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66
during this epidemic. At the end of the year 1893, the notifications
of this disease had considerably lessened.
DIPHTHERIA AND TYPHOID FEVER.
One hundred and seventy-eight cases of diphtheria and 66 of typhoid
fever were reported in Poplar; 349 cases of diphtheria and 207 of
typhoid fever were notified in Bromley; 19 deaths through diphtheria
and 12 on account of typhoid fever occurred in Poplar; 45 deaths
from diphtheria and 31 through typhoid fever were registered as
belonging to Bromley. The tables on page 85 shew the death rate
per iooo living. In these tables—to make them comparable with
those of the Registrar-General—diphtheria includes also membranous
croup; typhoid fever with typhus, simple continued and ill-defined
fevers are included under the one heading of Fever.
As soon as possible after the receipt of the notification of a case
of typhoid fever or diphtheria the Inspector inspects the premises and
tests the drains. This plan is carried out in all infectious cases. I
think that the exceptionally hot and dry summer was the cause of a
great many cases on account of the rapid evaporation of water,
whereby many gullies became untrapped. In one of my reports to
the Sanitary Committee I drew attention to the condition of the
street gullies, and in consequence of this report and of another
which I presented to the Board at the desire of the Finance Committee,*
a Committee went round the district inspecting the said
Note:—Extract from my Report to the Board, September 1st, 1893:—" Indeed,
the fact is proved beyond the possibility of doubt; for in a number of instances,
on the testing of drains in private houses by means of the various tests, smoke and
fumes have been found to escape out of the gullies in the public streets, demonstrating
the absence of a proper trap, and the certainty of emanation of sewer gas.
In other cases, on examination, gullies are found to be of obsolete construction;
and others, 4jin. in thickness, built of porous bricks, which, as well as the surrounding
earth, have become sodden with sewage: providing a fair nidus for the
growth of putrefactive germs productive of disease and death." From this condition
I saw that there was a possibility of polluted ground air being drawn into
those houses whose sites were not covered with an impermeable layer of asphalte
or concrete, and that the air of the houses in the vicinity of the gullies would also
become contaminated from them in many ways. The new or re-constructed street
gullies are now faced internally with cement.