London's Pulse: Medical Officer of Health reports 1848-1972

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Islington 1893

Thirty-eighth annual report on the health and sanitary condition of the Parish of St. Mary, Islington

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41
ending recurrence of untrapped waste pipes to sinks; sinks connected
directly to the drains; small defective drains under the houses; gullies
in cellars; gullies in the cellars, til ted with bell-traps; defective connections
between the w e.'s and the soil pipe; w.e.'s without water supply,
etc., etc.; and so the defects go on with weary iteration.
But persons will say, "These facts prove nothing; a similar state
of affairs has been found in houses in which you have had typhoid fever,
scarlet fever, or whooping cough." I know it is so; but I answer
by saying that if, when the drainage has been put right, there
have been no new cases of sickness in the houses, although children
lived in them, who by reason of their age were likely to be attacked, it
is only reasonable to conclude that the defective drains were the most
probable origin of the disease, especially when no other circumstances
could explain it.
But I have even a better case than that afforded by the absence of
the disease in ordinary houses, which will go far to prove my contention
that Diphtheria is undoubtedly spread by sewer air.
For several years cases of Diphtheria had been constantly recurring
in the Yerbury Road Board School, and apparently without any
cause, so that at last I determined that the drainage system of
the school should be thoroughly examined. This was done, with the
result that very serious defects were discovered, through which it was
possible for sewer air to enter the school. The School Board were then
required by the Vestry to execute certain works, so that the drainage
might be made perfect. They demurred to some of the demands, so
that finally the case came into Court. Several times during its hearing
it was suggested that there was no proof that the conditions which were
discovered had been the cause of the disease, and the Vestry and myself
personally were challenged to prove it. The challenge was not accepted,
but on the contrary the Vestry counsel, knowing the difficulty of such
proof, and that medical authorities differed on the subject, stated again
and again that the Vestry did not allege that the Diphtheria had been
due to the school drains.
This was 15 months ago; but to-day I stand on different ground,
and I have no hesitation in affirming now that the school drains had
been the cause of the constantly recurring cases, because from the date