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the grounds and penetrates the wards during the periodic burnings which are
carried out. With the wind at all high, paper and dust of all kinds is carried into
the Infirmary grounds and buildings. I submit that these heaps constitute a
nuisance, and are distinctly detrimental to the health of the inmates, and appeal
to you to use your powers to put a stop to them.
With regard to the distances from the Infirmary to the boundary wall between
it and the siding, they are as follows:—
From the wall to the laundry, where women work and two of the staff sleep,
is 25 feet at about its centre. From the wall to the nearest ward is 55 yards. The
distance from the wall to the trucks I do not know, but it certainly does not exceed
10 yards at the west end. The amount of refuse removed by the Borough Council
from the Infirmary never amounts, at the outside, to two loads a week; the average
number dealt with at the siding being for this year 146. All the cases of enteritis
reported to the Committee have been, as I have already explicitly stated, cases
which developed the disease in the Infirmary.
With regard to the reports of the Local Government Board Inspector and the
Medical Officer of Health, the former states " that the evidence does not
suffice to show that the cases of enteritis were caused by the refuse "
The latter states " that because the handling of dust takes place near
an institution where children have been attacked by enteritis, it is by no means
necessarily a case of cause and effect."
It is preposterous to read either of these guarded statements as an expression
of the opinion that cases are not caused by the refuse, and still more preposterous
to take them as actual proof that the dust does not give rise to disease.
On the other hand, the Local Government Inspector states that the arrangements
are unsatisfactory, and at times give rise to a nuisance. This absolutely
confirms and justifies my reports.
Further, the Medical Officer of Health states that the farthest distance he has
ever detected the smell of dust was 85 paces from the carts, when a very strong
wind was blowing and work in active progress. But the work is in active progress
every week-day, and strong northerly winds have been prevalent, while the distance
stated is sufficient to carry the smell right into the wards.
This, therefore, again confirms my reports as to the nuisance, and only
strengthens me in my firm belief that the refuse is the cause of the outbreak of
enteritis and the resulting deaths.
(Signed) H. W. BRUCE.
A deputation from the Southwark Guardians attended on July
7th, 1913, before the Works and General Purposes Committee.
In a letter dated August, the Local Government Board communicated
with the Council asking for their observations and for a
report from their Medical Officer of Health.
The matter was considered by the Public Health Committee on
September 16th, together with a report from one of us, the main
features of which were to point out that the mortality in the
Borough corresponded generally with that of the St. Saviour's
Infirmary; that is, if there were many cases of enteritis in the
Borough it existed to excess at the Infirmary, and vice versa. It
was also pointed out that from Constance Road Workhouse and
from the immediate neighbourhood the Council has had no complaints
of the dust.
It will be seen that there are two questions to be dealt with—
(a) dust removal, (b) enteritis.
(a) So far as the first is concerned, Dr. Bruce's main allegations
are of dust-heaps left in the siding, half-full trucks left over Sunday,
in addition to the general complaint of the dust blowing about,
and of the smell of refuse and manure. (Letter of August 11th.)