BOARD OF HEALTH.

Globe, Volume XXIII, Issue 2293, 9 August 1881, Page 3

BOARD OF HEALTH.

A meeting of the Local Board of Health was held at 4.30 p.m. yesterday. Present— Messrs E. J. S. Harman (chairman), F. Hobbs, H. J. Tancred, H. J. Hall, O. E. Blakiston, J. Y. Boss, and Dr. Nedwill (medical officer). The quarterly report of the medical officer of health was read as follows : Christchurch, August sth, 1881. The Chairman Board of Health. Sir, —I nave the honor of submitting to yon my report on the health of the district for the quarter ending June 30th. Although only 111 householders reported cases of infections diseases during the three months, it must be remembered that in several instances more than one member in a family was ill, and doubtless som cases were not reported.

The numbers reported for the corresponding three months of 1880 were:— Scarlet

The mortality within the city was per 1000 of the population monthly :—April, 1.52 ; May, 1.05 ; Jnne, 1.11 ; and for the corresponding three months of 188# April, 1.12; May, 1.52 ; June, 1.30, The foregoing figures show a slight improvement for Christchurch on the corresponding quarter of 1880. The mortality in Sydenham for the last quarter was—April, 1.15; May, 2 01; June, 1.06; and for the corresponding three months of last year—April, 1.28; May, 1.03 ; Jnne, 0.64. These figures show that the health of Sydenham was worse during this quarter than during the corresponding quarter of last year. From the whole district zymotic diseases were credited with 24 deaths, namely—--9 from diphtheria—l in Eicoarton, 5 in Avon, and 3in Sydenham ; 5 from typhoid fever—l in Christchurch, 4 in Sydenham, 1 in Eiccarton, and 1 in Heathoote; 1 from dysentery in Christchurch; and 7 from diarrhoea —4 in Christchurch, 2 in Sydenham, and 1 in Avon. Although no deaths were registered from measles during the quarter, towards the end of this period 19 cases were reported, just the nnmber for which certificates of death from this disease were given in Dunedin. On glancing over the above tables it will be seen that 15 more cases of typhoid fever have been reported this quarter than for the corresponding period of last year, and that the increase has been made up from the district outside Christchurch. It is worthy of note, as directing attention towards unsanitary causes, that of the 17 cases of typhoid fever and 7 of diphtheria reported from Sydenham, 10 of the former and 5 of the latter were from the Addington side of the district, while in the Avon division all the cases of diphtheria were confined to Papanui proper, or St. Albans. This epidemic of diphtheria in the north part of the Avon district has been running on since October last, and has caused 11 deaths, namely, 5 ia the December quarter, 1 in the March quarter, and 5 in last quarter. I have already reported to the Board that in the first instance the disease was disseminated from the Papanui Public School. I also reported that the epidemic was continued, and spread through the agency of the private school in the village, but by some misunderstanding the reporters excised the latter part of this statement. I now repeat it, ns I cannot conceive that a private school has any more right to distribute infectious disease than a public one.

Typhoid fever during the quarter has not followed its usual course of diminishing in frequency as winter advances. Tho number of cases reported in May was more than double the number reported in April. This anomaly will be still more apparent if we look at the same months of 1880; in that year the April cases number twice as many as those in May. Either under the influence of dry warm weather, or the decomposition of organic impurities, or the permeation of the filth sodden ground by air through the fall of the water-level, typhoid fever undoubtedly has been unusually prevalent during the winter. I am glad to learn that permission will no longer be given to deposit town refuse in the Opawa gravel pits. Enough filth has, however, already been buried in this neighborhood to make it imperative upon mo to caution the public against being in a hurry to build on such made ground, or to reside in the immediate vicinity of immense quantities of decaying organic matter. It is to be hoped that Christchurch will never again be subjected to such disgusting neglect as of late has been apparent in the scavenger’s department. On tho 2nd of June, on the 9th of July, and again on the 23rd of July, I addressed to you letters on this subject to point out the serious nature of the danger to public health which was likely to arise from tho befouling of the city. Instructions should be issued to Mr Brightling’s men to thoroughly cleanse and disinfect those places which have been rendered offensive. It would be neglect of duty on my part to close this report without referring to small pox. On former occasions, when alluding to this disease, its introduction into this colony seemed so remote that the subject of vaccination was not likely to receive the attention which the gravity of the situation now demands from authorities charged with the public health. Quite recently it was reported that a vessel had arrived at Port Chalmers having small pox on board, and within the last few days the Waipa anchored at Lyttelton having had one of her passengers ill with small-pox during the voyage from Lend a In Australia the disease seems to be spreading, and their quarantine regulations are so lax that wo run a groat risk of its introduction into New Zealand either direct from Sydney or through Victoria. The questions had better be asked at once, if small-pox was introduced here would it bo likely to spread, and are we prepared to cope with it ? Notwithstanding some evidence to the contrary, the opinion is all but universal that in vaccination and re vaccination properly performed wo possess absolute protection from fatal or even serious small-pox, and that in communities protected by vaccination and re - vaccination the diseaso_ cannot retain a hold, even if it has obtained one. Seme few months ago I examined 700 children under eleven years of age at two ol the Govern-

meut schools in Christchurch, and found that one out of every seven was unvaccinated, and one out of every six had been vaccinated so imperfectly that little, if any, immunity from smallpox had been secured by the operation. ; Add to this proportion the list of adults, either unvaccinated, indifferently vaccinated, or not revaccinated, and it will readily be seen what a large number of people susceptible to smallpox exist in the district. Probably 20 per cent, of unvaccinated children would be a small estimate, hut even this computation is sufficiently large to make a visitation from smallpox alarming. The Kegistrar-Goneral should at once publish for general information the percentage of unvaccinated children in the different districts, and the law which makes vaccination compulsory should be vigorously carried out. The RegistrarGeneral, however, cannot tell us what number of children remain unprotected from smallpox through careless vaccination, for the State has not provided for any systematic inspection of the results of vaccination by a competent person. But it is not only through neglect of vaccination that we are unprepared for an outbreak of smallpox, wo are also without hospital accommodation, and without the disinfecting chamber necessary for destroying the contagion of the disease.

I would venture to suggest that the time has now oome when the Government should seriously consider the advisableness &f making the Central Board of Health occupy the position in the colony secured for the Local Government Board in England. Indeed the New Zealand Public Health Act clearly contemplated that it should occupy this position, hut hitherto it has not taken advantage of the machinery placed at its disposal to enable it authoritatively to advise or direct Local Boards of Health. By clauses 189 and 190 of the Public Health Act it is the duty of every urban and every rural sanitary authority in England and Wales to appoint medical officers of health for the purposes of the sanitary Acts. In rural districts the medical officers may be only to a certain extent under the control of the Local Government Board, but the urban medical officers, whose salaries are partly paid out of moneys voted by Parliament, are subject to the control of the Local Government Board alone. Those authorities, however, who do not choose to receive payment from the public purse can appoint or dismiss their medical officers. All medical officers of health have to send their annual and any special reports to the Local Government Board, and have to give immediate notice to the same authority of any outbreak of dangerous epidemic disease. The Local Government Board is thus kept informed of the sanitary condition of the country ; it has its own medical officer to direct and supervise, to report either at stated intervals or on the recommendation of sanitary authorities, or at the request of the Board. It keeps medical officers np to their work, and if necessary, it also sees that Boards of Health carry out essential reforms. The proceedings of the medical officers to the Local Government Board are embodied in “ Eenorta to the Privy Council,” and laid before Parliament. It is needless to add that those reports are valuable for the guidance of sanitary authorities throughout the country. As I said before, the Public Health Act provides the machinery necessary to make the central Board a reality. Its medical officer should be thoroughly acquainted with the sanitary condition of each part of New Zealand. His report should be annually laid before Parliament; he should know the exact state of each part of the colony with regard to vaccination ; he should by actual inspection make himself acquainted with the many imperfect vaccinations styled “successful,” and should satisfy himself that vaccination fees were not being paid out of public funds for operations that were indifferently performed. A scale of awards, moreover, as in England, should he given for very efficient vaccinations. I have the honor to be, sir, yonr obedient servant, (Signed) Courtney Nedwxll, M.D., Medical Officer.

The Board considered the report.—Mr Hobbs suggested that the chairman should be ashed to take out from the report the recommendation of the medical officer respecting vaccination, and forward the same to the Central Board of Health.—Mr Hall thought that the best way would be for the chairman to forward a copy of the medical officer’s report, with comments by the chairman, to the Government. —Some discussion ensued, and ultimately it was resolved that the chairman forward the remarks of the medical officer with regard to smallpox to the Government, the report as a whole to be further considered at next meeting.—The chairman reported that in the case of a nuisance on the Gasworks road ho had had a summons taken out against the contractor. The case was heard and adjourned for a fortnight, to enable the contractor to remove the nuisance. He had mentioned that the Board meant most strictly to put a stop to the practice of depositing town rubbish in the gravel pits. This he hoped would be accomplished. As regarded the amendments proposed in the Health Act he had sent up a draft Bill containing the one positive instruction from him by the Board—viz., to enforce the reporting of infectious diseases by medical attendants. To this he had added a suggestion that the same power should be given by the Legislature to the Board of Health to inspect dairies and regulate the sale of milk, as existed in England under the provisions of the Contagious Diseases (Animals) Act. The Bill had been sent to Mr Stevens, and he (Mr Harman) had received a letter from the Colonial Secretary stating that the matter was under the consideration of the Government. He trusted that the Government would ere long take steps to give the Board such powers as were deemed necessary. He might say that at Mr Carter’s request the medical officer of health had visited Air Carter’s farm, and reported as follows :

Christchurch, August Bth, 1881,

The Chairman Board of Health. Sir,—At your request I have again visited Mr Carter’s dairy farm, and found it very clean, with the necessary pure water supply and out office accommodation. As Mr Carter, and his medical attendant by certificate, assure me that there is now no infectious disease in Mr Carter’s family, and as Mr Carter also assures mo that no communication takes place between his homestead and dairy, I am of opinion that he may with safety resume his occupation of milkman. I may state that although Mr Carter is aware that he lives outside the Christchurch Board of Health district, he has shown the greatest anxiety to carry out my recommendations, and has even urged me personally to satisfy myself as to the state of health of his family.—l have, &c., (Signed) Couetney Nedwili., Medical Officer. He thought this was very satisfactory. In reply to Mr White, the Chairman said that the inspector had visited the Lunatic Asylum, and notice had been given to the authorities there to provide some moans of drainage, or they would be indicted. The Chairman said he had received a memorandum by the Solicitor-Genera], addressed to the Colonial Secretary, which stated that there was no power in the Board of Health Act empowering the Board to inspect and regulate dairies per se. This would require legislation. After passing some accounts, the Board adjourned.

Fever (mostly Scarlet Typhoid). Diphtheria. Fever. Measles. 50 24 18 19 The cases have been distributed thus ; DiphScarlet Fever. theria. Fever. Measles Christchurch .. . 15 3 1 5 Sydenham . 17 7 8 3 Avon . 7 13 2 2 Heatheote . 9 0 6 7 Eiccarton . 2 1 1 2 And according to the months • — April ... . 15 6 4 0 May ... . 32 9 6 2 June . 3 9 8 17

Fever. Diphtheria. Fever. Distributed thus 35 18 4 Chriatohnrch ... 16 6 3 Sydenham 12 2 0 Avon 1 6 1 Heathcoto 6 3 0 Eiocarton 0 1 0 And according to the months : — April 22 7 2 May 11 6 1 Jnne 2 5 1