Yr Wythnos a'r Eryr

Annual Report for the Year 1898 of the Medical Officer of Health of the Edayrnion Rural District. Area of District 43,449 acres Population in 1891 S'1^1 Estimated population middle of 1898, 4913*5 To the Chairman and Members of the Edeyrnion Rural District Council. Gentlemen,—I respectfully submit for your con- sideration my annual report tor the year 1898. The district on which I report is the same as last year, and comprises six parishes (all situated in Mer- ionethshire), as well a the Corwen Workhouse, viz.: Population in 1891. Births. Deaths. Bettws G. G. 252 7 3 Corwen 2680 84 63* Gwyddelwern 727 2b 11 Llandrillo. 725 15 13 Llangar 633 9 15 Llansantffraid G. D.. 164 10 2 5181 151 107 includes 12 deaths in Corwen Workhouse. My calculations are made on the estimated popula- tion, which gives a decreasing population. This is prob .uJ." correct as regards three parishes which are entirely agricultural, but I have no hesitation in sta- ting that the population of the other three parishes, in each of which quarries are situated (or have a direct bearing on the resident community) and worked, there is a distinct increase of population since 1891. The census being only taken every ten years, my calcula- tions must be looked upon as unsatisfactory' and un- certain. I consider it is as important, if not more so, to emmier; te human beings, as it is to enumerate animals, &c. I consider this arrangement should be altered and improved upon. The number of births registered were 151, giving a birth-rate of 30*73 per ioco of the population. Last year the rate was 24*84 in this district. The number of deaths registered are 107, giving a de-ith-rate of 21*77 per 1000 of the population. Last year the rate was 19*59 in this district. The Infantile Mortality was 119-20 per 1000 register- ed births. Last year the rate was 146*34 in this dis- trict. The Zymotic Mortality was "407 per 1000 of the population. Last year it was 40 in this district. Deaths classified as to age (Table A):— Under 1 year 18 I year and under 5 years 13 5 years" 15 5 T 5" „ 25 „ 9 25 „ „ 65 21. 05 years and upwards 41 Total 107 19 of Lliese deaths were 75 years of age and upwards. *2 80 3 over 90 years of age. The birth-rate is a good deal higher than in the year 1897. The death-rate is also a good deal higher than in the year 1897. These rates are liable to fluctuate in sucn a small population from various reasons, and I feel cci-t iin are not an accurate record. Both the birth-rate and death-rate should be less, as probably the population of this district is more than the esti- mate I have made out. Looking at the ages of the dead,—19 over 75 years, also ro non-resident deats, 8 dead from Measles. As this disease will not again assume an epidemic form in the district for several years, this number should be distributed over six or seven years,—the previous epidemic of Measles was in 1892; also three deaths from Influenza. Therefore I consider the apparent increase in the death-rate shows nothing of an alarming nature. The Infantile Mortality figures have again dropped, and are for the year i ig-z per 1000 registered births, compared with 146*34 for the year 1897, and took place as follows :— Bettws G.G.,—Three in number. Cause. Age. I Diarrhoea, Convulsions Five months 2 Debility, Convulsions Six months 3 Premature birth Twenty days Corwen,—Ten in number. 1, 2 Convulsions i mth, 20 days 3 Acute Bronchitis Seven months 4 Premature birth Two months 5 General weakness, Convulsions Two days 6, 7, 8 Measles 9,7,11 months 9 Diarrhoea Four months 10 Abscess Exhaustion Two months Gwyddelwern,-Two in number. I Prematnre birth Thirteen days 2 Acute Gastritis. Two months Llandrillo,—One in number. I Premature birth Seven days Llangar,—Two in number. I Debility from birth, Convulsions 24 days 2 Enteritis, Convulsions. Three months On scrutiny the list does not come out very black. It is satisfactory to note that there is not a single death uncertified, which reflects to the credit of the registrar of deaths. The Zymotic Mortality is low (2 in 107), and these Were laryngeal Diptheria of a malignant type, which took place in the same farm house. There were two cases investigated by the coroner- one a young man found dead in a field near a main road; the other a case of burn. This case gave rise ?.agreat deal of talk at the time,—the clothes of the itn cau5?ht fire in a schoolroom during the midday nterval of school hours. The school authorities saw e.Pecessity of providing a fire guard.; and to the siik* Scvera* school authorities in the district, a IH u £ uarc* anc* Protection has been provided. I may n that such a guard ought to b« provided in every es'^lf house in which there are thriving oli-e branch- si | erhaps such a provision would be termed un- .gntly, but that is, of little, consequence when it ecomes a matter of life or death. EPIDEMICS. There were 74 cases of Infectious Diseases reported during the year, viz.—Scarlet Fever 69, Diptheria 2, Typhoid Fever I, and Erysipelas 2. MEASLES. This disease is not notifiable in this district, there- fore it is usually by accident that I ascertain the presence of the disease, or from serious complications accompanying or following the disease. The disease should be notifiable. The Corwen National Schools were closed for four weeks during the summer months owing to the pre- valence of this disease. Other schools entered on their summer holidays at an earlier period of the sum- mer than usual, and so avoided any compulsory closure of their schools. I drew special attention in my report last year that this disease is most fatal to children below school age, and warned parents or guardians of the necessity of trying to keep such children fom infection. This year proves that my warning was necessary, as we have had six deaths from Measles—the eldest of whom was 16 months old. If parents would bear this in mind when the next epidemic comes round, it would be the means of saving many a life. This time the epidemic occurred during very favourable weather, or from its severity and serious type the number of deaths would have been many more. I may also add that it is a recognised fact that Dip- theria is very liable to follow on the wake of Measles. I gave this note of warning at a Council meeting, and mentioned the desirability of paying close attention to any case of sore throat, however trivial it may appear at this particular time. SCARLET FEVER. Sixty nine cases were reported during the year, and I have reason to know of several more who were not reported, being of such a mild type, and not attended by any medical man, and the parents or guardians pleading ignorance of the nature of the illness, other symptoms and signs occurring during convalescence proving the nature of the primary trifling illness. Such cases are a source of great danger to the general public, as in all probability the patient is going amongst his friends and neighbours during a period ot time in a high state of infection, and it would be well for such patients, their parents or guardians, to bear in mind, for, not only their own sake, but for the sake of others, the necessity of taking all possible precau- tions against diffusing the infection. Also these are most frequently the type of case in which serious complications are liable to follow from such neglect, and the life damaged or rendered practically useless, to say nothing of the liability of being prosecuted for wilful exposure whilst in an infectious state. All the cases were situated in the parishes of Corwen and Llansantffraid, and were of a mild form with very few exceptions. There was no death, but several compli- cations, especially acute Bright's Disease, but all made a satisfactory recovery. It is hardly necessary for me to add that every possible precaution was taken to try and prevent the spread of the disease, as well as to modify its severity. DIPTHERIA. Two cases occurred in a farm house, of the laryngeal type, and proved rapidly fatal. The utmost precaution was taken as regards the other inmates, as well as outsiders, and the disease was stamped out. Reference will be made to the sanitary surroundings here again but I may add that everything considered necessary was done at once to put the place in a satisfactory sanitary condition. These two girls were beyond school age, and played outside the house in close proximity to a stagnant pond and sewer overflow from farm yard for hours daily,—their father sitting by with a broken leg, and I consider that the emanations arising from this filth poisoned these two girls,—the weather being hot during this time, whereas the other children, four or five in number, who attended school, aad did not fre- quent this poisouous spot, did not suffer from the disease. TYPHOID FEVER. There was one case imported into the district, which made a satisfactory recovery without doing any harm. ERYSIPELAS. There were two cases of a mild type. Probably sewer gas had some connection with one case. DIARRHOEA. This affection was not so prevelent in the district as during the year 1897. Two infants, aged respec- tively four and five months, died from the affection. INFLUENZA. There were a good many cases during the year, and were the direct cause of death in three instances in the early part of the year, and the indirect cause in several other instances, as well as conducing to the serious nature of many cases of illness, as well as undermining the general health of many an individual. MUMPS. This disease was prevelent in some districts during various times. Carrog suffered especially. WHOOPING COUGH. A case was imported into the town of Corwen on more than one occasion, but did not spread beyond the farm originally infected. CONSUMPTION. There were six deaths registered as due to Phthisis Pulmonalis, leaving entirely out of consideration any case in which tubercular disease of any other organ or part of the body had shown itself. Since my report of last year a regular crusade has been started against this disease, and I hope the general public will be taught, and will understand, the necessity of taking proper precautions in the interest of the healthy, but may be susceptible, individual. And I may add that the chief sourcc of danger is the sputum, which, if allowed to become dessicated, perhaps has a chance of floating in the air which is breathed, and therefore has an opportunity of entering the body, and perhaps falls on suitable soil for rapid development of its tubercle bacillus. Therefore I repeat my remarks of last year with still greater force, if possible, the abso- lute necessity of destroying all sputum, as well as other discharges, allow all possible free ventilation and sunshine into the sickroom, and thoroughly cleanse as carefully after this disease as after any of the other, now generally recognised infectious, dis- eases. DRAINS AND SEWERS. Drains have been constructed at Blaendre Isa, Ty Du, Carrog, Tai'r Organ and Prince of Wales Inn, Cynwyd. A new cesspool has been constructed at Laburnum cottage, Llidiart y Pare. Serious sanitary defects where found in connection with the sink drains, &c., at the National Schoolhouse, Cynwyd, have been remedied. I look at the mode this sink and drains were constructed and arranged as due to the want of proper supervision during construction, and this in- stance shows plainly that no sink, drain, or sewer, should be closed before the work is seen by the Sani- tary Inspector, as I plainly demonstrated here before any fatal consequences occurred. New drains have been constructed at Hendreforfydd Bach, Hendreforfydd Fawr, Tirllanerch, and Gwerny- pandy; a cesspool in an unsuitable situation, and now closed, and a new one constructed. The privy at Berwyn Arms has been removed after months of arranging, and a new one constructed in a satisfactory situation, after a great deal of trouble. The arrange- ment in connection with the slop water at the Harp Inn Yard, Corwen, is still unsatisfactory. The nuisance arising from cowhouses and pigstyes at the blue Bell Inn, Gwyddelwern, have been abated. Several pigstyes have been closed, including one at Nantfach, three at Cynwyd, many renovated in and about the villages, and nuisance arising therefrom abated. Many ashpits have been attended to, and the one at the Gwyddelwern School reconstructed. In my report for 1897 I commented on the want of privy accommodation generally throughout the dis- trict. Now I have the pleasure of stating that this deficiency is remedied. Within the last four or five years 59 new privies have been constructed. No great progress has been made in connection with the purifi- cation of the sewage of Corwen. HOUSES AND COTTAGES. The old house at the Forge, Derwen, has been Eulled down, and a new one constructed. The new ouse at Llandrillo Station is still under the considera- tion of the Council owing to non-compliance with the By-laws. The house at Harotty Gerrig has been repaired. No satisfactory arrangement has been yet arrived at with respect to the Corwen Almshouses. The out-door sleeping accommodations have been under the careful observation of the Sanitary Inspec- tor, and any faults or defects are attended to and remedied. WATER. A satisfactory constructed channel has been made to convey the brook water across the road in near proximity to the public well at Gwyddelwern, with the object of protecting the water at the well from liabi- lity to pollution. This district was blessed with frequent and copious rain during the year, so there was no complaint of deficiency; so nothing was said or done at Cynwyd, and no great addition in private supply was done by any private owners. Towards the close of the year a petition was presented to the Council by the inhabitants of Melinywig, drawing attention to the public wells and liability thereof to pollution from storm water. The matter is now under consideration. The hamlet being situated in two counties—Merioneth and Denbigh, more time is required to arrive at a satisfactory arrangement. The pump has been put in a satisfactory order at Ty'ny- coed, Llandrillo. The inspector has during the year made a house to house visit, with the primary object of enquiring into the water supply, its source and distance from the habitation. Part of the district has been reported upon, and the complete report will be soon ready, when close scrutiny of which will be ne- cessary and desirable. During the tour of water supply inspection, special attention was also paid to pigsties and privies. I have nothing unfavourable to report concerning any of the slaughter houses, bake- houses, or common lodging houses situated in the district. It is within my knowledge that the Inspector fre- quently calls attention to what may appear trifling sanitary defects, as I do myself during my peregrina- tions about the district, such as manure, ash heaps, any decaying vegetable or animal refuse. In the town of Corwen a cart goes round regularly once a week or oftener, if required, to collect any deposits and any undesirable refuse from houses. I beg to remain, Gentlemen, Your Obedient Servant, HOWEL WHITE, M.B., D.P.H. (Camb.) Corwen, Feb. 15, 1899.