Disease, Mortality Rates and the Sanitary Condition of Preston

The poor sanitary conditions in Preston undoubtedly contributed to the shocking mortality rates in the town during the 1870’s, with the statistics even suggesting that it was the most unhealthiest place in Britain to live. So severe had mortality rates become in Preston that during the last quarter of 1873 death rates were exceeding those of births.

The figures showed that 894 births were recorded in this period with 929 dying. In fact in over 70 towns and cities throughout the country the mortality rates averaged the annual rate of 26 per 1.000 residents. In Preston however during the period mentioned, the rate was a staggering 44 per 1,000 making it the worst place in the country in terms of officially recognized mortality rates.

Within the seething masses of London the rate averaged 23.7 deaths per 1,000 residents, while in Liverpool and Manchester where the grim living conditions had previously been well documented, rates remained around 29 per 1,000. Newcastle-on Tyne, another major city had mortality rates similar to Manchester and Liverpool, while in the midlands Wolverhampton, surrounded by heavy industry, suffered not half the Preston death rates. The only town of a similar nature to come anywhere near the shocking state of things in Preston was Wigan, where its frequent colliery disasters pushed the rate up to 42.5 per 1,000. Compared to major cities abroad as well, Preston fared just as badly. In Paris, Berlin, Vienna, Amsterdam and New York figures from the first quarter of 1874 ranged between 24.2 to 29.2. Even among the poverty stricken populations of far off Calcutta, Bombay and Madras, the death rate varied between 24.3 and 40 per 1,000.

An alarming number of deaths among children in Preston attributed to Measles and Scarlet Fever had contributed to the high death rate in the first quarter of 1874. Nevertheless, the town had consistently produced high mortality rates over the prevailing years. It was becoming more and more apparent to people that the appalling death rates in the town had a direct link with inadequate sanitary provision and poor housing. As the Preston Chronicle reported,

“It may have been in the bulk of those cases where both fever and measles have been so deadly in their results, the internal and surrounding sanitary arrangements have been defective, a state of things which would as a matter of physical necessity aggravate any illness and that the consequences of such defectiveness in combination with and acting upon the disease, rather than the disease itself, have seriously accelerated the fatality which has taken place.

In many of the back and side streets of Preston, sanitary matters are by no means as they ought to be. Drains are not sufficiently scoured out, middensteads are too near the houses and even if they were not, many are rendered pestilent in consequence of the stupidity or inability of those who empty them. The streets, those referred to, are we suspect, neither swept nor cleansed so completely and regularly as they should be. What we want in Preston is a thorough system of sanitary inspection, a system which will not only keep a sharp look out upon every nuisance and offensive accumulation, but insist upon its prompt removal. We blame none of our Borough officials for this, we are inclined to blame their masters, the Corporation for permitting a system of sanitation to exist which could not possibly work satisfactorily. Our bills of mortality will never come down to that normal level which is to be desired until our sanitary regulations are amended.”(PC May 16th 1874)

Following these dreadful revelations concerning the shockingly high death rates in Preston, the work of the town’s Sanitary Committee became increasingly important. The committee set to work identifying perceived sources of disease and potential threats to the health of the town’s residents.

In August 1874 they reported severe cases of Scarlatina had occurred in Isherwood St, while a house in Avenham Road were the occupant had suffered from a contagious disease, had been thoroughly disinfected. The condition of the cellar dwellings in Blelock St was reported and the committee gave orders that a number of them would be closed within ten days. Several house drains in Poplar St and Berry St were described as being blocked and it was ordered that notices should be issued requiring the landlords to remedy the defect. The committee gave orders for the removal of an accumulation of manure from Gorst St and the Nuisance Inspector seized several baskets of decayed fruit which were being offered for sale at Preston Market.

The Sanitary Committee had quite considerable power which was rightfully exercised when the occupants of a house in Hudson St refused to allow the property to be disinfected following a case of fever. The committee immediately issued notices on the occupants requiring the disinfection process to go ahead, with the threat of non compliance resulting in prosecution. Cases of Smallpox which had occurred in High St, Wellington St and Fleetwood St had also resulted in the disinfection of the affected properties. A number of homes in Craggs Square, Appleton Row, and Atkinson St were reported to be in an unhealthy condition and ordered to be purified forthwith, while previous notices for purification that had been issued to certain owners and ignored in Crown St and Appleton Row would now lead to a summons before the Magistrates. An accumulation of stagnant water and manure in Craggs Square was also ordered to be removed.

The Committee was also determined to end the practice of keeping pigs in the back yards of houses. Several parties were reported as keeping these animals in properties in Church St, Clarendon St, Everton Gardens and Mill Hill and were ordered with notices to remove the pigs immediately. In previous instances reported the committee, offenders had removed the swine only to bring them back several weeks later. It was decided that any further actions of this nature would result in prosecution. (PG August 29th 1874)

Apart from the work of the Sanitary Committee, the pioneering work of Dr H O Pilkington, Medical Officer of Health for Preston from 1874 to his death in 1920, did much to improve conditions and the ultimate health of the people of Preston. In 1883 Dr Pilkington, in his annual report on the mortality and sanitary condition of the town, drew attention to what he believed were the chief contributors to disease and ill health in the town. He wrote,

“The number of deaths from Typhoid fever during the previous twelve months amounted to 48. The great majority of these deaths occurred in houses unprovided with water closets and having no internal communication with the drains. “

Interestingly, Dr Pilkington believed the spread of disease was not just attributable to poor and ineffective sanitation within the homes of the operatives. He was keen to emphasize what he perceived as a link between disease and the workplace.

“In many cases”, said Pilkington, “The deceased persons were employed in the factories and it is very probable that the origins of such attacks is often to be found in the defective nature of the privy arrangements at these mills, rather than at the homes of the operatives. An examination of several mills showed that though there were relative degrees of badness, in almost all, the privy arrangements were open to objection. In factories of several stories in height, the general plan is to have one or two small closets opening from each room and communicating with a large shaft down which the excreta falls into a cesspool at the bottom. In the weaving sheds of one storey in height there are the same small closets opening directly from the work room and emptying into large cesspools, which therefore contain a large quantity of liquid and in all cases, give off a most offensive odour.”

With particular reference to infant mortality caused by diarrhoea which tragically took so many young lives, Dr Pilkington remarked,

“The unsuitable food upon which many of these infants are fed, the confined air of the sleeping and living rooms, the small yards and impeded circulation of air around the houses, were the chief causes of this loss of infantile life. It is during the summer and autumn months when diarrhoea is prevalent that the dangers arising from the contracted yards become especially apparent. The privy, ashpits and dividing walls occupy a large share of the few square yards with which each house is provided. The midden with its decomposing contents is near the kitchen door and beneath the bedroom window. The circulation of air impeded by buildings on all sides is insufficient to disperse or dilute the dangerous emanations which find their way into the houses, laden with the seeds of sickness and death. Moreover, with very few exceptions, these yards are covered with a cobbled pavement which soon gets out of order and as a consequence allows the soil to become saturated with foul matter, or the liquid contents of the closet which readily percolate into the ground each time the ashpit is emptied.”

Dr Pilkington in his recommendations suggested that all yards, lobbies and rear passages should be improved by the laying of an impervious surface which could then be washed and cleaned thoroughly. He also made reference to the time infants spent with their mothers following confinement, when he wrote,

“In addition to these sanitary arrangements account must be taken of the evil consequences of mothers returning to work too early, by which the infants of the tenderest of age are deprived of the maternal care so necessary to their well being and so ill replaced by the attention, or may itbe neglect, of a paid nurse.”(PC March 24th 1883. Dr H O Pilkington-Morality & Sanitary Condition of Preston)

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