BOARD OF HEALTH.

Globe, Volume XXIV, Issue 2581, 15 July 1882, Page 3

BOARD OF HEALTH.

The usual fortnightly meeting of this Board was held yesterday at 3 p.m. Present— Messrs W. Vinoent (in the chair), S. Manning, J. E. Parker, L. Harper, and Dr. Doyle. The Chairman said the City Council had taken no step es yet re the proposed oonferenoe. The medioal report was then read as follows : Christchnrch. Jnly 13th, 1892. The Chairman Local Board of Health. Sir, —I have the honor to submit to you my report on the health of the district for the quarter ending June 30th. The following are the numbers of the cases of infectious diseases reported for the three months:—

The mortality in Chr. stchnrch was per 1000 of the population monthly—April 1.03, May 1.03, Jane 1.41; and for the corresponding three months of ISBl—April 1.52, May 1.05, June 1.11. Tha foregoing figures show an improvement for Christclrnrch on the corresponding quarter of 1881. The mortality in Sydenham for the last quarter was—April 1.37, May 0.80, June 0.63 ; and for the corresponding period of 1881—April 1.15, May 2.01, June 1.06. These figures show that the health of Sydenham was very much better daring this quarter than during the corresponding quarter of 1881. Zymotic diseases caused only 5 deaths in Christchurch, 3 from fever and 2 from diarrhoea, and in Sydenham 3 deaths, 2 lrom diarrheal and 1 from fever.

Diphtheria duting the quarter was principally confined to St. Albans, and was credited with 9 deaths in this borough. The Avon district for many years past has not been quite free from this disease. Sometimes only sporadic cases are heard of, at other times it becomes epidemic. During the latter part of 1880 and first half of 1881, on two separate occasions it became epidemic at Papanui, an investigation carried out at that tima with some care excluded anything like a water or milk origin of the outbreak, but proved conclusively that the epidemic form was assumed by the gathering together of children at the Papanui schools. Isolated cases have been reported from the St. Albans district ever Bince the outbreak at Papanui in Cctober, 1880. Thirty-thrca case 3 have beon reported during the quarter from 26 houses. This number does not include all the individuals attacked, as in many families several persons suffered. As at Papanui, bo has it been at St. Albans, milk has not been implicated, and though there socms to have been an impression that the water at the St. Albans school might have been in some way connected with diphtheria, an analysis of three samples from the school by Professor Bickerton has shown it to be perfectly wholesome. There is the strongest evidence, however, to prove that the public school is mainly responsible for disseminating the disease.; in several instances children remained in attendance up to the time of taking ill. Tho school premises are clean, and cannot be held liable for giving rise to the outbreak. It is generally admitted that low-lying, badly drained sites pre dispose to diphtheria, and there seems to be an increasing amount of evidence iu favor of the same insanitary conditions which cause typhoid fever being equally potent in developing this complaint. In what condition is St. Albans T The whole of the district has been for years saturated with house slops and excremental human filth, and the absence of any dustbins has permitted heaps of decaying matter, both animal and vegetab'e, to accumulate iu the immediate neighborhood of dwellings. In the p pulous portion of St. Albans alone, a recent examination by the Inspector disclosed the fact that 200 resspools were still in use. It is a further significant fact that of twenty-six houses in St. Albans from which cases of diphtheria have been reported, only two of them are connected with a sewer ; seventeen are in streata in which no sewer has been laid, and the remaining seven houses are in streets in which there are sewers, but the owners have not connected. So much for the absence of house drains. As no fresh cases have been reported since the 28th June, and as the school has been disinfected and well ventilated, I think it might now be opened. Great caution, however, will have to be exercised by the master in admitting pupils, and it appears advisable that in the case of those families which have had diphtheria in their houses, a further absence from school of four weeks should be required of their children. In connection with this outbreak I would again remind the Board of the necessity of providing an infectious diseases hospital. Disinfectants I find are only very sparingly ÜBed, the expense in many instances appearing responsible for this neglect. I wonld therefore advise the Board to procure a stock of disinfectants, to be sold at cost price or given away if necessary to those unable to purchase them ; and further I wsnld advise that where it appears unlikely that iiisinf ecticn will be properly carried out the Board shonld itself do the work-

The subject of the licensing and inspection of dairies should not be allowed to remain in its present unsatisfactory condition. Epidemics of disease through the agency of milk brought about a state of pablic feeling 'which demanded an Amended Health Act and an Order in Council Ai jet the amended law has not been takes hdviutage of to control dairies and protect the public ; tor those purposes the Board bhonld take ac ion in two directions. However advisable it might be to have a medical man as inspector of dairies, it seems doubtful if the public aro prepared, at the present, to pay for such as inspector. I therefore recommend the Board to move the Government firstly to have the Order in Council so altered that it may no longer be a condition that the inspector should be a duly qaalified medical man; and secondly, to make provision to charge a feercr a license. Aa in linglaud, I ihink tho order should exempt from its operation the owners cf only one or two cows, wht» sell milk to their neighbors for th'ir convenience. The Board cannot reasonably be expscted to keep watch over hosts of such small holders, they should not ba encouraged to sell milk excapt to iheir neighbors, who will be in a position to protect themselves. When_ infectious disease occur 3 among such people, it is almost certain that; he psrsou who nurses tho patient milks tho cows. Large dairy keepers, for the best of reasons, will keep thsir premises clean, and allow no parson to conse near miik who has been in connection with infoctious sickness, because the pecuniary risk of having their dairies closed will be too giOit. The Board should take advantage of Parliament being now in session to again bring under tho notice of the Government tho unsatisfactory state of the law with regard to tho vaccination of children attending tho public schools It will be remembered that Government in September, 1881, forwarded circulars to pablic vaccinators, quoting the following (164th) Eection cf tho Pablic Health Act: -"Every child admitted to any school which Bhall be maintained in whole or in part by grant or froai rates, or from any public funds, or by any endowment, whether colonUl, provincial, municipal, or_ district, sbill be vaccinated by a public vaccinator, unless such child shall have been previously vaccinated,'' and stating that " it was the desire of the Government th-rt the above provi" ion of the Act Bhall be cirricd out, and j on requested to tako tho necessary stepj to vaccinate those children attending any such schools as may be included in the terms of tho Act, who have not been previously vaccinated." " Tho necessary steps" were taken in this district, at the satae time the Public Vaccinator informed Government that the line laid down in the circular for the guidance cf tbo Public Vaccinatorf could not be pursued without breaking the law, and advised Government that' the only safe course a Public Vaccinator could follow was to visit the schools without previous notice, eo as to ascertain the n-imes of all thoso unvaccinated ; tHr.l the parents or guardians of all uMvacoinntad children should bo served with notice calling upon them to have vaccination performed within a specified time ; nnd that failing to comply with tho provisions of the Public Health Act they saould bo summoned before a Magistrate for di»obedionce cf the law.' Government wisely withdrew from the position taken up in the circular but, unwisely, I thirjk, shrank from the responsibility of authorising public vaccinators to ascertain, by examination, whather vaccina*io;> had been performed. Tfce decision of Government was in the foilowirg words :■—" That as the Publio Health Act p (.rides Baltic, tbo ohildrau, as schoolchildren cannot bay acoina ted in case •: t'tir refusal and as it is not expedioat to insist upon examining the children in schools

in direct opposition to the will of the echoo! committees, tie Government regret they are not able to pat yon in a position to carry out your recommendV.ionß." There the matter rests, and I think the above fact* fall; justify me in sajiag that it leaves the subject of ccheol vaccination in a most unsatisfactory position. I trust the Board mil continue action nntil the regiatration area is made conterminous with, the _ sanitary area. At present I can five statistics of abont cnly one-balf of the district—for Christchnrch mi Sydenham, As lithographed map; of <he combined health diatrict, pointing ont tha different portions, hare been prepared and forwarded to medical practitioners, Government should again be requested to instruct the local registrar to make separate returns and charge for them. Under any circumstances in the case of St. Albans, which has been constituted into a borough, there can be no possible objection azainst treating it in the eame way as Christchnrch and Sydenham. In the case of de iths t ciurriit g at the hospital there is nothing in the local registrar's bo;k to show whether the persons were residents of Christchnrch or elsewhere. 1 his infcrin&Tian could easi'y be supplied, and would enable 21 e to report without waiting to see ths BegistrarGeneral's returns. I have the honor to ho, sir, Tour obedient servant, (Signed) Coubtkbt Kxdwill, Medical Cffiacr. Mr J. B. Parker moved, Mr S. Manning seconded, and it was resolved—" That the suggestions in the Health Officer's report respecting St. Alban's rchools be earned out." After discussion, Dr. Bed will was requested to see what recommendations he can bring forward at the next meeting of the Board as to the best disinfectants, and the prices at which they can Id be purchased in bulk. Respecting the inspection of dairies, and compuliorr vaccination, the Chairman suggested that a letter on same be drafted and sent to the Colonial Secretary and members for the distriot, with Dr. Ned will's report attached. On the motion of Mr J. E. Parker, Messrs W. Vinoent, S. Manning, Dr. Doyls, ard the mover, were appointed a sub-committee foe that purpoie. This was all the business.

i S.& .2 1 Q S a 3" 1 Christchurch 6 4 9 2 Sydenham ... 13 4 10 1 vivon... ... — 3 1 _ Heathoote ... 6 3 2 2 Riccarton ... 2 _ yproydon ... — _ _ 3t Albans ... 1 33 — 1 28 47 22 6=103 According to the months they were distributed thug: — April 17 12 43 1 May 4 17 12 2 Jane 7 18 7 3 28 47 £2 6 The numbers repor!?d for the corresponding three months of 1881 were :«■» 50 21 18 19=111 Distributed thus : — Christchurch, 15 3 1 5 Sydenham ... 17 7 8 3 Avon 7 13 2 2 Heathcote ... 9 — 6 7 Riccarton ... 2 1 1 2 And according to the months — April 15 6 4 0 May 32 9 6 2 Jane ... 3 9 8 17