marked C.-Total amount of solid matter pergallon, 80’47 grains, of which organic (chiefly sewage) matter,17’17 grains. The solid residue contains a large quantity ofnitric acid, chiefly in the form of nitrate of lime. The wateris wholly unfit for drinking purposes.

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"’2. Water marked D.-Total amount of solid matter pergallon, 66 grains, of which organic (chiefly sewage) matter,7’6 grains. Large quantities of nitric acid as above. Waterunfit for drinking purposes.

" ‘ 3. Water marked F.-Total amount of solid matter pergallon, 78 grains, of which organic (chiefly sewage) matter,12-02 grains. There is an enormous quantity of nitric acidcontained in the residue, nearly the whole of it consisting ofnitrate of lime. Water perfectly unfit for drinking pur-poses.

" ’4. Water marked G.-Total amount of solid matter pergallon, 63’1 grains, of which organic (sewage) matter, 7-57grains. Considerable quantity of nitric acid as above. Waternot fit for drinking purposes." 5. Water marked H.-Muddy looking, taken after rain.

Total amount of solid matter per gallon, 109’66 grains, ofwhich organic (sewage) matter, 16’83 grains. The appearanceof the water, and the fact of the sample having been takenafter the rain, account for the large amount of solid mattercontained in it. There is a large quantity of nitric acid con-tained in the water as above, and it is quite unfit for drinkingpurposes.

"’6. Water marked I.-Total amount of solid matter pergallon, 115-83 grains, of which organic (sewage) matter, 15’73grains. Enormous quantity of nitric acid as above. Waterwholly unfit for drinking purposes." 7. Water marked J.-Total amount of solid matter per

gallon, 73’49 grains, of which organic (sewage) matter, 5’05grains. Large quantity of nitric acid as above. Water notfit for drinking purposes." ’From the general character of the residue, and from the

large quantity of nitric acid contained in it (arising from

oxydised sewage) I draw the conclusion that the waters C, D,F, G, H, I, and J, are more or less contaminated with sewage,which might have leaked into the wells, perhaps from cess-pools in the neighbourhood. As long as cesspools are allowedthere will always be a danger of sewage contaminations.’

" After a short discussion the Board decided to inform theowners of the wells in question of the result of the analysis,and to order each of them to take the inwater supply fromthe town mains. The inspector was also ordered to open thesewers, where necessary, to see that no escape of sewage tookplace. "The report of the same chemist upon the water supplied by

the town mains shows that the action of the Board, if carriedfar enough, will ultimately produce good results. He says :-

" 8. Water marked A (upper reservoir).-Total amount ofsolid matter per gallon, 17’42 grains, of which organic (vege-table) matter, 3’08 grains. The organic matter is of vegetableorigin, and uninjurious. There is no nitric acid in the water :it is fit for drinking purposes."

It is said that the Board intend to continue similar investi-

gations, and to close wells as they are condemned. The con-dition of the pestilential "brook" is attributed to its beingthe boundary line between Stroud and the adjoining parish,and thus not under any existing local jurisdiction. But theauthorities of the parish, on the other side, have now beenasked to co-operate with those of Stroud ; and it is hoped thatsome good result will be obtained by the application. Therisk is, of course, that, as the disease passes away, the abidingdanger may be neglected or forgotten.The type of fever has been mild ; and, as five deaths have

been registered, it may be presumed that about thirty caseshave occurred.

In this story, simple as it is, and often as others like it havebeen told, there is melancholy proof of the need to teach thepublic something of the alphabet of sanitary science. Nothingbut sheer ignorance, or at least the indifference resulting fromignorance, could have elevated the limits of parochial juris-diction into an efficient cause of the state of things existingin the " brook " at Stroud.

THE announcement comes to us from Newark of thesudden death from apoplexy of Dr. H. Morton, of that town.The deceased gentleman was sixty-seven years of age, andfilled the posts of physician to the hospital and dispensary, andof honorary physician to the local board of health. Newarkis greatly indebted to Dr. Morton’s unwearied exertions in allmatters relating to the improvement of its sanitary condition.

THE CONTAGIOUS DISEASES ACT ATALDERSHOT.

THE following is an extract from the quarterly report of themedical officer of the Lock Hospital at Aldershot, just pre.sented to the Secretary of State for War. It will be noticeq.that Dr. Barr specially directs attention in his comments tothe necessity of instituting systematic periodical examina.

tions,-that is, of applying the Act more stringently than atpresent.

Dr. Barr thus comments upon the working of the Act atAldershot :-

" In a former report I had the honour of laying before youmany and weighty reasons for the absolute necessity of effect-ing strict, and sufficiently frequent, periodical examinations.It is gratifying to me to be able to state, that at this station aconsiderable advance has been and is being made in carryingout this exceedingly important duty.

" The number of registered prostitutes, who frequent thecamp and neighbourhood, will average about three hundred;and, as already stated, there have been 871 attendances on theappointed and a few special days during the past three months.But although the large majority of these women have volun-tarily submitted to attend on these occasions, each being re-minded or warned when her turn for appearing has arrived bythe police, a laborious task falls on the latter. In addition tothe constant coming in of strange females, and the necessaryinquiries and close observation connected with them, somefew, even of those long resident here, have persisted in existingout of doors, in drains, and obscure places, and, being in amiserably dirty and impoverished condition, have from timeto time succeeded in concealing themselves from the consta-bulary. Very lately a party of four, who had thus eluded de-tection, were discovered, the smoke from a fire around whichthey were seated proving a guide to the police. On examina-tion, it was found needful to detain all for treatment in thishospital."In the early part of July last, a number of unfortunates,

many of whom, very young, had left their homes to followregiments just come into this camp, and others, who were old,well-known prostitutes, most of whom had been many timesin various hospitals and gaols, made their appearance at thisstation. More lately, numerous women from near and distantlocalities, seeking employment during the season as hop-pickers, were, during the evening, detected in both camps,avowedly for the purpose of prostitution. In each event theconduct of the police-inspector was most praiseworthy.