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35
Annual Report of the Medical Officer of Health—1868—1869.
"some 15 to 20,000 are killed, and perhaps twenty times that number grievously sickened
and endangered," denotes a people badly fed, overcrowded, intemperate, and using for
domestic purposes water polluted with excrementitious matter. This last cause, and which
is a principal one, is so offensive and disgusting, that no efforts private or public should
bo wanting to prevent its continuance. When the cesspool system was in full operation,
the riddance of this evil was impossible, but now that cesspools are the exception, and,
indeed, only to be met with in some of the better class houses which have escaped the
supervision of Vestries, the object is quite capable of being realised. In every case of
fever, excrementitious matter should at once be disinfected and removed, and full ventilation
maintained.
We have hardly recognised the powerful influence of intemperance in the production of
fever. In the year 1851 a remarkable diminution of this disease occurred in Edinburgh,
and for which no sanitary reason could bo given, inasmuch as no sanitary works in the way
of drainage and the like had been done. Intemperance, however, had been marvellously
diminished, owing to the operation of "The Forbes Mackenzie Act." Precisely the reverse
of this happened in Liverpool. In defiance of sanitary measures which had been carried
out in a vast and effective manner, neither money nor labour having been spared, an
epidemic of fever broke out and prevailed. Previous however to this outburst, the Free
Licensing had come into full practice, and with it a terrible increase of drunkenness. For
four years this gigantic experiment was tried, and for four years this disease prevailed,
showing no signs of abatement. The Free Licensing was abolished, and with that step the
death rate immediately fell, and to a lower degree than it had been for years. I have more
than once in my fortnightly reports placed before you the cost which cases of fever have
incurred. A calculation has been made of the cost of an epidemic of fever, which continued
for three years in Abordoen; and the amount of its cost, lot it be borne in mind, is said to be
understated rather than overstated. Aberdeen is a small healthy town, and one not likely
to have afforded a field for the spread and duration of fever. There were under treatment
1631 persons, at an average of twenty-five and a half days for each, the amount for which
at the moderate rate of 5/- per week came to £4,217: 10: 0. This, with the loss of labour,
loss of life and burials, raised the whole sum to £55,021: 4 : 0, "a tax on the inhabitants
of something over fifteen shillings per head." But no tax could pay for the suffering, sorrow,
and bereavement which was undergone by those who had been afflicted, and who had
lost friend and relative. We have had only one case of fever in thirty-six years, said an
Eldress of the Shakers in America to Mr. Dixon, and we were very much ashamed of ourselves
for having it—it was wholly our own fault.* No doubt can possibly exist that fever
is controllable, and might be abolished as it apparently is by the Shakers; but how few
practice their exemplary conduct, and how few possess their remedies—"good food and
sweet air." In contrast with these, think of our poor with their wretched circumstances without,
and unregulated passions within, and little surprise will exist that fever should be
absent in the one case, and over present in the other.
Hot weather is a great test of the healthiness of towns. A high temperature promotors
rapid decomposition, causes great evaporation, and gives life and energy to the lowest ???
of life. The belief now generally prevails that those latter are in some way or ???
connected with epidemic diseases. The heat during the last summer ???
*Hepworth Dixon New America: quoted from Sir J. Simpson's ???