Denbighshire Free Press

THE HEALTH OF DENBIGH.1 Annual Report for 1902 of the j Medical Officer of Health (DR. GRIFFITH WILLIAMS ROBERTS). 0 The following is a verbatim copy of the report of Dr. Griffith Williams Roberts, Hectical Officer of Health, on the health of the town and its sanitary condition for 1902, just presented to the Council To THE UrmAN SANITARY APTHOKITY, BOEOUCH OF DENBIGH. tJentlemen, It gives me pleasure to furnish yon for the year 1902 with a report regarding the health of the Municipal Borough of Denbigh, containing an acreage of 8,868 units and a population of 6,439 (census 1001). During the past year, as compared with the preceding one, there was a decrease of 1 birth, but an increase of 17 upon that of the year 1900. The number of births registered were 140, giving AN equal number of males and females. For the s&vae period there were registered 241 deaths. Of these, the greatest proportion occurred under the age of 65, whilst 51 were over that age. Of the deaths taking place in the two Institutions linfirmary and Asylum) 79 did not belong to the locality. Heart disease was responsible for a large number of the deaths certified, and a dimi- nution was not noticeable in those for phthisis, "Whilst deaths from diseases of the respiratory organs were lower than usual, owing probably %o the small and gradual changes in temperature as a whole throughout the year. The district tuts maintained its reputation for good 'health notwithstanding the presence in our midst of an ftpidemic of Diphtheria. In the aggregate a great amount of good work lhas been done in the sanitation of the town, but some large measures remain for the work of the future. REPORT OF DIPHTHERIA, 1902. An outbreak of Diphtheria of an epidemic character, I am sorry to report, has broken out during the year, and which taxed the resources of the Sanitary Authorities to the utmost aIrd became a source of great anxiety to them. Sporadic cases are with us from time to time— going back for instance to the previous year there were 6 cases-and occasionally, as in the years 1894 and 1895, the numbers verged upon an epidemic, when there were 47 and 20 eases res- pectively whilst in the year 1877 a special report was entered into by Dr Thorne Tborne, one of the officers of the Local Government Board, on account of the excessive prevalence of the disease as compared with previous years. Prom the year 1895 there has been a steady decrease in the number of cases up to the end of ithe year 1900, which presented no single instance of the disease. It may be interesting to com- pare our topographical position and incidence IF the disease with those of other localities. Jrrom Government reports the greatest incidence of death from Diphtheria attaches itself pre- eminently to the East Coast; next to East Yorkshire, Kent and Essex and next to Wales and the counties bordering upon the Midlands Whilst the smallest death-rate registered was recorded in the Midland Counties as well as in Lancashire, Somerset and Devon. So that in Denbigh we derive from our position primarily an average liability to the disease. In England .generally, during recent years, from the reports of nearly every authority, there has been an idyer- increasing tendency to the development of, AND mortality from Diphtheria this has reached a pitch which the Registrar General has termed formidable. This tendency to augmentation has not only been noted in the country districts— -which have always been recognised as its favourite haunt—but has relatively increased to A still greater extent in town. During this same period great advances have been made in every department of sanitary science, and whilst this increase has prevailed in country districts, it has been noted in cities particularly, even when all modern improve- ments in sanitation are employed and it may be interesting to notc- that a conclusive con- nection between Diphtheria and a tainted supply of water or imperfect drainage has net been established; in fact with our facilities for experience continually extending as regards bacteriological research the organism (Diplococcus of Kleis Loejjler) which is the direct cause of Diphtheria, has never yet been discovered in II sewer air." Scarlet and Typhoid Fevers (as far as diseases can be) are pre-eminently agreed to be the standardizing measure of what the drainage and water systems are If we were to take for granted that in the case of Diphtheria bad drainage was alone the cause, such a supposition would a prion be shown to be wrong if we referred to such a year as 1897, when there were 14 cases of Scarlet, 12 cases of Typhoid, and none of Diphtheria; or of the year following when there were 13 cases of Scarlet Fever, 8 cases of Typhoid, and 1 of Diphtheria. On the other hand, such years as 1895, when there were 5 cases of Typhoid, 6 of Scarlet Fever, and 20 of Diphtheria, or 1894 when there were H cases of Typhoid, 18 of Scarlet Fever, and 47 of Diphtheria, are less conclusive. The above method of four examples represents the two ex- tremes as met with in our data for the past 10 years. One of the most modern and generally- approved observations has been that of cold moist winds as conducing to the abnormally rapid spread of the disease in an infected district. Y THE conditions in the Vale of Clwyd and in Denbigh itself are for physical reasons especially liable to produce a constant supply of moisture in the air, and this moisture is noticeable as being even more considerable during and after wet weather. During the past year, however, the rainfall has been below the average, and cold "winds have not prevailed to any marked extent. Personally I am inclined to consider atmospherio humidity as most favourable to the prevalence of Diphtheria, although malignant epidemics .have been known to occur at times in excessively -dry weather (chiefly abroad). Furthermore, in so far as any place may be said to be prone to the disease, such causes may be mentioned as Organic decomposition of vegetable accumulations and which pertains to most rural inland places damp houses, of which there are many in the Borough, and faulty drainage as lowering the itality of the individual attacked. Far more important as preventatives are the due, oomplete, tmd sufficient isolation of each patient, and personal contact, together with thorough dis- infection. Regarding the former, we do not at present possess an Isolation Hospital that the community will use; and as for the latter, the difficulties in the way of stamping out the disease, even with the most approved means of disinfection, may be guaged when it is remembered that the disease may be conveyed by cats, flies, &c., and that the tenacity to life displayed by the virus may on such a medium as gelatin be as long as 547 days, whilst ordinary fomites kept in the dark for 150 days may still be virulent. Besides pre- disposing and other causes which are not yet understood such as telluric conditions and others vaguely attributed to epidemic waves," accumulation of susceptible persons," "facilities for convection," "climatic" and meteorological," any of which we may have, three are worthy of notice in the cause and pro- pagation in an out-break such as we have in the J year 19 j2. These are the supposed logical j necessity of a "previous ease," the conveyance by milk, and the diffusion by school children. HISTORY or OUT-BREAK IN THE BOROUGH FOE THE YEAR 1902. For a period of over 18 months, namely, from April, 1899, to December, 1901, no single case of Diphtheria was reported to me however, on December 12th, 1901, the first case was notified .after the interval, and followed by five other cases during that month. Other cases of Diph- theria had previously occurred in the adjoining vountry surrounding the Borough on the East, I SOUTH, and South- West sides previous to Decem- ber 12th, 1901: also the case of a child who had died in Liverpool of Diphtheria, and was brought over to be buried in Denbigh, is worthy of men- tion this took place on December 5th. Whether the incident of bringing the child from Liverpool fcad any connection or not with cases of Diph- theria occurring in Denbigh about a week later I cannot be traced, the coincidence however exists. During the year 197 notifications of Diphtheria were received by me the maximum number of cases occurred during the month of November, when 70 cases were recorded; also during the months of April, October and July the numbers were relatively high, being 36, 28 and 15 res- pectively. Lamentable as the loss of life has been, still when we consider that case mortality in well-marked epidemics is usually high—being about 30 per cent-we must come to the con- clusion that the severity of the epidemic was not of the highest. There were, I regret to say, 21 deaths attributable to the disease. A few cases only of Paralysis occurred, and some of the deaths registered were due to Pcsi-diphtheretic Asthenia. MILK, All suspicion of this being the scarce of trouble proved upon examination to be without basis, as no relation could be found between the supply of milk (which is due to 11 sources) and those at- tacked by the disease hence it was considered necessary neitb-- lo stop any supply, nor to call in the services ct a Veterinary Surgeon to deter- mine the occurrence or not of Bovine Diphtheria. SCHOOLS. Nearly all the cases occurred amongst children attending the Elementary Schools, and of these JI both as regards the number of children attacked, and as regards the primary date of outset, one I school in particular, namely, Fron Goch Infant School, claimed special attention. The balance I of evidence goes to show that the disease having once started in the Fron Goch School was spread in the usual way from child to child, thus lead- ing a little later to the whole district becoming full of scattered cases. As soon as evidences of the propagation of the disease by this means be- came sufficiently uniform not to be mistaken, it was deemed desirable to close the schools for a period of six weeks. They were thus closed on April 28th. Owing to a continuance of the diseasa at a further date the schools were kept closed until after Christmas. At the recommendation of the representative of the Local Government Board, the schools are to be still kept closed until further notice. Isolation is still defective, but as far as possible was carried out and maintained for at least 14 days after the disappearance of membranes; and after exposure a quarantine of 10 days as far as possible carried out. No children from infected households were allowed to attend sahool, but duri?'* the earlier stages of the out- break children were not prevented by the non- production of a medical certificate from putting in an appearance, so that to obviate any mischief arising from so lax a condition a plan was executed whereby due notice was immediately sent to the Schoolmaster or Mistress concerned, 1acquainting them with the fact that owing to Diphtheria certain pupils and their associates could not be allowed to attend within a given period. I have already (May 20th) supplied the Local Government Board with a report upon the epidemic of Diphtheria, and also with a more detailed report of the cases, and a table shewing the school attended by each child, and the dairy I from which each family was supplied with milk. I reiterate the opinion that the present epidemic I was primarily due to an imported case into the Town, and also secondarily to children suffering from sore-throat not recognized at the time as Diphtheria, attending school and so spreading the disease. Many of the homes of these children are over-crowded, damp. badly ventilated, with no through ventilation, and yards unpaved and sodden. Nearly all the children-stricken with Diphtheria were connected with the Elementary Schools. There are besides four other schools in the Town of Denbigh, one of which contains 120 scholars, day and boarders, who all inhale the same air and drink the same water, and not a single case of Diphtheria occurred amongst the scholars of these four schools; this fact, to my mind, is sufficient evidence that in a great measure the disease is propagated through the careless and dirty habits of the lower class, and also by children and also by children from infected houses playing with other children and so spreading the disease. Furthermore, as was pointed out in my report for the month of December, the closing of the schools has given 1 conclusive evidence that the cause of the con- tinuance of the epidemic was associated piri passu with the continuance of school. On a case being notified, the premises are at once inspected and in due time fumigated and dis- infected, and if any nuisance is found, steps are taken to remove it, and any defective drains re- laid to the main on a more modern principle. During my first visit of inspection to the Fron Goch Schools, duly reported by me in the month of April, a vertical pipe 36-ft. high and tacked on to the external wall of the Infant School, where it terminated below the eaves, was noticed in the girls' play-ground. This shewed defective jointing, and tb pipe was thought at the time to be in communication with the Council's Sewer which passes through the plav-ground. This theory subsequently was found to be correct and the shaft has been abolished. The drainage also of the schools was in part relaid. The Infant Schools are ventilated, but hot to my sufficiently, and to that end I recommended the use of a Boyle's Ventilator. The houses occupied by the working-classes are usually two-storied with thick rubble-stoned walls, and containing two rooms on each floor. In the main they are in fair condition structurally, although in the past there has been a good deal of 11 jerry-build- ing and lack of damp-proof courses, with the result that many houses of apparently good exterior are damp and also admit rain through defective roofs. There are also houses which are old and dilapidated, and these are usually damp, badly lighted, and have no through ventilation, There is but little crowding of dwellings upon insufficient area-generally there is a super- abundance of open space. I should on many occasions have had to report some serious epidemics if it had not been for the fresh air and sunshine, which are Nature's prime factors in the preservation of health. We are making steady progress with the removal of insanitary surroundings and the substitution of more whole- some conditions. Regarding the outbreak, incidents of the terror-stirring variety have occurred displaying sensationalism where one might least have ex- pected it. These heedless methods of advertising grossly exaggerated and mistaken views were, I trust and believe, impelled by the dictates of ignorance rather than of malevolence they are, however none the less regrettable. It might here be remarked on behalf of would-be non- progeasionists that a letter written to the Sanitary Authority or the Local Government Board, or an interview held with their officers would receive the attention that such would merit, and would most probably carry out the end in view by the originalist, equally as well without doing to the district that harm which we all deplore. WATER SUPPLY. 1 he Local Government Board having decided to aid the enquiry into the epidemic of Diph- theria, the Drainage, &c., it was deemed advis- able by the Council to take this opportunity of approaching that Body as regards the water supply. During past years I have made reports upon the water, and in the year 181)9 re- published the Analytical Report of Dr. Campbell Browne, of Liverpool (showing the contaminated condition of the supply). Numerous complaints having been received from time to time regard- ing both the inadequate supply and condition of the water furnished to the town, it wag decided that the site of the collecting ground should be visited, and I was asked to make a report thereon. Accordingly on Thursday. June 4th, 1902, the I fallowing members of the Council met at the ■ Town Hall, Denbigh, at three o'clock p.m.f Councillor Dr Lloyd (Deputy Mayor and Chair- ta&n Qf the Saijitaq ComffiUteeJ, Councillors R i Htimplireys Roberts, W Mellarcl, 7 Humpnr. Jones and James Hughes, together with Mr Wm 1 Windsor. Sanitary Inspector Mr Edwara Parry, Deputy Town Clerk, and myself, Medical Officer j of Health. The party drove to Bryn Mulan and inspected the watershed and reservoir belonging to the Denbigh Water Company. The gathering-ground and Reservoir are situ- ated about two miles South-West of Denbigh, outside the Borough, wherespringa are conducted by means of ditches (cot through boggy land) to a channel, and then How into the Reservoir. The gathering-ground is for the most part used as grazing land and manured, with one or two fields under ciftivatiom. There are several small farms and houses, all inhabited, on the gathering-ground. During heavy rains the surface contamination of this land from cattle grazing and fertilizers must find its way into the Reservoir feeders. The houses and farms are dotted over the gathering-ground, and some are near to the ditches supplying the Reservoir. The surface (for the most part) round and about the houses is unpaved, and sub-soil pollu- tion from the garbage and manure is bound to follow. Some of the houses have privy-middens, whilst others have pail closets. In cases of infectious sickness in any of these premises very serious consequences might result. On Grees Gwytta land two pools were ob- served in a foul condition, used by cattle for drinking; the overflow from both these dis- charges into the Reservoir Stream. There are a number of ditches within the water shed in a moie or less foul condition, and containing rank vegetation which obscures the water and prevents due aeration. In most of the ditches cow litter was observed. One of the feeders to the channel traverses a ditch abutting on a much frequented road and is very liable to pollution from surface washings, pedestrian and other traffic; and also receives the overflow from a cattle drinking trough on the main road. Some of the tenants of the houses informed us that the water in summer in the channels is unlit for domestic purposes, and they are obliged to obtain their supply from another source. The Reservoir is a natural valley dammed across and paved with rubble stones having open joints. The water was 14 feet deep, and this appears to be about the normal level as evid- enced by the growth of vegetation above the water-line. Close to the Reservoir there is a chamber in which the water is strained through gravel: this is roofed over with straw and heather thatch in a foul and decaying condition, causing a serious pollution of the water in the chamber. The water in the chamber was overflowing at door level and prevented access into the interior. The gathering ground is inadequate to supply the needs of the Borough, especially during time of drought. To augment the above supply a well has been sunk at Pont Tstrad within the Borough and close to the river. It would be advisable to make a series of careful tests to ascertain whether the I well water is influenced by the river or not. The mains from the Reservoir and Pont Ystrad Well are tapped to supply the houses along the route, and the water is again strained through gravel beds at Love Lane within the Borough and then flows by gravitation to a tank by the Town Hall which supplies premises be- yond Post Office Lane. Three samples of water were obtained from the intake of Reservoir, the Reservoir, and the Gravel Chamber by Reservoir respectively in new sterilised stone jars which were immediately sealed aDd submitted to W Foulkes Lowe, F.I.C., F.C.S., County Analyst, Chester, for analysis. The foregoing conditions evidence the need of the Water Company owning the whole of the gathering ground, when they could effectually control and regulate the erection of new houses, and also prevent pollution and contamination of the feeders to thd Storage Reservoir. We consider the above source of water supply inadequate and unsatisfactory :— (1st) From sheep and cattle pastured on gather- ing ground and having access to spring heads and their contents. (2nd) The supply for the main part derived from surface drainage of land and liable to pol- lution from decaying wood and vegetable matter, manure, and fertilizers, (3rd) The ditches in a more or less foul con- dition, and containing much rank vegetation. (4th) Great danger in times of flood from sewage from farms finding its way direct into feeders of Reservoir; a)so manure from cul- tivated lands being washed in by rain. The result of the analysis by the County Analyst of the above referred to samples was as follows :— June 13th, 1902. Intake. Reservoir. Outlet. In parts per 100,000 of water. Total solid matter in solution 26-4 22-8 23-2 Loss in ignition 2-8 3-4 2'8 Phosphoric Aoid v.l.t. l.t. v.l.t. Chlorine 206 2-25 2-25 Nitrogen its Nitrates and Nitrites 6-246 0-246 6-246 Oxygen required to oxidise organic matter in three hours 0*155 0-157 0-114 Oxygen required to oxidise organic matter in fifteen minutes 0-043 0-066 0-054 Free Aminoiiia 0*006 0-003 0*0135 Albuminoid Ammonia 0-008 0-015 0-013 Total Hardness ii-so ii-so ii-so Permanent Hardness 6'86 6 57 6 00 Temporary 594 523 580 Nitrates Nil. Nil. Nil. Microscopical examination of sediment:- (No. 1) Flocculent-organic matter swarming with infusoria (chiefly) cotton fibres and fungoid growths. (No. 2) Very numerous nomads and infusoria fungoid growths and starch granules. (No. 3) Fragments of straw, very numerous nomads, vorticella and fungoid growths. The water from the intake was turbid and greenish-yellow in colour; that from the Reser- voir and outlet was slightly turbid and somewhat yellowish in colour. The sample from the inlet yielded the cystine re-action very strongly, and that from the out- let to a smaller extent. I had not sufficient quantity to apply this test to the Reservoir samples. All three samples are in a very unsatisfactory condition for a drinking water, and I consider that the result of the analysis indicates a pollu- tion of the water with both animal and vegetable matters. The water is a hard one and bad for washing and for use in steam boilers. The analysis of the other two sambles is nearly completed, and I shall be able to forward my report to-morrow. W. FOULKES LOWE, F.I.C., F.C.S., A.R.8.M." Chester, June 14th, 1902. Shallow Ditch. Well. Jn parts per 100,000 of water. (1) (2) Total solid matter in solu- tion 284 ..43-36 Loss in ignition 4*0 ..2 56 Phosphoric Acid. v.l.t. v.i.t. Chlorine. 1-86 2-16 Nitrogen as Nitrates and Nitrites 0-493 0-329 "Nitrates Traces. Nil. Oxygen required to oxidise organic matter in three hours 0*216 0-141 Free Ammonia 0-007 0 0015 Albuminoid Ammonia o-016 0-014 I Total Hardness — — Permanent Hardness — — Temporary — I Microscopical examination of sediment :— (1) Flddcolent.or^^ matter; fungoid growths I and numerous iufi.ísorltl and nomads. (2) Numerous fragments of QpttOS fibre and fungoid growths. The sample from the ditch was yellowish in colour and slightly turbid. It yielded the cystine re action strongly. In many respects I consider this sample the worst of the five examined, and it is evidently considerably polluted, chiefly I should say with vegetable matter, but also with animal matter. The sample from the Shallow Well was clear and colourless. It also yielded the cystine re-action strongly. In some respects this sample is of better quality than the others, but at the same time it is not a good water. Both of these samples are hard waters, and the Well water is very much harder than the others, but I have not had time to estimate the actual hardness. From the whole of the results I should judge that the water running to the Reservoir is very polluted it appears to undergo a very slight im- provement in the Reservoir, and at the outlet it appears to be still further contaminated. W. F. LOWE, F.I.C., County Analyst." I have been asked on behalf of those not generally so well informed as the rest, though otherwise interested persons, to offer some ex- planations as to the ultimate meaning of some of the terms used in the County Analyst's Report, Ac. it is. however, difiicr.lt to know when to begin and end in such a proceeding without unduly lengthening my own report. However, in the first place it becomes a moot point as to whether the water obtained from the pumping process near the bed of the river be direct river water or not. In other words- (A) Is the pump supply derived entirely from water obtained from an Artesian Well, or I (B) Is the water so obtained simply river water. If (A) be the case the only question to be asked will be:-Is that supply adequately-sufficient for the requirements of the whole and every part of the town without drawing from any ether source ? (B) In this connection it may be interesting to note the conclusion arrived at by the Analyst who represented the interests of the Asylum at a time when its water supply was in process of debate. His dictum repudiated any such idea as a river water supply for the Asylum, and accordingly that Institution went to the expense of obtaining water from Bryntrillyn—a distance of eight miles. We are thus brought face to face with the un- comfortable suggestion that water which is bad for the people at the Asylum is good enough for the townspeople. Even granted that owing to the presence of a large volume of water tending to dilute its impurities, it were possible during certain times of the year to get a sufficiently good sample of water from the River Ystrad, the yield, from natural conditions, is liable to inter- missions, and in seasons of drought would almost entirely arrest the flow of any water, so that the sewage or other impurities that gain aoceps to the stream would remain undiluted. Finally, to enable this water to be above suspicion for household purposes it requires much purification in the shape of costly filtration on account of (A) Suspended matter. (H) Organic matter. (c) More than a suspicion of specific pol- lution. I might further remark that a large amount of Chlorine, say 100 parts per million, especially when associated with an exoess of organic matter or oxidized nitrogen, is a sign of animal pollution. As a rule nitrates are due to the oxidation of nitrogenous organic matter of animal origin (the risk of this pollution arising from animal sources has been shewn). When even accompanied by only a small proportion of organic matter, nitrates in water, from a source open to suspicion, must be regarded as oxidized filth which may at any time be followed by such a serious condition as unoxidized filth, hence Typhoid, Ac. Cystine is the chief constituent of (a rarely occurring) stone in the urinary bladder in men and dogs. It may also occur in solid collections foand in the kidney, and is occasionally found in the urine. So far as I know it has no other origin in nature. In October I had to report that many of the privy-middens in the Castle area were in a foul and dilapidated condition. On communicating with the owners of the property they said they were anxious to convert the same into W.C's. On applying to the Water Company, one of the owners was told it was impossible for the Water Company to supply the requisite water for the purpose. This area is still without a proper water supply. DRAINAGE, KTC. For some time past, and particularly during the past three years-with special reference to 1899-1 have called more than ordinary attention to the main drainage system, and its importance has been frequently urged, as well as the various aspects connected with its inefficiency such as the River Pollution Act at Captain Bridge, &c., Ac., and I might incidentally mention that both the Local Government Board and the authorities concerned are well aware from these reports that the drains of the Town, particularly from the Infirmary to the outlet, are anything but satis factory. Whilst pointing out the defects of the system, I have not felt it incumbent upon me, for reasons duly given at the time in each of my reports, to speak as strongly as otherwise I should have felt obliged. I still am under the same feeling of restraint, because I think and believe that the subject has been and is seriously in the minds of the authorities as to the execution of an efficient combined scheme of main sewerage, and I do not think the serious aspect of the question is lost upon them. The choice of two schemes has been brought forward. 1.—That in which an entirely new system shall be undertaken. 2.—A new system for part of the area, with the reparation of the more obvious defects in the old system. No 1 is obviously the better plan for adoption of the two. The necessary legislation has already been somewhat delayed, and it is to be hoped in this particular that no method of further shelving will enter the minds of the governing body. The drainage of the houses and the paving of unpaved and badly paved yards proceeds apace, together with trapping and ventilation, and I am glad to be able to report satisfactory progress, although much remains to be done. Amongst the many unsanitary premises inspected, two in Charnell's Well are worthy of mention. These two drains which were found to empty into the brook have been relaid and joined to the main drain. Some untrapped street gullies were found communicating with the sewers and remedied. There have been for the year 29 con- versions of privies into W.C's. Five of these were wet privy middens and situated in the very centre of the Town. In each case the innova- tion was accompanied by a renewal of drainage. It is estimated that there are still about 70-80 middens left in Denbigh alone. Several privy- middens also in the outlying districts were dealt with, and were converted into dry-earth closets owing to the pollution of streams. Some others have still to be similarly treated. Thirteen pigs were removed previous to the removal of styes, the execution of which work in all cases will soon be finished. SCAVENGING, From my enquiries, and from the fact of my not having received any complaints, I learn that this has been carried ea throughout the year in a perfectly normal manner; and the means at present available, i.e., one horse and cart, is sufficient to enable everybody to have a clearance at least once a week in some cases where it seems necessary, two calls weekly are made. A gcod deal of vegetable refuse still finds it way into the bins notwithstanding the protestations issued by the Sanitary Inspector. FACTORY AND WORKSHOPS ACT. No notice either verbal or in writincr has been received for the Inspector under this Act regarding any remediable defect affecting public health. The provisions of the Act- are not of any gre.it importance to the district, inasmuch as there are few factories (3) in the neighbour- hood, and these when worked are kept going by only a very few hands. Places of business, chiefly dressmakers, mii- liners, and tailots, of which there arc places, have been duly visited. Small breaches of cleanliness, one defective floor, and one case of over-crowding due to extra work suddenly being imposed upon the tailoring trades (de- pendent upon the large increase of men work- ing at the Asylum) were noted and remedied. In all 10 notices were served in regard te Factories and Workshops. A registration of the workshops is kept in conformity with the requirements of the Act, and I am glad to say that in this district no out-workers or domestic workshops have been found to be in existence. There are 17 Bakehouses in the Borough, none of which are underground or below street I evel, and all are kept clean, with good floors, ic., in conformity with the Act. NOXIOUS TBADKS. Until recently there were (apart from slaughter-houses") three such places of business in the Borough but on my first visit during the year, the one at the top of Henllan-street was found to be no longer in use, and already had shewn signs of not being worked. Several structural defects were noticed and pointed out at the similar place of business in the occu- pation of Mr Lloyd Jones, at Lenton Pool. The pits are antique as regards construction, and the yard required to be drained and made impervious. Covered bins were also required to hold the trotters and other refuse which could then be removed once or twice weekly, The-e defects required immediate attention, which the owner promised to bestow upon them. The third premises visited in Factory places shewed as regards both the Fell mo tiger's yard and Melting houses all to be satisfactory. SLAUGHTER HOUSES. These are kept up in a fairly good condition, and although they are fully up to the require- ments of the district and are in every way tit places for the proper dressing of food, they do not altogether exhibit all modern embellish- ments. Covered bins, however, are in some instances required and ought to be provided for the reception of offal as a means of doing away with all tendency towards accumulation upon the premises. LODGING BOUSES. These, as well as the workshops, Ac., were periodically visited. A summons was taken out on December 19th in the case of one person accused of keeping such a place without being licensed. Five other houses are on the register. As I have intimated in previous reports they are not model lodging house pattern, but they supply the needs of the class of people in our locality. NUISANCES, KTC. The number of nuisances discovered was 197, and of these 192 were abolished. During the year 30 complaints have been received Regard- ing oue of the cases, application was afterwards made for the necessary licence for a slaughter house. Refusal was made pending the pro- duction of sufficient evidence as to efficient water supply, drainage, dco. This proved an unsurmountable barrier. The number of re-visits with inspections during the year has been 410. There have been 55 preliminary notices served, 10 of which afterwards became official. Pew legal proceedings towards carrying out the suggestions of the Sanitary Authorities were required owing to the ready compliance in most cases, on the part of persons concerned, others yielding to a little pressure. SMALL POX. In February, owing to the outbreak of small pox in various parts of the country, advice was given that the necessity of revaccination upon the part of all persons should be urged in some public manner by the Sanitary Authority. It was also advised that until further notice Chicken pox should become included in the list of diseases for notification. On approach- ing the Local Government Board on the subject that end was obtained. It stills behoves the Council to consider the grave aspect arising from the importation into the district of so unwelcome a visitor as Small pox, so that thay may be prepared beforehand for any emergency that may shew itself. In October I bad occasion again to deal with this question, and specially notified to the Council the points as laid down in the memorandum of the Local Government Board, and in this par- ticular urged upon the Council to give their attention to the subject with a view of joining with the other Urban Councils in the district who might be willing to erect and maintain an Infectious Isolation Hospital; and that forth- with discussion should take place as to the site, &c. TUBERCULOSIS. In the month of August attention was drawn to the fact that no response had taken place to the invitation to all relatives of the diseased in cases of Tuberculosis that all infected rooms should be disinfected by the Sanitary Authori- ties free of charge, although, both in Welsh and English, leaflets containing, as well, many directions and explanations, had three years previously been issued bread cast. This was considered sufficient reason for the compulsory notification of Tuberculosis. It was advised also that the County Councils be approached with a view of providing a Sanatorium for con- sumptives too poor to undergo the proper t i-eattnent in the vicinity of their own homes. STEAM DrsiNFECTOR. The want of a Steam Disinfector has been greatly felt during the past year, and upon several occasions I have been obliged to give orders for what was necessary in this way to go through the high temperature process at Rhyl. DAIRIES. The County Authorities have at my sug- gestion had the milk analysed from time to time. The samples were with one exception a case of dilution—found to be good. The Dairies, thirteen in number, and two Milk Shops, have been periodically inspected. HOUSING. Incidentally IOn that part of my report deal- ing with Diphtheria, attention was drawn to the over-crowding which was found to obtain too frequently in houses in certain areas of the Borough. There is still apparently a scarcity of houses of the description needed by the labouring and lower classes, and to thia I specially called attention in my report for the year 1900. A glaring case of over-orowding I recently had to report in the month of June where a family of seven persons occupied one bedroom. Of late a good number of new houses have been built, of these 25 were erected in the Castle area. Also several houses, ten of which were situated in Henllan Street have been reconstructed, having come under the range of the Public Health Act. Several insanitary properties have been visited, and in some cases my suggestions were laid before the respective owners less urgent defects were left in the hands of the Sanitary Inspector to deal with. I must again call attention to the very lax way in which modern houses are allowed to be built. Cases have come under my notice where the W.C. is in far too close communication with the larder, and again in the Castle area occupants of new houses have aot been supplied with bins before occupation of the houses took place. NEW INSPECTOR OF NUISANCES. The present Saaitary Inspector for the Borough has only taken on the duties here during the past four months. Under the cir- cumstances we can hardly expect him to make an annual report. Much of bis time has been taken up with disinfection, &c., in connection N\ ith the epidemic of Diphtheria, but he has already shewn his energy and desire for work. I am glad to say that this strong point is hig capacity for practical work, and incidentally I may say that during hi* first month's tenure, 16 privies were converted into W.C's. at a time when the Town and it., intricacies were new to him. My best thanks then are due to the present Inspector for tfl.. studied assistance he has given me, especially in connection with the Factory and Workshop* Act. GRIFFITH WILLIAMS ROBE HI s.