4 lon 19 REPORT on THE SANITARY CONDITION of the CITY OF LONDON, FOR THE YEAR 1851-52, By JOHN SIMON, Esq., F.R.S., medical officer of health to the city of london, one of the surgical staff of st. thomas's hospital. Ordered to be Printed, September 28th, 1852. LONDON. PRINTED BY C. DAWSON, FENCHURCH STREET, CITY. 1852. THE SANITARY CONDITION of the CITY OF LONDON. Mr. SIMON'S FOURTH ANNUAL REPORT. To the Hon. the Commissioners of Sewers of the City of London. Lancaster Place, September 28th, 1852. Gentlemen, I beg leave to lay before your Honourable Court the several tables which I have prepared, to illustrate the mortality of the City of London during the past year. They refer to fifty-two weeks, dating from September 28th, 1851, to September 25th, 1852. In the first table I have distributed the 3,064 deaths of the period, according to their localities and seasons ; showing them as they occurred, male and female, during each quarter of the year, in the 4 MORTALITY OF THE CITY OF LONDON. several districts and sub-districts of the City. For the foot of each column, I have calculated the year's death's rate, per thousand of the living, in the district or sub-district referred to ; and at the head of the columns, for facility of reference, I have introduced an analysis of the population, founded on the Registrar-General's recent census. In the second table all the deaths of the last four years are stated, in a form which will enable you to compare one year with another, and one sub-district with another, in respect of their several contributions to the total mortality of the period. In the third table 12,540 deaths* of the last four years are classified according to the ages at which they befell. This table is arranged in a manner to display its results, first for each year separately, and next for each Union separately ; in order that you may observe what local or annual differences have obtained as to the ages of chief mortality. The fourth table also relates to the last four years. It restricts itself to those various forms of acute disease—epidemic, endemic, and infectious, which occasion, most of all, the predominant mortality of particular districts or seasons; and which * In the remaining number (17) the particulars of age and residence could not be correctly ascertained. MORTALITY OF THE CITY OF LONDON. 5 are susceptible, in the highest degree, of being mitigated or removed under an efficient sanitary system. In their general import these documents agree very nearly with last year's record; though showing unfortunately a somewhat higher death-rate, and especially a larger proportion of fever. On former occasions I have examined, with great minuteness, all such facts as these tables set forth, and have offered you the best suggestions in my power for the mitigation of preventable disease. The sanitary condition of the City is now substantially the same as at the date of my last report; and any comment which I might make on the present tables could be little else than a repetition of arguments already submitted to your notice. Therefore, as other topics of importance to the health of the City press for more immediate consideration, I refrain from occupying your time by any further remark on the materials which I subjoin. I have the honour to remain, Gentlemen, Your obedient Servant, JOHN SIMON. 6 Note to Table No. I. In making the calculations on which the Rates of the following Table are founded, I have reckoned the Workhoitse-Population and Workhouse-Deaths of each Union, as forming part of the aggregate population and aggregate mortality for such Union respectively; and in proceeding to calculate the Sub-District mortality, I have distributed, among the several Sub-districts, the population and mortality of their Union Workhouses, apportioning these in the ratio of the respective Sub-District Population, so as to prevent the high Workhouse Mortality from telling unjustly against that Sub-District in which the Workhouse happens to be situated. Hospital Deaths have been distributed according to the residences of the patients ; so that the North Division of the West London Union (in which St. Bartholomew's Hospital is situated) now retains only its just proportion of deaths. 7 TABLES. No. I. Analysis of the Year's Mortality, as to the Four Quarters of the Year, and as to the several Districts and Sub-Districts of the City. Population of City— In Unions or Registrars' Districts East London Union, 44,593. West London Union, 28,634 City of London Union, 56,455 129,682 In Registrars' Sub-Districts. Saint Botolph, Cripplerate. Workhouses. North Sub-Dis. South Sub-Dis. Workhouse. s. w. N. W. South, . e. n. e. Workhouse. 23,435 20,582 576 12,350 15,875 409 9,184 11,847 11,431 10,373 12,826 794 Deaths in four quarterly periods terminating as follows :— M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M F. M. F. M. F. I. 1851, December 27th 800 Deaths 73 67 59 58 32 32 40 28 37 43 18 12 33 30 29 25 26 26 23 25 32 23 9 20 140 117 64 68 80 30 63 54 52 48 55 29 II. 1852, March 27th 773 deaths 62 62 50 46 18 30 30 24 58 43 25 12 20 22 33 28 33 28 31 19 27 40 17 15 124 96 48 54 101 37 42 61 61 50 67 32 III.–, June 26th 774 deaths 54 56 78 53 21 17 39 31 65 56 23 8 24 23 29 22 22 19 30 17 33 26 17 11 110 131 38 70 121 31 47 51 41 47 59 28 IV.–, September 25th 717 deaths 77 83 54 62 6 20 35 39 41 36 17 14 26 18 15 17 29 20 15 11 31 23 12 16 160 116 26 74 77 31 44 32 49 26 54 28 Deaths for the whole year— 3064 In Registrars' Sub-Districts. 534 460 176 266 379 129 196 198 203 171 235 117 In Unions or Registrars' Districts 1170 774 1120 Rate of Mortality per thousand of the population:— ForSub-Distr 26.45 25.99 * 25.70 28.06 * 23. 08 18.55 19.57 18.34 20.14 * For the City aggregately, 23.62 For Unions 26.23 27 .03 19.83 8 Tables. No. II. Enumeration of Deaths during the last Four Years, as distributed in Sub-Districts and in Districts, or Unions. East London Union. 1848-9. * 1849-50 1850-1. 1851-2. Total of four Years. St. Botolph Sub-District 613 462 582 628 2285 Cripplegate Sub-District 659 503 549 542 2253 Entire East London Union, or District 1272 965 1131 1170 4538 West London Union. North Sub-District 427 371 347 322 1467 South Sub-District 669 351 351 452 1823 Entire West London Union, or District 1096 722 698 774 3290 City of London Union. South-west Sub-District 310 193 208 215 926 North-west Sub-District 267 190 190 223 870 South-east Sub-District 284 238 279 227 1028 South-east Sub-District 233 202 236 193 864 North-east Sub-District 286 242 236 262 1026 Entire City of London Union, or District 1380 1065 1149 1120 4714 Total Mortality of the City 3763 2752 2978 3064 12,557 * During the year 1848-9 there were fifteen cases of death, in the registration of which the residence was imperfectly recorded. These cases, therefore, though included in the total (3763) are excluded from the Subdistrict enumeration. See also Note to No. III. 9 tables. No. III. Deaths of the last Four Years, stated separately and conjointly, classified according to Ages, and distributed in Unions. Deaths in the Population of the City of London. Under 5 Years. Under 10 Years. Under 15 Years. Under 20 Years. Under 30 Years. Under 40 Years. Under 50 Years. Under 60 Years. Under 70 Years. 70 and upwards. Totals. During the Year 1848-9 1243 202 92 90 292 345 396 355 366 367 3748 During the Year 1849-50 1032 83 44 70 166 200 251 254 318 334 2752 During the Year 1850-1 1194 124 48 60 169 227 248 261 303 342 2976 During the Year 1851-2 1197 113 57 84 196 253 267 260 287 350 3064 * Sum of Four Years 4666 522 241 304 823 1025 1162 1130 1274 1393 12,540 Deaths of the last Four Years distributed in Unions. East London Union 1950 185 75 89 268 335 387 341 432 476 4538 West London Union 1157 117 65 98 254 301 321 318 349 309 3289 City of London Union 1559 220 101 117 301 389 454 471 493 608 4713 * During the year 1848-9 there were fifteen cases, and during the year 1850-1 two cases, in respect of which the particulars of age or residence could not be ascertained with sufficient accuracy for the purposes of this table. The addition of these to the total amounts in the table would give the correct number of deaths for those years, viz. 3763 and 2978 respectively, and 9493 for the general total. I have likewise been enabled to introduce some corrections in my account of the mortality during the first year. At that time my means for accurate registration of deaths were necessarily imperfect; and my first death-list contained 36 cases (chiefly of certain patients in St. Bartholomew's Hospital) which ought not to have been reckoned to the mortality of the City. In carefully revising my tables of that date, I have excluded these cases, and have thereby reduced the total number of deaths for the year in question to 3763. In the report referred to it was estimated at 3799. i 10 TABLES. No. IV. Comparative fatality, during the last Four Years, of certain acute diseases—chiefly epidemic, infectious, and endemic. Deaths in the Years terminating as follows, viz.; Fever. Acute Diarrhoœa, (not of infants) Dysentery and Cholera. Scarlet-Fever and Cynanche Maligna. Small-Pox. Erysipelas, Puerperal Fever and Phlebitis. Diarrhœa, Bronchitis and Pneumonia of Infants under 3 years of age. Measles, Hoopingcough and Croup. Hydrocephalus and Convulsions of Infancy. Total of preceding columns. at Michaelmas 1849 166 825 135 17 44 285 196 264 1932 „ 1850 118 54 32 33 40 243 124 219 863 „ 1851 107 23 46 41 17 340 272 282 1128 „ 1852 165 37 86 96 24 330 132 308 1178 Total number of Deaths in the four years 1848-52 556 939 299 187 125 1198 724 1073 5101 At a Meeting of the Commissioners of Sewers of the City of London, held at the Guildhall, 28th September, 1852. This Report having been laid before the Court and read, Ordered, That the same be printed, and that a copy be sent to every Member of this Court, and of the Court of Common Council JOSEPH DAW, Principal Clerk.