Z Cs - AU. .trr„. to « S J-i • .y/rt,,,/ X A'. ADDRESSED TO yY THE MEDICAL OFFICE* / ^ /dc^ Telephone N° 4707. jkjk * ^ /w*- CU-V/" %^U MC *5t—-v^ J •/ fa/"'* Report ON THE VITAL AND SANITARY STATISTICS OF THE Parish of Lambeth, During the Year 18 9 5 (With an Account of the work done by the Inspectors, and the Proceedings taken under the Food and Drugs, Margarine, and Public Health Acts), by JOSEPH PRIESTLEY, B.A., M.D., D.P.H., Medical Officer of Health. With the Compliments of the Medical Officer of Health. Report ON THE VITAL AND SANITARY STATISTICS OF THE Parish of Lambeth, During the Year 1895 (With an Account of the work done by the Inspectors, and the Proceedings taken under the Food and Drugs, Margarine, and Public Health Acts), by JOSEPH PRIESTLEY, B.A., M.D., D.P.H., Medical Officer of Health, Printed by order of the Vestry, by Merser & Sons, Printers, 268-270, Kennington Road, London, S.E. Public Health Department, 333, Kennington Road, London, S.E. May, 1896. To the Chairman and Members of the Vestry of the Parish of Lambeth. Gentlemen, I beg herewith to present to you my first Annual Report on the Health and Sanitary Condition of your Parish—the thirty-eighth Annual Report of the Medical Officer of Health; and in doing so to mention that I have carefully been over, and prepared, the various facts and statistics, adding information in the form of Tables, from which you will be able to gauge the progress you have made in sanitary matters during the last 10 years. Under the terms of my appointment under the Local Government Board, I am only expected to write a Report for the part of the year 1895 during which I have had the honour to act as your Medical Officer of Health, but with the permission of your Sewers and Sanitary Committee (and at my suggestion), I am able to lay before you a Report for the whole year. I should be wanting in gratitude if I did not take the opportunity of the presentation of this, my first Annual Report as Medical Officer of Health for Lambeth, to again thank you for having appointed me to such an important Office, and to state that it will at all times be my constant endeavour to worthily fill the position, and to do everything I possibly can to give satisfaction to you as a Vestry, both individually and collectively, consistent with the honest execution of my duties. To you, Mr. Chairman, especially, I owe thanks for the kindness I have received at your hands in the way of advice and suggestions, on taking up my duties as Medical Officer of Health, and since. I am, Gentlemen, Your obedient Servant, JOSEPH PRIESTLEY, B.A., M.D., D.P.H., Medical Officer of Health. 1* 4 I.—VITAL STATISTICS. The Registrar-General returns the estimated population of London* for the middle of the year 1895 as 4,392,346,† consisting of 2,076,113 males and 2,316,233 females, and states that there were registered during the year 37,593 marriages, 133,715 births (68,085 males and 65,630 females), and 86,937 deaths (44,184 males and 42,753 females). There were registered, too, 11,545 deaths from the seven chief zymotic diseases. The excess of registered births over deaths—i.e., the natural increment, is 46,778, and the estimated increase of population is 43,395. Calculated out, the uncorrected rates per 1,000 of the population are as follows:— Marriage-Rate 17.1 Birth-Rate 30.5 Death (general)-Rate 19.8 Death (zymotic)-Rate 2.64 If the deaths of strangers (1,799) are deducted, the corrected death-rate is 19 4, and the corrected zymotic deathrate 2.62; whilst allowing for sex and age distribution the death-rate for London is 21.15 per 1,000, the standard deathrate—(i.e., the death-rate at all ages, calculated on the hypothesis that the rates at each of twelve age periods were the same as in England and Wales during the 10 years 1881 —1890) being 17 97, and the factor for correction for sex and age distribution (i.e., the death-rate at all ages in England and Wales during 1881—1890 divided by the standard death-rate for London) 1.0656. The death-rate (corrected for age and sex distribution) is obtained by multiplying the recorded death-rate by the factor for correction. Taking the corrected rates for London 1895, they may be subdivided into Districts as follows:— * By "London" is meant Registration London, i.e., the Administrative County of London with the exception of the hamlet, or civil parish, of Penge. t The Quinquennial Census (taken March 29th, 1896) gives the enumerated population fpr London as 4,411,271, 5  Enumerated Population 1881 (Census). Enumerated Population 1891 (Census). Estimated Population 1895 (middle of year). Marriage-Rate. Birth-Rate. Death-Rate. Zymotic DeathRate. Deaths under 1 year to 1000 Births. London 3,815,544 4,211,743 4392346 17.1 30.5 19.4 2.62 165 South Districts 1,265,148 1,524,472 1,640,736 ... 30.9 18.7 2.47 161 West Districts 669,473 740,735 773,274 ... 25.6 17.8 2.07 170 North Districts 906,052 993,884 1,033,745 ... 28.9 18.0 2.26 151 Central Districts 282,133 247,538 234,151 ... 29.8 24.2 3.15 185 East Districts 692,738 705,114 710,440 ... 37.5 23.5 3.89 178 6 The basis of all statistical calculations is an enumerated or estimated population, and taking the censal (enumerated) populations for Lambeth during 1881 and 1891, by logarithms we are able to calculate the estimated populations for 1895, not only for the Parish as a whole, but also for the Registration Sub-districts, and the Parliamentary Divisions or new Wards. Further, these populations can be sub-divided into various age periods, and according to sex. Upon these estimated Lambeth populations all the 1895 rates in the present Report have been calculated, and compared with those for London; whilst the total populations have been carefully corrected, and worked out, for the last 40 years for future use. The populations are all (censal years included) estimated to the middle of each year, a constant rate of growth being assumed from census to census, and the 1881—91 growth being carried on to 1895, in the case of the totals. The males and females, and the age periods, are on the hypothesis of a constant rate of change in the sex and age proportions of the population from census to census (these proportions being taken as constant since 1891). The populations in the Registration Sub-districts, and in the Parliamentary Divisions or new Wards, are on the hypothesis that the changes in the proportion of each to the total have gone on since 1891 as during the decennium 1881—91. Fortunately, the figures of the new quinquennial Census taken March 29th, 1896, in accordance with the provisions of the Equalisation of Rates (London) Act, enable me to re-calculate and correct the figures for 1891—96, though it is to be regretted that this quinquennial Census gives no particulars as to sex and age-periods. 7 The estimated population to the middle of 1895 for Lambeth Parish is 284,885, consisting of 134,562 males and 150,323 females; and this population may be sub-divided as follows:— A. As to Registration Sub-districts. Total. 13,448 13,798 17,177 38,651 53,033 41,713 78,293 28,772 284,885 Females. 6,680 6,732 8,522 19,359 27,048 22,448 43,295 16,239 150,323 Males 6,768 7,066 8,655 19,292 25,985 19,265 34,998 12,533 134,562 Registration Sub-districts. Waterloo Road, First Waterloo Road, Second Lambeth Church, First Lambeth Church, Second Kennington, First Kennington, Second Brixton Norwood Parish of Lambeth 8 9 B. As to Parliamentary Divisions and New Wards. Parliamentary Divisions and New Wards. Males. Females. Total. Marsh Bishop's North Division 30332 29991 60323 Prince's Vauxhall Kennington Division 37426 38362 75788 Stockwell Brixton Brixton Division 34883 41796 76679 Tulse Hill Norwood Norwood Division 31921 40174 72095 Parish of Lambeth 134562 150323 284885 C. As to Age-Periods. Age-Periods. Males. Females Total. 0—1 3692 3676 7368 1—5 13294 13062 26356 Total under 5 16986 16738 33724 5—20 41895 44419 86314 20—40 45181 50912 96093 40—60 22883 26464 49347 60—80 7206 10873 18079 80 and upwards 411 917 1328 Total over 5 117576 133585 251161 10 The Parish of Lambeth contains 4,059 statute acres, inclusive of 79 tidal water and 39 foreshore, with an *estimated population of 284,885 persons to the middle of the year 1895. The total estimated increase of the population is 2,308, but the "natural increment"—i.e., the excess of births over deaths is 3,782, so that we must assume an exodus of 1,474 in excess of those who came into the Parish during the year. The estimated number of inhabited houses to the middle of the year 1895 is 39,895, and the rateable value of the Parish on April 6th, 1895, was .£1,575,325, an increase of £6,512 on the previous year, as the following Table shews:— Year. Rateable Value.† 1895 £1,575,253 1885 1,410,104-10-0 1886 1,492,504 1887 1,490,933 1888 1,491,518 1889 1,491,851 1890 1,498,535 1891 1,526,176 1892 1,540,047 1893 1,551,023 1894 1,562,868 Yearly average for 10 years, 1885-1894, £1,505,555 19 0. *The Quinquennial Census (taken March 29th, 1896), gives the enumerated population of Lambeth as 295,033. †These rateable values are (he figures as settled by the Assessment Committee, and do not include, therefore, any new properties that may come into existence between the meeting of such Committee and the following financial year. 11 THE BIRTH-RATE. The number of Births registered in Lambeth during the year 1895 was 9,341, as compared with 9,232 for the year 1894. Of the total 9,341 births, 4,838 were males, and 4,503 females, showing an excess of 335 males. The birth-rate for Lambeth is, therefore, 32.8 per 1000 inhabitants (35.9 for males and 29.9 for females), as compared with 30.5 for London (32.8 for males and 28.3 for females); whilst in the various Registration Sub-districts the birth-rates work out as shewn in Table A. Tables B and C shew the number of births and the birth-rates for the last 10 years in Lambeth. The birth-rate affects the death-rate by altering the age constitution of the population, and the inter-relationships of birth- and death-rates are important in considering the Vital Statistics of a Community. With a persistently high birth-rate the age constitution (in the early years) is affected considerably, as will be easily understood by an example. Supposing a high birth-rate be maintained for 20 years, there will be an increase of persons living under 20 years of age, and, therefore, though the number of persons under 5 years of age is increased, causing thereby an increased death-rate, the number of persons between 10 and 20 years of age is also increased, and the death-rate thereby decreased. The rate of mortality amongst young children (under 5) and the aged (60 and upwards) is higher than amongst persons of other age periods (e.g., 5 to 20, 20 to 40, 40 to 60), so that a persistently high birth-rate may produce a low death-rate; or, in other words, the lower the average age constitution of a population, the lower 12 ought to be the death-rate. An intermittently high birthrate, on the contrary, would increase the percentage of children under 5 years, and so, indirectly, the death-rate. These facts are important. The age distribution of a population depends, too, on the increase or decrease from immigration or emigration. I may summarise by saying that a high birth-rate does not necessarily cause a high death-rate, and vice versa; nor does the death-rate necessarily directly affect the birthrate. The death-rate and birth-rate must be taken together, as the death-rate per se gives no reliable information as to the relative healthiness or otherwise of a particular district. For this reason, in considering the statistics of the various Registration Sub-districts of Lambeth, I have given their birth-rates and death-rates side by side, so that any deductions that are drawn are on the understanding of the importance of their inter-relationship. 13 Table A, giving the number of Births and the Birth-Rates in each Registration Sub-District of Lambeth during 1895 (arranged quarterly). Registration Sub-District. Estimated Populations (middle 1895). No. of Births. Total for the Year 1895. Rate per 1000. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Male. Female. Male. Female. Male. Female. Male. Female. Waterloo Road 1st 13,448 69 90 58 62 73 52 49 65 518 38.5 „ 2nd 13,798 145 117 147 110 131 110 120 118 998 72.3* Lambeth Church 1st 17,177 96 83 71 74 83 57 78 76 618 35.9 „ 2nd 38,651 229 196 203 201 206 206 199 189 1629 42.l† Kennington 1st 53,033 226 213 227 226 218 223 206 197 1736 32.7 2nd 41,713 171 141 146 127 139 140 127 108 1O99 26.3 Brixton 78,293 275 266 270 280 270 259 247 226 2093 26.7 Norwood 28,772 93 76 90 75 95 76 81 64 650 22.6 1304 1182 1212 1155 1215 1123 1107 1043 284,885 2486 2367 2338 2150 9341 32.8 * Including the Lying-in Hospital. † Including the Workhouse. 14 15 Table B, shewing the Estimated Populations, Numbers of Inhabited Houses, Marriages, Births, and Corrected Deaths for the Year 1895, and Ten Years preceding, in Lambeth Parish. The Year. Estimated Population. Estimated No. of Inhabited Houses. Marriages. Registered Births. Corrected Number of Deaths. Deaths from 7 Chief Zymotic Diseases. Deaths in Public Institutions. Total Ages. Under 1 year. Under 5 years. 1895 284885 39895 2220 9341 5559 1420 2187 732 1511 1885 262625 36743 2275 9143 5035 1198 1961 628 884 1886 264770 37058 2184 9047 5302 1344 2163 726 1112 1887 266933 37374 2066 9110 5292 1382 2294 892 1143 1888 269114 37689 1985 9017 5095 1196 1990 634 1533 1889 271312 38004 1997 8906 5057 1259 2071 727 1460 1890 273529 38319 2060 9017 5842 1369 2228 696 1320 1891 275763 38634 2140 9097 5886 1387 2251 692 1438 1892 278016 38950 2107 9226 5457 1250 2091 705 1578 1893 280287 39265 2233 9222 5219 1325 1925 748 1741 1894 282577 39580 2224 9232 4837 1223 1936 680 1484 Note.—(a) Enumerated Population at Census 1891 was 275,203. (b) Actual number of inhabited houses at Census 1891 was 38,556. Table C, shewing the number of persons per house, the Marriage-, Birth-, and Death-Rates, and proportion of Deaths in Public Institutions, for the Year 1895, and ten years preceding. The Year. Estimated No. of Persons per house, per Year. Marriage-Rate per 1000 Population. Birth-Rate per 1000 Population. Death-Rate per 1000 Population Deaths of Children under 1 year, per 1000 births. Deaths of Children under 1 year, per 1000 deaths. Deaths of Children under 5 years, per 1000 deaths. Zymotic Death Rate, per 1000 Population. Deaths in Public Institutions per 1000 total uncorrected deaths. 1895 7.1 15.6 32.8 19.5 152.02 255.4 393.4 2.6 257 9 1885 17.3 34.8 19.17 131.03 237.9 389.5 2.4 170.5 1886 16.2 34.2 20.25 148.6 253.5 407.9 2.7 203.7 1887 15.5 34.1 19.83 151.7 261.2 433.5 3.3 211.1 1888 14.8 33.5 18.93 132.6 234.7 390.6 2.4 297.3 1889 14.7 32.8 18.64 141.4 248.9 409.5 2.7 284.5 1890 15.1 32.9 21.36 151.8 234.3 381.4 2.5 2221 1891 15.5 32.9 21.34 152.5 235.6 382.4 2.5 236.6 1892 15.2 33.2 19.63 135.5 229.06 383.2 2.5 272.4 1893 15.9 32.9 18.62 143.7 253.9 368.8 2.7 305.9 1894 15.7 32.7 17.12 132.5 252.8 400.3 2.4 284.7 Note.—(a) Enumerated Number of Inhabited Houses at Census 1891 was 38,556. (b) Enumerated Number of Inhabited Houses at Census 1881 was 35,404. 16 THE MARRIAGE-RATE. The number of marriages registered in Lambeth during the year 1895 was 2,220, as compared with 2,224 for the year 1894. The marriage-rate for Lambeth is, therefore, 15.6 per 1,000 inhabitants, as compared with 17.1 for London. Tables B and C shew the number of marriages and the marriage-rates for the last 10 years in Lambeth, and it will be noticed that the marriage-rate has been gradually, but persistently, falling during that period, as also during the previous decennium. THE DEATH-RATE. The total number of deaths registered in Lambeth during the year 1895 was 5,857, as compared with 5,213 for the year 1894. Of the total 5,857 deaths 2,923 were males and 2,934 females, shewing an excess of 11 females. The death-rate for Lambeth is, therefore, 20.56 per 1,000 inhabitants (21.7 for males and 19.5 for females), as compared with 19.8 for London (21.3 for males and 18.5 for females). These rates are, however, uncorrected, and on analysing the 5,857 deaths registered in Lambeth Parish it is found that 702 represent deaths occurring within the Parish amongst persons not belonging thereto. These are to be deducted, but, on the other hand, there are 404 deaths registered outside the Parish of persons belonging thereto, and these must be added, giving a corrected number of deaths for Lambeth during 1895 of 5,559, and a corrected death-rate of 19.5 per 1,000 inhabitants, as compared with 19.4 for London (the total corrected number of London deaths being 85,138). The Institutions, &c., where the 404 Lambethians died during 1895, may be grouped as follows:— 17 I. General Hospitals 134 Bolingbroke 1 Charing Cross 14 French 2 German 1 Gt. Northern 3 Guy's 18 Hostel of God 3 King's 8 London 6 Middlesex 3 Royal Free 2 St. Bartholomew's 15 St. George's 12 St. Luke's 1 St. Mary's 1 St. Peter's 1 St. Thomas's 3 University 7 Westminster 33 II. Special Hospitals 60 Belgrave 1 Brompton 9 Cancer 5 City of London 1 Convalescent Home (Winnifred House) 1 Cottage Home, Wandsworth 1 Evelina 19 Friedenheim 3 Gt. Ormond Street 6 National 4 Nursing Home, Clapham 1 Shadwell 1 Sydenham 2 Victoria 6 Fever— 37 Fountain 25 South-Eastern 7 Ships 2 Homerton 1 North-Western 1 Western 1 III. Infirmaries and Workhouses 16 Camberwell Infrmy 2 „ Wrkhse 3 Islington Infirmary 1 St. Saviour's Infrmy 10 IV. Asylums 135 Aged Pilgrims 1 Bethnal House 5 Banstead 11 Camberwell House 3 Caterham 20 Cave Hill 23 Central London Sick Asylum 1 Colney Hatch 7 Darenth 9 Grove Hill 3 Hanwell 10 Ilford 23 Leavesden 7 Middlesex 4 Peckham House 8 V. Unclassifiable Places 22 H.M. Prison 1 River Thames 10 Railway 3 Private Addresses 6 2 18 Summary. I. General Hospitals 134 II. Special and Fever Hospitals 97 III. Infirmaries and Workhouses 16 IV. Asylums 135 V. Elsewhere (Unclassifiable) 22 Total 404 In Tables B and C will be found the total corrected number of deaths and the corrected death-rates for Lambeth during the last 10 years, whilst Table D gives the corrected deathrates during the year 1895 in the several Registration Subdistricts, with the corresponding birth-rates and the corrected zymotic death-rates. It will be seen that the Registration Sub-districts vary not only in regard to their birth-rates, but also in regard to their death-rates (general and zymotic). Thus, the four Inner Districts average a birth-rate of 47.2 per 1,000 (though the Lying-in Hospital and the Workhouse must be remembered in this connection and allowed for), a corrected death-rate of 26.92, and a corrected zymotic death-rate of 4.57 per 1,000 as compared with 27.08, 16.37 and 1.77 per 1,000 respectively for the corresponding averages of the Outer Districts. As we examine the various statistics of Lambeth Parish (divided into Inner and Outer Districts only) more minutely, the same differences will be found to obtain. Thus, there will be found to be comparatively a larger number of deaths under five years of age in the Inner than in the Outer Districts; so, also, the infantile mortality (or deaths under one year per 1,000 births), the deaths from the various zymotic diseases (whether taken in the 19 portion of 1,000 of the population or of 1,000 total deaths, and whether taken collectively or separately), the zymotic incidence, i.e., the number of cases notified per 1,000 of the population—the Diarrhoea rate being especially marked in this respect—will all be found to be greater in the Inner than in the Outer Districts. It will be noticed, too, as a corollary, that the number of deaths amongst persons of 60 years and over (old age) is greater, but amongst those of 20 to 40 years (adolescents) smaller, in the Outer than in the Inner Districts. Taking different groups of diseases, it will be observed from the number of deaths that the Inner Districts also suffered during 1895 out of all proportion from phthisis, tubercular diseases, and respiratory diseases generally, and from premature births, whilst the number of infants suffocated whilst in bed with their parents was in the Inner Districts 25, and in the Outer 18, representing a proportion of 3 to 1, taking the different populations into consideration. The density of population, it must be remembered, is greater in the Inner than in the Outer Districts—an average of 163, as compared with 68, persons to an acre. These facts are significant and point to the necessity for careful sanitary inspection and supervision in the Inner Wards, with the adoption of such measures as will improve hygienically the surroundings and lives of the inhabitants of that portion of the Parish, consisting for the most part of the very poor and the working classes. To systematically and successfully grapple with this important subject more Inspectors are needed, and I am glad to be able to report that the Vestry has, during the year 1895, risen to the occasion (with a practically unanimous vote), and decided on December 12th last to appoint at once three more Inspectors. 2* 20 Unfortunately, however, the Local Government Board has not given its sanction to this number (suggested by your Medical Officer of Health and approved by the Vestry), with the result that the Parish is still (May, 1896) left undermanned as regards the Inspectorial Staff. I cannot help but feel that it would have been more politic on the part of the Board to have sanctioned the three additional Inspectors, and afterwards to have pressed the Vestry to appoint more, when represented to be necessary by your Medical Officer of Health, Such a line of action on the part of the Board would, I submit, have been more to the advantage sanitarily of the Parish of Lambeth.* The surroundings of the inhabitants of the Inner Districts are not satisfactory, and it will need the full support of the Vestry (a support which, I feel sure, I shall at all times obtain), to enable your Medical Officer of Health and the Inspectors to improve them. Many houses will have to be closed, or (what would be better) rendered fit for human habitation, but to accomplish this your Officers are beset with difficulties which some of the members of the Vestry can, I think, have no conception of, what with the vested interests of this person and that person, whether in the shape of a superior lessor or a ground landlord. As your Medical Officer, I am sanguine that the unanimous support of the Vestry will enable my Department to override most (if not all) of these obstacles, and so slowly but surely give the poorer members of the Community surroundings and conditions of life to which they are justly entitled, and the possession of which will tend to make their lives happier and brighter, and so to *On April 16th, 1896, the Vestry decided to appoint four additional Inspectors, a number which at last has been sanctioned by the Board in a letter dated June 10th, 1896. 21 raise their moral and social status. Such improvements are sadly wanted in your Inner Wards, and will in time, I think, be effected by careful and systematic inspection, and the enforcing judiciously of the stringent powers now vested in you by virtue of the Public Health and other Acts, including the numerous important Bye-laws (more especially those relating to houses let in lodgings). Before leaving this part of the Report, I trust I may be allowed to congratulate the Vestry upon having decided to appoint, and upon having actually appointed on June 27th, 1895, a Medical Officer of Health to devote his whole time and attention to the duties of his Office. Such an appointment was needed in a large Parish like Lambeth (the second largest in London), for the work in connection with the Sanitary or Health Department is becoming yearly more and more important, now that London possesses such a stringent Public Health Act with the numerous bye-laws connected therewith. The Public, too, are becoming more and more alive to what is due to them sanitarily, and therefore more and more exacting in that respect; whilst the "workers" are beginning to demand better conditions of life, not only when at work but also when at home. Such demands will have to be met by the Vestry, with the result that the lives of the people will be happier, brighter and longer—the average duration of life increased and the mean age at death extended. This is something to be accomplished, and, when accomplished, to be proud of; and I feel sure that all trouble and expense will be more than compensated by the appreciation which will be received from the ratepayers and the public at large. With a sufficient staff of competent Inspectors, with a Committee and Vestry at all times willing to assist and support their Officers, I am sanguine that much will be accomplished in future for Lambeth, and that your Parish will come to be in the foremost rank of sanitation; and that even the (to my mind somewhat unjust) aspersions that have recently been cast upon Lambeth will be forgotten. 22 TABLE D. Shewing the number of Births and Deaths, with Birth- and 1895. The Deaths are from all causes, and from the chief outside the Parish, by omitting strangers who die within the into the Districts from which they have been removed during DISTRICTS. Persons per Acre. Estimated Population (middle 1895). Total Births. Birth-rate per 1000 of the Population. Total Deaths (corrected). General Death-rate per 1000 of the Population. Waterloo Road, 1st 200.7 13448 518 38.5 349 27.3 „ „ 2nd 137.9 13798 998 72.3 370 28.1 Lambeth Church, 1st 106.03 17177 618 35.9 439 26.6 „ „ 2nd 207.8 38651 1629 42.1 977 25.7 Kennington, 1st 108.2 53033 1736 32.7 951 18.3 2nd 83.8 41713 1099 26.'3 724 17.8 Brixton 54.8 78293 2093 26.7 1241 16.1 Norwood 28.5 28772 650 22.6 365 13.3 District not stated ... ... ... ... 143 ... Lambeth 72.3 284,885 9341 32.8 5559 19.5 London 56.8 4,392,346 133.715 30.5 85138 19.4 N.B.—In the 143 cases where the district is not stated, the were sub-divided equally in the eight Districts. Census 1891 23 TABLE D. Death-rates in each of the Registration Sub-Districts of the Parish during Zymotic Diseases, and are corrected by adding Lambethians who die Parish, and by re-distributing persons who die in Public Institutions illness. Total Deaths from Total Zymotic Deaths. Zymotic Death-rate per 1000 of the Population. Zymotic Death-rate per 1000 of the Total Deaths. Diarrhœa Death-rate per 1000 of the Population. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Typhoid or Enteric. Continued Fever. Diarrhœa. 0 21 1 6 11 0 2 0 16 57 4.2 155.3 1.2 0 8 7 11 10 0 0 0 28 64 4.6 164.9 4.6 0 18 6 14 20 0 1 0 27 86 5.1 190.4 5.07 0 53 9 10 32 0 3 1 56 164 4.4 169.8 4.4 1 24 6 21 19 0 6 0 44 121 2.3 124.9 .83 1 7 4 9 12 0 6 0 34 73 1.8 101.08 •82 0 14 15 26 21 0 7 1 44 128 1.6 102.4 •56 0 6 5 6 7 0 1 0 14 39 1.4 102.09 •48 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 151 53 103 132 0 26 2 263 732 2.6 131.7 •92 55 2629 829 2289 1480 5 596 10 3574 11467 3.6 134.7 •81 death-rate has been calculated on the assumption that these deaths Return gives the area of Lambeth as 3,941 statute acres. 24 The 5,559 corrected deaths may be further analysed and tabulated according to age-periods as follows:— 1420, i.e.,25.5 % of the total deaths took place under 1 yr. of age 767 „ 13.8 „ „ „ „ between 1 & 5 yrs. 2187 „ 39.3 „ „ „ „ under 5 yrs 260 „ 4.7 „ „ „ „ between 5 & 20 yrs. 664 „ 11.9 „ „ „ „ „ 20 & 40 yrs. 941 „ 16.9 „ „ „ „ „ 40 & 60 yrs. 1225 „ 22.03 „ „ „ „ „ 60 & 80 yrs. 282 „ 5.07 „ „ „ „ over 80 yrs. 3372 „ 60.7 „ „ „ „ over 5 yrs. If now we take the estimated populations at the different age-periods, we are enabled approximately to estimate the mortalities per 1,000 persons at each ageperiod for Lambeth, and compare them (1) with those for London generally during 1895, and (2) with the London averages for the ten years 1881—90, as shewn in Table E, which gives a more trustworthy idea of the sanitary condition of the Community—to be gained from the death returns, and which is on the whole satisfactory as far as Lambeth is concerned. It must be remembered, however, that the healthiness of the Outer Wards dilutes the unhealthiness of the Inner Wards, giving to the whole Parish an apparently fairly healthy appearance; but you must not be misled, but rather encouraged to make your Inner Wards as satisfactory from a health point of view as your Outer Wards. Tables F, G, H shew the uncorrected deaths (male and female), arranged as to Registration Sub-Districts, age-periods, and quarters respectively, and have been added for comparison with similar Tables given in former Reports of Lambeth. 25 TABLE E . Shewing Mortalities in Lambeth at different Age-Periods compared with (1) those for London, 1895. and (2) the averages for London for years 1881—90. Age-periods. LAMBETH. LONDON. Estimated Populations (Middle 1895) Mortality Rates per 1000 Population, 1895 Mortality Rates per 1000 Population, 1895 Uncorrected. Average of Ten Years, 1881-90, per 1000. Corrected. Uncorrected. 0—5 33724 64.8 69.2 67.08 68.4 5—20 86314 3.01 8.8 3.5 8.4 4.3 20—40 96093 6.9 6.9 7.7 40—60 49347 19.07 20.3 20.2 60—80 18079 67.8 76.9 67.2 63.3 80 and upwards 1328 212.3 212.9 206.2 *Under 1 year 7368 152.0 156.3 166.0 152.0 All Ages 284885 19.5 20.6 19.8 20.5 I have used the Age-Periods adopted in previous Lambeth Reports, though it is considered more accurate to sub-divide as follows :— 1— 5, 5—10, 15—25, 25—35, 35—45, 45—55, 55—65, 65—75, 75—85, 85 and over. * N.B.—The Rates under 1 year are given in terms of 1000 births. 26 TABLE F Shewing the uncorrected Mortality, Male and Female, in the different Districts, and a comparison of the number of deaths in each Quarter during the year 1895. SUB-DISTRICTS. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total No. of Deaths in each District. M. F. Total. M. F. Total M. F. Total M. F. Total. Waterloo Road, 1st 42 52 94 37 25 62 43 51 94 42 34 76 326 Waterloo Road, 2nd 43 45 88 21 32 53 42 26 68 32 35 67 276 Lambeth Church, 1st 130 114 244 114 84 198 152 110 262 121 88 209 913 Lambeth Church, 2nd 218 208 426 155 143 298 173 150 323 143 124 267 1314 Kennington, 1st 134 144 278 85 84 169 113 93 206 71 81 152 805 Kennington, 2nd 102 121 223 66 59 125 64 76 140 59 68 127 615 Brixton 187 258 445 128 156 284 146 152 298 113 147 260 1287 Norwood 52 72 124 31 34 65 32 35 67 32 33 65 321 Totals 908 1014 1922 637 617 1254 765 693 1458 613 610 1223 5857 N.B.—1539 persons died in the Public Institutions, including 702 strangers. 27 TABLE G Shewing the uncorrected mortality (i.e., including that of strangers), at different ages in each District of the Parish. SUB DISTRICT Under 1 year 1 year to 5 years 5 to 60 years 60 years & upw'ds. Total Male Female Total Male Female Total Male Female Total Male Female Total Waterloo Road, 1st 67 53 120 41 38 79 42 44 86 14 27 41 326 Waterloo Road, 2nd 51 39 90 20 30 50 49 49 98 18 20 38 276 Lambeth Church, 1st 120 70 190 76 78 154 269 195 464 52 53 105 913 Lambeth Church, 2nd 171 113 284 74 89 163 261 191 452 183 232 415 1314 Kennington, 1st 159 107 266 49 56 105 109 100 209 86 139 225 805 Kennington, 2nd 84 73 157 35 27 62 101 110 211 71 114 185 615 Brixton 148 128 276 110 122 232 189 218 407 127 245 372 1287 Norwood 44 33 77 17 13 30 43 58 101 43 70 113 321 Totals 844 616 1460 422 453 875 1063 965 2028 594 900 1494 5857 28 TABLE H. Shewing the uncorrected deaths (i.e , parishioners and strangers), at various age-periods in each quarter. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total Male Female Total Male Female Total Male Female Total Male Female Total Under 1 year 232 164 396 172 119 291 286 231 517 154 102 256 1460 Between 1 and 5 years 96 121 217 98 111 209 125 100 225 103 121 224 875 Between 5 and 60 years 338 313 651 250 200 450 242 228 470 233 224 457 2028 60 years and upwards 242 416 658 117 187 304 112 134 246 123 163 286 1494 Totals 908 1014 1922 637 617 1254 765 693 1458 613 610 1223 5857 29 INFANTILE MORTALITY. Of the 5,559 deaths 1,420 were infants under one year of age, giving a proportion of 152 (corrected) per 1,000 births, the uncorrected rate being 156.3. The chief causes of these deaths were diarrhoea, premature birth, convulsions, bronchitis and pneumonia, whooping cough, atrophy, inanition and debility. This method of expressing the infantile mortality in the terms of the infantile population (i.e., per 1,000 births), is more trustworthy than estimating the number of infants living at the time from the censal returns, the ages of infants under one year being frequently incorrectly returned (generally understated). Table I gives the infantile mortality in different towns in England and Wales, etc., for the purpose of comparison; whilst in the various Registration Sub-Districts of Lambeth the infantile mortality is found to vary from 307 per 1,000 births in Lambeth Church First to 118 in Norwood (the low rate of 90 per 1,000 births in Waterloo Road Second, being explainable by the fact that this Sub-District contains the General Lying-in Hospital), thus:— Total No. of Births Total Deaths under 1 year (uncorrected) InfantileMortality per 1,000 births (uncorrected) Waterloo Road, 1st 518 120 231.7 „ 2nd 998 90 90.2* Lambeth Church, 1st 618 190 307.4 „ 2nd 1629 284 174.3 Kennington, 1st 1736 266 153.2 „ 2nd 1099 157 142.9 Brixton 2093 276 131.9 Norwood 650 77 118.5 Lambeth 9341 1460 156.3 *Including the Lying-in Hospital. 30 TABLE I. Shewing the Infantile Mortalities in the Registrar-General's 33 Large Towns of England and Wales (including London), and in Lambeth Parish. Uncorrected Deaths under one year per 1000 Births. Average Ten Years, 1885-94. England and Wales (33 Large Towns). 182 164 London 166 153 Lambeth 156.3 142.2 Croydon 134 121 Bristol 143 145 Halifax 158 159 Huddersfield 158 163 Derby 161 147 Brighton 164 148 West Ham 168 152 Birkenhead 174 160 Portsmouth 175 145 Plymouth 178 165 Swansea 178 156 Cardiff 179 163 Birmingham 183 171 Gateshead 186 161 Newcastle-on-Tyne 186 164 Sunderland 189 164 Norwich 190 170 Oldham 190 175 Nottingham 190 168 Leeds 191 174 Sheffield 197 175 Leicester 203 201 Bradford 203 167 Manchester 203 182 Hull 205 163 Liverpool 210 186 Bolton 212 174 Wolverhampton 2l8 175 Salford 231 189 Blackburn 236 197 Burnley 242 210 Preston 248 229 *London Districts- North 151 145 South l6l 148 West 170 156 East 178 163 Central 185 167 *The figures are corrected for the London Districts, 31 CLASS I.—ZYMOTIC DISEASES. Principal Zymotic Diseases. The principal Zymotic diseases are seven in number, viz., smallpox, measles, scarlet fever, diphtheria, whooping cough, "fever" (including typhus, typhoid or enteric, and simple or continued), and diarrhoea; and the zymotic deathrate is made up from the total deaths from these diseases. As a test of the sanitary condition of a Community, the zymotic death-rate is of approximate value. In Lambeth during 1895 there were registered 1,118 deaths from the seven zymotic diseases, and of these 193 were strangers, 874 parishioners who died within the Parish, and 51 parishioners who died without the Parish. Subtracting the strangers, and adding on the parishioners who died without the Parish, there is a corrected total of 732, giving a zymotic death-rate per 1,000 inhabitants of 2.6, the corrected rate for London being 2.6, varying in the various Metropolitan Districts as shewn on page 5. The zymotic death-rates (corrected) for the different Registration Sub-Districts of Lambeth vary also, as shewn in Table D, which, in addition, gives the death-rates and birthrates for comparison. The zymotic death-rate (average) for the Inner Districts is, we have seen, 4.57, and for the Outer, 1.77—a difference explainable partly from the fact of the over-crowding and the absence of proper means of home isolation in the former, as compared with the latter, Districts. (See p. 18). During the year 1895, under the Notification Clauses of the Public Health (London) Act, 1891, 2,685 cases of infectious diseases have been reported, and of this number only 816 (i.e., 30.4%), were removed to the Hospitals of the Asylums Board, or to other Hospitals, and 1,869 (i.e., 69.6%), remained under treatment at their own homes. 32 These percentages are not satisfactory, but are explainable by the fact that there was great difficulty experienced in getting infectious cases (more especially scarlet fever), removed to the Hospitals of the Asylums Board— a state of affairs that was accentuated towards the end of the year 1895, with the result that an official representation was made by your Medical Officer of Health to the Board, asking that special attention might be paid to the cases sent on by your officials for removal. This representation, apparently, had the desired effect, for I am able to report that I experienced no further difficulty in getting cases removed afterwards. There is little doubt, I think, but that the deadlock arose from the want of sufficient accommodation, and the apparent absence of method in choosing the cases, and not from any remissness on the part of the Managers, who did their best under what were exceptionally trying circumstances. During times of pressure, and with an insufficiency of isolation accommodation, I submit that only the most severe cases, the most destitute, and those that cannot possibly be isolated at their own homes should be removed, and that the choosing of such cases should be left to the Medical Officer of Health for the particular District in question. If no such system as this be adopted, isolation in London must be more or less of a failure. 84.3% smallpox cases, 34.4% scarlet fever, 30.8% typhoid, and 27.6% diphtheria, were removed to Hospital respectively. Table J gives the averages of Notification certificates received in Lambeth since 1889, and it will be noted that during 1895 the total number is 49 above the average— the greatest number of Notifications being received in 1893— though the incidence per 1,000 of the population during 1895 is below the average incidence for the years 1890—94 (i.e., since the introduction of the Compulsory Notification Act). 33 TABLE J. Shewing the number of Certificates for the Notifiable Zymotic Diseases received in Lambeth since the introduction of the Notification Act, i.e., in the six years, 1889—94, and in the year 1895. Disease 1889 1890 1891 1892 1893 1894 Notifications received during 1895 Annual average of 5 years 1890—94 Small-Pox 0 15 3 22 99 26 51 33.0 Cholera 0 7 4 26 23 10 16 14.0 Diphtheria 286 330 330 504 789 521 614 494.8 Membranous Croup 0 46 29 47 49 26 23 39.4 Erysipelas 92 248 258 420 587 315 355 365.6 Scarlet Fever 879 1126 858 1832 2275 1198 1389 1457.8 Typhus 0 0 1 3 3 2 0 1.8 Typhoid or Enteric 64 150 149 117 160 268 201 168.8 Continued or Relapsing 0 41 33 34 58 48 20 42.8 Puerperal 15 13 11 20 27 19 16 18.0 Totals 1336 1976 1676 3025 4070 2433 2685 2636.0 Average per 1,000 of population... 4.9 7.2 6.1 10.9 14.5 8.6 9.4 9.5 N.B.—The 1889 column represents only two months, the Notification Act coming into force on October 31st, 1889. 3 34 In the case of each infected house, an inspection was made, and the drains, and sanitary fittings tested, with the results that of the 2111 infected houses— (a) 392 (i.e., 18.6 %) were found to have defective drains. (b) 993 (i.e., 47.04%) were found to have defective drains, or defective traps, fittings, and appliances. (c) 1118 (i.e., 52.96%) gave no result with the tests. (d) 601 (i.e., 28.5%) were found to have defective traps fittings, and appliances, but not defective drains. Sub-divided according to the different notifiable diseases, the results are as follows:— Disease. No. of Infected Houses. Numbers shewing Defects as to Percentage shewing Total Defects. Percentage giving no Results. Drains. Traps, Fittings and Appliances only. Total. Smallpox 41 10 12 22 53.7 46.3 Cholera* 12 6 0 6 50.0 50.0 Diphtheria 498 99 137 236 47.4 52.6 Membranous Croup 22 3 5 8 36.4 63.6 Erysipelas 250 33 75 108 43.2 56.8 Scarlet Fever 1065 184 301 485 45.5 54.5 (Typhus 0 0 0 0 0.0 0.0 Typhoid 187 48 61 109 58.3 41.7 Continued or Relapsing 20 6 4 10 50.0 50.0 Puerperal 16 3 6 9 56.3 43.7 2111 392 601 993 47.04 52.96 *These were in all probability cases of Diarrhoea or Cholera Nostras. It will be noted that 18.6% of the infected houses shewed, with the test, defective drains, and 28.5% defective traps, fittings, and appliances. Table K gives the average percentages for the last 4 years (i.e., practically from the introduction of the Notification Act), and it will be noted with satisfaction, in regard to infected houses in Lambeth, that the year 1895 is 22.2% below the average in respect of defective drains, and 18.5% below the average in respect of defective traps, fittings, and appliances. 35 TABLE K. Giving number of infected houses with percentages of (1) General Defects, and (2) Defective Drains, during the years 1895 and the four preceding years. 1891 1892 1893 1894 Average for last 4 years 1891—94 1895 Number of Infected Houses 1417 2430 3179 2012 2259.5 2111 Number of Houses with defects found 903 =63.7% 1474 =60.7% 1641 =51.6% 1089 =54.1% 1276.7 =56.5% 993 =47.04% Number of Houses with defective drains found 316 =22.3% 720 =24.7% 658 =20.6% 464 =23.06% 539.5 =23.9% 392 =18.6% Number of Houses with no defects found 514 —36.3% 956 =39.3% 1538 =48.4% 923 =45.9% 982.7 =43.5% 1118 =52.96% 3* 36 The seasonal mortality from the different zymotic diseases is well shown by arranging the deaths quarterly, thus:— 1895. Smallpox. Measles. Whooping Cough. Scarlet Fever. Diphtheria. FEVER. Diarrhœa. Membranous Group. Erysipelas. Puerperal Fever. Cholera. Influenza. Typhus. Typhoid. Continued. 1st Qtr. ... 14 61 10 19 ... 5 1 12 3 2 4 1 113 2nd Qtr. ... 30 26 9 19 ... 3 0 65 2 4 2 1 23 3rd Qtr. 1 31 30 8 35 ... 5 0 159 3 2 3 10 5 4th Qtr. 1 76 15 26 30 ... 13 1 27 1 2 4 1 7 Totals 2 151 132 53 103 ... 26 2 263 9 10 13 13 148 Taking the zymotic diseases collectively, it is noticed that the 3rd quarter shewed the highest mortality, and the 2nd quarter the lowest. Measles, Scarlet Fever and Typhoid reached their maxima in the 4th quarter; Influenza in the 1st; Whooping Cough in the 2nd; Diarrhoea and Cholera in the 3rd; and Diphtheria in the 3rd and 4th. Table L shews the zymotic seasonal variations in the different Registration Sub-Districts, whilst Table N gives the monthly mortalities from the zymotic diseases. Table M gives the deaths from the seven principal zymotic diseases during 1895, and for the ten previous years, not only in Lambeth Parish, but also (for comparison) in London. 37 TABLE L. Showing Zymotic seasonal variations in the different Registration Sub-Districts during 1895. Registration Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Zymotic Death-rate per 1000 inhabitants. Waterloo Road, 1st 7 6 18 26 57 4.2 Waterloo Road, 2nd 12 16 23 13 64 4.6 Lambeth Church, 1st 9 21 32 24 86 5.1 Lambeth Church, 2nd 23 33 73 35 164 4.4 Kennington, 1st 31 24 45 21 121 2.3 Kennington, 2nd 9 13 30 21 73 1.8 Brixton 24 31 39 34 128 1.6 Norwood 7 8 9 15 39 1.4 Lambeth 122 152 269 189 732 2.6 38 39 TABLE M. Shewing the number of Deaths from the principal Zymotic TABLE M Diseases in the ten years 1885—94, and in the year 1895. Disease. 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 Total Deaths in 1895. Proportion of Deaths to 1000 Deaths 1895. Annual Average of ten years 1885—94. Proportion of Deaths to 1000 Deaths in 10 years. Smallpox 85 3 1 0 0 0 0 1 5 1 2 0.4 9.6 1.8 Diphtheria 69 61 106 103 155 74 78 127 172 138 103 18.5 108.3 20.4 Scarlet Fever 16 56 120 82 73 57 46 76 69 64 53 9.5 65.9 12.4 Fever. Typhus 1 0 1 0 1 0 1 0 1 0 0 0.0 0.5 0.09 Typhoid or Enteric 28 29 39 36 31 31 28 22 36 46 26 4.7 32.6 6.1 Simple Continued 3 6 8 3 5 3 7 2 4 0 2 0.4 4.1 0.8 Measles 115 137 152 119 157 183 128 187 113 182 151 27.2 147.3 27.9 Whooping Cough 142 196 187 171 137 194 239 135 151 110 132 23.7 166.2 31.3 Diarrhœa 169 238 278 120 168 154 165 155 197 139 263 47.3 178.3 33.6 Lambeth 628 726 892 634 727 696 692 705 748 680 732 131.7 712.8 134.4 London 11241 11121 12684 10503 9709 12270 9675 11983 13223 11544 11467 134.7 11395.3 129.2 40 TABLE N. Deaths from Zymotic Diseases (Strangers deducted). For the Four Weeks ending January. February. March. April. May. June. July. August. September. October. November. December. December. Total. Smallpox ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 Measles ... 2 2 13 11 10 17 13 8 3 32 8 32 151 Scarlet Fever 2 3 2 4 3 3 2 3 4 9 12 1 5 53 Diphtheria 7 2 6 2 5 10 12 6 14 11 15 6 7 103 Whooping Cough 3 15 26 24 14 9 13 10 9 5 2 ... 2 132 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... 0 Enteric Fever 4 1 ... 1 ... 1 2 2 1 3 6 2 3 26 Continued Fever ... ... 1 ... ... ... ... ... ... ... 1 ... ... 2 Diarrhœa 3 5 2 4 12 23 89 76 24 17 6 2 ... 263 Chief Zymotic Diseases 19 28 39 48 45 56 135 111 60 48 75 19 49 732 Membranous Croup 2 1 ... 1 1 ... 2 1 ... ... 1 ... ... 9 Erysipelas ... ... 2 3 1 ... 1 ... 1 ... 1 1 ... 10 Puerperal Fever 1 1 2 1 ... 1 ... 1 2 ... 2 ... 2 13 41 SMALLPOX. During 1895, two deaths (both unvaccinated children) were registered in Lambeth from smallpox, as compared with one during 1894, and an annual average of 9.6 for the last ten years (1885 to 1894). Fifty-one cases were notified during 1895, as compared with 26 during 1894, and an annual average of 33 for the five years 1890 to 1894. The deaths took place in the third and fourth quarters of the year respectively. Of the 51 cases notified, 43 were removed to Hospital and 8 were treated at their own homes. The case mortality for the year is, therefore, 3.9%, varying from 4.7% to 0% according as the cases were treated at hospital or at home respectively—the absence of mortality amongst the home-treated cases being due either to their mildness, or to the fact probably that some of them were not smallpox. The age and sex incidence and mortality for smallpox cases notified in Lambeth during 1895 are as follows:— Ages Number of cases notified Deaths Death rate per 100 M. F. Total M. F. Total Under 1 year 2 1 3 0 1 1 33.3 1 to 5 1 1 2 0 1 1 50.0 5 to 10 3 0 3 0 0 0 0.0 10 to 20 4 4 8 0 0 0 0.0 20 to 40 1 6 6 22 0 0 0 0.0 40 to 60 3 6 9 0 0 0 0.0 60 and over 2 0 2 0 0 0 0.0 Age not stated ... 2 2 0 0 0 0.0 Total 31 20 51 0 2 2 3.9 In London, during 1895; there were registered 55 deaths out of a total of 1076 cases of smallpox notified, giving a case mortality of 5.1%. 42 Registration Sub-Districts. Total No of Cases Notified. Cases Treated at Home. Cases Removed to Hospital. No. of Deaths. Case Mortality per 100. Rate of Persons Notified per 10,000 Inhabitants. At Home. In Hospital. Waterloo Road, 1st 3 ... 3 ... ... 0.0 2.3 Waterloo Road, 2nd 2 ... 2 ... ... 0.0 1.5 Lambeth Church, 1st 2 ... 2 ... ... 0.0 1.2 Lambeth Church, 2nd 10 ... 10 ... ... 0.0 2.6 Kennington, 1st 20 2 18 ... 1 5.0 3.8 Kennington, 2nd 8 4 4 ... 1 12.5 1.9 Brixton 4 ... 4 ... ... 0.0 0.5 Norwood 2 2 0 ... ... 0.0 0.7 Lambeth 51 8 43 ... 2 3.9 1.8 Tables O and P give the Vaccination Statistics for the year 1894, and the first half of 1895—those for the second half of 1895 not being ready in time for this Report. It will be noticed that during 1894, 17.2 percent, of the children born are unaccounted for as regards vaccination, and 65.5 per cent, were successfully vaccinated ; whilst during the first half of 1895, 19.6 per cent, are unaccounted for, and 57.9 per cent, have been successfully vaccinated. 43 TABLE O—VACCINATION RETURNS, 1894. Registration Sub-Districts. No. of Births Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Had Smallpox. Postponed on Medical Certificate. Removed to other Parishes. Gone and not found. 111 or not otherwise accounted for. Waterloo Road, 1st 501 315 2 61 ... 11 2 107 3 Waterloo Road, 2nd 1018 584 ... 123 ... 12 *175 *117 7 Lambeth Church, 1st 629 379 1 79 ... 10 5 143 12 Lambeth Church, 2nd 1565 919 10 217 ... 30 †55 †322 12 Kennington, 1st 1806 1141 21 198 ... 33 ‡94 ‡277 42 Kennington, 2nd 1060 728 6 88 ... 32 11 138 57 Brixton 2045 1513 7 175 ... 46 13 207 84 Norwood 663 501 1 67 ... 16 4 40 34 Lambeth 9287 6080 48 1008 ... 190 359 1351 251 *Hospital Cases (216) included. †Workhouse Cases (101) included. ‡Maternity Cases (86) included. 44 TABLE p.—VACCINATION RETURNS FOR THE FIRST HALF-YEAR, 1895. Registration Sub-Districts. No. of Births. Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Had Small- pox. Postponed on Medical Certificate. Removed-to other Parishes. Gone and not found. Ill or not otherwise accounted for. Waterloo Road, 1st 275 182 l 35 ... 1 2 47 7 Waterloo Road, 2nd 509 274 1 54 ... 7 105 54 14 Lambeth Church, 1st 319 173 ... 37 ... 16 3 74 16 Lambeth Church, 2nd 817 425 8 121 ... 26 36 170 31 Kennington, 1st 887 454 11 120 ... 32 63 146 61 Kennington, 2nd 576 326 6 61 ... 58 6 87 32 Brixton 1080 728 4 104 ... 82 8 110 44 Norwood 328 210 1 28 ... 38 4 19 28 Lambeth 4791 2772 32 560 ... 260 227 707 233 The Yearly Returns are not made up for the Local Government Board until the August in the following year. 45 Whilst on the subject of smallpox, mention may be made of the fact that on August 2nd, 1895, a letter was received by the Vestry from the Local Government Board asking them to instruct their Medical Officer of Health to visit all cases of smallpox, and to take such measures as might be necessary to secure, as far as possible and as far as practicable— (a) The isolation of the patient. (b) The vaccination of any person who may have been exposed to infection. (c) The thorough disinfection of the premises, and (d) The checking of the extension of the disease. Further, the Vestry were to instruct their Medical Officer of Health to report in detail to them all particulars, as to precautionary measures taken in each individual case, and to furnish the Local Government Board with a copy of such reports. It may be added that all this is extra work thrown upon your Medical Officer of Health, who, the Vestry have (as already pointed out on page 21) wisely decided, shall now devote the whole of his time to the duties of his Office. SCARLET FEVER. During 1895, 53 deaths were registered from scarlet fever, as compared with 64 during 1894, and an annual average of 65 9 for the last ten years (1885 to 1894). 1,389 cases were notified, and of these 911 were treated at their own homes, and 478 were removed to hospital. The case mortality for the year is, therefore, 3.8% varying in wide limits in the different Registration Sub- 46 Districts, and from 2.3% to 6.7% according as the cases were treated at home or in hospital respectively. The age and sex incidence and mortality for scarlet fever cases notified in Lambeth during 1895 are as follows:— Ages Number of Cases Notified Deaths Death rate* per 100 M. F. Total M. F. Total Under 1 year 8 15 23 5 2 7 25.0 1 to 2 25 30 55 5 5 10 16.7 2 to 3 47 43 90 6 6 12 12.6 3 to 4 50 46 96 2 7 9 8.9 4 to 5 61 75 136 2 0 2 1.4 5 to 6 58 73 131 2 4 6 4.4 6 to 7 56 55 111 0 2 2 1.7 7 to 8 57 74 131 0 1 1 0.8 8 to 9 56 48 104 1 1 2 1.9 9 to 10 57 77 134 1 0 1 0.7 Over 10 years 150 171 321 1 0 1 0.3 Age not stated 38 19 57 0 0 0 ... Total 663 726 1389 25 28 53 3.8 *In 57 cases the ages are not given, but in calculating percentages, there 57 cases have been equally distributed amongst the different age-periods. 47 In London during 1895 there were registered 829 deaths out of a total of 20,654 cases of scarlet fever notified, giving a case mortality of 4.01 %. The number of scarlet fever cases notified in Lambeth during the year was 1,389, as compared with 1,198 for 1894, and an annual average of 1,457 for the five years, 1890 to 1894. No scarlatinal milk outbreak occurred during 1895. Registration Sub-Districts. Total No. of Cases notified Cases treated at Home Cases removed to Hospital No. of Deaths. Case Mortality per 100 Rate of Persons Notified per 1000 Inhabitants. At Home. In Hospital Waterloo Road, 1st 63 36 27 0 l 1.6 4.7 Waterloo Road, 2nd 90 49 41 3 4 7.8 6.9 Lambeth Church, 1st 63 48 15 4 2 9.5 3.7 Lambeth Church, 2nd 135 58 77 2 7 6.7 3.5 Kennington, 1st 234 137 97 3 3 2.6 4.4 Kennington, 2nd 199 137 62 1 3 2.01 4.8 Brixton 404 310 94 5 10 3.7 5.2 Norwood 201 136 65 3 2 2.5 6.9 Lambeth 1389 911 478 21 32 3.8 4.9 The want of sufficient hospital accommodation was chiefly felt in regard to scarlet fever, and was, undoubtedly, the cause of the cases increasing in numbers, many of the patients left at home having practically no efficient means of isolation, with the result that the disease spread. 48 WHOOPING COUGH AND MEASLES. During 1895, 132 and 151 were registered from whooping cough and measles respectively, as compared with 110 and 182 during 1894, and annual averages of 166 and 147 for the last ten years (1885 to 1894) respectively. In London, during 1895, there were registered 1483 and 2633 deaths respectively, from whooping cough and measles, giving corresponding death-rates of 3.4 and 6.0 per 10,000 living. Registration Sub-Districts. Number of Deaths from Whooping Cough. Number of Deaths from Measles. Whooping Cough. Deaths per 10,000 Inhabitants. Measles. Deaths per 10000 Inhabitants Waterloo Road, 1st 11 21 8.2 15.6 Waterloo Road, 2nd 10 8 7.3 5.9 Lambeth Church, 1st 20 18 11.7 10.5 Lambeth Church, 2nd 32 53 8.3 13.7 Kennington, 1st 19 24 3.6 4.5 Kennington, 2nd 12 7 2.9 1.7 Brixton 21 14 2.7 1.8 Norwood 7 6 2.4 2.1 Lambeth 132 151 4.6 5.3 In both diseases the Inner Districts have suffered more severely than the Outer Districts—in whooping cough the ratio being as 3 to 1; in measles as 4.5 to 1. These results were to be expected, considering the more insanitary and the more crowded the dwellings, and the poorer the inhabitants of the former compared with the latter districts. The Table on page 36 shows the seasonal mortality incidences of these two diseases—whooping cough at its height in the second, and measles in the fourth, quarter of the year. 49 DIPHTHERIA. During 1895, 103 deaths were registered in Lambeth from diphtheria, as compared with 138 during 1894, and an annual average of 108.3 for the last ten years (1885 to 1894). 614 cases were notified during 1895, as compared with 521 in 1894, and an annual average of 494 for the five years, 1890 to 1894. Of the 614 cases notified, 172 were removed to hospital, and 442 were treated at their homes. The case mortality per cent. for the year is, therefore, 16.8, varying from 27.3 to 12.7, according as the cases were treated at hospital or at home respectively. The age and sex incidence and mortality from diphtheria cases notified in Lambeth during 1895 are as follows:— Ages. Number of cases notified. Deaths. Death-rate per 100. M. F. Total M. F. Total Under 1 year 6 0 6 4 1 5 83.3 1 to 5 88 86 174 29 34 63 36.2 5 to 10 90 100 190 10 14 24 12.6 10 to 20 57 62 119 1 6 7 5.9 20 to 40 26 56 82 3 0 3 3.7 40 to 60 3 8 11 0 0 0 0.0 60 and over 2 2 4 0 1 1 25.0 Age not stated 9 19 28 0 0 0 0.0 Total 281 333 614 407 56 103 16.8 Membranous Croup might with advantage be classified with Diphtheria—the tendency of improved methods of diagnosis (e.g., bacteriological) being to show that these two 4 50 Registration Sub-Districts. No. of Cases Notified. Cases treated at Home. Cases removed to Hospital No. of Deaths. Case Mortality per 100 Rate of Persons Notified per 1000 Inhabitants. At Home. In Hospital Waterloo Road, 1st 40 27 13 5 3 15.0 2.9 Waterloo Road, 2nd 51 34 17 5 3 19.6 3.7 Lambeth Church, 1st 48 38 10 3 9 18.8 2.8 Lambeth Church, 2nd 105 65 40 5 6 12.4 2.7 Kennington, 1st 117 72 45 10 11 17.9 2.2 Kennington, 2nd 68 46 22 5 5 16.2 1.6 Brixton 145 121 24 18 9 18.9 1.8 Norwood 40 39 1 5 1 15.0 1.4 Lambeth 614 442 172 56 47 16.8 2.2 diseases have been, and are still often, indistinguishable the one from the other. During 1895, in Lambeth, 23 cases were notified from this disease, and 9 deaths were registered, giving a case mortality of 39 05 as compared with 26 cases notified, and 4 deaths during 1894. 4 of the 23 Lambeth cases of Membranous Croup were removed to Hospital. In London, during 1895, there were registered 2460 deaths out of a total of 11,887 cases of diphtheria and membranous croup notified, giving a case mortality of 207%. * *In London Statistics, Diphtheria and Membranous Croup are now groupe i together by the Registrar-General. 51 TYPHOID FEVER. During 1895, 26 deaths were registered in Lambeth from typhoid (or enteric) fever, as compared with 47 during 1894, and an annual average of 32.7 for the last ten years (1885 to 1894). 201 cases were notified during 1895, as compared with 268 during 1894, and an annual average of 168.8 for the five years, 1890 to 1894. Of the 201 cases notified, 62 were removed to hospital and 139 were treated at home. The case mortality for the year is, therefore, 12.9%, varying from 161% to 115%, according as the cases were treated at hospital or at home respectively. The age and sex incidence and mortality for typhoid cases notified in Lambeth during the year are as follows :— Ages Number of Cases Notified Deaths Death-rate per 100 M. F. Total M. F. Total Under 1 year 0 0 0 0 0 0.0 1 to 5 10 5 15 1 1 2 13.3 5 to 10 14 13 27 2 1 3 11.1 10 to 20 26 19 45 2 2 4 8.9 20 to 40 45 39 84 7 8 15 17.9 40 to 60 8 8 16 2 0 2 12.9 60 and over 1 0 1 0 0 0 0.0 Age not stated 8 5 13 0 0 0 0.0 Total 112 89 201 14 12 26 12.9 52 In London during 1895, there were registered 614 deaths out of a total of 3710 cases of typhoid notified, giving a case mortality of 16.5%. Registration Sub-Districts. Total No. of Cases notified Cases Treated at Home. Cases removed to Hospital No. of Deaths. Case Mortality per 100. Rate of Persons Notified per 10,000 Inhabitants At Home. In Hospital Waterloo Road, 1st 14 11 3 l l 13.9 10.4 Waterloo Road, 2nd 26 17 9 0 0 0.0 18.9 Lambeth Church, 1st 10 8 2 0 0 10.0 5.9 Lambeth Church, 2nd 29 14 15 l 3 10.3 7.5 Kennington, 1st 30 19 11 5 1 20.0 5.7 Kennington, 2nd 27 14 13 4 3 22.2 6.4 Brixton 48 41 7 4 2 14.6 6.1 Norwood 17 15 2 1 0 5.9 5.9 Lambeth 201 139 62 16 10 12.9 7.06 Typhoid Fever in a district is considered as a sanitary index—the more typhoid, and the less sanitary the District, and vice versa. On this assumption Lambeth shews, during 1895, a satisfactory return. Typhus and Continued Fever are generally bracketted with Typhoid under the heading "fever." During 1895, there were in Lambeth no cases notified, and no deaths registered, from typhus, and only 20 cases notified, and two deaths registered, from continued fever, whilst there were in London five deaths registered from typhus, out of a total of 15 cases notified (i.e., 33.3% case mortality), and 10 deaths from continued fever out of 107 cases notified (i.e., 9.3% case mortality). 53 PUERPERAL FEVER. During 1895, in Lambeth 13 deaths were registered from Puerperal Fever (a disease of child-bed), as compared with 11 during 1894, and an annual average of 15.9 during the last 10 years (1885—94). 16 cases were notified, giving a case mortality of 81.3%. In London during 1895 there were registered 208 deaths out of a total of 249 cases notified, giving a case mortality of 83.5%. Registration Sub-Districts. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Waterloo Road, 1st 1 1 100.0 Waterloo Road, 2nd 1 0 0.0 Lambeth Church, 1st 1 0 0.0 Lambeth Church, 2nd 3 3 100.0 Kennington, 1st 3 2 66.6 Kennington, 2nd 2 2 100.0 Brixton 5 5 100.0 Norwood 0 0 0.0 Lambeth 16 13 81.3 54 ERYSIPELAS. During 1895, in Lambeth 10 deaths were registered from Erysipelas, as compared with 19 for 1894, and an annual average of 20.1 during the last 10 years (1885—1894). 355 cases were notified, giving a case mortality of 2.8%. In London, during 1895 there were registered 179 deaths out of a total of 5994 cases notified, giving a case mortality of 2.9%. Registration Sub-Districts. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Waterloo Road, 1st 14 2 14.3 Waterloo Road, 2nd 29 0 0.0 Lambeth Church, 1st 25 0 0.0 Lambeth Church, 2nd 107 0 0.0 Kennington, 1st 35 1 2.9 Kennington, 2nd 42 1 2.4 Brixton 79 5 6.3 Norwood 24 0 0.0 Ward not stated ... 1 ... Lambeth 355 10 2.9 55 DIARRHŒA. During the year 1895, there were registered 263 deaths from diarrhoea, as compared with 139 during 1894, and an average of 178.3 for the last 10 years. Of these 263 deaths, 239 (i.e., 90.9 per cent.) were in children under five years of age, and 190 (i.e., 72.2 per cent.) in infants under seven years. July and August were the most fatal months (see Table Q), though the disease was prevalent also during June, September and October. In this connection it is interesting to note that the mean monthly air temperature was in June, 61°.4; July, 62°.6; August, 62°.2; and September, 62°.2, whilst the 4-ft. earth thermometer registered 56° F. on June 11th, rising to 62° F. on Sept. 7th, and sinking to 56° F. again on October 13th. 56° F. is the so-called "critical" earth temperature for diarrhœa, i.e., the temperature at which the germs of this particular disease begin to multiply and prove themselves dangerous.* Age mortalities from Diarrhaœ were as follows:— Age. Total Deaths. Percentage of Total Deaths from Diarrhœa. Under 1 year 190 72.2 1 to 5 49 18.6 5 to 20 1 0.4 20 to 40 0 0.0 40 to 60 2 0.8 Over 60 21 7.9 Total 263 ... In London, there were registered during 1895, 3600 deaths from diarrhoea, giving a rate of 8 3 per 10,000 living, and 41% of total deaths. * The 4-foot earth temperatures were taken in Regent's Park, and I beg to acknowledge my indebtedness to Mr. Wm. Marriott, of the Royal Meteorological Society, for the information in connection therewith. 56 Registration Sub-Districts. Number of Deaths. Diarrhoea Death-rate per 10,000 Inhabitants. Waterloo Road, 1st 16 11.9 Waterloo Road, 2nd 28 20.3 Lambeth Church, 1st 27 15.7 Lambeth Church, 2nd 56 14.5 Kennington, 1st 44 8.3 Kennington, 2nd 34 8.2 Brixton 44 5.6 Norwood 14 4.9 Lambeth 263 9.2 In the Inner Wards the average diarrhœa death-rate per 10,000 inhabitants is 15.6, as compared with 6.8 for the Outer Wards, i.e., 2.3 to 1. Under the heading of diarrhœa may be classed the 16 cases of cholera notified in Lambeth during the year, as there is no reason to regard any one case as "Asiatic Cholera"; and also the 92 deaths registered from " Enteritis." 57 TABLE Q. Shewing the Diarrhoea Mortality in Lambeth in each month during the year 1895. Registration Sub-Districts. Jan. Feb. Mar. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Total Waterloo Road, 1st 1 1 ... ... ... 1 5 4 1 2 1 ... 16 Waterloo Road, 2nd 1 ... 1 ... ... 6 11 5 4 ... ... ... 28 Lambeth Church, 1st ... 1 ... ... 1 2 9 7 3 3 1 ... 27 Lambeth Church, 2nd ... ... ... ... ... 3 28 15 5 4 1 ... 56 Kennington, 1st ... 2 2 ... ... 1 20 12 4 2 1 ... 44 Kennington, 2nd ... 1 ... ... 1 2 14 13 ... 2 1 ... 34 Brixton ... ... ... ... ... 6 11 23 3 ... 0 1 44 Norwood ... ... ... ... ... 0 4 6 2 ... 1 1 14 Totals 2 5 3 ... 2 21 102 85 22 13 6 2 263 58 INFLUENZA. During 1895, 148 deaths were registered from Influenza, as compared with 44 during 1894, and an average of 45.l for the last 10 years. Of these 148 deaths, 113 were registered during the first quarter of the year. In London, there were registered 2,156 deaths from Influenza during 1895. Reviewing the past history of Lambeth in relation to Epidemic Influenza, it will be seen that the disease has been practically epidemic since 1890, rising to a maximum in 1892 and again in 1895. The Local Government Board issued during the year 1895 a Memorandum to all local Sanitary Authorities, giving a short history of Influenza Epidemics, and suggesting methods of prevention. A copy of this Memorandum is herewith produced:— Memorandum on Epidemic Influenza. Influenza became epidemic in England in the winter of 1889-90; it occurred in epidemic form in the spring of 1891, and was maintained up to June of that year; a third epidemic took place in the winter of 1891-92, and after a minor recrudescence in the spring of 1893, a fifth prevalence on a wide scale took place in the winter of 1893-4. England is now passing through a sixth epidemic period. Two detailed reports have been issued by the Board on the subject. The first was Dr. Parsons, "On the Influenza Epidemic of 1889-90," with an introduction by Sir George Buchanan, M.D., F.R.S., the Board's Medical Officer of that date. The second was a "Further Report on Epidemic Influenza, 1889-92," by Dr. Parsons, with papers on the Clinical and Pathological aspects of the Disease, by Dr. Klein, F.R.S., and an introduction by myself. 59 A "Provisional Memorandum upon Precautions advisable at times when Epidemic Influenza threatens, or is prevalent," was also drawn up by me in January, 1892, and was issued by the Board to local sanitary authorities. The further study made by the Medical Department as to the natural history of Influenza, and as to its clinical and bacteriological characteristics, goes to show that it is a disease against which it is most difficult to apply measures of prevention with any substantial prospect of success. Influenza is highly infective from person to person; its infectious quality is often manifested before the disease is fully recognised; its incubation period is one of the shortest of all infectious diseases; it varies so much in intensity that many cases are never diagnosed at all; one attack confers no marked immunity against another; and the infection is largely eliminated by means of the lungs, the sputa of the sick being invariably charged, during the acute stage of the disease, with its pathognomonic micro-organism. The disease calls primarily for measures of isolation and of disinfection, but there are difficulties in making any such measures universally applicable. Wherever they can be carried out, the following precautions should, however, be adopted: 1st. The sick should be separated from the healthy. This is certainly important in the case of first attacks in a locality or household. 2nd. The sputa of the sick should, especially in the acute stage of the disease, be received into vessels containing disinfectants. Infected articles and rooms should be cleansed and disinfected. 3rd. When Influenza threatens, unnecessary assemblage of persons should be avoided. 60 4th. Buildings and rooms in which many people necessarily congregate should be efficiently aerated and cleansed during the intervals of occupation. It should be borne in mind that the liability to contract Influenza, and also the danger of an attack, if contracted, are increased by depressing conditions, such as exposure to cold, and to fatigue whether mental or physical. Attention should hence be paid at epidemic periods to all measures tending to the maintenance of health, such as the use of clothing of suitable warmth, and a sufficiency of wholesome food. Persons who are attacked by Influenza should at once seek rest, warmth, and medical treatment, and they should bear in mind that the risk of relapse, with dangerous complications, constitutes a chief danger of the disease. R. THORNE THORNE. Local Government Board, Medical Department, March 6th, 1895. Table shewing the number of deaths from Epidemic Influenza during the last 10 years in Lambeth and London. 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 Average for 10 years (1885-94.) 1895 Lambeth 1 1 0 0 0 47 131 142 85 44 45.1 148 London (including Lambeth) 3 5 5 3 5 652 2336 2264 1526 750 795.2 2156 61 The 21 deaths from venereal affections (Syphilis, etc.,) are the only other point calling for note in the class of Zymotic Diseases. Classes II. and III.—Parasitic and Dietetic Diseases. 34 deaths were registered in Lambeth in these classes from Alcoholism and Delirium Tremens. Class IV.—Constitutional Diseases. Of the total 1018 deaths under this class, 231 were due to Cancer, 511 to Phthisis, and 175 to Tubercular Meningitis and other forms of Tuberculosis. Class V.—Developmental Diseases. The total number of deaths in this class was 354, consisting of 165 from Premature Birth, 154 from Old Age, and 35 from Atelectasis and Congenital Malformations. Class VI.—Local Diseases. 1. Diseases of the Nervous System caused 564 deaths, including 109 from Convulsions, 186 from Apoplexy, and 29 from Epilepsy. 2. 415 deaths were due to diseases of the Circulatory System. 3. The diseases of the Respiratory Organs caused the large number of 1,250 deaths (730 from Bronchitis, and 390 from Pneumonia). Many of these deaths were indirectly connected with the Influenza Epidemic of the previous year. 4. Diseases of the Digestive Organs caused 343 deaths, of which 117 were due to Enteritis and Peritonitis, 98 to diseases of the Liver, and 23 to Dentition. 62 5. Diseases of the Urinary System caused 124 deaths. 6. Diseases of the Reproductive System, Integumentary System, Locomotive System, Lymphatics, Organs of Special Senses, etc., caused together 89 deaths. Class VII.—Deaths from Violence. 201 deaths in all, including 25 from Accidents, 15 from Burns and Scalds, 23 from Drowning, 43 from Suffocation in bed (all infants under 1 year), and 39 from Suicide. Class VIII.—Other Causes. 194 deaths were registered in this class, consisting of deaths from Dropsy, Tumours, Hæmorrhages, or other ill-defined or non-specified causes. Different rates of mortality from different diseases or groups of diseases (also sub-divided as to Districts) are given in terms of the total deaths in Tables R and S; whilst Table R gives also the deaths from the chief Infantile Diseases, expressed in terms of the infantile population (or number of births).* Allowing for the slight differences between corrected and uncorrected death returns, it will be noted that, in regard to infantile diseases, Lambeth compares favourably with London—in only one case (i.e., Whooping Cough) is the Lambeth rate higher. (*Vide also pages 18—24) 63 TABLE R. Shewing Classification of Causes of Deaths in Lambeth during 1895, compared with London. A.—Total Deaths from all causes and at all ages, with percentages of deaths to total deaths. Class of Disease. Lambeth Parish. London. Total Deaths. Percentage of Total Deaths. Total Deaths. Percentage of Total Deaths. I.—Zymotic Diseases 958 17.2 14865 17.1 Seven Principal 732 13.2 11545 13.3 Influenza 148 2.7 2156 2.5 II.—Parasitic 11 .2 61 .7 III.—Dietetic 38 .7 544 .6 IV.—Constitutional 1018 18.3 16679 19.2 Cancer 231 4.2 3612 4.2 Phthisis 511 9.2 7974 9.2 Tubercular Diseases, excluding Phthisis 175 3.1 3542 4.07 Rheumatism (Acute and Chronic) and Gout 31 .6 535 .6 V.—Developmental 354 6.4 5579 6.4 Old Age 154 2.8 2468 2.8 VI.—Local Diseases 2785 50.09 42684 49.1 Circulatory System 415 7.5 6905 7.9 Bronchitis 730 13.1 10633 12.2 Pneumonia 390 7.01 5989 6.9 Pleurisy and other Diseases of the Respiratory System 125 2.2 1716 1.9 Respiratory System, excluding Phthisis 1250 22.5 18482 21.3 VII.—Violence 201 3.6 3407 3.9 Suicide 39 .7 482 .6 VIII.—Other Causes 194 3.5 3118 3.6 64 TABLE R (Continued). B.—Deaths of infants under one year of age from the chief infantile diseases and from all causes, expressed in terms of 1,000 births. Lambeth Parish. London. Total Deaths under One Year (corrected). Percentage to 1000 Births. Total Deaths under One Year (uncorrected). Percentage to to 1000 Births. From all causes 1420 152.0 22173 165.8 Diarrœha 190 20.3 2772 20.7 Convulsions 97 10.4 1816 13.6 Respiratory Diseases 274 29.3 4306 32.2 Premature Births 165 17.7 2514 18.8 Tubercular Diseases (including Phthisis) 80 8.5 1595 11.9 Measles 31 3.3 557 4.2 Whooping Cough 70 7.5 619 4.6 Suffocation in Bed 43 4.6 631 4.7 Enteritis 64 6.9 958 7.2 Dentition 12 1.2 235 1.8 65 TABLE S. Giving Death-rates for different groups of diseases in the various Registration SubDistricts, calculated as percentages of the total deaths for each district. Phthisis. Other Tubercular Diseases. Cancer. Respiratory Diseases. Premature Births. Suffocation in Bed. Old Age. Rheumatism and Gout Waterloo Road, 1st 9.8 3.3 2.7 26.9 5.4 1.9 2.2 0.3 Waterloo Road, 2nd 12.1 2.3 4.9 24.2 4.4 0.5 1.3 0.3 Lambeth Church, 1st 7.4 3.5 3.7 25.2 3.5 0.9 1.3 0.4 Lambeth Church, 2nd 8.8 3.6 1.9 25.6 1.6 1.2 2.9 0.2 Kennington, 1st 8.8 2.8 3.6 21.9 3.09 0.9 2.9 0.7 Kennington, 2nd 9.3 3.6 3.2 20.5 2.9 0.5 3.5 0.8 Brixton 9.5 2.9 5.9 19.5 2.6 0.4 3.02 0.7 Norwood 8.4 2.4 6.9 18.9 2.9 0.0 3.7 1.05 Lambeth 9.2 3.1 4.2 22.5 0.8 2.8 0.6 N.B.—Where the Districts are not definitely stated, the deaths have been equally subdivided amongst the eight Districts. 5 66 This method of giving the mortality from any given disease as a percentage of the total deaths is fallacious, dealing as it does with two variable factors. It is preferable, therefore, to state the mortalities of different diseases or groups of diseases as percentages, or per 1,000 of the persons living, i.e., of the population enumerated or estimated for the time being; or in the case of deaths under one year, these may be (as I have shewn) expressed in terms of the total number of births. This latter method I have also adopted with reference to deaths from (1) suffocation whilst in bed with parents, and (2) premature births—such deaths being generally in infants under one year of age {see Table T.). In this way a more trustworthy comparison can be made between the different incidences of diseases in the various Registration Sub-districts of Lambeth, and a careful study of the following Table T is interesting. Taking the enumerated Populations of the various Registration Sub-districts for Lambeth as given at the Census 1896, and the estimated Populations for the middle of the year 1895, it will be seen that the differences may be disregarded, and the rates throughout this Report accepted, for all practical purposes, as the following table shews:— Estimated Population (Middle 1895) from Censuses 1891 and 1896. Estimated Popula'ion (Middle 1895) from Censuses 1891 and 1881. Under Estimated. (Per Cent.) Over Estimated. (Per Cent.) Waterloo Road, 1st 14166 13448 5.3 Waterloo Road, 2nd 14284 13798 3.5 Lambeth Church, 1st 18665 17177 8.7 Lambeth Church, 2nd 40705 38651 5.3 Kenningion, 1st 52200 53033 1.6 Kennington, 2nd 42695 41713 2.4 Brixton 80510 78293 2.8 Norwood 28745 28772 .09 Lambeth 291970 284885 2.5 67 TABLE T., Giving death-rates for different groups of diseases in the various Registration Sub-Districts calculated in terms per 1,000 of the population or the total births. Per 1000 of the Population Per 1,000 Births Phthisis Tubercular Cancer Respiratory Diseases Old Age Rheumatism and Gout Premature Births Suffocation  Waterloo Road, 1st 26.03 8.9 7.4 69.9 4.5 0.7 38.6 13.5 Waterloo Road, 2nd 33.3 6.6 13.9 64.5 2.2 0.7 17.04 2.0 Lambeth Church, 1st 19.2 9.3 9.9 64.04 2.3 1.2 25.9 6.5 Lambeth Church, 2nd 22.5 9.3 4.9 64.6 6.9 0.5 9.8 7.4 Kennington, 1st 15.7 5.09 6.6 39.8 4.9 1.3 17.3 5.2 Kennington, 2nd 16.06 6.5 5.8 35.0 5.8 1.4 20.02 3.7 Brixton 15.07 4.6 9.6 30.5 4.6 1.02 15.9 2.4 Norwood 10.43 3.13 9. 04 22.9 3.8 1.4 16.9 0.0 Lambeth 17.9 6.1 81.09 43.8 5.4 1.09 17.7 2.7 5 * N.B.—Waterloo Road 2nd contains the Lying-in Hospital, and Lambeth Church 2nd, the Workhouse and the Infirmary, giving large infantile populations and, consequently, small death-rates from premature birth and suffocation. 68 69 TABLE U. Local Government Board Table A.] District, classified according to Diseases, Ages, and Localities. Table of DEATHS during- the Year 1895, in the Lambeth Mortality from all causes, at subjoined ages. Mortality from subjoined causes, distinguishing deaths of Children under flve years of age. 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Names of Localities adopted for the purpose of these Statistics ; public institutions being shewn as separate localities. (Columns for Population and Births are hi Table B.) At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1 2 3 Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Smallpox. scarlatina. iiphtheria.| Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 6 ...... ...... 1 8 ...... ...... 25 40 Royal Infirmary (Women and Children) 59 20 20 8 1 10 ...... Under 5 5 upwds. ...... ...... ...... ...... ...... ...... ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... 1 2 2 ...... 13 19 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 20 10 14 ...... ...... 1 41 ...... 6 61 156 Remainder of Waterloo Road First 267 102 54 7 7 70 27 ...... ...... 3 ...... ...... 1 ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... 18 32 12 8 37 111 Under 5 5 upwds. ...... ...... 2 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 1 ...... ...... 11 12 General Lying-in-Hospital, York Road 13 12 ...... ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 1 1 Under 5 5 upwds ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 8 9 22 ...... ...... 1 29 ...... 3 49 128 Remainder of Waterloo Road Second 263 78 50 12 13 82 28 ...... 2 5 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 5 ...... ...... 26 28 21 14 40 135 Under 5 5 upwds. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 2 6 ...... 7 ...... ...... 5 16 5 18 59 139 St. Thomas's Hospital 552 54 85 58 51 276 28 ...... ...... 21 ...... ...... 10 ...... ...... 4 ...... 1 ...... ...... ...... 1 ...... 26 18 50 55 241 413 Under 5 3 upwds. ...... ...... 7 1 ...... ...... ...... ...... ...... 4 ...... 18 20 22 ...... ...... 2 53 ...... 6 78 209 Remainder of Lambeth Church First 361 135 74 11 y 95 39 ...... 3 2 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 3 1 ...... 21 41 15 21 50 152 Under 5 5 upwds. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 2 ...... 1 10 13 Lambeth Workhouse 56 13 ...... ...... 1 13 29 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 23 7 1 12 43 Under 5 5 upwds ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 2 4 ...... ...... 1 14 ...... 1 42 64 Lambeth Maternity 595 48 16 2 24 304 201 ...... ...... ...... ...... ...... 1 ...... ...... 1 ...... 4 ...... ...... 2 1 ...... 112 149 56 7 198 531 Under 5 5 upwds. ...... ...... ...... 4 ...... ...... ...... ...... ...... 1 ...... 44 32 49 ...... ...... 1 86 3 12 134 374 Remainder of Lambeth Church Second 663 223 151 19 18 163 89 ...... ...... 5 1 ...... ...... 1 ...... 3 ...... ...... 5 ...... ...... 1 1 39 68 49 9 111 289 Under 5 5 upwds. ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 1 ...... 3 9 13 Clapham Maternity 13 13 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Under 5 5 upwds ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... St. Peter's House 28 ...... ...... ...... ...... 5 23 Under 5 5 upwds ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 8 ...... ...... 20 28 ...... ...... ...... ...... ...... 1 ...... ...... ...... 8 ...... ...... 17 42 ...... ...... 2 64 2 14 176 357 Remainder of Kennington First 764 250 107 14 27 213 153 ...... 1 8 ...... ...... 3 ...... ...... 2 ...... ...... ...... ...... 1 2 ...... 60 92 49 9 187 407 Under 5 5 upwds ...... ...... 2 1 ...... ...... ...... ...... ...... ...... 1 5 12 29 ...... ...... 3 41 1 9 121 231 Kennington Second 615 169 62 14 23 194 153 Under 5 5 upwds ...... 2 6 1 ...... 4 ...... ...... 1 ...... ...... 2 ...... 4 5 ...... 53 66 53 12 183 384 ...... ...... 70 71 Local Government Board Table A—continued.] TABLE U. Table of DEATHS for the Year 1895, in the Lambeth TABLE U. District, classified according to DISEASES, AGES and LOCALITIES. Names of Localities adopted for the purpose of these Statistics; public institutions being shewn as separate localities. (Columns for Population and Births are in Table B.) Mortality from all causes, at subjoined ages. Mortality from subjoined causes, distinguishing deaths of children under flve years of Age. At all Ages- Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 60. 65 and upwards. (i) 1 2 3; 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers Cholera. Erysipelas. Measles Whooping Cough. Diarrhoea and Dysent???ry. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Iujuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) South Western Hospital 211 12 116 58 9 16 ...... Under 5 5 upwds ...... 56 66 ...... ...... 1 ...... ...... ...... ...... ...... 3 ...... ...... ...... ...... ...... ...... ...... ...... 2 128 ...... 17 39 ...... ...... 15 ...... ...... ...... ...... ...... ...... 1 ...... ...... ...... 1 2 ...... ...... 8 83 Remainder of Brixton 1076 264 115 31 43 314 309 Under 5 5 upwds. ...... 5 9 1 ...... 1 1 ...... ...... ...... 2 12 21 37 ...... ...... 5 81 1 10 193 379 ...... 2 7 ...... ...... 4 ...... ...... 4 ...... 2 2 ...... 6 3 ...... 90 121 78 11 367 697 Lambeth Old Workhouse School 4 ...... 2 2 ...... ...... ...... Under 5 5 upwds. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 1 1 2 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 1 ...... ...... ...... ...... ...... 1 2 Lambeth New Workhouse School Nil. ...... ...... ...... ...... ...... ...... Under 5 5 upwds. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 8 8 British Home for Incurables 8 ...... ...... ...... ...... 4 4 Under 5 5 upwds ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Remainder of Norwood 309 77 28 13 14 90 87 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Under 5 5 upwds. ...... 1 2 ...... ...... ...... ...... ...... ...... ...... ...... 6 7 12 ...... ...... ...... 19 2 2 54 105 Totals ...... ...... ...... ...... ...... ...... ...... ...... 1 3 ...... ...... 1 ...... ...... ...... ...... ...... ...... ...... 2 2 ...... 23 38 25 l 108 204 Under 5 5 upwds. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 5857 1470 880 219 238 1850 1170 Under 5 5 upwds ...... 71 127 7 3 1 ...... ...... 13 5 144 130 244 ...... ...... 24 456 14 86 1025 2350 ...... 20 61 2 ...... 39 ...... ...... 17 ...... 7 9 1 23 18 1 470 688 117 148 1585 3507 The subjoined numbers have also to be taken into account in judgingof the above records of mortality. Deaths occurring outside the district among persons belonging thereto 404 24 52 23 33 217 55 Under 5 5 upwds 2 9 12 ...... ...... ...... ...... ...... ...... ...... ...... 3 2 3 ...... ...... ...... 12 4 1 28 76 ...... 6 8 ...... ...... 5 ...... ...... 1 ...... ...... ...... ...... 1 1 1 45 23 30 30 177 328 Deaths occurring within the district among persons not belonging thereto ... 702 74 165 94 53 260 56 Under 5 5 upwds ...... 41 68 ...... ...... 1 ...... ...... ...... ...... 1 5 ...... 8 ...... ...... 4 17 4 11 79 239 ...... 12 37 ...... ...... 20 ...... ...... 5 ...... 1 ...... 1 ...... ...... ...... 21 31 46 53 233 463 72 73 TABLE V. TABLE V. Table of Population, Births, and of New Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of health, during the year 1895, in the Metropolitan Sanitary District of Lambeth, classified according to Diseases and Localities. Local Goverment Board Table B. Registration Sub-Districts. Population at all Ages. Registered Births. New Cases of Sickness in each the knowledge of the Medical Locality, coming to Officer of Health. Number of such Cases removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. mated to middle of 1895. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Fevers. English Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) Waterloo Road,lst 14031 13448 518 3 63 40 1 ... 14 ... ... 1 ... 14 3 27 13 ... ... 3 ... ... ... ... 4 Waterloo Road, 2nd 14644 13798 998 2 90 51 1 ... 26 ... ... 1 ... 29 2 41 17 ... ... 9 ... ... ... ... 5 Lambeth Church, 1st 18075 17177 618 2 63 48 1 ... 10 2 ... 1 5 25 2 15 10 ... ... 2 ... ... ... ... 4 Lambeth Church, 2nd 39097 38651 1629 10 135 105 3 ... 29 7 ... 3 11 107 10 77 40 1 ... 15 ... ... 1 ... 27 Kennington, 1st 50586 53033 1736 20 234 117 7 ... 30 ... ... 5 ... 35 18 97 45 ... ... 11 ... ... ... ... 5 Kennington, 2nd 39708 41713 1099 8 199 68 8 ... 27 2 ... 1 ... 42 4 62 22 ... ... 13 ... ... ... ... 5 Brixton 73405 78293 2093 4 404 145 2 ... 48 9 ... 4 ... 79 4 94 24 1 ... 7 ... ... ... ... 4 Norwood 25657 28772 650 2 201 40 ... ... 17 ... ... ... ... 24 ... 65 1 ... ... 2 ... ... ... ... 2 Totals 275,203 284,885 9341 51 1389 614 23 ... 201 20 ... 16 16 355 43 478 172 4 ... 62 ... ... 1 ... 56 74 75 Lambeth.—Deaths registered at several groups of Ages from Different Causes in the 52 Weeks ending Saturday, 28th December, 1895. CAUSES OF DEATH. Under 1 year. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. Total at all Ages. CAUSES OF DEATH. Under 1 year. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80 80 and upwards. Total at all Ages. All Causes 1420 767 260 664 941 1225 282 5559 Apoplexy 4 3 1 5 40 66 17 136 Epilepsy - 2 7 10 4 4 2 29 Convulsions 97 12 - - - - - 109 Smallpox Vaccinated Other Diseases of Brain, &c. 40 35 8 35 60 96 16 290 Unvacciuated 1 1 - - - - - 2 Dis. Orgs. Special Sense 6 1 2 1 1 — — 11 No statement Measles 31 111 9 — — - - 151 Dis. of Circulatory System 9 5 28 57 114 169 33 415 Soarlet Fever 7 32 14 — — - - 53 Typhus Croup 2 3 - - - - - 5 Relapsing Fever Influnza 6 7 2 18 44 59 12 148 Bronchitis 147 95 5 13 105 292 73 730 Whooping Cough 70 62 - - - - - 132 Pneumonia 101 105 14 41 59 62 8 390 Membranous Croup 1 6 2 - - - - 9 Pleurisy - 3 1 3 2 2 - 11 Diphtheria 4 67 29 2 - 1 — 103 Other Diseases of Resp. Sys. 24 10 2 10 34 30 4 114 Simpal and undefined Fever - 1 - - 1 — — 2 Dentition 12 11 - - - - - 23 Enteric fever - 2 6 18 - - - 26 Cholera and chol. Diarrhœa 9 4 - - - - - 13 Sore Throat, Qninsy 1 1 1 1 1 1 — 6 Diarrhœa, Dysentery 190 49 1 - 2 17 4 263 Enteritis 64 7 6 4 5 5 1 92 Remittent Fever Peritonitis 3 1 4 9 4 4 — 25 Hydrophobia Diseases of Liver 6 - 1 11 35 40 5 98 Glanders Others, Digestive System 27 6 7 10 17 28 4 99 Cowpox and Vaccination 1 1 - - — — — 2 Disease of Lymphatics, &c. 1 - 1 2 1 2 - 7 Venereal Affections 16 2 - 1 1 1 — 21 Erysipelas 4 - - 1 1 2 2 10 Disease of Urinary System - 3 4 17 35 57 8 124 Pysemie, Septicæmia 1 - 1 2 1 — — 5 Puerperal Fever - - - 11 2 — — 13 Dis. of Generative System - 1 1 7 7 4 - 20 Ague - - - 1 1 — — 2 Other Zymotic DiseaBes 1 1 — — 1 — — 3 Accidents of Childbirth — — 1 13 — — — 14 Thrush 9 - - - - - - 9 Dis. of Locomotive System 1 - 4 5 4 4 2 20 Woems and other Par. Dis. - - - - - 2 - 2 Disease of Integ. System 3 2 1 2 3 5 1 17 Starvation, want of brst. milk 4 - - - - - - 4 Accidents. By Railways - - - 3 1 - - 4 Alcoholism, Delirium Tr. — — — 10 14 9 1 34 Rheu. Fev., of Heard - - 5 8 4 2 - 19 By Vehicles or Horses - 2 5 1 6 3 — 17 Rheumatism - - - 1 - 3 - 4 In Ships, &c. (not Drowning) Gout - - - 1 3 4 - 8 In Building operations - - — — 3 1 — 4 Rickets 13 12 - - - — - 25 In Conflagrations Cancer - 1 1 27 100 99 3 231 By Burns, Scalds, Explosions — 9 2 1 1 — 2 15 Tabes Mesenteriea 33 13 4 4 2 1 - 57 By Drowning - - 5 12 4 1 1 23 Tubercular Meningitis 23 36 10 3 1 - - 73 By Suffocation in bed 43 — — — — — — 43 Phthisis 8 12 47 244 167 33 - 511 By Poisons or Poisonous Vprs. — 2 — — 1 2 — 5 Scrofula, Tuberculosis 16 10 9 7 3 — — 45 Other or not stated causes 10 5 3 9 10 8 — 45 Other Constitutional Diseases 1 1 4 5 17 17 — 45 Violence other than Accidental. Premature Birth 165 - - - - - - 165 Homicide 5 — — 1 — — — 6 Atelectasis 12 - - - - - - 12 Suicide - - 1 17 13 7 1 39 Congen. Malformations 23 — — — — - - 23 Execution Old Age - - - - - 75 49 154 Other Causes 165 12 1 — 6 7 3 194 76 77 Lambeth.—Deaths registered in the various Sub-Districts from Different Causes in the 52 Weeks ending Saturday, 28th December, 1895. causes of death. Waterloo Road 1st. Waterloo Road 2nd. Lambeth Church 1st. Lambeth Church 2nd Kenningtn. First. Kenningtn. Second. Brixton. Norwood. Ward not stated. Total. * causes of death. waterloo Road 1st. Waterloo 2nd. Lambeth Church 1st. Lambeth Church 2st Kenningun First. Kenningun Second. Brixton Norwood Ward not stated. Total. All Caases 349 370 439 977 951 724 1241 365 143 5559 Apoplexy 7 5 4 15 23 23 45 7 7 136 Smallpox Vaccinated Unvaccinated — — — — 1 1 — — — 2 No statement Epilepsy — 2 — 5 2 4 12 2 2 29 Measles 21 8 18 53 24 7 14 6 - 151 Convulsions 9 6 11 16 22 14 l6 15 — 109 Soarlet Fever 1 7 6 9 6 4 15 5 — 53 Other Diseases of Brain, &c— 8 13 22 55 44 41 70 18 19 290 Typhus — — — — — — — — — — Dis. Orgs. Special Sense 1 1 — 3 — 2 4 - — 11 Relapsing Fever — — — — — — — — — — Influenza 4 2 5 13 29 20 61 12 2 148 Dis. of Circulatory System 15 21 22 79 77 61 92 32 16 415 Whooping Cough 1 10 20 32 19 12 21 7 — 132 Diphtheria 6 10 9 13 21 11 27 6 — 103 Croup — 1 1 — 1 — — 2 — 5 Membranous Croup - - 1 5 - 2 1 - - 9 Simple and undefined Fever - - - 1 - - 1 - - 2 Bronchitis 55 57 68 135 118 82 144 42 29 730 Enteric Fever 2 - 1 3 6 6 7 1 - 26 Pneumonia 32 25 35 91 68 38 71 17 13 390 Cholera and Chol. Diarrhœa - - 4 1 8 - - - - 13 Pleurisy i 1 1 3 2 2 1 — — 11 Diarrhœa, Dysentery 16 28 27 56 44 34 44 14 - 263 Other Diseases of Resp. System 6 6 6 21 20 24 23 7 1 114 Remittent Fever — — - — - - - - — - Dentition 4 1 2 3 1 6 6 — — 23 Hydrophobia - - - - - - - - - - Glanders - - - - - - - - - - Sore Throat, Quinsy — 1 — - 2 2 1 — — 6 Cowpox and Vaccination - - - - 1 1 - - - 2 Enteritis 9 4 9 15 17 15 22 — 1 92 Venereal Affections 2 5 2 3 3 2 3 1 - 21 Peritonitis 1 1 3 1 4 5 8 2 — 25 Erysipelas 2 - - - 1 1 5 - 1 10 Diseases of Liver 3 5 8 13 17 19 19 13 1 98 Pyemia, Septicemia - — 1 — - - 3 1 - 6 Others, Digestive System 5 5 5 15 21 14 23 9 2 99 Puerperal Fever 1 - - 3 2 2 5 — — 13 Disease of Lymphatics, &c. — — — 1 — 1 2 3 — 7 Ague — — — 1 — — 1 — — 2 Other Zymotic Diseases — — — — 3 — — — — 3 Disease of Urinary System 3 7 7 18 20 18 35 16 1 124 Thrush 1 1 2 - 1 1 3 - - 9 Disease of Generative System 1 2 2 3 3 3 3 2 1 20 Worms and other Par. Dis. - - - - - - 1 1 - 2 Starvation, want of Breast Milk - - 1 1 1 1 - - - 4 Accidents of Childbirth 2 — — 2 2 4 3 1 — 14 Disease of Locomotive System 3 — 1 4 1 2 4 4 1 20 Alcoholism, Delirium Tremens 2 4 2 5 10 3 8 — — 34 Rheu. Fever, Rheu. of Heart — 1 2 — 3 5 6 2 — 19 Disease of Integ. System — 1 — — 8 1 6 — 1 17 Rheumatism 1 — — 1 1 1 — — — 4 Accidents. Gout — — — 1 3 — 2 2 — 8 Rickets 2 1 3 6 6 3 2 2 — 25 By Railways — — — - 4 - -—- - - 4 Cancer 10 19 17 19 35 24 75 26 6 231 By Vehicles or Horses — - 2 3 5 2 3 2 - 17 Tabes Mesenterica 2 1 7 13 11 8 13 2 — 57 In Ships, &c. (not. Drowning) - - - - - - - - - - Tubercular Meningitis 7 4 7 12 10 l6 15 2 — 73 In Building operations — 1 - - 5 - - - - 4 Phthisis 35 46 33 87 83 67 118 30 12 511 In Conflagrations — — — — — - — - — — Scrofula, Tuberculosis 3 4 2 11 6 3 8 5 3 45 By Burns, Scalds, Explosions — — 1 5 1 5 3 - — 15 Other Constitutional Diseases 3 1 3 9 7 7 12 2 1 45 By Drowning 6 5 1 6 2 2 — - 1 23 By Suffocation in bed 7 2 4 12 9 4 5 - — 43 Premature Birth 20 17 16 16 30 22 33 11 - 165 By Poisons or Poisonous Vprs. — 1 — — — 3 1 — — 5 Atelectasis 1 - 2 5 3 1 - - — 12 Other or not stated causes 2 2 6 8 7 11 5 3 1 45 Congen. Malformations 1 1 3 — 8 1 8 1 — 23 Violence other than Accidental. Old Age 6 3 4 27 26 24 36 11 17 154 Homicide - 1 — 1 — 1 3 — — 6 Suicide 1 4 2 6 4 7 12 2 1 39 Execution Other Causes 8 16 18 32 31 18 51 17 3 194 78 INQUESTS. During the year 1895, 516 cases were submitted to the Coroner who, in 95 instances, decided that no further inquiries were necessary; but, in the other 421 cases, held inquests with the following results:— I. Natural Causes 152 II. Accidental Causes 219 Burns and Scalds 33 Drowning 23 Run over 23 Falls, &c. 50 Suffocation 49 Alcoholism 15 Knocked down by Engine 5 Want of attention at Birth 3 Gunshot Wounds or Fractures 5 Exposure 6 Misadventure 4 Blow from Cricket Ball 1 Excitement 1 Blood Poisoning 1 III. Homicidal Causes 46 Suicide 40 Murder 5 Manslaughter 1 IV.Open Verdicts 4 Found Drowned 3 Found Dead 1 Total 421 79 LAMBETH PARISH. SUMMARY OF VITAL AND MORTAL STATISTICS, &c., FOR 1895. Area of Parish—3,941 statute acres (exclusive of tidal water, 79, and foreshore 39, statute acres respectively), divided into 8 Registration Sub-districts, 4 Parliamentary Divisions, and 8 New Wards. The Parliamentary Divisions and New Wards are co-extensive. Population (estimated middle of 1895)—284,885 (males, 114,562; females, 150,323). Density—72 persons per acre. Inhabited Houses—38,556 at Census, 1891 Rateable Value—£1,575,325. Marriages—2,220, being 15.6 per 1,000. Births—9,341, being 32.8 per 1,000. Deaths (corrected)—5,559, being 19-5 per 1,000. Infantile Mortality—1,420 under 1 year, or 152 per 1,000 births. Zymotic—Death Rate 2 6 per 1,000. Increase of Population 2,308; but the natural increase or increment (i.e., excess of Births over Deaths) was 3,782. 80 II.—SANITARY WORK. Return showing the Number of Nuisances removed or abated in the Parish of Lambeth, from the 1st January to the 31st December, 1895. Number of Cases 7645 Public Health (London) Act. Notices served 2476 Smallpox 41 Scarlet Fever 1065 Typhoid 187 Measles 135 Diphtheria 498 Diarrhœa 230 Puerperal Fever 16 Erysipelas 250 Membranous Croup 22 Continued Fever 20 English Cholera 12 Total 2476 81 Public Health (London) Act, and Metropolis Local Management Act. Notices served 5169 Works Structural:— Drainage Defective 1161 Intercepting Traps with Fresh Air Inlets required 549 Ventilating Pipes required 561 Indoor Sinks connected with the Drain 763 Rain Water Slack Pipes connected with the Drain 674 Bath Waste connected with the Drain 46 'I'raps Defective, or of Obsolete Pattern 1248 Closet Pan and Connections Defective 748 Water Supply to Closet Defective 173 Closet Dilapidated 184 Draw Off from Main for Drinking Purposes required 501 Dust Bins Defective 614 Premises Dilapidated 76 Ventilation under the Floors required 374 Roofs Dilapidated 218 Soil Pipes Defective 71 Paving Defective 431 Damp and Unwholesome Houses 47 Dung Receptacles required 142 Works not Structural:— Cisterns Dirty 76 Manure Accumulations 69 Underground Rooms occupied 42 Animals improperly kept 31 Stopped Drains 121 Overcrowding 62 Ballast Burning 3 Bodies Removed 1 Foul Urinals 9 Through Ventilation provided 11 Refuse Accumulations 52 No Water Supply 196 Dirty Premises 432 9685 No. of Summonses and Orders issued 58 Details as to Summonses and Orders taken out and obtained during 1895, with penalties and costs amounting in all to ^"58 2s. od., are given in full on pages 84 to 94. 6 82 HOUSING OF THE WORKING CLASSES ACT, 1890. During 1895, 16 houses have been condemned by the Medical Officer of Health as follows:— Date of Representation to the Sanitary Authority. Date of Resolution of the Sanitary Authority. Locality of Premises. Present Condition (i.e., result). Nov. 4, 1895. Dec. 17, 1895. 1A, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10, Chartley Place, Lower Marsh Closed by order of the Magistrate. Nov. 18, 1895. Dec. 17, 1895. 1, 2, 3 and 4, Cottage Place, and Rose Cottage, Stannary Street. Put into habitable repair, to the satisfaction of the M.O.H., by the Owner. Reviewing the past history of Lambeth in respect of this Act (Part II.), I find that:— In 1893, 8 houses were condemned— 199 and 203, Kennington Road. 4, 5, 6, and 7, Chester Gardens, Kennington Road. 5 and 7, Lower Kennington Lane. In 1894, 39 houses were condemned— 1 to 9 (inclusive), Vauxhall Cottages. 1 to 6 (inclusive), Coburg Mews, Goding Street. 1, 2, 6, 7, 8, 9, 10, and 11, Cottage Place Ne1wburn Street. 1 to 7 (inclusive), Hamilton Yard, Lower Marsh. 137, 138, Lower Marsh. 23, 24, Mitre Street, New Cut. 21, 22 and 23, Caffyn Street, New Cut. 83 OFFENCES UNDER THE PUBLIC HEALTH ACTS, DURING 1895. NAMES AND ADDRESSES OF OFFENDERS, WITH NATURE OF OFFENCE, AND AMOUNT OF PENALTIES AND COSTS IN EACH CASE. 6 * 84 85 Date. Name. Address. Offence. Penalty. Costs. May 17 Edward Hammond Thompson Bedford Hall, Clapham Non-compliance with Notice of Vestry to repair the roof, yard paving, and outer w.c., at 151, Stockwell Road (Order made to do work in 7 days) ... 0 10 0 „ 23 Harry Bartholomew Lynch 49, Greek Street, Soho Non-compliance with Notice of Vestry to entirely reconstruct the water-closets at 86, Stamford Street (Order made to do work in 7 days) ... 0 6 0 June 13 James Judd 525, Railway Arch, Rotherhithe New Road Removing fish offal without a properly constructed carriage , contrary to the Bye-laws of the London County Council 0 5 0 0 2 0 July 4 William Grey 25, Wandsworth Road Providing a drain at No. 4, The Grove, jointed with plaster of Paris contrary to the Regulations of the Vestry 0 5 0 1 3 0 „ 4 ,, ,, ,, Repairing drain at 23, worth Road in such a mamner as to be dangerous to health, drain being left open 44 days 0 5 0 0 2 0 „ 12 Henry Durant 67, Spa Road, Bermondsey Removing fish offal after 10 o'clock in forenoon contrary to Bye-laws of L.C.C. 1 0 0 0 2 0 ,, 12 Michael Higgins 17, Gratwick Street, Bermondsey Removing fish offal without using a properly-constructed carnage, contrary to Byelaws of L.C.C. 1 0 0 0 2 0 Carried forward 2 15 0 2 7 0 86 87 Date. Name. Address. Offence. Penalty. Costs. July 26 R. T. Kingham 6, Finsbury Square, Sec. Lon. Gen. Omnibus Co. Brought forward 2 15 0 2 7 C Using a receptacle for dung in a situation causing a nuisance and being dangerous to health, at Bowling Green Street Mews. Mr. Denman adjourned summons for 14 days to enable Company to make arrangements for the daily removal of the dung. Summons re-heard 9th August, the Company undertook to remove the dung daily, upon which the Magistrate adjourned the summons sine die 0 2 0 Aug. 8 Messrs. Thumwood & Maynard 226, Clapham Road Depositing for the preparation of sale certain articles, to wit—5 cases of condensed milk, which were unsound, unwholesome, and unfit for the food of man 20 0 0 0 2 0 „ 9 J. C. Taylor Norwood House, Southall Nuisance caused by the filthy condition of the premises at Coburg Mews. (Order made upon the Owner to pave, level and drain the premises within seven days from the service of the Order, and to pay 4/costs). 0 4 0 ,, 9 John Record 2, Fitzalan Street, Kennington Road Permitting the water closet to be in such a state as to be a nuisance to the occupiers of the premises, the water closet having been wilfully stopped up. The proceedings were taken under sec. 46 of the Public Health Act. The occupier vacated the premises, and summons was adjourned sine die Carried forward 22 15 0 2 15 0 88 89 Date. Name. Address. Offence. Penalty. Costs. Sept. 11 The Occupier 23, Beacondale Road, Gipsy Hill Brought forward 22 15 0 2 15 0 Non-compliance with Notice of Vestry to provide a proper and sufficient supply of water for domestic purposes (Order made prohibiting the use of premises for human habitation, Defendant to pay 5/- costs) 0 5 0 .. 25 John Pocknall 2, Lanfranc Street Non-compliance with Notice of Vestry to abate the overcrowded state of top back room 2 0 0 0 2 0 Oct. 4 Joseph Miller 3, Joiners' Yard, Camberwell Green Removing fish offal after the hour of 10 o'clock in the forenoon, contrary to the Bye-laws of L.C.C. 0 10 0 2 0 Oct. 4 William Johnson 6, Eastlake Road Removing fish offal without using a properly constructed carriage, contrary to the Bye-laws of the LC.C. 0 5 0 0 2 0 „ 11 E. Davis 2, Orchard Road, Shepherd's Bush Non-compliance with Notice of Vestry to put the drains into proper order and condition at No. 9, Goding Street. (Order made upon the Owner to do the necessary works within 21 days, and to pay 6/- costs) 0 6 0 Nov. 1 Mr. Reeve 15, Wingmore Road Non-compliance with notice of Vestry to provide a proper dung receptacle at Stables, Arch No. 506, Ridgway Road, in accordance with the Bye-laws of the L.C.C. 10 0 0 2 0 Carried forward 126 1 0 3 14 0 90 91 Date. Name. Address. Offence. Penalty. Costs. Nov. 1 Mr. Cornell . Stables in rear of Belinda Road Brought forward 26 1 0 3 14 0 Non-compliance with notice of Vestry to provide a proper dung receptacle at Stables rear of Belinda Road, in accordance with the Byelaws of the L.C.C. 1 0 0 0 2 0 ,, 1 Mr. Redman 25, Vining Street Non-compliance with notice of Vestry to provide a proper dung receptacle at No. 105, Stockwell Road, in accordance with the Bye-laws of the L.C.C. 0 2 0 „ 1 Fredk. Brown 111, Upper Kennington Lane Exposing for sale 5 lambs' livers, which were diseased and unfit for the food of man 5 0 0 0 10 0 „ 1 John Thorpe 53, C. Avenue, London Central Meat Market, W. Smithfield For selling to F. Brown, of No. Ill, Upper Kennington Lane, 5 livers which, at the time of sale, were unsound and liable to be seized under the 47th Section of the Public Health (London) Act, 1891 10 0 0 1 11 0 „ 1 Thomas J. James 2, Denny Street, Kennington Cross (Cowkeeper) Using a receptacle for dung in such a situation that it caused a nuisance and was dangerous to health, contrary to the Bye-laws of the L.C.C. (Owner undertaking not to commit a similar nuisance in future to pay costs only) ... 0 2 0 „ i R. Eyres 217, Camberwell Road Non-compliance with notice of Vestry to put the watercloset into proper order and condition at No. 2, Wickham Street. (Order made for the work to be done forthwith, and Defendant to pay 6/- costs ... 0 6 0 Carried forward 42 1 0 6 7 0 92 93 Date. Name. Address. Offence. Penalty. Costs. Nov. 1 Charles Reeves 23, Tinworth Street, Albert Embankment (Carman) Brought forward 42 1 0 6 7 0 Removing certain foecal and offensive matter without using a suitable carriage properly constructed, i.e., contrary to the Bye-laws of the L.C.C. ... 0 2 0 )) W. Wrinch Providence Wharf, Albert Embankment (Manure Contractor) Removing certain fecal and offensive matter without using a suitable carriage properly constructed, i.e., contrary to the Bye-laws of the L C.C. Mr. Wrinch did not appear, and summons adjourned to 8th and then to 15th inst., and then Mr. Wrinch (through his solicitors) gave a written undertaking to in future use covered vans, and to comply with the Bye-laws. Summons withdrawn ... 0 2 0 Dec. 6 Occupier 38, Saltoun Road For non - compliance with Notice of Vestry to provide a fit and proper water supply for domestic and other purposes at 38. Saltoun Road (House closed. Summons withdrawn. ... 0 2 0 )) Maurice Davis 7, Brondesbury Road, Kilburn For non-compliance with Notice of Vestry to repair the yard paving at 4, Dolland Street, in accordance with the Vestry's Bye-laws 2 0 0 0 2 0 Dec. 18 Alfred Vaughan 21, Stamford Street Depositing for the purpose of sale certain articles, to wit, 13 pieces of liver intended for the food of man, the same being diseased and unsound 5 0 0 ... Dec. 20 Mr. Green 57, Elizabeth Street, Walworth Non-compliance with Notice of Vestry to put the w.c. into proper order and condition at 32, Vassall Road. (Work being done, Owner to pay costs) 0 2 0 Carried forward 49 1 0 6 17 0 94 Date. Name. Address. Offence. Penalty. Costs. Dec. 20 Mr. Godbolt 57, Flaxman Road Brought forward 49 1 0 G 17 0 Non-compliance with Notice of Vestry to put the roof into proper order and condition at 143, Flaxman Road. (Work being done Owner to pay costs) ... 0 2 0 Housing of the Wording Classes Act. Jan. 10 1895 The Owner Nos. 1, 2, 3, 4, 5, 6 & 7, Hamilton Yard, Lower Marsh The premises being in such a state as to be dangerous or injurious to health, and unfit for human habitation. (Order made to close the premises, the Owner to pay 6/- costs in each case). (10/- allowed to Occupiers of Nos. 3 & 6, to be paid by the Owner). (The Occupier of No. 3 to remain for 21 days on account of illness). ... 2 2 0 Totals £49 1 0 9 1 0 95 SANITARY WORK IN LAMBETH PARISH. Particulars of Works carried out during 1895, and for 18 years previously. Year. Tctal Number of Cases. Sanitary Work, Structural and Permanent. Sanitary Work not Structional. 1895 7645 8581 1104 1894 6975 7672 1911 1893 8769 9207 2046 1892 7173 6931 2190 1891 5557 7232 3173 1890 5588 5053 3251 1889 6854 4192 2662 1888 4891 2969 1922 1887 4565 2430 2135 1886 4504 2433 2071 1885 3567 1459 2108 1884 3727 1621 2106 1883 3000 1294 1766 1882 3239 1267 1972 1881 3730 1293 2437 1880 3259 1106 2153 1879 3075 960 2115 1878 3310 1169 2211 1877 3563 1299 2264 96 PARTICULARS AS TO DISINFECTION carried out in Lambeth Parish during 1895. Cases in which bedding has been disinfected at home 251 „ „ „ „ „ at Chamber 2,462 Cases in which bedding has been destroyed 67 Replaced by the Vestry 3 Premises disinfected and disinfectants supplied 7,146 Articles of Bedding Disinfected. Beds 3,684 Bolsters 904 Pillows 3,736 Mattresses 1,360 Palliasses 54 Chair Cushions 604 Clothing 1,592 Blankets 1,293 Rugs 113 Counterpanes & Eiderdown Quilts 159 Carpets 17 Total 13,516 Articles of Infected Bedding Destroyed. Beds 18 Bolsters 0 Pillows 27 Mattresses 11 Palliasses 27 Chair Cushions 16 Clothing 41 Sundries 46 Total 186 No. of Infectious Cases, 2,685. 97 DISINFECTION STATISTICS. For five years prior, and five years subsequent, to the passing of the Notification of Infectious Diseases Act; and for the year 1895. 1885 1886 1887 1888 1889 Yearly average for 5 years preceding the Notification Act. 1890 1891 1892 1893 1894 Yearly average for 5 years succeeding the Notification Act. 1895 No. of Cases in which Bedding, etc., has been Disinfected. At Home 16 62 52 7 144 56.2 179 246 593 343 177 307.6 251 At Chamber 569 236 722 902 951 676.0 1391 1570 2546 3042 2286 2167.0 2462 No. of Cases in which Bedding, etc., has been destroyed. 52 8 57 48 79 48.8 185 275 314 224 119 223.4 67 No. of articles of Bedding,etc., disinfected 2275 916 3078 3121 3778 2633.6 3013 6747 9909 11513 8022 7840.8 13516 No. of articles of Bedding, etc., destroyed. 144 59 92 61 267 124.6 333 467 605 674 544 524.6 186 Premises Disinfected and Disinfectants Supplied. 727 736 1276 1255 1277 1054.2 1722 1816 3157 5896 5742 3666.6 7146 98 The work in connection with the Disinfecting Department has increased greatly during the last few years, as shewn by the figures given in the Table on page 87. In this Table, I have contrasted the amount of disinfection done five years before, and five years since, the Notification of Infectious Diseases Act, 1889, came into force. It will be seen that during the latter quinquennium the premises disinfected and disinfectants supplied have increased in numbers 247%; the articles of bedding, etc., disinfected or destroyed, 203%; and the number of cases in which bedding, etc., have been disinfected or destroyed, 245%. If, now, we compare the disinfection work done during 1895 with the average for the last (previous) five years, i.e., during the five years subsequent to the passing of the Notification Act, there is still an increase of 40% during the former period. The amount of work in connection with the Disinfection Department of the Parish of Lambeth has, therefore, increased, and the Department become correspondingly more important, from whatever point the subject be viewed. 99 ANALYSIS OF FOOD AND DRUGS. During the year 1895, more samples have been purchased and submitted to the Public Analyst for analysis than in any previous year. Taking the last ten years (1885—94), the annual average as to number of samples taken is 341 of which 55.9 (i.e., 16.4%) were found on analysis to be adulterated. The average annual number of summonses issued is 39.9, with the annual average of 39 4 convictions and 16.5 cautions. The annual average amount of penalties is £73 8s. 4d., and of costs, £25 1s. 8d. Comparing those averages with the actual numbers and figures for 1895, some idea of the extra amount of work that has been done in this particular Department will be gained, for in 1895 500 samples were purchased, of which 87 (i.e., 17.4%) were adulterated. In connection with these adulterated samples, 64 summonses were issued, and in 23 cases the vendors were cautioned, with the result that there were 62 convictions, with £149 15s. 0d. in penalties, and £41 18s. 0d. in costs. Full details are given as to the various foods and drugs obtained, with the percentages of adulterations in each case, not only during the year 1895, but also for each of the previous ten years (1885—94). 7* 100 SALE OF FOOD AND DRUGS ACT. Samples procured by Inspector Wiggs, together with the result of Analyses, during the year 1895. SAMPLES. NUMBER PROCURED. NUMBER ADULTERATED. Milk 246 52 Butter 136 20 Coffee 34 9 Mustard 11 ... Pepper 9 ... Lemonade 2 ... Sago 1 ... Tapioca 1 ... Arrowroot 2 ... Cocoa 3 ... Corn Flour 1 ... Condensed Milk 1 ... Chocolate Powder 1 ... Baking Powder 1 ... Margarine 1 ... Gin 8 1 Rum 12 3 Olive Oil 1 1 Pickles 2 ... Tomato Sauce 1 ... Jam 1 ... Vinegar 3 ... Whisky 5 ... Iodide of Potassium 1 ... Bromide of Potassium 1 ... Ginger Toddy 1 ... Tincture of Iodine 1 1 Medicine 5 ... Claret 1 ... Cheese 0 ... Lard 3 ... Sugar 1 ... 500 87 Summonses issued, 64; Convictions, 62; Cautioned, 23. 101 Year No. of Samples Analysed No. of Samples adulterated Percentage of Samples Adulterated No. of Summonses issued No. of Convictions No. of Cautions Penalties Costs 1895 500 87 17.4 64 62 23 149 15 0 41 18 0 1894 495 107 21.6 81 79 26 199 0 0 45 11 0 1893 498 120 24.09 79 79 41 207 17 0 48 19 0 1892 332 65 19.5 43 43 22 66 8 6 32 9 0 1891 292 48 16.4 25 24 23 28 13 6 15 1 0 1890 300 40 13.3 30 28 10 39 1 0 19 6 0 1889 300 47 15.6 29 29 18 46 0 6 18 2 6 1888 300 35 11.6 22 22 13 22 9 6 14 16 0 1887 300 32 10.6 32 32 3 30 10 6 20 5 0 1886 297 23 7.7 23 23 2 27 19 0 14 7 6 1885 296 42 14.2 35 35 7 66 4 0 21 19 6 Average of 10 years 1885—94 341 55 9 16.4 39.9 39.4 16.5 73 8 4 25 1 8 102 TABLE Shewing per-centages of different adulterated Samples during 1895, and in the previous ten years. Y ear. Milk. Butter. Coffee. Bread and Flour. Cocoa and Chocolate. Cheese and Lard. Other Groceries. Sundries. Spirits. Brandy. Gin. Rum. Whiskey. Ale and Porter. Wines. Aerated Waters. Drugs. 1895 21.05 14.7 26.4 — 0.0 0.0 0.0 16.6 16.0 — 12.5 25.0 — — 0.0 0.0 12.5 1894 27.6 22.4 30.0 — 0.0 0.0 5.3 0.0 0.0 0.0 0.0 0.0 0.0 — — — 0.0 1893 30.4 35.04 11.1 0.0 18.2 0.0 3.3 0.0 8.7 20.0 0.0 0.0 11.1 — — — 0.0 1892 31.3 36.4 18.4 — 66.7 0.0 2.1 0.0 0.0 0.0 0.0 0.0 — 0.0 — — 0.0 1891 47.8 5.0 3.8 0.0 — — 2.6 0.0 0.0 0.0 0.0 — 0.0 0.0 — 0.0 0.0 1890 19.3 12.1 23.3 0.0 0.0 — 5.0 0.0 57.1 100.0 66.7 0.0 50.0 0.0 — — — 1889 28.1 22.2 12.9 — — 0.0 3.9 0.0 — — — — — 0.0 — 0.0 — 1888 20.7 9.3 8.6 0.0 — 0.0 5.08 0.0 11.1 — 0.0 33.3 0.0 0.0 — 0.0 — 1887 14.01 12.8 8.4 0.0 — — 5.0 0.0 — — — — — 0.0 — — 0.0 1886 6.2 12.0 12.9 0.0 — — 8.8 0.0 0.0 — 0.0 0.0 0.0 0.0 — 0.0 — 1885 18.3 23.9 20.0 0.0 — — 0.0 0.0 11.6 00 25.0 25.0 0.0 — — — — 0.0 means that all Samples were reported to be genuine and unadulterated. — means that no Samples were taken during the year. 103 OFFENCES UNDER THE FOOD AND DRUGS AND MARGARINE ACTS, DURING 1895. NAMES AND ADDRESSES OF OFFENDERS, WITH PARTICULARS AS TO EACH OFFENCE, AND THE AMOUNTS OF PENALTIES AND COSTS IN EACH CASE. 104 105 Date. Name. Address. Offence. Penalty. Costs. Jan. 25, 1895 Messrs. Spurgeon Bros. 147, South Lambeth Road Selling Butter containing 75 per cent. added Margarine 2 0 0 0 12 6 „ Richard Barratt 215, Kennington Road Selling Butter containing 75 per cent. added Margarine 2 0 0 0 12 6 Feb. 7, Messrs Jones Bros. 57, Auckland Street Selling Butter containing 83 per cent. added Margarine 5 0 0 1 1 0 „ „ „ Selling Milk containing 10 per cent. added Water 5 0 0 1 1 0 Mar. 13, William Oakley 9, Vine Street, York Road Selling Milk from which the Cream had been abstracted to the extent of 40 per cent. 3 0 0 0 12 6 „ Walter Holland 6, Lanfranc Street Selling Milk containing added Water to the extent of 18 per cent. 2 0 0 0 12 6 „ George Catling 25, Commercial Road Selling Milk containing added Water to the extent of 26 per cent. 4 0 0 0 12 6 „ Edward Slight 13, Cornwall Road, S.E. Selling Milk containing added Water to the extent of 7 per cent. 2 0 0 0 12 6 „ William Frew 104, Westminster Bridge Road Selling Milk containing added Water to the extent of 17 per cent. 2 0 0 0 12 6 „ G. Allen 25, Durham Street Selling Milk containing added Water to the extent of 26 per cent. 5 0 0 0 12 6 Mar. 22, J. G. Marsh 154, Clapham Road SellingCoffeecontaining added Chicory to the extent of 50 per cent. 1 0 0 0 12 6 „ Elizabeth Evans 15, Mansion House Street Selling Milk containing added Water to the extent of 16 per cent. 0 5 0 0 12 6 „ Henry Taylor 48, Mansion House Street Selling Milk containing added Water to the extent of 9 per cent. 0 10 0 0 12 6 „ John Haines 1, Colwyn Street Selling Milk containing added Water to the extent of 9 per cent. 0 10 0 0 12 6 „ Evan Morgan 5, Wilcox Road Exposing a parcel of Margarine without having a label attached and marked " Margarine," contrary to the Statute 0 10 0 0 12 6 „ „ „ Selling Margarine in package not duly marked (Margarine Act, 1887) 0 10 0 0 2 0 Carried forward 35 5 0 10 6 6 106 107 Date. Name. Address. Offence. Penalty. Costs. Brought forward 35 5 0 10 6 6 April 3 David Morgan 79, Tower Street, Southwark Selling Milk containing added Water 10 per cent. 5 0 0 2 2 0 „ 5 James Malyon 40, Lingham Street Selling Milk containing added Water 40 per cent. 5 0 0 0 12 6 „ 19 GeorgeWalpole 79, Sussex Road Selling Milk containing added Water to the extent of 10 per cent. 0 10 0 0 12 6 „ 19 Daniel Davies 447, Coldharbour Lane Selling Milk containing added Water to the extent of 10 per cent. 1 0 0 0 12 6 „ 19 Messrs. Jones Bros. 5, Milkwood Road Exposing a parcel of Margarine for sale by retail without having label attached and marked "Margarine" 1 0 0 0 12 6 ,, 22 Messrs. Spiers and Pond New Bridge Street, E.C. Selling Milk from which the Cream had been abstracted to the extent of at least 30 per cent. 1 0 0 0 12 6 May 8 Thomas Felse Stevens 40, Swan Place, Old Kent Road Selling Milk containing added Water to the extent of 14 per cent. 0 5 0 0 12 6 ,, 17 Charles Frederick Buxton 37, Westow Hill Selling Coffee containing added Chicory to the extent of 30 per cent. Summons dismissed June 6 3 Daniel Varral 31 & 33, Dorset Road Selling Coffee containing added Chicory to the extent of 65 per cent. 3 0 0 0 12 6 ,, 6 - Hooker 142, Dorset Road Selling Coffee containing added Chicory to the extent of 65 per cent. 5 0 0 0 12 6 ,, 6 Thomas Fevyer 59, Bond Street, Vauxhall Selling Milk containing added Water to the extent of 10 per cent. 2 0 0 0 12 6 Carried forward 59 0 0 18 1 0 108 109 Date. Name. Address. Offence. Penalty. Costs. Brought forward 59 0 0 18 1 0 June 6 Elizabeth Jones 133, Denmark Road Selling Milk containing added Water to the extent of 8 per cent. 2 0 0 0 12 6 „ 6 A. M. Grove 291, Camberwell Grove Selling Milk containing added Water to the extent of 16 per cent. 3 0 0 0 12 6 „ 20 James Gosford 3, Brandon Road Selling Milk from which the Cream had been extracted to the extent of 50 per cent. 2 0 0 0 12 6 „ 20 J. Buck 4, Mill Lane, Brixton Hill Selling Milk containing added Water to the extent of 10 per cent. 2 0 0 0 12 6 „ 28 Richard Peters 73, Larkhall Lane Selling Butter containing added Margarine to the extent of 90 per cent. 1 0 0 0 12 6 July 12 J. Cooke 1, St. Oswald's Place Selling Milk from which the Cream had been extracted to the extent of 45 per cent. ... 0 2 0 „ 12 J. Cooke 1, St. Oswald's Place Selling Milk containing added Water to the extent of 19 per cent. 2 0 0 0 12 6 „ 12 Elizabeth Brown 23, Bird Street Selling Milk containing added Water to the extent of 9 per cent. 0 10 0 0 12 6 „ 12 A. Handsley Oval Place, Dorset Road Selling Milk containing added Water to the extent of 13 per cent. Summons dismissed Warranty proved „ 17 Thos. Jones 75, Oakley Street Selling Milk containing added Water to the extent of 23 per cent. 2 0 0 0 12 6 „ 17 Mary Ann Bannister 77, Oakley Street Selling Milk containing added Water to the extent of 10 per cent. 0 10 0 0 12 6 July 31 Charles Clark 21, Launcelot Street Selling Milk containing added water to the extent of 13 per cent. 1 0 0 0 12 6 „ 26 John Williams 188, Warham Street Selling Milk containing added water to the extent of 8 per cent. 5 0 0 0 12 6 ,, 26 E. Mildon 1, Warner Road Selling Milk containing added water to the extent of 8 per cent. 2 0 0 0 12 6 Carried forward 82 0 0 25 13 0 110 111 Date. Name. Address. Offence. Penalty. Costs. Brought forward 82 0 0 25 13 0 Sep. 20 Frederick Porter 20, Ethelred Street Selling Coffee containing added Chicory to the extent of 56 per cent. 1 0 0 0 12 6 Oct. 4 Mary Ann Jones 138, Tyers Street Selling Butter containing added Margarine to the extent of 85 per cent. 3 0 0 0 12 6 Oct. 23 H. H. Broughton "The Windmill," New Cut Selling Gin diluted with water to the extent of 4.2 degrees below the legal standard 10 0 0 0 12 6 „ 24 James Stimpson 19, Bengeworth Road Selling Milk containing added water to the extent of 20 per cent. 2 0 0 0 12 6 „ 24 E. McWilliams 34, Morval Road Selling Milk from which the cream had been abstracted to the extent of at least 50 per cent. 2 0 0 0 12 6 „ 24 The Universal Dairy Co. 150, Camberwell Road Selling Milk containing added water to the extent of 10 per cent. 1 0 0 0 12 6 „ 24 Messrs. Crane & Co. 143, Lambeth Walk Selling Tincture of Iodine deficient in strength of Iodine to the extent of 40 per cent., and of Potassium Iodide to the extent of 50 per cent. of the respective amounts required by the B.P. 5 0 0 0 12 6 „ 30 Charles Anderson The "Spanish Patriot," Lower Marsh Selling Rum diluted with water to the extent of 10.4 degs. below the legal limit 5 0 0 0 12 6 „ 31 Messrs. Ashby Bros. Hartington Road, South Lambeth Selling Milk containing added water to the extent of 18 percent. 0 10 0 0 12 6 „ 31 James Futcher Fovant, Salisbury Selling Milk containing added water to the extent of 16 per cent. 3 0 0 0 12 6 Nov. 7 E. McWilliams 34, Morval Road Selling Milk from which the Cream had been abstracted to the extent of 60 per cent. 5 0 0 0 12 6 „ 21 Joseph Reading "The Lord Clyde," Auckland Street Selling Rum diluted with water to the extent of 8.7 degrees below the legal limit of 25 degrees under proof 5 0 0 0 12 6 ,, 28 W. Scragg 162, Wyndham Road Selling Butter containing added Margarine to the extent of 50 per cent. 2 0 0 0 12 6 Carried forward 126 10 0 33 15 6 112 113 Date. Name. Address. Offence. Penalty. Costs. Brought forward 126 10 0 33 15 6 Nov.28 J. P. Ashton 175, Camberwell New Road Selling Butter containing added Margarine to the extent of 55 per cent. 2 0 0 0 12 6 „ 28 Henry Clifford 67, Coldharbour Lane Selling Butter containing added Margarine to the extent of 60 per cent. 2 0 0 0 12 6 „ 28 G. Bult 65, Loughborough Road Selling Butter containing added Margarine to the extent of 90 per cent. 2 0 0 0 12 6 „ 28 Messrs. Newman Bros. 2, Milkwood Road Selling Butter containing added Margarine to the extent of 50 per cent. 2 0 0 0 12 6 „ 28 R. Beagley 120, Landor Road Selling Butter containing added Margarine to the extent of 45 per cent. 2 0 0 0 12 6 „ 28 George J.Carter 14, Cleaver Street Selling Butter containing added Margarine to the extent of 80 per cent. 2 0 0 0 12 6 Jan. 1 Messrs. Edwards & Co. 59, New Cut Selling Butter containing added Margarine to the extent of 65 per cent. 3 0 0 0 12 6 „ 2 Richard Peters 73, Larkhall Lane Selling Butter containing added Margarine to the extent of 55 per cent. 1 0 0 0 12 6 „ 2 Richard Peters 73, Larkhall Lane Selling Coffee containing added Chicory to the extent of 35 per cent. 1 0 0 0 12 6 „ 2 Frederick Churchill 96a, Larkhall Lane Selling Coffee containing added Chicory to the extent of 90 per cent. 0 2 6 0 12 6 „ 2 A. Burnett 155, South Lambeth Road Exposing a parcel of Margarine without having label attached and marked Margarine 0 2 6 0 12 6 Carried forward 143 15 0 10 13 0 8 114 Date. Name. Address. Offence. Penalty. Costs. Brought forward 143 15 0 40 13 0 Jan. 3 D. R. Evans 8, Atlantic Road Exposing a parcel of Margarine without having label attached and marked Margarine 5 0 0 0 12 6 „ 3 J. Smith 74, Shakespeare Road Exposing a parcel of Margarine without having label attached and marked Margarine 1 0 0 0 12 6 Totals 149 15 0 41 18 0 115 Cow Houses and Slaughter Houses. The following Licences were granted or refused during 1895 :— SLAUGHTER HOUSES. Old Licences renewed 48 Old Licence refused 1 Total number of Licensed Slaughter Houses 48 COW HOUSES. Old Licences renewed 33 Old Licences refused 2 Total number of Licensed Cow Houses in Lambeth 33 116 Lambeth Parish.—Estimated Mean Population in the middle of each year, 1856-1896, corrected from the Censuses (including that for 1895), and separated into males and females. Year. Population. Persons. Males. Females. 1856 150,824 68,901 81,923 57 153,120 69,945 83,175 58 155,450 71,004 84,446 59 157,816 72,080 85,736 60 160,218 73,171 87,047 *1861 163,065 74,501 88,564 62 167,215 76,534 90,681 63 171,471 78,623 92,848 64 175,835 80,768 95,067 65 180,310 82,972 97,338 1866 184,899 85,235 99,664 67 189,604 87,560 102,044 68 194,430 89,948 104,482 69 199,378 92,401 106,977 70 204,452 94,921 109,531 *1871 209,370 97,359 112,011 72 213,535 99,399 114,136 73 217,783 101,483 116,300 74 222,115 103,609 118,506 75 226,533 105,781 120,752 1876 231,040 107,997 123,043 77 235,635 110,260 125,375 78 240,323 112,571 127,752 79 245,103 114,929 130,174 80 249,979 117,337 132,642 *1881 254,216 119,435 134,781 82 256,292 120,477 135,815 83 258,386 121,528 136,858 84 260,497 122,588 137,909 85 262,625 123,658 138,967 1886 264,770 124,736 140,034 87 266,933 125,824 141,109 88 269,114 126,922 142,192 89 271,312 128,029 143,283 90 273,529 129,145 144,384 *1891 276,162 130,442 145,720 92 280,032 132,270 147,762 93 283,956 134,123 149,833 94 287,935 136,003 151,932 95 291,970 137,909 154,061 *Census Year. Index. INDEX OF TABLES. PAGE. A. The number of Births and the Birth-Rates in each Registration Sub-District of Lambeth during 1895 (arranged quarterly) 13 B. The estimated populations, numbers of inhabited houses, Marriages, Births and corrected Deaths for the year 1895 and the ten years preceding, in Lambeth Parish 14 C. The number of persons per house, the Marriage-, Birth- and Death-Rates, and the proportion of Deaths in Public Institutions, for the year 1895 and ten years preceding 15 D. The number of Births and Deaths, with Birth- and Death-Rates in each of the Registration SubDistricts of the Parish during 1895. The Deaths are from all causes and from the chief Zymotic Diseases, and are corrected by adding Lambethians who die outside the Parish, by omitting strangers who die within the Parish, and by re-distributing persons who die in Public Institutions into the Districts from which they have been removed during illness 22-3 E. Mortalities in Lambeth at different age-periods compared with (1) those for London, 1895, and (2) the averages for London for years 1881-90 25 P. The uncorrected mortality, Male and Female, in the different Districts, and a comparison of the number of Deaths in each Quarter during the year 1895 26 G. The uncorrected mortality (i.e., including that of strangers) at different ages in each District of the Parish 27 H. The uncorrected Deaths (i.e., Parishioners and strangers) at various age-periods in each Quarter 28 page. I. The Infantile mortalities in the Registrar-General s 33 Large Towns of England and Wales (including London) and in Lambeth Parish 30 J. The number of Certificates for the notifiable Zymotic Diseases received since the introduction of the Notification Act (i.e., in the six years 1889-94, and in the year 1895) 33 K. The number of infected houses, with percentages of (1) General Defects, and (2) Defective Drains, during the years 1895 and the four preceding years 35 L. Zymotic seasonal variations in the different Registration Sub-Districts of Lambeth during 1895, with the Zymotic Death-Rate per 1,000 inhabitants 37 M. The number of Deaths from the principal Zymotic Diseases in the ten years, 1885-94, and in year 1895 38-9 N. Deaths from Zymotic Diseases (strangers deducted) . 40 0. Vaccination Returns, 1894 43 P. Vaccination Returns for the first half-year, 1895 44 Q. The Diarrhœa Mortality in Lambeth in each month during the year 1895 57 R. The classification of causes of Deaths in Lambeth during 1895, compared with London— (a.) Deaths from all causes and all ages, with percentages of deaths to total deaths. (b.) Deaths of infants under one year of age from the chief infantile diseases and from all causes, expressed in terms of 1,000 births . 63-4 S. Death-Rates for different groups of diseases in the various Registration Sub-Districts, calculated as percentages of the total deaths for each district 65 T- Death-Rates for different groups of diseases in the various Registration Sub-Districts, calculated in terms per 1,000 of the population, or the total births 67 U- Table of Deaths during the year 1895 in the Lambeth District, classified according to Diseases, Ages and Localities 68-71 iii. PAGE. V. Table of Population, Births, and of new cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health, during the year 1895, in the Metropolitan Sanitary District of Lambeth, classified according to Diseases and Localities . 72-3 Mortality Tables, shewing Deaths from all causes in Lambeth during 1895, sub-divided— (a) As to different Age-Periods 74-75 (b) As to Registration Sub-Districts 76-77 Corrected estimated mean Populations for Lambeth for 40 years, 1856-1895 116 GENERAL INDEX. PAGE. Abatement of Nuisances 80-82, 95 Age Distribution of Scarlet Fever 46 Area of Parish 10 Births and Birth-Rate 11, 12, 13, 14, 15, 22 Cholera 56, 74, 76 Constitutional Diseases 61 Cow Houses 115 Costs 83-94, 103-113 Deaths and Death-Rates 16-28 Diphtheria 49-50 Diarrhœa 55, 56, 57 Dietetic Diseases 61 Deaths from Violence 62 Deaths from Ill-defined and Non-specified Causes 62 Developmental Diseases 61 Enteric 51, 52 Erysipelas 54 Food Adulteration 99-114 Food and Drugs 99-114 Housing of the Working Classes Act 82 Infantile Mortality 29, 30 Infectious Diseases Inspection 80 Inhabited Houses of Lambeth 14, 15 Influenza 58-60 V. PAGE. Inquests 78 Inner Districts, Mortalities and Birth-Rates 18-23 Inspectors—Increase of Staff 20, 21 Introductory letter 3 London (County of)—Vital Statistics 4, 5, 6 Lambeth 7-79 Local Diseases—Nervous System, Heart, Respiratory Organs, Digestive and Urinary Organs, Reproductive System 61, 62 Local Government Board and Inspectors 20 Marriages and Marriage-Rate 16 Measles 48 Mortality Tables 74-77 Metropolitan Asylums Board 31, 32, 47 Notices served 80, 81 Notifiable Infectious Diseases 31-33 Notification Certificates received, 1895 31, 32, 33 „ „ „ 1889-95 33 Outer Districts—Mortalities and Birth-Rates 18-23 Puerperal Fever 53 Public Institution Deaths 14-18 Violent Deaths 62 Population of Lambeth 7, 8, 9, 116 Population of London 5 Parasitic Diseases 61 Prosecutions 83-94,103-114 Public Health Acts 83-94 Food and Drugs 103-114 Penalties 83-94, 103-114 Quinquennial Census, 1896 10, 66 Registration Sub-Districts 18-20, 22, 23 General Diseases 26, 27 Zymotic Diseases 37, 41-56 vi. PAGE. Rateable Value of Parish 10 Removal of Infectious Diseases 31, 32 Summary of Vital Statistics (Lambeth) 79 Sanitary Defects 80, 81, 82 Small Pox 41-45 Scarlet Fever 45-47 Smoke Nuisances 81 Sanitary Work 80-98 Simple Continued Fever 52 Slaughter Houses 115 Typhoid 51-52 Typhus 52 Vital Statistics, London 4, 5, 6 Lambeth 7-79 „ „ Summary (Lambeth) 79 Vaccination Returns 42-45 Work of Sanitary Staff 80-115 Whooping Cough 48 Zymotic Diseases 31-61 „ „ Principal 31, 32, 33, 34, 36, 37, 38 „ „ (Arranged quarterly) 37