BOARD OF HEALTH.

Globe, Volume XXIV, Issue 2464, 28 February 1882, Page 3

BOARD OF HEALTH.

The Board met at 4 30 p.m. Present— Mesßra Vino?nt (chairman), P. Jones, 8. Manning, A Aehworth, F. Hubbard, and Dr. Doyle. The Chairman reported that the committee appointed to consider the matter of the Contagious Diseases Hospital had inspected the site, and the matter wae now in the hands of the committee of the City Counoil. There was some difficulty in dealing with the question of the salo of milk by dairi.s outßide the health district. He thought the difficulty might be met by obtaining the co-operation of tho Selwyn County Counoil and the City Council. The aeoretary read the reply of the solicitor to various questions, which stated that the Board could not charge a registration fee for the dairies nor could their inapestor inspect the dairies without the health distriot, though the milk was sold within the district. The City Council could not, under their delegated powers from that Board, make regulations for the inspection of dairies, but the Board of Health could inspect the dairies in the city of Christ ohurch. The Chairman said ho might say that it was not intended to send tho Medical Officer to inspeot all the dairies, but merely for the usual inspector to ace the dairies in his regular rounds, reporting to the Medical Officer on any speoial case requiring his attention. He had the authority of the late chairman of the former Board for saying that they never contemplated using the Medical Officer as inspector of the dairies in the mannor contemplated by some. The secretary pointed out as the medical officer of health was also medical officer for

many of the Boad Board district*, it would be ai well for them tc» be communicated with on the subject, and e*ked to join in the appointment of the medfea-l officer of health to inspect the dairies in thiir respective districts.

Mr Ashworth was opposed to the matter altogether. He had had large experience amongst dairymen, and did not believe that there was anything like the danger stated arising from milk. Mr Jones moved —" That the secretary be requested to oommunioate with the Tatioos suburban Boad Boards, asking their cooperation in carrying out the regulations for the inspection of dairies, &s." This was put and agreed to. The following correspondence was read. From the Government, stating that as the Aot _ did not provide any penalty for non- i vaccination of children as tohool ohildren, ( there was no power to compel ohildren to un- I dergo examination, they regretted not being | able to carry out the suggestions of the vaccination officer. The secretary stated that on receipt of this letter he had written calling the attention of the Government to sections 152 and 16* of the Public Health Act, 1876 J and a reply had been received stating that the vaccination officer could enforce the section 152 1 rigorously, but as to 164 the sohool eommittees objecting to the examination made it inadvisable to press it.

A letter was read from Mr Harding, complaining of the nuisance arising from Jackson's creek.

It was resolved that Mr Jones and the inspector visit tbe spot and report. A letter was read from Mr John Strong, enclosing a report from Professor Bickerton as to the method adopted by him in disposing of the gases caused by tbe melting- of tbe fat by him. The Board declined to consider the matter until the report of the medical officer, to whom the case had been referred, bad been reoeived.

The annual report of the Medical Officer of Health was read as follows : Christchurch, February 22nd, 1882. Bir,—l have honor to submit to you my report on the health of the district for the year ending December 31st, 1881. The following are the number of the householders who reported cases of infectious diseases for the twelve months:—

162 77 37 165 *Nine of these cases were admitted to the Hospital from places ontside the district. In all there have been reported to the Board 441 cases of infectious 'diseases, the increase being caused chiefly by an epidemic of measles, and by the outbreak of typhoid fever, -which was spread through the agency of milk from a farm on the Lincoln road. For the year ending December 31st, 1880, 281 householders reported cases of infectious diseases, namely :

For the year 1879 there were reported only 195 cases. It will be my duty presently to show that this increase for 18S1 is not entirely owing to increased sickness, but to better attention being now given to notifying such cases to the Board. The following statistical table will show the estimated population, the births, and the deaths from the various causes in Christchurch for the years 1881,1880, and 1875, and in Sydenham for the years ISBI and 1880 :

For the remainder of the district I can give no statistics until the Board can persuade the Government to cause to be made by the local registrar those returns which hare been already asked for. I understand that the secretary to the Board is having prepared a lithographed map of the district, which will, I hope, do away with the difficulty raised by the .Registrar- General. The average population of Christchnrch for tha year 1881 being 15,181, and the number of births for this period boing 561, it follows that the birth rate amounts to nearly 37 per 1000 of the population. This birth rate is Tory much lower than for 1880, when it was nearly 45 per 1000. Doubtless the tide of depression which swept over the colony during the year 1879 caused tne number of marriages to fall off and the births to diminish in consequence. The death rate for the year is extremely satisfactory, not merely on account of its being very low for this year, but because it has been steadily decreasing. For 1879 it was 20.15 per 1000 of the population, for 1880itwasl7 98, and for ISBI only 15 2(5. Thcimprovoment for the j ear extends to all the dieeaEeß mentioned in the table except those occurring among very young children. Infant mortality, however, in this table is calcnlated not by the proportion of deaths to total deaths, but by the proportion of deaths under ono year to the number of births registered. Since writing this report I have ascertained that I under-estimated the population in both Christchnrch and Sydenham by about 300 and 510 each respectively. The effect of this would be to slightly lower both the birth and death rate. In the infectious diseases class the de r th rate has fallen from 5.6 in 1880 to 3 6; only four dea'.hs were registered from measles, although the epidemic of this disoase wa= very widespread, aa tha first part of this report shows. Dysentery caused only just over one-half the number of deaths credited to it in the previous year, the number being in the proportion of 14 to 27. Typhoid fever proved fatal in only eiaht cases, or five less tban in 1880. In the important class of iunpr diseases there is also a decrease, the rate having come down from 4 1 in 1860 to 2.7 in 1881. I trust that all those who exclaim against the taxes which hive to be raised for carrying out drainage and othei improvements, which have for their oVjoct the preservation of the public health, will pacee to look well »t the table of statistics which I have given for 1875. t o jear before the drainage works began. They will see a population one-third less having an nggre gate of deaths of one-third more, and tho death rate in the zymotic class vtry nearly three times as heavy as at present. Typhoid fever, with its

I forty-nine deaths in one year, or mors than six: i times its present number; diseases of the lungs, j carrying off victims in the proportion of nearly , three to one, as compared with what they are now doing; while they will see an infant mortality column which is truly alarming. But thosr e is something further to be looked at, of which this table gives no record—the pecuniary 1 loss, the pain, and grief, and sorrow, andsufferi me which is caused by each case of preventihla disease; for it must not be lost sight of that for each caee of death from preventable disease there are more than ten serious cases of preventive sickness. Sydenham, with an - average copulation for the year of 8128, has also, like Christchurch, gone back inits b'rth rate. _ From the extraordinary high figure of fifty-nine per thousand of the population, the births have receded to the Ibbs but still high rate of 53.2. Unlike the caee of Christchurch, however, the health of Sydenham has not been so good as it was in 1830. The annual death rate from all caaees his increased from 16 3 in 1880 to 17.50 in 1881. Measles helped to swell the zymotie i list by having attributed to it Sve deaths. Diphtheria has been more fatal, while typhoid fever claims ten deaths, or more than three times the number for last year. Sydenham, however, has not had' typhoid' fever and diphtheria evenly distributed over the entire district, the cases have bseapchiefly numerous in that portion towards the sswth-west in the direction of Bosewarne's paddock, wherethere is an absence of any kind of drainage. But it is in the class tabulated under diseases of the respiratory organs that the ereatest falling away has occurred. The remedies for this are better drainage, more care to prevent the air in and around houses from becoming vitiated' from, damp and noxious exhalations which arise from filth, sodden ground, and better ventilation, more especially in bed rooms. The only other part of the combined district which I wish to refer to in consequence of sickness is Papanui, where diphtheria continued throughout the - year, and caused six deaths. However it may have originated, this disease wai disseminated'in the first instance by the public school, and afterwards by the agency of the private school in the village. That the disease retained its bold on the district so long is cause for no surprise. Land naturally swampy, which has been saturated with excrements! filth and with 1 houseslops thrown over it, or allowed to find its way into dirty stagnant road side ditches would soon engender a state of things where diphtheriawould feel at home. During the year the advocates of sanitary reform (I might say, in Christchurch) have carried important measures, and placed them upon the Statute Book of the colony. It will new be more easy to grapple with infectious diseases, for the large brdy of medical practitioners will furnish prompt returns of their approach, while the inspection and registration of dairies ought to prevent such outbreaks of typhoid fever as that which oeeurrreit in July last. Several prominent public nuisances have been removed. The offensive part of'the candle works in Montreal street, Sydenham, hasbeen discontinued, the wholesale disposal of town refuse no longer finds its way into the Walth am gravel pits, and in the rural portion of the district cesspits are not nearly _ so numerous. Filth accumulations in the immediate neighborhood of dwellings arebecoming of less frequent occurrence, and slop water is not so generally got rid of' by throwing it over the ground at back doors. The system of sewers has now so far approached' completion that iu a few months house drains can be used over a large area to carry away liqn ; d filth. It is to be hoped that the citiaens of Christchurch will not again, by their apathy, permit a few shortsighted and ill-informed people to neutralise the efforts of those who havebeen trying to secure the additional water supply, which is urgently required for flushing pnrpoaes and fire-prevention. Our sewers and drains, if properly attended to, should bring usincreased health and comfort, but if the supply of water for flashing them is deficient th»y will most assuredly become breeding grounds for typhoid fever and other infectious diseases. The side channels are in some places simply sickening, and street watering should be more generally attended to, as tbe atmosphere of towns is verycon siderahly vitiated by the amount of organic matter which is carried about in dust. Our wholesome artesian water is gradually failing in proportion to the number of places in which the source is tapped. If it ceases to rise above the_ surface level an clement of danger is introduced by contamination from soakage from the surrounding ground. We should, therefore, economise this pure water for household übo, and no longer permit it to be wantonly wasted, as may be seen at hundreds of places every day. Moreover, we are committing the absurdity of spending money to lower the level of the ground water, which is being materially raised by the unrestricted flow from the artesian wells. Goitre, or enlargement of the neck, has been of frequent occurrence in and around Christchurch, and it will Da interesting to watch whether, as the district becomes better drained, this complaint will become lees common, as malaria is supposed by many to cause it. The question of the water carriagn of excreta versus the dry earth or pail system of removal cannot much longer be postponed, for the present barbarous arrangement is too disgußting to be continued. The infant mortality rate showsusthatsomethingmußtbe wrong, that we are violating some laws of health, too many children are beitg hand fed or improperly fed, their food must be undergoing putrifactive changes or they are breathing air which is loaded with decaying animal matter. In populousplaces low ground should be raised to the street level, but the greatest care should he takento prevent gullies and nolle.ws being filled np with rubbish. Houses should not be built on such made ground until at least three yeara have elapsed, and even then the whole floor space should be covered over with cement to keep any noxious exhalations from rising into the rooms. But little progre:S has been made employing properly constructed bins for receiving house refuse or kitchen garbage, and the dustman's services are not by any means sought after by every householder. Many hotelkeepers, in spite of the recommendations of the Licensing Commissioners—recommendations made at the instance of this Board, see letter appended dated February the 9th, 1880—(still neglect to employ the niphtmen as frequently as is desirable, and to keep their closets supplied with earth. Some have no boxes for earth, others have boxes not much larger than those used for holding cigars, and most of them supply no earth at ail. The recommendations have not been carried out, or have been carried out in such a Bham fashion as to thoroughly defeat the obj :ct in view, namely, the prevention ef the spraad of typhoid fever by having the excreta disinfected and frequently removed. Since I began to write this report, my attention has been drawn by one of the city inspectors to a nuisance in connection with one of the large hotels in the centre of the town. Two waterclosets discharge into a tank with an overflow pipe which empties into the side channel. A. more disgusting or highly dangerous nuisance it would scarcely be in the power of any one to make, and the attention of the Licensing Bench should be directed to it. In the matter of school hygiene_ I have still to report, as I reported in 1880, that " some of the schools are deficient in accommodation for the number of children attending them, and masters are sometimes obliged to use passages for class rooms. The veßtilation is in some schools very imperfect. Cloak rooms are in several schools deficieat in space, and at none of the schools are they sufficiently removed from' the school rooms, sufficiently ventilated, or capable of being sufficiently heated to dry the clothes. The urinals are at some schools either not concreted; not flushed with water, or not properly drained. The closets have in no instance received that attention which, judged of from a sanitary point of view, they deserve, at all the schools they are without exception deficient ia reßpect of ventilation, not one ot them being ventilated from beneath the seat by a ah-ft running up above tho roof. The pans as a rule are not emptied ofiener than once a week, and there is no attempt made at any of them to nee earth." It onaht to be needless for mo to point out how necessary it is that the Enrroundings of schools should be such as not to be prejudicialto health, for it is well known that young children are peculiarly susceptible to the dtleterious effects of bad air, whether caused by want of ventilalation. by overcrowding, or by the effluvia arising from neglected closets. The State has provided most liberally for education, could not our legislators be induced to go a step farther and make some reasonable provision for carrying out such simple sanitary precautions as will tend to preserve the health of the children and at the same timo teach them habits of decency and cleanliness? Ffficient scavenging ought to be extended to the mora thickly populated portions of the district outside Christchurch and Sydenham. The hole dug in the ground for raceiving excrement iB a dangerous nuieance, and Ebonld bo abolished from every part of the distriet. While the necessity is apparent of making drains to carry away surface and slop water, it must be seen that there are some places where the houFe3 r,ro so scattered that drains cannot be made, the expense would be too great. In such places the plots of ground are frequently so large that the excret* can be buried and the slops disposed of in the gardens without causing a nuisanca. If people will live in _ out-of-the-way places and build their houses in low lyaig damp sites on account of some personal convenience, they muEt make personal efforts to ktep their aurrouuflings in a healthy condition. Several reforms are still absolutely ne'esssry. Abattoirs are urgently required. An infectious diseases hoapital and disinfecting chamber must be provide! as a natural sequence to the compulsory reporting of cases of a contagious character. The health areas must be msde conterminons with the birth and death regutratiin boundaries. The farther information to bo obtainid will be so valuable that the Board Bhonld willingly pay for the extra clerical work, as is tho custom in England. Above all, a system should be deviled for carrying out vacci-

nation with some degTeo of efficiency. 'No hf alth authority which ia alive to the gW.vity of the situation cin qni'tly hold ita pe.**.e while large numbers Df children are permitted to remain in a condition na dangeroaa to the safety of the public ai if no clauses Telt'tvn? to vaccination •were embodied in the Public He-ill h Act. I have the honor to be, lir, Your obedient servant, Courtney Nedwii.li, Medical Offi-er of Health. The following ia a copy of the letter referred to : February 9th, ISBO. To the Chairman of tho Licensing Board, Christehurch. Sir, —I am requested by the Local Boardof Health to call your attention to the danger incurred in licensed houses by the neglect _of proper pre-antiona atrainst tho dissemination of"Ujhoid fever. Acting on the advice of their lajfeni'-diial officer, Dr. Powel), »nd of the proBent officer, Br. Nedwill, thay think it advisable to make the following suggestions : Ist. That the use of earth should be compulsory in all Kceaßod houses. . 2nd. That in all thickly populated localities such closets should he emptied daily. 3rd. That a notice should bo posted inaide the door of each closet reqaes'ing those who use the closet to deposit some dry earth in the pan before shntting down the lid. I have the honor to be sir, Tour obedient servant, (Signed) E. J. S. Haejian, Chairman. The Chairman said tho report, was a most valuable one, and the medical officer deserved the warm thanks of the Board for it. Mr Jones said he concutred with the chairman. He trusted that the public would •tody it carefully, and help to carry out. the suggestions made by the modical officer. He would move—" That the report be received and adopted, and that the thanks of the Board be given to Dr. Nedwill for his very valuable and able report." He trusted that the Legislature would Bee their way clear so to amend tho Vaccination Act as to provide for the vacoination of all children, particularly those attending the State schools. Mr Manning seconded the motion, which ■was carried, and the disousaion of the suggestions contained therein deferrod till next meeting.

Dr. Nedwill reported that he had inspeotod the premises of Mr King, and found that the nuisance was very muoh abated. If Mr King erected a condenser something like that got ont by Mr Hancock, the nuisance would not be heard of again. Mr Hancock had failed with his condenser because he had not made nis tank airtight. If Mr King had a condenser, without whioh be could not get rid of the nuisance, the smell Would be reduced to a minimum. Of course no machine, however perteot, would got rid of the omell of decayed fat stored on the premises, if that existed.

Dr. Doyle moved—" That in the opinion of this Board Iho powers delegated to the City Council under the Public Health Aot should be revoked." In speaking to the motion standing in his name he wished first of all to disavow any intention of hostility to the Oity Council, or allow it to be supposed that he did not look upon them as being perfectly capable and willing to oarry out sanitary matters in the oity, still ho thought the position that the three others, members of this Board, and himself occupied, was ridiculously absurd, after being elected by the ratepayers of Ohristchuroh to represent them to find that the Oity Council expected them to hare no voice in matters of health relating to the city. It oould scarcely be possible that the ratepayers returned them to aot the part of dummies. He regretted that the action of a former Board prevented the four members of this Board returned for Ohristoburch, and the chief inspector, from taking any action in sanitary matters relating to the city, for were they not told that they had delegated their powers ; in fact he could not see why the oity members should be upon this Board, unless they were intended to c-xeroise undue influence over the other districts which had their own representatives. A few years ago it was well leoognised that for sanitary purposes tho city and suburbs could not be divided, in fact it was the practical recognition of this principle which brought the Ohristchuroh District Board of Health into existence. In England it was the rule for the city or borough councillors to aot as the sar.itary authorities within their own boundaries unless it is found necasonry to combine districts for drainage and other sanitary purposes, when tbey ceased to be the custodians of the public health, and gave place to the commissioners appointed over the combined district, leaving only one authority. This is exaotly what had happened here, and he was sure they should not be far wrong if they adopted the rules which had been found to .vork so woll in the older country. Sewers had already boen laid in many parts of tho conjoined district, house connections are daily increasing, and presently the pumping engines will be at work. Ho thought the members of the Board would admit that anything which was likely to lead to collision of authority was a thing to be avoided, and this was the spirit which had actuated him in bringing forward this resolution. They wore Ktr&ra that house connections could net be made with any sewer except by the direction and under the supervision of an officer of this Board, and the Oity Council had no power to compel any one to conneot his premises with a sewer. When the connections were made this Board alone bad the power to see that proper traps were put in and that the connections were afterwards kept well flushed and perfectly clean. They were also aware that this Board alone could compel or allow the connection of any water closet with the sewers, and it required no groat stretch of imagination to pioture such a state as the following: A case of typhoid fevor is reported from a heuse in the city ; the city inspector reports that the premises are all right, but the honse connections are at fault. The inspector from this Hoard says the connections are all right, but the yard is in a filthy condition. That collision will arise in this way no one can for a moment doubt, and a conflict having once taken place they would probably have eaoh body >n its dignity as the Council is now, and supporting its own officers to the detriment of the public and neglect of every .sanitary law. From what he had already stated he thought it must be perfectly patent to the members of this Board that as soon as they began to utilise their sowers, and when everything ought to work smoothly, it would be found that on the contrary clashing must of necessity take place. So deeply sensible .was he of the necessity of united action that if it would satisfy the Council he wonld ■ prefer seeing the four representatives for 'Ohristchuroh on that Board retire, and their places filled up by four members from the Council rathor than run the risk arising from divided authority. His idea of carrying out sanitary work effectually was to have one strong Board of Health that will represent the whole district, and if they affirmed this principle he had little doubt the City Council would assist them in providing ways and means. He was well awuro that the Aot limited their rating powers to Is in the £, but as all the money comes out of the pockets of the'ratepayers, it mattered not to him whether it was levi.d by the Council or by this Board. The Act could ■easily be amended if they agreed with him in thinking that the principle ho was advocating he the right one. Mr Hubbard seconded the motion. Some disou o sion ensued, and Mr Jones suggested that Dr. Doyle should withdraw bis resolution to-day and bring it up to a full Board. Dr. Doyle said he felt the position he occu" pied as a most anomalous one. He was there as the representative of the city without nny power whatever. He had come forward to aid by his knowledge in health matters, and he found that the representatives of the city had no power. Under these circumstances be would far rather leave his aoat altogether. Acting on Mr Jones' suggestion, he would withdraw the motion for the present, as it was an important matter, and bring it up when there waß a fuller Board.

The motion was then withdrawn, and the Board adjourned at 6 p.m.

Fever (mostly DiphScarlet Typhoid). theria. Ferer. Measles Christchurch... 47* 13 8 77 Sydenham ... 62 17 14 25 Avon 15 38 5 20 Heath cote ... 20 3 9 29 Biccarten ... 18 5 1 12 Spreydon ... 0 1 0 2

Fever (mostly DiphScarlet Typboid). theria. Fever. Christchnrch 92 14 14 Sydenham ... 38 11 7 Avon ... 20 19 7 Heathcote ... 33 11 3 Riccartoa ... 4 5 2 bpreydon 0 0 1 187 60 34

m o CT § - t=> B s • S* c 3 bQO oo <=> oo QO oo : : o Ox 00 Cx o* o Estimated population in ro CD 00 OX middle of year. oo Cl Cl Ox Cl Ol •vl Births. CO OX co CO o CO Deaths. u - 0-1 year. O Cl •si 2 o <=> Ox o S. 5 cr Cl Cl o IS £ 1 —5 years. £0 © 3Q *"• bO s| 5 years and over. P-ffl -sj to Principal zymotic o 00 Cl Cl 00 diseases. C/t H-' kr* 1 c ” Measles. 1 - I CO *- Scarlet fever. CO - CO CO | Diphtheria. - 1 - - o | Croup. 1 1 to 1 - Erysipelas. a § 1 ►-* 1 Whooping cough. Fever — mostly o B CO CO UJ CD typhoid. 00 Cl CO k^s CO to ° Diarrhoea. to Ox kf^ to -a Cl Dysentery. ! 1 1 Cl OI Ill-defined cases. _ ■ to Diseases of the , o o to •a respiratorv organs. £ OX CO CO o to Phthisis. Ox CO CO Cl CO Births. CO O to B 30.4 •g_g •a eft o 16 3 15 26 17.98 Deaths. 3 JL ® * 5 s° k£>CO Ox CO Deaths trom != S ’ CD bo Cl Cl to zymotic diseases. Deaths from disOX CO CO Cl eases of respiratory O o CO organs, including i phthisis. Infant mortality rate calV-* 1 culated by proportion o O kf- ! of deaths under 1 year CO t£» o CO to 1000 births regis1 tered.