GRE 72 BOARD OF WORKS FOR THE GREENWICH DISTRICT. SECOND ANNUAL REPORT of the Medical Officer of Health GREENWICH DISTRICT Presented to the District Board on the 26th May, 1858. PRINTED BY AUTHORITY OF THE BOARD. 1858 flashman, printer, blackheath road, greenwich. ANNUAL REPORT. TO THE GREENWICH DISTRICT BOARD OF WORKS. Gentlemen, In obedience to your instructions, I beg to lay before you my Annual Statement upon the Sanitary condition of your, District. In many of my Monthly and in my last Annual Report were submitted to your notice such practical and general suggestions for the mitigation and prevention of diseases, that, were they to be repeated on this occasion, I consider I should be unnecessarily trespassing on your patience and valuable time. I purpose, therefore, to introduce to you the following Tables, accompanied with such few and brief remarks as will appear to require your particular attention, and from which you will be able readily to ascertain the progressive changes that have taken place in the District since the commencement of your labours. In my last Annual Report, it was shewn that in the years 1854, 1855, and 1856, the deaths in the District took place in the following numbers, viz:— In 1854 were 2526 deaths. In 1855 „ 2025 „ In 1856 „ 1897 „ And although it will appear that during the past year of 1857, the numbers have risen to 1901, still, on taking into consideration the increase of population, the present Returns will not shew any unfavourable results. 4 The first Table that I have now the honor of laying before you will exhibit the deaths in the whole District, as they occurred during each successive month in the year. TABLE No. 1. Greenwich, East. Greenwich, West. St. Paul, Deptford. St. Nicholas, Deptford. M. F. Total. M. F. Total. M. F. Total. M. F. Total. January 32 20 52 20 19 39 25 26 51 20 8 28 February 36 14 50 18 11 29 25 30 55 3 8 11 March 31 15 46 21 10 31 26 22 48 11 9 20 April 47 25 72 24 17 41 31 24 55 1 9 10 May 35 27 62 19 16 35 33 26 59 6 14 20 June 33 7 40 15 11 26 21 16 37 10 5 15 July 36 19 55 16 8 24 22 28 50 3 2 5 August 26 13 39 20 17 37 30 31 61 6 6 12 September 26 24 50 34 16 50 21 34 55 10 5 15 October 14 18 32 25 11 36 40 28 68 3 4 7 November 36 32 68 15 18 33 40 32 72 2 8 10 December 41 32 73 31 14 45 33 26 59 10 3 13 Total 393 246 639 258 168 426 347 323 670 85 81 166 5 In the second Table will be seen the number of deaths occuring in the District during each quarter of the year. TABLE No. 2. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Greenwich, East 53 99 49 148 60 115 59 174 45 88 56 144 76 91 82 173 Hospital 56 65 55 41 Union House 39 49 44 56 Greenwich, West 75 59 40 99 81 58 44 102 85 70 41 111 85 71 43 114 Dreadnought Hospital 24 21 26 29 St. Paul, Deptford 76 78 154 85 66 151 73 93 166 113 86 199 St. Nicholas, Deptford 34 25 59 17 28 45 19 13 32 15 15 30 Total 268 192 460 275 197 472 250 203 453 290 226 516 6 The third Table will shew a comparative statement of the deaths as they occurred Quarterly in the different Divisions of the District daring the years 1856 and 1857. TABLE No. 3. Greenwich, East. Greenwich, West. St. Paul, Deptford. St. Nicholas, Deptford. Total. Greenwich, East. Greenwich Hospital. Greenwich Union. Greenwich, West. Dreadnought Hospital. 1856 1857 1856 1857 1856 1857 1856 1857 1856 1867 1856 1857 1856 1857 1856 1857 First Quarter 65 53 54 56 53 39 98 75 16 24 134 154 29 59 449 460 Second Quarter 58 60 67 65 60 49 106 81 31 21 159 151 53 45 534 472 Third Quarter 58 45 63 55 45 44 79 85 21 26 166 166 29 32 459 453 Fourth Quarter 59 76 55 41 29 56 97 85 32 29 153 199 32 30 457 516 Total 240 234 239 217 187 188 380 326 100 100 608 670 143 166 1897 1901 7 The fourth Table will shew the total number of deaths occuring in the different Divisions of the District during the year 1857. TABLE No. 4. Males. Females. Total. Greenwich, East Greenwich, East 234 393 246 639 Greenwich Hospital 217 Greenwich Union 188 Greenwich West Greenwich West 326 258 168 426 Dreadnought Hospital 100 St. Paul, Deptford 347 323 670 St. Nicholas, Deptford 85 81 166 Total 1083 818 1901 The fifth Table will shew more clearly a comparative statement of the deaths as they occurred in the different Divisions of the District during the years 1856 and 1857. TABLE No. 5. Greenwich, East. Greenwich, West. St. Paul, Deptford. St. Nicholas, Deptford. Total. Greenwich, East. Greenwich Hospital. Greenwich Union. Greenwich West. Dreadnought Hospital. 1856 240 239 187 380 100 608 143 1897 1857 234 217 188 326 100 670 166 1901 From the above Table it will be seen that although the number of deaths have only increased by 4 during the whole year of 1857, still it will appear that a considerable variation has taken place in the mortality of the District as regards the comparative numbers to be assigned to the different Divisions of the District in the years of 1856 and 1857. Throughout the whole Parish of Greenwich, exclusive of the Union Workhouse and the Dreadnought Hospital Ship, it is shewn that there is a considerable diminution in the rate of mortality ; and even in the Union Workhouse there has been an increase of but one death. The Dreadnought Hospital Ship will shew a somewhat remarkable coincidence, the numbers being 100 in each year. I regret to have to point out to you, and it cannot fail to be remarked by the Members of your Board, that the Parishes of St. Paul and St. Nicholas, Deptford, 8 shew a considerable increase in the number of deaths daring the year 1857 as compared with the former year of 1856. The same remark will nearly apply to the 7 previous years, as shewn in the next Table, with the exception of the two Cholera years of 1849 and 1854. But, as regards the Parish of Greenwich, there has been less mortality in the past year of 1857 than has taken place during any year since 1850, in which year the deaths were very much reduced in number, no doubt in consequence of the premature destruction of many infirm and aged persons by the Cholera of the previous year of 1849. The following Table will shew the relative number of deaths as above alluded to, during the past 9 years. TABLE No. 6. Greenwich. St. Paul, Deptford. St. Nicholas, Deptford. In the Year 1849 1633 699 203 „ 1850 1060 432 123 „ 1851 1167 516 135 „ 1852 1161 545 148 „ 1853 1276 521 188 „ 1854 1471 729 325 ,, 1855 1327 569 166 „ 1856 1146 608 143 „ 1867 1065 670 166 The seventh Table will shew the comparative number of males and females that have died in the District during the past two years. TABLE No. 7. Males. Females. Total. 1856 1104 793 1897 1857 1083 818 1901 The next table will shew the births and deaths that occurred in the District during each month and each quarter of the year 1857. The ages at which each death took place, and the different diseases causing such deaths. 6 TABLE No. 8. Population. Births. Deaths. Ages at time of Death. Causes. M. F. Total. M. F. Total. Under 5 5 to 10 10 to 20 20 to 30 30 to 40 40 to 60 60 to 80 80 to 90 90 & upwards Scarlatina.. Measles. Hooping Cough. Small Pox. Diarrhœa & Dysentery. Fever. Phthisis. Heart and Chest Diseases, beside Phthisis. Croup. Intestinal Affections. Brain Disease. Convulsions. Puerperal Fever. Atrophy & Old Age. Influenza Cholera. All other Diseases. Inquests. Total. January 131 112 243 97 73 170 54 4 5 14 12 26 41 10 4 4 .. 2 5 6 5 12 40 2 10 13 4 .... .... .. .. 48 19 170 February 130 139 269 82 63 145 44 5 3 10 7 20 39 15 2 5 2 6 3 4 3 17 41 1 2 8 8 1 22 .. .. 22 1 145 March 121 101 222 89 56 145 43 2 7 6 15 21 45 6 .. 1 .. 1 .. 1 4 23 39 .. 7 18 9 ... 16 .. .. 18 7 145 Total 66998 382 352 734 268 192 460 141 11 15 30 34 67 125 31 6 10 2 9 8 11 12 52 120 3 19 39 21 1 38 .. .. 88 27 460 April .... 147 122 269 103 75 178 61 1 5 13 9 21 56 12 .. .. 1 1 .. 5 9 28 46 2 7 24 11 1 14 .. .. 22 7 178 May .... 141 126 267 93 83 176 62 1 7 11 10 27 50 7 1 .. 5 7 .. 2 10 18 36 1 13 18 12 .... 24 .. .. 27 3 176 June .... 105 100 205 79 39 118 40 .. 2 12 10 19 32 3 .. 3 1 .... 1 3 6 27 15 2 9 17 4 .... 10 .. .. 9 10 118 Total 66998 393 348 741 275 197 472 163 2 14 36 29 67 138 22 1 3 7 8 1 10 25 73 97 5 29 59 27 1 48 .. .. 58 20 472 July .... 99 103 202 77 57 134 36 3 10 12 9 17 36 11 .. .. 1 .... 1 11 11 24 14 1 12 15 5 1 16 .. .. 15 7 134 August .... 46 106 200 82 67 149 64 2 5 7 6 17 32 16 .. 2 .. 1 .. 39 7 23 17 1 6 14 7 .... 21 .. .. 11 .. 149 September .... 124 157 281 91 79 170 75 3 12 10 5 21 32 11 1 1 1 1 .. 29 11 11 22 1 19 21 10 .... 25 .. .. 13 5 170 Total 66998 317 366 683 250 203 453 175 8 27 29 20 55 100 38 1 3 2 2 1 79 29 58 53 3 37 50 22 1 62 .. .. 39 12 453 October .... 140 129 269 82 61 143 59 8 6 9 6 23 24 8 .. 3 1 3 .. 8 ll 15 31 1 15 14 7 .... 12 .. .. 18 4 143 November .... 84 95 179 93 90 183 54 5 2 18 10 20 51 18 5 2 .. 1 .. 6 8 16 57 .. 8 12 12 .... 26 .. 1 26 8 183 December .... 145 106 251 115 75 190 62 4 12 18 17 24 40 12 1 1 .. 6 1 2 13 26 53 .. 1 15 9 .... 23 4 1 23 12 190 Total 66998 369 330 699 290 226 516 175 17 20 45 33 67 115 38 6 6 l 10 1 16 32 57 141 1 24 41 28 .... 61 4 2 67 24 516 Total 66998 1461 1396 2857 1083 818 1901 654 38 76 140 116 256 478 129 14 22 12 29 11 116 98 240 411 12 109 189 98 3 209 4 2 252 83 1901 11 The Ninth Table will shew a comparative statement of the different ages at which death took place during the years 1856 and 1857. TABLE No. 9. Under. 10 10 to 20 20 to 40 40 to 60 60 to 80 80 and upwards. Total. 1856 760 77 264 236 461 99 1897 1857 692 76 256 256 478 143 1901 In some of my former Reports, I have directed your attention to the large amount of Infantile Mortality occuring in your District, and at the same time made such suggestions and remarks as appeared applicable to the existing causes of such mortality. Following such remarks, I submitted that it should not only be your endeavour but also your duty to assist the Legislature in removing the evils that press so heavily on the younger branches of your population. Such assistance you have readily afforded, and it is with great satisfaction that I have this year to report a great reduction in deaths amongst children under 10 years of age, and a certain decrease at all ages under 40 years; and you will perceive, by Table No. 9, that from the age of 40 and upwards, life has been very considerably prolonged, or at all events, that a greater number of persons have died at an advanced age than during the previous year of 1856. It would, perhaps, be assuming too much to attribute this favourable change to the many Sanitary improvements that have been effected in the District; but under any circumstances, it is a step in the right direction. Many years must necessarily elapse before it will be in my power to lay before you any very conclusive data on these points; but as far as my present Tables are completed, it is very satisfactory to be able to advance the above facts. The next Table will shew a comparative statement of deaths occuring from Epidemic and Chest Diseases during the past two years. TABLE No. 10. Scarlatina. Measles. Hooping Cough. Small Pox. Diarrhœa and Dysentery. Fever. Chest. 1856 24 47 77 14 90 79 661 1857 22 12 29 11 116 98 663 12 The next Table will convey to you the death-rate per 1,000 in the different Divisions of the District during the year 1857. TABLE No. 11. Divisions of the District. Population, Census 1851. Deaths. Deaths per 1000 including Hospitals and Union House. Deaths per 1000, excluding Hospitals and Union House. Greenwich, East. Greenwich, East 12628 16228 234 639 39 18 ,, Hospital 2600 217 „ Union House 1000 188 Greenwich, West. Greenwich, West 18607 18800 326 426 22 17 Dreadnought 193 100 St. Paul, Deptford 24899 670 26 26 St. Nicholas, Deptford 7071 166 23 23 Total 66998 1901 29 20 The twelfth Table will shew the comparative death-rate in the different Divisions of the District during the two past years of 1856 and 1857. TABLE No. 12. Greenwich, East. Greenwich, West. St. Paul, Deptford. St. Nicholas, Deptford. Including Hospitals and Union House. Excluding Hospitals and Union House. Including Dreadnought Hospital. Excluding Dreadnought Hospital. 1856 41 19 25 21 24 22 1857 39 18 22 17 26 23 13 It will not bo necessary to make any observation upon the foregoing Table No. 12, beyond directing your attention to the improved death-rate of the two Divisions of the Parish of Greenwich, and of the increased death-rate of the two Parishes of Deptford. The next two Tables, No. 13 and 14, will shew the number of births in the District during the year 1857. TABLE No. 13. Greenwich, East. Greenwich, West. St. Paul, Deptford. St. Nicholas. Deptford. M. F. Total. M. F. Total. M. F. Total. M. F. Total. First Quarter 58 58 116 91 93 184 185 145 330 48 56 104 Second Quarter 83 73 156 107 80 187 156 153 309 47 42 89 Third Quarter 69 75 144 74 79 153 145 169 314 29 43 72 Fourth Quarter 68 62 130 104 76 180 156 157 313 41 35 76 Total 278 268 546 376 328 704 642 624 1266 165 176 341 TABLE No. 14. Males. Females. Total. Greenwich, East 278 268 546 Greenwich, West 376 328 704 St. Paul, Deptford 642 624 1266 St. Nicholas, Deptford 165 176 341 Total 1461 1396 2857 The fifteenth Table will shew the comparative number of births in the District in the years 1856 and 1857. TABLE No. 15. Greenwich. St. Paul, Deptford. St. Nicholas, Deptford. Total. 1856 1194 1232 300 2726 1857 1250 1266 341 2857 14 The next Table will shew the comparative number of births and deaths in the District, including the Hospitals and Union Workhouse. TABLE No. 16. Greenwich, including Hospitals and Union House. St. Paul, Deptford. St. Nicholas, Deptford. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Births 654 596 1250 642 624 1266 165 176 341 1461 1396 2857 Deaths 651 414 1065 347 323 670 85 81 166 1083 818 1901 Excess of Births 3 182 185 295 301 596 80 95 175 378 578 956 In the following Table will be shewn a comparative statement of births and deaths, exclusive of the deaths occuring in the Hospitals and Union Workhouse. TABLE No. 17. Greenwich. St. Paul, Deptford. St. Nicholas, Deptford. Total. Births 1250 1266 341 2857 Deaths 560 670 166 1396 Excess of Births 690 596 175 1461 In submitting to you the foregoing Tables, it has been my endeavour so to classify the facts as that they should readily convey to you their practical meaning. The deaths, the ages at which those deaths took place, and the diseases causing those deaths, are so recorded that you will be enabled easily to compare the healthiness or unhealthiness of the different Divisions of your District; and, in after years, when the Sanitary arrangements which you have already carried out, shall have more thoroughly developed their anticipated good, and when other arrangements which you have now in contemplation shall have produced their legitimate results, the Annual renewal of these Tables cannot fail 15 to serve a very important purpose, indicating the state of the health of your District from the commencement of your labours, and conveying to your successors the power whereby they will be enabled to estimate the amount of Sanitary improvement which your former measures shall have produced. In consequence of the reports of the analysis that have appeared in the daily papers respecting the Water Supply to this District, it may be expected that I should on the present occasion offer some remarks thereon. But, inasmuch as the Sanitary Committee have been entrusted with the investigation of the subject, I submit that it will be desirable to await the result of such investigation, upon which a Report in due time will be forwarded for your consideration. There is but one other subject upon which I shall further venture to offer a few remarks, viz., "Sewerage and House Drainage." During the past year, a very large number of houses have been inspected, and the necessary Reports made thereon by your officers; numerous Privies have been emptied; many Bog-holes and Cesspools have also been emptied, and filled up with rubbish; many houses have been supplied with water to the closets and for domestic purposes; and nuisances of almost every description have been removed. But, in addition to these Sanitary improvements, it is a great satisfaction to be able to report the completion of 3,339 feet of new Sewerage in the District, viz:—1,797 feet in the Parish of Greenwich, and 1,542 in the Parish of St. Paul, Deptford; and from the 25th of March, 1856, to the 25th March, 1857, there have been 459 houses drained into the Sewers, viz:—406 in the Parish of Greenwich, and 53 in the Parishes of Deptford, making a total of 1,372 houses drained into the Sewers since the commencement of your operations under the Metropolis Local Management Act. In my last Annual Report it was remarked that the Sewerage of the upper parts of the Town of Greenwich and the District of New Town, Deptford, could with safety be commenced without reference to the Scheme for the Main Drainage of the Metropolis. I venture again to urge upon your serious consideration the allimportant necessity of continuing the Sewerage of those parts of 16 the above-mentioned localities that are not already provided with such important Sanitary arrangements. The great fact must meet you at every turn, that a very large number of streets in those Districts are without main Sewers, wherein overflowing Cesspools, choked Drains, and Privies have been emptied and cleansed only to fill again; and wherein originate the principal causes of diseases that annually carry off the large amount of your infantile population. Without presuming too much upon the changes that can be effected by human efforts, I may boldly venture to affirm that, in proportion to the extension of the Sewerage, House Drainage, and the thorough Ventilation of the dwelling houses, particularly of the poorer classes in the District, so will the rate of sickness and mortality be thereby diminished. It is, therefore, from the conviction that your Towns will be relieved of a large amount of human suffering; that your infantile population more particularly will shew signs of improvement in health, strength, and general development of their frames; that diseases which now assume the most aggravated forms, will succumb to the more powerful influences of pure and uncontaminated air; and that your rateable property, which is now overwhelmed with many weighty incumbrances, will be relieved of its burthens, that I have again pressed upon you the extension of the Sewerage of your District. I remain, Your most obedient Servant, HENRY N. PINK. Crooms Hill, 26th May, 1858. FLASHMAN, PRINTER, GREENWICH.