Dr. Morris, medical officer of health for Rushden, in the course of his annual report, presented to the Rushden Urban Council, says :-
The estimated population is 13,658, and the number of inhabited houses 2,932.
The majority of the inhabitants are engaged in the manufacture of boots and shoes and processes incidental thereto.
There were registered during the year 287 births (142 males and 145 females), giving a birth-rate of 21.01 per 1000 of the estimated population, viz., 13,658, as compared with 281, or at the rate of 20.08 per 1000, last year. One transferable birth was received, and eight births were illegitimate.
The deaths from all causes numbered 121, or at the rate of 8.8 per 1000 of the population, as compared with 126, or at the rate of 9.3 per 1000, last year. Of the deaths registered 16 were transferable, one of which had only resided in your district for about three weeks.
Infantile Mortality
Twenty-four of the deaths recorded were of children under one year of age, giving a rate of 83.6 per 1000 registered births, as compared with 28 deaths at the rate of 99.6 per 1000 registered births last year.
While the general death-rate has been steadily declining throughout the country, there has been no corresponding diminution in the mortality of infants under one year of age. As a rule the mortality is greater with industrial conditions.
The real causes are chiefly centred in two factors the nature of the food supply of the child, and the income of the parents, and, therefore, the diet and nutrition of the mother. If the mother is healthy, well fed, and comfortably housed, and can, and does, nurse her own offspring, the chance of the infant in the first year of life is increased three or four times. Nothing can take the place of the mother’s milk, and it would indeed be wiser and more economical to feed the child through the mother.
Scarlet Fever
Ninety-eight cases were notified thirty-seven in the first, twenty in the second, fifteen in the third, and twenty-six in the fourth quarters respectively. The disease was generally of a mild type, no death having been returned from this complaint.
Scarlet fever has in recent years increased enormously throughout the country, and is practically endemic in this and many other industrial centres. Mistakes in diagnosis and delay in notification naturally add to its continuance and extension.
It was found necessary during the year to take legal proceedings against the parents of some children for failing to notify their children who were found running about the streets in the peeling stage.
Another case which came under my notice was of a boy who was at home unwell. This boy was sent for by the School Medical Officer to be examined, and on presenting himself at the school was found to be in an advanced stage of peeling. On these premises being visited by your Inspector it was discovered that the boy had been allowed to play about the house and two more notifications were subsequently received.
Several other cases were found to be in the advanced stage on notification being received, and it is hoped the legal proceedings taken will act as a warning to parents and impress upon them the need and duty of early notification and isolation.
Small Pox
I am pleased to again report there has been no necessity to use the Small Pox Hospital during the year.
The suggestion to use this Hospital for Consumptive Patients appears to be a good one, and I trust the County Authority will see their way clear to adopt these premises for that purpose and thus benefit some of the persons notified in your district.
Diphtheria and Membranous Croup
Twenty-two notifications referring to diphtheria were received during the year, as compared with thirty-eight in the previous year, and forty-three in the year 1910. In fifteen cases bacteriological examination was obtained, and of these, nine gave a positive result, and six negative. It is to be regretted that this is not done in every instance, as, in accordance with the provisions made by the Council, no charge is made to the medical practitioners or the patients.
The free supply of Anti-toxin to suitable cases is still available, and it was procured for most of the cases, a supply being kept at the Council Offices for that purpose.
Two deaths are returned from this disease, both being transferable, one between five and fifteen, and one between twenty-five and forty-five years of age.
Enteric Fever
I am pleased to report that no cases have been notified from this disease during the year.
Diarrhoea
Only two deaths are reported from this complaint, both of which were of children under one year of age, as compared with nine deaths in the previous year.
Measles
This complaint is not notifiable in the district; no deaths have occurred.
Whooping Cough
One death has been returned from this disease of a child under one year.
Bronchitis and Pneumonia
Two deaths have occurred, both of which were under one year of age.
Phthisis
Sixteen deaths have been returned from this disease, as compared with nine in 1911, and fourteen in 1910; one between one and two, two between five and fifteen, seven between fifteen and twenty-five, and six between twenty-five and sixty years.
Other Tubercular Diseases
Six deaths have been returned; one under one year, one between two and five, two between five and fifteen, one between fifteen and twenty-five, and one between twenty-five and forty-five years respectively.
Cancer and Malignant Disease
The deaths again show a decrease on the previous year, only seven deaths having occurred, as compared with nine in 1911, and fifteen in 1910. Five deaths were of persons between the ages of forty-five and sixty-five, and two over sixty-five years.
Accidents and Suicides
One death has been registered as the result of accident, and two from suicide.
Puerperal Fever
Two cases were notified from this disease, with one death.
Erysipelas
Seven cases were notified from this disease, as compared with nine last year. No deaths have been registered.
Tuberculosis and Consumption
Sixteen deaths, one being a child under two years of age, were attributed to pulmonary consumption; Two deaths were between five and fifteen, seven between fifteen and twenty-five, five between twenty-five and forty-five, and one above sixty-five years of age.
In the campaign against tuberculosis the year will always stand out with special distinction, and have far reaching results, and which indeed will in all probability, make, in a comparatively short period of time, this a rare disease.
Housing Accommodation
The systematic housing inspection of the district has again received attention during the past year, and a number of houses have been inspected and their sanitary conditions and surroundings inquired into and entered in the register provided for that purpose. This branch of special duties takes up a considerable amount of time, and involves a large amount of re-inspection work, which is carried out by your Sanitary Inspector.
Special attention has been given to the sanitary requirements of these premises; in some instances shallow wells have been closed and the town water laid on to the houses, new glazed stoneware sinks have been fixed in a number of houses in place of insanitary and defective quarry sinks, several houses of the “back to back” type have had their ventilation improved, either by fixing windows in their blank walls, where possible, or by carrying a shaft through the ceiling.
During the year twenty-six houses were specially reported upon. Five houses, which on inspection were considered to be in such a state as to be unfit for human habitation, have been closed, the remainder either having been repaired or are receiving attention at the time of writing.
There are a good number of houses in the district with a large number of occupants, but these do not come under the legal definition of over-crowding, but are certainly occupied by more people than is desirable.
Four cases of over-crowded rooms were discovered during the year, but as the Housing Accommodation at present is heavily taxed, owing, no doubt, to the exceptionally busy state of the staple industry, it is difficult to deal with over-crowding when discovered; although, taking the town generally, I do not consider there is much over-crowding to be complained of.
The National Insurance Act, 1911, provides for the appointment of Insurance Committees in Counties and County Boroughs and gives them and other bodies among other powers, authority to allege, if they think fit, excessive sickness in any district to be due to the bad housing, insanitary conditions, or neglect on the part of Sanitary Authorities, and to apply to the Secretary of State or to the Local Government Board for an enquiry. The person holding such enquiry, if satisfied of this, will have power, under certain conditions, to apportion blame and to penalise local authorities or owners of property for neglect, and to award costs.
The tendency of legislation in recent years has been not merely to largely increase the actual work of the Medical Officer of Health, but to add generally to his responsibilities in every direction, without providing for any commensurate remuneration.