The Sun.
London, England, 1859-05-19 00:00:00

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PRICE 4D. STAMPED, SD,

MR. SIMON'S REPORT ON ME
PUBLIC HEALTH.

A pocket blue-book of 40 pages contains a report
of the medical officer of the Privy Council on Pub-
lic Health. Mr. Simon first recapitulates the pro-
ceedings taken during the year ISSB, under the
Public Health Act of that year, especially as regards
public vaccination. It is likely to be arranged, in
conjunction with the College of. Surgeons, that a cer-
tificate shall be required from some public vacci-
nator, to the effect that the candidate for the
diploma of the College of Surgeons has prac-
tically studied vaccination and its results. Ar-
rangements have also been made for the supply of
lymph, so as to compensate for the advancing
diminution of those sources of lymph on which the
public had heretofore depended for supply. The
largest vaccinating station of Manchester had be-
come contributory to the lymph supply of the
National Vaccine Establishment, and Mr. Simon
thinks this step of great importance, as the con-
nexion of provincial stations with the Central Vac-
cine Board, by making them superintendent con-
tributories of lymph, is a first step towards giving
them that special position and guaranteed charac-
ter which would suggest their being recognised as
national schools of vaccination. Another advan-
tage will be the making of a commencement towards
what may hereafter fill a present want in medical
education. It will hardly be believed that hitherto
many a medical student has completed his studies
without having had any convenient opportunity of
learning to vaccinate ! It has therefore often been
wished that some well•frequented vaccination
stations, situate in those large towns where medical
schools mxist, could be available for educational
purposes.

Mr. Simon has most hiudably made local inquiries
relative to the prevalence of disease and its preven-
tion, in Conway, Windsor, and Wrraysbury. In
Conway it was found that the sanitary laws were
most inefficiently- administered, and that cleanliness
was disgracefully neglected. There was scarcely
any house-drainage, privy accommodation was
miserably deficient, andpigs abounded; in short,
within tho walls of this dirty town (so well known
to tourists in Wales by its fine old castle), nuisances
existed to a flagrant and dangerous extent. The
diseases actually existing in the town at the time
of the inquiry could not, Mr. Simon admits, be pro-
perly imputed to the state of the place ; but in
other respecti Conway has not altogether escaped
from the ordinary consequences of filth. The pro-
visions of the law were to be more strictly en-
forced, and a " Nuisance Removal ' Board has
since been nominated. At Wraysbury, and, indeed,
in the whole Eton union, there was apparently
great insufficiency of vaccination, and malig
nant smallpok was carrying all before it. The typ-
hoid fever at Windsor (a common " filth fever," as
Mr. Simon styles it), is clearly traceable to unclean-
liness and extreme slovenliness in the removal of.
filth. The nuisances were literally innumerable,
and the town had as many stenches as—or more
than—the famous old city that adorns the banks of
Father Rhine. But the great evil was defective_
sewage arrangement, the external ventilation being
utterly inadequate. In fine, " the system of sewer-
age, with frequent domestic defects of sink trap-
ping, favoured the habitual escape of sewer atmos-
phere into houses ; last year, from accidenal cir-
cumstances, the sewer atmosphere was at about its
maximum of poisonousness, and the result was an
epidemic of typhoid fever." Disease, however, the
precursor of " pale death," did not on this occasion
verify the aphorism of the Roman poet ; for,
while it unscrupulously invaded " the cottages
of the poor," it passed by " the palaces of
Kings." Windsor Castle, in fact, was remarkably
exempt from the pestilence, a phenomenon to be
attibuted not to "the divinity that cloth hedge"
Kings and Queens, but to the very prosaic secon-
dary cause of obedience to hygienic laws, the
drainage of the Castle being abundantly ventilated
and in capital order, and, in curious corroboration
of this position, it is shown that while the " Castle
proper," which is drained apart from the town, was
free from fever, the cloisters and the mews, de-
pendencies of the Castle, which alone were in
communication with the town sewers, were severely
scourged by the epidemic. The Local Board of
Health is denounced as not irresponsible for the
existence of the fatal causes at work, while Mr.
Austin, Mr. Simon's collaboratorr on this occasion,
severely stigmatises the incompetence of the town
surveyor—a charge which Mr. Simon endorses with
opinions of members of the boardrespecting his "cul-
pable inefficiency." Mr. Simon has reason to doubt
that typhoid fever was at Windsor communicated
by contagion, although he will hazard no assertion
on the general principle. The result of Mr. Simon's
valuable inquiries afiout the disease (epidemic) of
diptheria cannot be submitted to their lordships for
some time to come. A part of them will, it is hoped,
be ready before the autumnal recess, in the form of
a supplement to the present report. On the gene-
ral state of public health in England, to which Mr.
Simon very briefly refers, the essential points
evolved are-1, the present very large total of deaths,
and, 2, the inequality of their distribution in different
districts of the country. There are, as already
shown, 100,000 deaths every year that ought not
fairly to take place ; these 100,000 deaths (in ex-
cess) are due to bad drainage, impurity of water,
overcrowded and uncleansed habitations, want of air,
unwholesome occupations, neglect of children, and,
above all, the omission or malpraxis of vaccination.
Towns are the chief sufferers, although it is not in
towns alone that the means of public cleanliness
are neglected; for in hamlets and villages, no less
than in cities, refuse often remains unremovcd from
about the dwellings of the people; but in this case
the quantity of nuisance in proportion to the quan-
tity of wholesome ventilation commonly remains
small, and an amount of sanitary neglect, which to
dense urban populations would be the sure cause of
great 'mischief, remains comparatively harmless in
rural districts with scattered populations.
Some of the diseases consequent on a violation of
the sanitary laws are shown to prevail twice or thrice,
some 10 or 20 times, some even 40 or 50 times as
fatally in some districts as in other districts of
England; the result being that the mortality of
some districts is higher than that of others by 50 to
100 per cent., and that the death rate of the whole
country is 33 per cent. above the death rate of its
healthiest parts. These facts arc startling, and
Mr. Simon does not wish to soothe the public mind
into the slothful apathy of indifference by disguising_
the truth, or " prophesying smooth things." The
second part treats generally of the state of public
health in England, and the remarks on this head
are so important that we extract them without
abbreviation :
" The essential points which I deem it necessary to
bring under your lordships' consideration are—first,
the present very large total of deaths ; and secondly,
the inequality. with which deaths are distributed in
different districts of the country. From the Regis-
trar-General's last quarterly report I learn, that in
the year 1858 the deaths in England amounted to
450,018. If the views be correct which in the above
mentioned report I had the honour of submitting in
detail for the consideration of her Majesty's Govern-
ment, this mortality very greatly exceeds the normal
rate of death. It represents an excess of at least 300
deaths a .day above what the best authorities consider
the natural and attainable death-rate of England;
and if this death-rate, which fortunately is habitual
in a tenth part of the districts of England, had not
been exceeded by the death-rates of the remaining
population, there would have been in the year 1858
a saving of more than 100,000 lives. In the report
already referred to, I have stated the grounds on
which it seems certain that, if only a few simple
sanitary faults were corrected throughout the coun-
try, the average annual mortality might be reduced
even to this large extent. Absence of proper
drainage and scavenging, impurity of water supply,
overcrowded, ill-ventilated, uncleansed dwellings ;
—unwholesome conditions connected (but often
not necessarily connected) with the pursuit of
certain branches of industry; neglect of children,
incidentally (but Pot unavoidably). arising from the
employment of mothers in factories ; omission or
mal-performance of vaccination : these few heads
indicate our chief sanitary evils, and their average
annual fatality may safely be reckoned at more than
100,000 deaths. As regards the local distribution
of this large excess of mortality,
speaking generally,needhardly
inform your lordships that,
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in 1858. The faculltdeoiasftsristhboueftliarge total excess, taken
in conjunction with the statement just quoted, and
with such information as can be gathered from the
quarterly returns of the local registrars, is all that