Old Ilkeston Logo

Disease in the town

(Ilkeston’s water supply)

The drainage of the town was a very primitive affair.
True, there were grates in the streets, but as there was no carrying water, anyone going through the streets after the midday meal, especially on Sunday was assailed by the unpleasant smell of cabbage water, etc.
But people were glad to have this way of drainage, inefficient as it was, rather than the old cesspools.

The Buchanan Report.

In 1870, in connection with a fatal epidemic of scarlatina and prevalence of enteric (typhoid) fever, the inspector for the Medical Department of the Privy Council George Seaton Buchanan produced a report on the Sanitary Condition of Ilkeston.
He discovered that ‘excremental pollution’ was widely diffused in the water of the town and cited ‘ill-kept roads and unclean channels’, overflowing ashpits with filthy refuse, and pig-styes far too close to cottages.
(See Mrs. Joseph Scattergood).

Street scents and disease.

It was shortly after the smallpox outbreak of 1872/73 — in May 1873 — that the Pioneer returned to one of its popular themes – ‘have a go at the Local Board members’.
The newspaper believed that the actions and premises of several members of the Board were responsible for some of the more foul smells bedevilling the town at that time – smells which the Board was conveniently overlooking.

“STREET SCENTS, as patronised by members of our Local Authority, are becoming quite fashionable and noteworthy, on the approach of summer days and sunny weather.

“Houses have for some time past been pretty well fumigated with strong scents by the illustrious sub-medical officer (Dr. Robert Wood) and sub-inspector (Woolstan Marshall), with a view to prevent the spread of disease. The streets, it appears, are to undergo a different process, under the management of certain members of the Board, uncontrolled of course, by the Medical Officer, Surveyor, and Inspector of Nuisances. The scent most approved is produced by a concentrated mixture of house refuge and slops, and pig and stable manure, which is carefully deposited on the causeways, in the channels, and on the carriage ways in the Market-place, Bath-street, and other chief thoroughfares of the town. The delightful fragrance of this mixture is most frequently scented near the residence of some members of the Local Board, and generally at mid-day, when people are going to or returning from the factories, or taking their evening walk. The right of these particular members to monopolise the distribution of this scent in their respective localities is spiritedly preserved and patronised, and attempts to create the same sweet fragrance in quarters not inhabited by members of the Board, are promptly repressed and the parties punished or threatened with punishment.*(below)

 “Many ratepayers have an idea that these scented muckheaps in the town streets do not emit a very pleasant odour, and are not less hurtful to the public health than the pigstyes and cesspools in the gardens of the poor, about which the richly-paid officers of the Board indulge in much tall talk, and to suppress which, the iron fangs of the law are often needlessly applied.

“When and wherever street scents are patronised by members of the Board, it might not be amiss if the said members would place themselves in the centre of their mixture, and there remain until its sweetness has fully evaporated”.

* For example, see what happened to John Woodroffe in Mount Street.

In 1874 the Local Board announced the ‘discontinuation of free removal of night soil’.
It would no longer organise the emptying of privies, privy cisterns, ashes pits, etc. gratuitously as heretofore. Householders could now do this independently or apply to the Inspector of Nuisances who would organise removal for a fee.

In June 1879 there was another outbreak of enteric fever in Ilkeston, followed by one throughout 1880, with a total in that year of 191 cases and 17 deaths.

In July 1880 a resident in Station Road wrote to the Local Board, stating that he and his wife had both been exceedingly ill recently and blamed this on the bad smell caused by the blocking of a sewer near to his house. To support his claim he enclosed a medical certificate stating that the unsanitary condition of the neighbourhood had certainly caused his illness, but the writer’s claim for compensation – he had been unable to work for several days – were duly noted by the Board and duly ignored.

In his report to the Local Board at this time the Medical Officer of Health, Dr. Robert Wood, wrote…
“I have visited several cases of fever in the town, and in every case but one have found the grates untrapped, and I believe the foul smells from the drains are the principal cause in producing zymotic diseases, especially fever. I recommend a freer ventilation of the sewers and drains of the town”.

In November 1880 a(nother) Local Government Inquiry was held at the Town Hall, this time to consider the Local Board’s application for a loan of £12,000 for sewage works, and an additional loan of £2000 for improvements to the water supply.
At that time the Pioneer included a résumé of events so far.

  • various sewage disposal schemes had been put forward in recent years.
  • plans by Mr. Brundell, civil engineer of Doncaster, for yet another scheme, were recently prepared but set aside.
  • the Local Board’s surveyor George Haslam had then prepared specifications for a sewage works at Little Hallam.
  • land had been compulsorily purchased to accommodate the works.
  • since the last Board elections in April the newly elected members called for a reconsideration of the surveyor’s scheme.
  • the Erewash Canal Company has called upon the Local Board to cease the influx of sewage into its canal and asked the Board to pay for the cleaning of the canal between Barker’s Bridge and Babbington Wharf.

 

The Blaxall Report.

The Buchanan Report of 1870 (above) had made several recommendations to improve the sanitary condition of Ilkeston.
In 1881 the then inspector for the Local Government Board, Dr. Francis Henry Blaxall, produced another report in which he noted that since the previous report Ilkeston’s Local Board had “not been altogether unmindful of the duties imposed upon (it) by the Legislature. At the same time, through the want of sustained effort on (its) part the measures undertaken have not fulfilled the desired end, while there has been a total want of remedial action in respect of certain conditions which exercise a very prejudicial effect upon the public health”.
In other words, get your finger out!!

Dr. Blaxall’s report searched for the causes of the enteric fever and its spread in Ilkeston, and identified the town’s privies, water supply and sewers as the most likely sources of fever. He examined each one in turn.

Privies

“As regards excrement disposal, the privies from their extreme unwholesomeness were highly condemned by Dr. Buchanan, who advocated the substitution of earth closets for the midden privies in vogue. But no improvement has been effected in this important particular, the atmosphere in and around the dwellings continuing to be polluted by emanations from decomposing excrement stored in large pits, which serve also as receptacles for refuse”.

Middens was basically open holes leading to a cesspool, which could leak into the water supply. They were emptied by ‘night-soil’ men, employed by the Local Board who charged 1s 6d per load … the Board then sold them on at 1s per load. The charge created a disincentive for householders to have their privies emptied at frequent intervals.
In an earth closet — a form of composting toilet — excrement was covered with, and broken down by, earth and could then be used as fertiliser.

However the Blaxall report pointed out that the privies in the infected houses in Ilkeston were no different to those of healthy families in the same area or to those in unaffected parts of the town. They were all generally unwholesome!!

So they could be ruled out as a cause of the fever.
However once infected, these privies were a danger to the people using them and to the water supply which may happen to be in their near vicinity, and so could contribute to the spread of the disease.

Water Supply

The report noted that the Local Board’s three public sources of water were said to be supplying 170,000 gallons per day, to slightly more than half the town’s houses as well as to its trades. This was calculated to work out at less than 20 gallons per head for those persons using the public water supply. Altogether 1531 houses were supplied with the town water and within these houses there were 31 cases of fever spread throughout the town.

The report would not therefore impugn the town water.
The remainder of the town was dependent for its water supply on private wells and rain-water tanks.

“The (private) wells are sunk in a soil befouled of filth from privy pits, refuse heaps, and other contaminating conditions…. Further, owing to a faulty arrangement connecting these (water) tanks with the sewers by means of overflow pipes, the water is exposed to dangerous contamination by sewer air. In two or three instances … the effluvium arising from them was very offensive… while in one instance a black line indicated that sewage had found its way into the tank by means of the overflow pipe. The tank water is complained of as being very black, the people stating they can write their names with it”.

A total of 1340 houses relied on these private sources of drinking water and here there were 74 infected families, 46 dependent on wells and 28 on tanks. All the wells were exposed to pollution and one particular well in Spring Grove Terrace was used by several people who later became infected.
Spring Grove Terrace was a row of ten cottages, close to the Rope Walk by the canal, supplied by one well.
Just 15 feet from the well, standing on a higher level, was the nearest privy, while a slop drain carrying the terrace’s sewage to a ditch, ran close by. In September 1880 the terrace recorded its first case of fever and in total, seven affected families suffered 15 cases of disease there. Of the seven families, six got their drinking water from the well. The remaining three unaffected families got water from other wells.
Inhabitants of houses nearby with separate privies, drainage and water supply were also unaffected.

The report’s conclusion was that the water from this particular well certainly contributed to the contagion in this terrace, though the privy and drain might also be implicated.

Attention then shifted to Springfield Terrace, at the rear of the Rutland Street Gas Works, a row of 24 cottages of which 14 were affected, giving rise to 31 cases of fever. Its well was at one end of the row with a slop drain and privy pit very close by, and with surface drainage seeping into it. The well was closed down and town water was thereafter provided.

There was a similar examination of a row of cottages in Ebenezer Street. Six families had obtained their drinking water partly from a well and partly from a rain-water tank, both in close proximity to a filthy privy pit. Five of these six families went down with the fever. As the tanks had an overflow pipe into the sewer, the question as to whether the sewer air was causing the fever arose.

Sewers

“It is satisfactory to report that the (Board), after long opposition on the part of some of its members, (will) provide intercepting sewers, which, after collecting the contents of the various sewers, shall convey the sewage to land, there to be disposed of by infiltration”.

The Local Board had been given permission to obtain a loan to carry out this sewage scheme and Dr. Blaxall noted the urgent necessity for the work to be carried out without delay.

In the meantime, “the sewerage continues very imperfect and defective, and all the sewage finds its way … into the river or canal. There is no provision for the ventilation or flushing of the sewers. The heads of them are closed and the street gullies trapped, while the outlets are left open, allowing the air to blow freely up the sewers…..”

In the first half of 1880 the cases of fever were not confined  around one particular sewer.
However in July and August of that year the area around Granby Street, William Street and Brussels Terrace suffered particularly. Here there were 250 houses, of which 47 were affected giving rise to 90 fever cases, many of them occurring at the same time. The rest of the town accounted for 2500 houses where only 47 families were attacked.

The Report’s conclusion

The report looked for a link to account for the 90 cases of fever and found it in the infected air of the sewers.

“The simultaneous appearance of cases in different streets in a specified area around Rutland Street pointed to a common centre of origin, and the only condition to which the sufferers were alike exposed was the infected air of the sewers escaping either within or around their dwellings.”
It was also of the opinion that the cases found in Springfield Terrace were caused by infected sewer air rather than by polluted well water.

Taken from Dr. Blaxall’s Report…..

Year Deaths (all causes) Smallpox Measles Scarlatina Whooping Cough Fever Diarrhoea Total (Zymotic diseases)
1871 167 4 6 9 19
1872 208 23 7 2 4 8 44
1873 240 20 1 9 30
1874 270 5 3 19 27
1875 300 2 35 8 7 16 68
1876 285 13 3 5 7 23 51
1877 241 5 5 4 13 27
1878 321 3 47 8 14 72
1879 239 1 3 2 8 14
1880 328 15 4 1 16 28 64
Total 2599 43 40 97 39 50 147 416

*Note that there were no deaths from diphtheria in this decade.

From the figures in the above table, the report deduced that Ilkeston’s death rate from these diseases compared unfavourably with that of England and Wales in the same period…. and the health of the town was declining rather than improving!! 
Another table showed also that the annual death rate of Ilkeston was also worse than that of 50 large towns in England and Wales.

Dr. Blaxall stated that “the increase in the mortality here exhibited is a matter for serious consideration by the (Local Board), and should impress them with the vital importance of taking immediate steps to improve the sanitary state of their district, experience teaching that a high death-rate goes hand in hand with prevalence of such preventable conditions as are met with in this town.
“With regard to the frequent recurrence of epidemic disease of a highly contagious nature, such as smallpox and scarlatina, the (Board) have made no provision in the way of an infectious disease hospital, and have thus neglected a measure of the first importance, in attempting to arrest the progress of infectious disease, with reference specially to scarlatina, to which this town is peculiarly subject, and against which there is no known prophylactic, such as that afforded by vaccination in regard to smallpox”

Dr. Robert Wood of the Market Place, Medical Officer of Health to the Local Board, had already advised the Board that such a hospital should be built, as well as suggesting the ventilation of the sewers and a more regular removal of privy contents.

Recommendations from the Blaxall Report.

  • The necessity of adopting an improved system of privy accommodation by the adoption of the dry earth or water carriage principle.
  • The systemic removal at short intervals of refuse and manure from the vicinity of houses.
  • The use of town water instead of that obtained from wells and rain-water tanks, and especially to see that the communication between tanks and sewers no longer exists. And to increase the supply of such water.
  • The ventilation of all sewers and drains, the proper trapping of drains in the vicinity of houses, and the prevention of direct communication between indoor sinks and waste-water pipes and the sewers and drains.
  • Sewage should be no longer permitted to flow into and pollute the river and canal.
  • The completion of the proposed sewerage works, with means of flushing the sewers.
  • The provision of a hospital for the reception of cases of infectious disease.

 

A Cottage hospital.

In May 1882 a case of smallpox was reported in Belvoir Street and the female patient had to be taken to Nottingham Hospital, the latter institution accepting her with great reservation and complaint.
Two months later and another case of the same disease appeared in Eyre’s Gardens.
Now the Local Board decided to convert its cart sheds in Pimlico into a temporary isolation hospital, by which time the patient was ‘improving’ and didn’t wish to go to the hospital anyway!
Plans for a more permanent sanatorium at Little Hallam were now prepared and accepted by the Local Board in July 1882.

Meanwhile the selection of the premises in Pimlico as a temporary smallpox shelter had not gone down well with local residents who promptly organised an outdoor protest meeting in the Market Place.
And it was local resident, draper William Smith of the Market Place, who took the responsibility upon himself to send the crier around town announcing the meeting at which he argued that “foul miasmas would arise from the ill-constructed sewers leading to the house”.
Many also pointed out that an ‘isolation hospital’ should obviously be in an isolated spot and not in the centre of town as Pimlico was.
And it was not lost on many at the meeting that the Board members had chosen a site sufficiently well away from their own domestic dwellings!!

In August 1883 the Nottingham Corporation presented Ilkeston Local Board with a bill for £7, being the cost of admission and maintenance for the Belvoir Street smallpox victim. It was promptly paid.

In February 1884 a Town Hall meeting discussed the desirability of building a Cottage Hospital at Ilkeston.
This was supported by Drs. Henry Potter of Wilton Place and James Frederick Digby Willoughby of Dalby House.
Opposing it were Drs. Robert Wood of the Market Place and Charles Alfred Cooper of  Bonsall Place who both thought that the hospitals at Derby and Nottingham were sufficiently near as to make the need for a local hospital unnecessary.
Those at the meeting decided to form a committee — what else!! — the purpose of which was to identify a suitable site where a local hospital might be built.

By the end of August 1884 premises in Station Road were fitted up and ready for the reception of patients, so long as there were not more than ten of them at one time
These served as ‘Ilkeston Hospital’ until March 1894 when a new one was opened in Heanor Road.
By that time the old institution had treated 462 in-patients and 1559 out-patients.
Throughout its ‘life’ Miss Martha Alice Dean, native of Ilkeston, was the matron, Dr. Robert Wood was its consulting surgeon and Dr. Harry Potter was a serving doctor there.

Vaccination.

The word ‘vaccination’ was first used in connection with the work of Edward Jenner at the end of the eighteenth century when he used a cowpox virus to help develop a smallpox vaccine.
In 1853 the Government’s Vaccination Act made vaccination for all infants compulsory although it was not strictly enforced and gave rise to much resistance.
A provision of this Act was that any vaccinated child had to be examined a week later to determine the results of the vaccination.
And this is what landed coalminer Willoughby Francis Cope and his wife Emma in trouble. Their son Willoughby was vaccinated by George Blake Norman, public vaccinator, in October 1866 but the child was brought for his re-examination a week too late. The doctor felt the need to take the parents to court, as an example. There had been a public cost and inconvenience, although Dr. Norman hoped that the court would be lenient with its fine. The magistrates concurred and imposed a penalty of 6d with costs — the full penalty was 20s (forty times that which was imposed).
After this judgement it was stated that in future cases of such neglect the full penalty would be enforced — and parents were also reminded that they were liable to the same penalty if they did not have a child vaccinated within three months of its birth.
This ‘compulsion’ was extended by a further Act in 1867 and more opposition ensued.
From the early 1870’s compulsory vaccination was more strictly enforced, although fierce opposition continued and anti-vaccination propaganda grew.

One Thursday morning in June 1881 a rumour spread throughout Ilkeston that four black doctors were in town to carry out a compulsory vaccination programme on all school children in the area. Parents besieged the schools to protect their children from these unknown vaccinators and many were taken out of school as a precaution. Two or three schools – normally with more than 600 scholars – had to be closed as a result. The rumour had no foundation.

In November 1882 the Ilkeston Advertiser printed a letter from the secretary of the Derby Anti-compulsory Vaccination League detailing a recent case in Darley. A three-month old girl was vaccinated in September of that year and subsequently developed abscesses and rashes on her arms and neck; she died a month later, her parents convinced that the vaccination was the cause of her death.
After an investigation by the Local Government Board it was decided that in this case the public vaccinator was at fault in using dirty and contaminated instruments which had caused septicaemia in the infant.
The Advertiser was not convinced that this was an exception. Such cases were ‘seriously numerous, and are pretty certain to increase’.
The newspaper then outlined its  case against compulsory vaccination and its simple solution….
Let those who believe in the efficacy of vaccination be vaccinated — as often as they like.
If their belief is correct, they are then immune to any infection… they can have no fear of ‘misguided creatures who will not admit the prophylactic poison into their bodies’.
Let those who fear vaccination more than the chances of contracting smallpox remain unvaccinated.
The latter may be ‘centres of infection’ but they cannot infect the ‘wise ones who have guaranteed themselves by Dr. Jenner’s process’.

The Vaccination Act of 1898 allowed parents to become ‘conscientious objectors’ and obtain a certificate of exemption (from vaccination) for their child.

Miasma.

In the 1870’s Louis Pasteur and Robert Koch established the Germ Theory of Disease, arguing that a specific organism caused a specific disease.
Before this — and even after their work —  one theory put forward was that ‘miasma’ or bad air — poisonous vapours — was a cause of disease.
To many people – and many in Ilkeston — this would seem to make sense in the newly industrialised parts of nineteenth century England with its filthy and stinking slum areas that bred disease.
The levels of disease and epidemics decreased when the sanitation and housing in these areas were improved, tending to confirm the ‘miasma’ theory.
For example in 1881 the neighbours of butcher Elizabeth Hawley of South Street were convinced that the fever, diarrhoea and other diseases in their area were caused by the stench of decaying matter coming from her premises — from the offal, blood and garbage of the slaughter-house thrown onto her manure heap. The Local Board’s medical officer Robert Wood, supported by the Inspector of Nuisances, successfully canvassed that the ‘nuisances’ should be immediately taken away in properly- constructed boxes.

In the month before Adeline Columbine was born in East Street – September 1854 – over 500 people had died in agony in the Broad Street area of Soho, London, when it was struck by an outbreak of cholera, the most deadly and swift outbreak of the disease to strike Britain.
The London weather had been hot and to many doctors the cause of the epidemic was obvious – the air was poisoned.
John Snow, a local physician, was not convinced by this explanation however, and believed that it was an infected water supply which was spreading the cholera.
Through a careful study of the disease victims and a thorough collection of data, John – the ‘father of modern epidemiology’ — was able to show a link between a possible contaminated water source and the deaths.
Though at that time the germ theory of disease was yet to be demonstrated, John’s suggested action to counter the cholera outbreak was to take the handle off the Broad Street water pump.

It seems that 26 years later a similar solution to the outbreak of fever in Ilkeston’s Springfield and Spring Grove Terraces was adopted.

And 50 years after the cholera outbreak in Broad Street, Soho, what do we find in Pimlico, Ilkeston?

“Death from English cholera at Ilkeston –the sanitary condition of the town.
Considerable anxiety was occasioned in Ilkeston on Sunday morning (July 1883) when it became known that a child named Bostock, aged about four years, had died at 8.20 a.m., in Pimlico-place, from English cholera.
“It appears that the child, who belongs to the ordinary working class, was taken suddenly ill on Friday. It became by rapid degrees very much worse, soon after it was first seized with illness, and suffered from vomiting, purging, cramp, and convulsions.
Dr. Wood was sent for, and upon attending the child, was satisfied that it was afflicted with English cholera. He applied all the remedies within his power, but in spite of the most skilful and careful medical attention the child died. Very soon after death the body turned completely black.
“It may be explained that Pimlico-place, where the child lived, although occupying one of the most elevated positions of the town, and within a stone’s throw of the Town Hall, the headquarters of the Local Sanitary Authority, is one of the most foul spots in the place. It appears that in addition to a general state of very bad sanitary arrangements the neighbourhood of the house where the disease in question was contracted and the child died is rendered additionally obnoxious and unhealthy by people keeping pigs, Refuse, it is stated, has been allowed to accumulate until it forms a large heap, and the liquor runs down the small yard immediately facing the door of the house where this fatal case of disease has occurred. The deceased was playing about this spot during Friday before it was taken ill.
Recently the dreadfully obnoxious exhalations of sewer-gas from the gratings in the Market-place, at the corner of the thoroughfare known as Pimlico, and in Bath-street have formed a fruitful topic of comment, and some letters have been addressed to the local newspapers on the subject, but at present there is no change.
“The smells continue, and it is stated that there is some cause to fear, although precautions have been taken to prevent any further result from the deplorable case that has already occurred, that unless some decided steps are taken by the proper authorities to speedily prevent the constant uprising of the noxious gas that is now daily encountered in the town, something more alarming than a solitary death through bad sanitary arrangements will take place”. (IA July 1883)

*Pimlico Place was a cluster of cottages off the south side of Pimlico and located behind the rear yard of the Sir John Warren Inn which itself was contributing to the unhealthy environment.
Members of the Local Board were satisfied that ‘offensive accumulations from a pigstye’ had led to this case of cholera. The surveyor was sent to examine the premises of the deceased and ‘a more efficient system of disinfecting the public sewer grates was decided upon’.
The Board ordered Isaac Attenborough, owner of the Inn, to improve its sanitation. More and better privies were needed as well as improved drains and cesspools.
But six months later Isaac was at the Petty Sessions,  summoned by the Board for allowing a nuisance to exist on his premises. The inn’s urinals and drainage were still in need of improvement.
Isaac was not best pleased; over the last few years he had made several alterations to satisfy the Board’s surveyor — they could not always be expecting him to be altering everything, could they?
Oh yes they could!!

(The Sudburys)