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41
Annual Report of the Medical Officer of Health—1896.
subject of practical disinfection is beset with difficulties. When I took office in 1892
I found, as I have said, one notification book and one notice paper for schools ; one
man who acted both as disinfector and as mortuary keeper; one hand-cart both for
conveying infected goods to the apparatus and bringing them back again after disinfection;
and an inefficient hot-air disinfecting apparatus.
We now, in 1896, have eleven books, eight notice papers, two disinfectors (one of
whom attends mortuary and Coroner's court); two hand carts, kept separately, one for
infected and one for disinfected goods; one of the best possible modern types of disinfecting
apparatus; and use of the Guy's Hospital incinerator for destroying infected
articles.
The difference between 1892 and 1896 represents, I submit, an enormous advance
in practical disinfection. For all that, it may be freely admitted that the present
system is far from perfect. That view I have repeatedly urged upon your Vestry.
In my Annual Report for 1892, I advocated efficient fumigation and free exposure
to air. These two steps are impossible unless the infected room or rooms be vacant
for at least twenty-four hours. In this poor parish a majority of the inhabitants live
in crowded rooms and tenements. The question naturally arises where persons thus
circumstanced are to go if shut out from their room or rooms for twenty-four hours.
In other words, we come round to what I have so often pointed out,—namely, the
want of a reception-house for individuals who have been exposed to infection.
As already said, I agree with the general conclusion of the Sub-Committee that
our present methods of room disinfection are imperfect. I cannot agree with them,
however, in tracing that imperfection altogether to a failure in duty on the part of
the disinfectors. I am inclined to seek the root of the matter first, in the shortness
of time during which the rooms are empty and available for sulphur fumigation, and,
secondly, in the smallness of the disinfecting staff. In the majority of disinfections
dealt with in this parish, about 75 per cent. of the inmates want to sleep at night in
the rooms that have been sulphured during the day. This leaves practically some
eight hours for fumigation and airing, which is, in my opinion, a totally inadequate
allowance. As to the second defect, the want of more disinfectors, the average
number of disinfections carried out in a year is 400. Were these evenly distributed,
the present staff would no doubt be sufficient. As a matter of fact, however, the cases
often come in six or eight in a day, and then it is out of the question for two men to
do the work with any approach to thoroughness.
As to cleansing infected rooms, and stripping paper from walls, it has always
seemed to me that such steps were highly desirable, In organising a system, however,
it seemed to me unwise to attempt too much at one time. My energies have, for the
last four years, been centred upon the refuge house, as that seemed to me to be the
pivot of proper disinfection. Should the Vestry decide to cleanse rooms and strip wall
papers under Section 60, it will be necessary (1) to organise a staff for that purpose;
(2) to provide a shelter for persons who would be ousted from their rooms (this would
be more than ever needed, because the process would become one of days instead of
hours, and the walls would be damp.)
As regards the alleged defects in the disinfectors' work, I would point out that no
specific complaints have been made to me by the sanitary inspectors. Ever since I
have been in this parish, the details of practical disinfection have been superintended
by the inspectors, with the understanding they should consult me as to any difficulty
or defect that might arise. It has also been confirmed by the action of Mr. Edwards,
chief inspector, who has invariably given the requisite orders to the men engaged in
disinfection. He has never, so far as I can remember, called my attention to anything
wrong in disinfection, except as regaids a few articles damaged in the steam apparatus.
He has also given verbal instructions to the disinfectors, as I have myself, although I
admit that I have never given written instructions. When I took office the disinfector