LOCAL GOVERNMENT DEPARTMENT

821

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Lincoln Rural -District.-Dr. Harrison, in dealing withthe deaths that occurred from preventable diseases during1889, refers to certain fatal attacks of enteric fever amongstpersons who had used a water-supply that had previouslybeen condemned as unfit for domestic purposes. The word-’ing of this reference implies that a polluted well was leftopen to be used for other than so-called domestic purposes,an arrangement that has again and again led to resultssimilar to those here recorded. A new supply is beingsought, by boring, for the village of Langworth, but although295 feet have been penetrated water has not yet beenreached. There is, however, abundant evidence as to theneed of a proper supply as a substitute for existing pollutedsupplies. The death-rate for the year was 18 ’4 per 1000, butby excluding the mortality in the county asylum it becomesreduced to 15 per 1000.

Holswodhy Rural District.-The death-rate in this dis-trict during 1889 was 15 per 1000. After dealing at lengthwith the vital statistics affecting the district, Mr. LinningtonAsh gives an account of the infectious diseases which haveprevailed, and he complains again how the management ofthese diseases is hindered by the absence of any provisionfor isolating the sick. Whilst no special action has beentaken during the year as to water-supplies, it is reportedthat gradually considerable change for the better has takenplace, but it is to be feared that periods of drought wouldseriously test the existing supplies. At Church Bridges,pollution of the stream is continued, a matter that may atany time place the authority in a difficult position. Onepoint of especial interest attaching to this report lies in the.circumstance that, since Mr. Linnington Ash has resignedhis office, this is his last official communication. We havefrom time to time adverted to the localities as to whichMr. Ash has been advising for sixteen years, and it is abun-dantly evident that, although all which he has urged uponthe authority has not yet been secured, the advice which hehas given has always been based on sound and scientificprinciples, and that its influence for good is certain to befelt in the district for a long time to come.Reading Urban District.--An exceptionally low death-

rate of 13’6 per 1000 prevailed last year in Reading, and thesanitary progress made, though embodying no striking- event, is stated by Dr. Alfred Ashby to have been continuousand satisfactory. In dealing with the zymotic cases, wenote that the six deaths from diphtheria, which are belowthe average, are associated with nine from non-spasmodiccroup, a disease which it is difficult to differentiate fromJenuine diphtheria. Careful inquiries are stated to havebeen made as to the diphtheria attacks, but there is nocomment as to the allied disease. Scarlet fever was heard ofin only twenty-seven instances, and it seems only to havebeen found necessary to secure hospital isolation in one case.The sewerage of the newly added portions of the borough ismaking rapid progress; but the question of improving thepublic water-supply has, notwithstanding the attention paidto it, not advanced. Reviewing the current work of the.year. Dr. Ashby expresses the opinion that a steady im-provement in public health is going on, and that the largeoutlay of money towards that end is now resulting in diminu-tion of death and of sickness with a corresponding increaseof capacity for work.

Sutton Coldfield Urban District -The population of thisborough is now estimated at 9100, and on this basis thedeath-rate is calculated as 11’3 per 1000. Last year it was10’7, and during the past ten years it has hardly exceeded15 per 1000. The zymotic rate for 1889 was also low--mamely, 0’8 per 1000. Dr. Bostock Hill regrets that the per-centage of deaths under one year of age to the registeredbirths nas risen from 7.6 to 9’5; but even with this increase,Sutton Coldfield still retains a place among the urban dis-tricts having a comparatively small infant mortality. Therewas no death during the past year from small pox, scarletfever, measles, enteric fever, or diphtheria; and the onlyoccurrence which had a serious aspect was an outbreak ofscarlet fever in a ladies’ school, the proprietress of which so

fully and intelligently complied with and forwarded the in-structions of the medical officer of health in such mattersas isolation, temporary removal of scholars, &c., that thedisease was promptly checked. No suspicion attached tothe school premises in so far as the cause of the disease wasconcerned. Dr. Hill claims that a low mortality in his dis-trict is no mere accident. It has followed on the mainte-nance for years of progressive sanitary work as regardssewerage, drainage, water-supply, and other matters ; andmeans have been provided for the check, by early isolation,.of such infectious fevers as may arise or be imported. Therecord of the past year’s work shows that the efforts toremove causes of disease and unwholesomeness are stillefficiently maintained.Torquay Urban District.-Mr. Karkeek speaks in strong

terms of the value of compulsory notification in the pre-vention of disease, and explains that in several instancesnot more than two hours have elapsed between the receiptof the notification and the removal of the patient to theisolation hospital. Where diseases such as enteric feverhave occurred, the information has also secured a remedyfor conditions that were dangerous to health. One suchinstance referred to relates to the closing of a local well,the water of which was celebrated for its coolness, bright-ness, and freshness; until, at last, when enteric fever oc-

curred, it was found that the filth which had got into it wasin excess of the power of the chemical action which hadheretofore brought about the desired brightness and fresh-ness. It is to be hoped that in his next report Mr. Karkeekwill tell us that no more wells sunk in the surface soil ofTorquay remain to endanger the lives either of visitors orof the hospitable inhabitants of that pleasant town. Thedeath-rate for 1889, when corrected for deaths amongst occa-sional visitors, was 12’4 per 1000.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 5345 birthsand 3601 deaths were registered during the week endingApril 5th. The annual rate of mortality in these towns,which had declined from 26 6 to 21’4 per 1000 in the precedingfour weeks, further fell last week to 19’3; the rate was16’7 in London and 21-5 in the twenty-seven provincialtowns. During the thirteen weeks of last quarter thedeath-rate in the twenty-eight towns averaged 24-7 per 1000,and exceeded by 1’7 the mean rate in the correspondingperiods of the ten years 1880-89. The lowest rates in thesetowns last week were 10’5 in Huddersfield, 12 9inBirkenhead,14’1 in Nottingham, and 15-5 in Leicester. The rates in theother towns ranged upwards to 25’0 in Wolverhampton,27-1 in Plymouth, 27’8 in Newcastle-upon-Tyne, and 28-6in Manchester. The deaths referred to the principalzymotic diseases, which had been 363 and 424 in thepreceding two weeks, declined again last week to 351 ;they included 145 from whooping-cough, 80 from measles,37 from diphtheria, 36 from diarrhoea, 34 from scarlet fever,19 from "fever" (principally enteric), and not one fromsmall-pox. The lowest death-rates from these diseaseswere recorded in Preston, Norwich, and Birkenhead ;while they caused the highest rates in Salford, Liverpool,Plymouth, and Derby. The greatest mortality from measlesoccurred in Liverpool, Plymouth, and Derby; and fromwhooping-cough in Newcastle-upon-Tyne, Derby, Liver-pool, Bristol, and Salford; and from ’’fever" " in Sunder-land. No marked excess of scarlet fever mortality wasrecorded in any of the great towns. The 37 deathsfrom diphtheria in the twenty-eight towns included 20 inLondon, 5 in Salford, 2 in Manchester, and 2 in Sheffield.No death from small-pox was registered in any of thetwenty-eight towns. Four cases of this disease were

under treatment in the Metropolitan Asylum Hospitals,and not one in the Highgate Small-pox Hospital. Thenumber of scarlet fever patients in the MetropolitanAsylum Hospitals and in the London Fever Hospitalwere last week 1087 ; 86 cases were admitted to thesehospitals during the week, against 87 and 91 in the pre-ceding two weeks. The deaths referred to diseases of therespiratory organs in London, which had declined from 510 to375 in the preceding four weeks, further fell to 296 last week,and were 147 below the corrected average. The causes of74, or 2-0 per cent., of the deaths in the twenty-eight towns