The location of the Isolation Hospital.

Disease

During 1912 there were 78 cases of scarlet fever, 11 cases of typhoid, 3 cases of puerperal fever, 13 cases of diphtheria and membranous croup, 65 cases of pulmonary tuberculosis, 23 cases of erysipelas, and 1 case of polio. The cases of scarlet fever came from the western part of Tipton and 11 of the cases of diphtheria were in people between the ages of 5 and 25 years. Dr. Underhill regretted that diphtheria antitoxin could not be freely supplied to medical men in the area. He also mentioned that the Tipton area was freer from tuberculosis than many other districts because of the towns high elevation, the healthy occupation of men and the open condition of the streets and alleyways.

In the previous year there had been 45 deaths from diarrhoea and enteritis in infants less than a year old. Dr. Underhill suggested that this was due to the dusty nature of the earth in the summer months. The dust contained decomposed organic matter which was inhaled by the infants. The death rate due to diarrhoea and enteritis over the previous five years was by the standards at the time, incredibly high: 30 deaths in 1907, 47 deaths in 1908, 26 deaths in 1909, 30 deaths in 1910, 85 deaths in 1911, and 24 deaths in 1912.

In 1912 there were 11 cases of typhoid, which resulted in 3 deaths. In the previous five years, deaths from the disease were as follows:  7 deaths in 1907, 7 deaths in 1908, 5 deaths in 1909, 7 deaths in 1910, and 2 deaths in 1911. There were also 56 cases of scarlet fever. 

In 1912 there was only one outbreak of measles, confined to one school, resulting in a single death. Because most children were affected before they reached the age of five years and in infants’ schools, they could not be admitted to the isolation hospital. If more than 50 percent of children were absent with the disease in a school, it would be automatically closed. Dr. Underhill remarked that a large number of mothers completely disregarded the need to nurse children sick with measles. He had on numerous occasions seen small children covered with the rash running around in the streets, coming into contact with other children. He charged working class mothers as being mostly at fault here. Epidemics of measles were frequent, as can be seen from the death rate: 29 deaths in 1907, none in 1908, 21 deaths in 1909, none in 1910, and 45 in 1911. There had been previous outbreaks of the disease in 1900 and 1905.

For a period of 12 days, from April 6th to April 18th, 1912 there were no deaths and the hospital remained empty.

Schools

Dr. Underhill had 16 schools under his control, 12 were council schools and 4 were church schools. The school furniture was regarded as old fashioned and the ventilation was criticised. He recommended that it could be improved by a regular and systematic opening of windows.

Dr. Underhill visited the pupils in each school twice a year in order to examine them. He also attended a daily surgery at his premises in Horseley Road at 10.30 in the morning to which any child could be sent by his teacher. During the examinations several interesting facts came to light. In certain parts of the town, the quality of the children’s clothing was poor and in some cases bare feet would have been better than the shoes that they wore.

At that time the Tipton Education Committee felt that it was not an option to build a schools clinic because Birmingham and Wolverhampton clinics were easily accessible.

Schools were sprayed weekly to combat disease, and district nurses regularly visited them to examine the heads and general cleanliness of the pupils. They also gave advice to the mothers of children with verminous heads, describing the best methods to keep them clean.

In 1912 the schools attendance officer reported only one absentee for blindness and 4 absentees for epilepsy. It was believed that backwardness in children was due to epilepsy, but Dr. Underhill stressed that the cases he came across were, congenital.

150 children were found to be infested with vermin. In some cases the child was sent away from school and not allowed to return until clean. 1,033 boys and 1,047 girls had their eyesight tested. 396 boys and 523 girls had perfect sight, but 101 children had serious eye defects. 3 girls and 10 boys had serious heart defects. The health of children's throats was reasonable, but of the 940 boys and 934 girls examined, 113 of each sex had enlarged tonsils. Dr. Underhill also advised the removal of adenoids from 58 children.

Most of the children were well fed. 1,026 cases were found to be fair and 52 were poor. Dr. Underhill was not satisfied with the condition of the children's teeth. He had not met a single child who used a toothbrush and there was not a schools’ dentist.

Food

Most of the food consumed by locals at the time was hygienic, but had a low nutritional value. Mr. Clifton, the sanitary inspector gained a certificate as a qualified meat inspector, so the inspection of meat was under his control. The cold meat on sale at Great Bridge Market, late on Saturday evenings was described as lacking nutrition, but on analysis there was no sign of disease. Local pigs were often inspected by special request and in many cases found to have a disease. During 1912, 18 tubercular pigs had been condemned as unfit for human consumption. The 24 local slaughter houses were found to be generally clean and serviceable, though most were old and not up to date.

One of the favourite local foods was fish and chips but fish frying was regarded as one of the principle nuisances because of the heavy fumes produced when frying, which gave some people much cause for concern.

Dairies, cowsheds and retail milk shops were visited during the year by the inspector. All sources of milk supply were kept under inspection. Dairies and milk shops were generally found to comply with standards, but cowsheds were criticised. Some were ill ventilated and hygienically unfit for dairy cows. In some cases where ventilating units had been fitted, they were not used because it was thought that fresh air diminished the animals’ milk supply, which was dismissed as fiction.

The town's water supply, maintained by the South Staffordshire Water Company, was praised as being good and plentiful, the only criticism being its chemical hardness.

The General Area

Dr. Underhill’s report gives a picture of an industrial town which does not claim to have very high standards of health and hygiene, but with good standards in many workplaces, which were generally lofty, not particularly overcrowded and occasionally whitewashed.

The population in 1912 was around 32,000 including a floating population who moved to the town when work was plentiful and left when work was not available. In 1912 there were 491 deaths, including 86 people sent here from other districts. The birth rate was slightly higher than the previous 10 years, amounting to 1,143 registered births.

The traditional coal mining industry was being superseded by a rise in the number of foundries which created more jobs and lighter work, such as polishing and assembling. This was ideal employment for women and was mainly taken up by younger single girls, who formerly went into service.

Doctor A. S. Underhill

Doctor Underhill, Tipton’s Medical Officer of Health, had an outstanding career. The Lancet, October 18th, 1890 includes a report stating that Dr. A. S. Underhill, of Tipton, was elected as president of the Birmingham Society of Medical Officers of Health. It was also reported in ‘Public Health’ January 1926 that Dr. A. S. Underhill was congratulated for completing 52 years in the public health service.