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(3) the outbreak of Typhoid Fever; (4) the exceptional mortality in
the Workhouse; and (5) the continued mortality from Consumption
and other Tuberculous Diseases, and from Influenza.
The extreme heat made apparent sanitary defects hitherto
undiscovered, rendered food, especially milk, not produced and
transmitted under perfect sanitary conditions, dangerous, and injuriously
affected the feeble and the aged. The deaths from
Measles and Whooping Cough occurred chiefly amongst the
children of the poor. These diseases not being at present on
your list for notification were not brought to my notice until the
death returns came in, and therefore I could take no measures to
prevent the mortality. The outbreak of Typhoid was traced to
milk imported from a distant county and from abroad. It is deplorable
that the health and the lives of the people should be at
the mercy of railway directors, who will not allow the churns to be
sealed whilst in transit, and of careless English and French farmers,
and of ignorant peasants. No milk should be allowed to enter a
district unless brought in sealed vessels and accompanied by a
certificate from the Medical Officer of Health of the district where
it is produced. Until this is the law, all milk should be boiled
before being consumed. The deaths from Tuberculous Diseases
amount as usual to about 10 per cent. of the total mortality.
CRUSADE AGAINST TUBERCULOSIS.
Since my last report a national crusade against this insidious
foe has been commenced under distinguished auspices. Your
Council, as the Guardians of Health for the district, can help
forward this good work by carrying out the following recommendations:—
(1) by the provision of a public slaughter-house where
all meat killed in the district and all meat imported may be inspected;
(2) by the stringent enforcement of your by-laws for
milk shops, dairies and cow sheds, and by requiring that all dairy
cows be tested by Tuberculin; (3) by the frequent examination of
the milk sold in the district to ascertain its freedom from the
tubercle bacillus; (4) by arranging for the notification of all cases
of Tubercular Disease; (5) by the disinfection of all rooms occupied
by tuberculous patients; (6) by means of frequent periodic houseto-house
inspections, raising the sanitary condition of all the houses
in the district, and (7) by the distribution of appropriate literature.
UNHEALTHY HOUSES.
The basis of all sanitation is a healthy dwelling-house. My
official duties have brought to my notice many houses, the state
of which is most insanitary. I find in my notes on Elm Bank
Cottages, where the typhoid outbreak commenced, the following
entries: "parlour: damp wall, floor joists defective; kitchen:
damp wall, floor joists defective; bedroom: damp wall, stair
"wall defective; scullery: floor defective, walls dilapidated;