LAM 70 Report on the VITAL AND SANITARY STATISTICS OF THE Parish of Lambeth, During the Year 1896 (With an Account of the work done by the Inspectors, and of 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, Printing Contractors, 268-270, Kennington Road, London, S.E. Public Health Department, 333, Kennington Road, London, S.E. February, 1897. To the Chairman and Members of the Vestry of the Parish of Lambeth. Gentlemen, The record of work that has been carried out by the Health Department of the Vestry of Lambeth during the year 1896 is highly satisfactory, and I take the opportunity of thanking and complimenting the Sanitary Committee and the Vestry for the ready way in which they have accepted my suggestions and acted upon them, thereby raising the sanitary status of the Parish to a higher level. If the Members of the Vestry continue to support their Medical Officer of Health and his Staff for the future in the same way as they have during the past year, the Parish of Lambeth will soon hold the proud position of being well to the front, if not of taking the lead, in sanitary matters and administraton in the Metropolis. Further, the courtesy and consideration which I have received on all hands both from the Members of the Vestry (individually and collectively) and from the various Official Departments of the Vestry, call for a frank acknowledgment from me; whilst I cannot miss this opportunity of at the same time speaking in high terms of the efficiency and esprit de corps of my own particular Department, of which I am proud to be the head. I am, Gentlemen, Your obedient Servant, JOSEPH PRIESTLEY, B.A , M.D., D.P.H. Medical Officer of Health. 4 VITAL STATISTICS. The first Quinquennial Census under the Equalisation of Rates (London) Act, was taken in London on March 29th, 1896, and the enumerated population in Lambeth Parish at that date is returned by the Registrar-General at 295,033, as compared with 275,203 at the 1891 Census, an increase of 19,830 in the last five years, i.e., 3,966 per annum (the yearly increase during the ten years 1881-91 being 2,150). Taking the censal populations of 1881,1891, and 1896, the estimated populations to the middle of the year 1896 can be calculated and are found to be as follows : — Estimated populations, middle 1896. ("296,061 (Censuses 1891 and 1896.) Lambeth Parish (287,213 (Censuses 1891 and 1881.) Sub-districts From Censuses 1896 and 1891 From Censuses 1891 and 1881 Under- Overesti- estimated. mated, (per centum) Waterloo Rd. 1st 14,192 13,300 i.e. 6.3 Waterloo Rd. 2nd 14,185 13,588 i.e. 4.2 Lambeth Church 1st 18,805 16,954 i.e. 9.8 Lambeth Church 2nd 41,091 38,535 i.e. 6.2 Kennington 1st 52,581 53,626 i.e. 1.9 Kennington 2nd 43,429 42,198 i.e. 2.9 Brixton 82,267 79,480 i.e. 3.4 Norwood 29,511 29,532 i.e. .01 296,061 287,213 i.e. 2.9 5 Censal (Enumerated) Populations. Sub-districts. 1881. 1891. 1896. Waterloo Road, First 15191 14031 14186 Waterloo Road, Second 16351 14644 14210 Lambeth Church, First 19876 18075 18770 Lambeth Church, Second 39859 39097 40994 Kennington, First 45232 50586 52486 Kennington, Second 35332 39708 43244 Brixton 62837 73405 81825 Norwood 19017 25657 29318 253699 275203 295033 From the above Table it will be seen that, with the exception of Waterloo Road Second (which has decreased 3%), all the other Sub-districts have increased, the three Inner 4.5 °/ol and the four Outer 9.3°/0 between 1891 and 1896. The Registrar-General returns the estimated population of London for the middle of the year 1896 as 4,421,955, consisting of 2,095,136 males and 2,326,819 females, and states that there were registered during the year 38,869 marriages, 135,796 births (69,536 males and 66,260 females), and 83,511 deaths (43,069 "males and 40,442 females). There were registered, too, 14,100 deaths from the seven chief zymotic diseases. The excess of registered births over deaths, i.e.. the natural increment, is 52,285, and the estimated increase of population is 41,025. 6 1896.—Sanitary Areas of the Metropolis. Enumerated Population, 1891 (Census). Enumerated Population, 1896 (Census). Estimated Population, 1896 (middle of year). Marriage-Rate. Birth-Rate. Death-Rate. Zymotic DeathRate. Deaths under 1 year to 1000 Births. London 4211743 4411710 4421955 180 30.2 18.2 3.11 160 South Districts 1524472 1642796 1648910 ... 31.3 17.8 3.22 157 West Districts 728418 766203 768187 ... 25.6 16.8 2.77 169 North Districts 993884 1040694 1043020 ... 28.9 16.9 2.77 150 Central Districts 259855 245683 244995 ... 30.5 21.3 2.98 168 East Districts 705114 716334 716843 ... 37.6 21.4 3.77 167 7 The estimated population to the middle of 1896 for Lambeth Parish is 296,061 consisting of 139,8-11 males and 156,220 females; and this population may be sub-divided as follows:— Registration Sub-districts. Males. Females. Total. A. As to Registration Sub-districts. Waterloo Road, First 7143 7049 14192 Waterloo Road, Second , 7263 6922 14185 Lambeth Church, First 9475 9330 18805 Lambeth Church, Second 20510 20581 41091 Kennington, First 25763 26818 52581 Kennington, Second 20056 23373 43429 Brixton 36775 45492 82267 Norwood 12856 16655 29511 Parish of Lambeth 139841 156220 296061 8 B. As to Parliamentary Divisions and New Wards. Parliamentary Divisions and New Wards. Males. Females. Total. Marsh North Division Bishop's 30,060 29,697 59,757 Prince's Kennington Division Vauxhall 37,671 38,580 76,251 Stockwell Brixton Division Brixton 35,599 42,619 78,218 Tulse Hill Norwood Division Norwood 32,332 40,655 72,987 Parish of Lambeth 135,662 151,551 287,213 N.B.—The 1896 Census takes no account of the Parliamentary and New Wards boundaries, so that the only estimated populations are those obtained from the Censuses 1881 and 1891. 9 C. As to Age-Periods. Age-Periods. Males. Females. Total. 0—1 3,837 3,820 7,657 1—5 13,815 13,574 27,389 Total under 5 17,652 17,394 35,046 5—20 43,537 46,160 89,697 20—40 46,954 52,909 99,863 40—60 23,780 27,503 51,283 60—80 7,491 11,301 18,792 80 and upwards 427 953 1,380 Total over 5 122,189 138,826 261,015 10 The Parish of Lambeth contains 4,059 statute acres, inclusive cf 79 tidal water and 39 foreshore, with an estimated population of 296,061 persons to the middle of the year 1896. The total estimated increase of the population is 4,091, but the " natural increment"—i.e., the excess of births over deaths is 4,494, so that we must assume an exodus of 403 in excess of those who came into the Parish during the year. The estimated number of inhabited houses to the middle of the year 1896 is 40,210, and the rateable value of the Parish on April 11, 1896, was £1,680,283, an increase of £105,030 on the previous year, as the following Table shews:— Year. Rateable Value.* 1896 £1,680,283 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 1895 1,575,253 Yearly average for 10 years, 1886-1895, £1,522,070 16 0. * These rateable values are the 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 Table A, giving the number of Births and the Birth-Rates in each Registration Sub-District of Lambeth during 1896 (arranged quarterly). Registration Sub-District. No. of Births. Total for the Year 1896. Rate per lOOO. 1st Quarter Male. Female. 2nd Quarter Male. Female. 3rd Quarter Male. Female. 4th Quarter Male. Female. Waterloo Road 1st 75 66 70 52 49 64 73 53 502 35.4 2nd 128 124 107 104 107 115 116 143 944 66.5* Lambeth Church 1st 92 68 85 75 74 77 101 77 649 34.5 2nd 215 242 208 193 178 185 247 219 1687 41.05 + Kennington 1st 250 218 21 7 219 227 239 j278 238 1886 35.9 „ 2nd 140 120 157 141 139 135 150 143 1125 25.9 Brixton 255 256 264 217 280 267 302 296 2137 25.9 Norwood 91 81 86 65 86 77 97 79 662 22. 4 1246 1175 1194 1066 1140 1159 1364 1248 2421 2260 2299 2612 9592 32.4 * Including the Lying-in Hospital. † Including the Workhouse. Table B, shewing the Estimated Populations, Numbers of Inhabited Houses, Marriages, Births and Corrected Deaths for the year 1896, 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. I896 296061 40210 2445 9592 5098 1313 2045 708 1588 1886 264770 37058 2184 9047 5302 1344 2163 726 1112 1887 265933 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 5812 1369 2228 696 1320 1891 276162 38634 2140 9097 5886 1387 2251 692 1438 1892 280032 38950 2107 9226 5457 1250 2091 705 1578 1893 283956 39265 2233 9222 5219 1325 1925 748 1741 1894 287935 39580 2224 9232 4837 1223 1936 680 1484 1895 291970 39895 2220 9341 5559 1420 2187 732 1511 Note.- (a) Enumerated Population at Census 1896 was 295033. (b) Actual number of inhabited houses at Census 1891 was 38,556. 12 13 THE BIRTH-RATE. The number of Births registered in Lambeth during the year 1896 was 9,592, as compared with 9,841 for the year 1895. Of the total 9,592 births, 4,944 were males, and 4,648 females, showing an excess of 296 males. The birth-rate for Lambeth is, therefore, 32.4 per 1000 inhabitants (35.3 for males and 29.8 for females), as campared with 30.7 for London (33.3 for males and 28.4 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 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. It will be noted that the Inner Wards have a higher average birth-rate than the Outer Wards (even after allowing for the Lying-in Hospital and Workhouse in Waterloo Road, 2nd, and Lambeth Church, 2nd, respectively), and this, no doubt, affects the death-rate by altering the age constitution of the population, and giving rise to a large proportion of persons under 5 years, amongst whom there is always a heavy death-rate. These facts must be kept in mind in considering the relative mortality of the Inner as compared with the Outer Districts. 14 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 1896, and ten years preceding. ] The Year. Estimated No. of Persons per house. 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 DeathRate, per 1000 Population. Deaths in Public Institutions per 1000 total uncorrected deaths. 1896 \ 16.5 32.4 17.2 136.9 257.6 401.1 2.4 295.7 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 7.4 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 2.5 222.1 1891 15.5 32.9 21.31 152.5 235.6 382.4 2.5 236.6 1892 15.04 32.9 19.5 135.5 229.06 383.2 25 272.4 1893 15.7 32.5 18.4 143 7 253.9 368 8 2.6 305.9 1894 15.4 32.06 16.8 132.5 252 8 400.3 2.4 284.7 1895 15.2 31.9 19.04 152.02 255.4 393.4 2.5 257.9 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. 15 THE. MARRIAGE-RATE. The number of marriages registered in Lambeth during the year 1896 was 2445, as compared with 2220 for the year 1895. The marriage-rate for Lambeth is, therefore, 16.5 per 1,000 inhabitants, as compared with 18 0 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. Marriage statistics are of little value. THE DEATH-RATE. The total number of deaths registered in Lambeth during the year 1896 was 5370 as compared with 5857 for the year 1895. Of the total 5370 deaths 2727 were males and 2648 females, shewing an excess of 84 males. The death-rate for Lambeth is, therefore, 18.14 per 1,000 inhabitants (19.5 for males and for 16.9 females), as compared with 18.6 for London (20.6 for males and 17.4 for females). These rates are, however, uncorrected, and on analysing the 5,370 deaths registered in Lambeth Parish it is found that 705 represent deaths occurring within the Parish amongst persons not belonging thereto. These are to be deducted, but, on the other hand, there are 433 deaths registered outside the Parish of persons belonging thereto, and these must be added, giving a corrected number of deaths for Lambeth during 1896 of 5098, and a corrected death-rate of 17.2 per 1,000 inhabitants, as compared with 18.2 for London (the total corrected number of London deaths being 81,721). The Institutions, &c., where the 433 Lambethians died during 1896, may be grouped as follows:— 16 I. General Hospitals 144 III. Infirmaries and Charing Cross 14 houses 12 French 2 Camberwell Infirmary 1 Guy's 27 Islington Workhouse 1 Hostel of God 2 Pancras Workhouse 1 King's 9 St. George's Union Infy. 1 London 4 St. Saviour's Infirmary 4 Middlesex 7 Strand Workhouse 1 Royal Free 2 St. Olave's Infirmary 1 St. Bartholomew's 14 St. Olave's Workhouse 1 St. George's 10 Westminster Union St. Peter's 1 Workhouse 1 University 3 Westminster 49 IV. Asylums 121 Aged Blind 1 II. Special Hospitals 138 Aged Pilgrims 1 Alexander Hospital 1 Banstead 10 Belgrave 3 Bethnal House 2 Brompton 9 Camberwell House 2 Cancer 5 Caterham 15 City of London 2 Cave Hill 27 Evelina 19 Central London Sick Friedenheim 2 Asylum 1 Gt. Ormond Street 1 Claybury 1 Homœpathic 2 Colney Hatch 5 Mildmay Hospital 1 Consumptive Females 1 Mount Pond, Clapham Darenth 7 Common 1 Grove Hill 5 North-Eastern 1 Grove House 1 North London 1 Han well 8 Nursing Home, Clapham 2 Ilford 23 Queen Charlotte 1 Leavesden 5 Royal Chest 2 Licensed Victuallers 2 Samaritan Free 1 Middlesex 1 Soho Women 1 Peckham House 2 St. Elizabeth 1 Salvation Army 1 Sydenham 1 18 Victoria 6 V. Unclassifiab'e Places Ambulance 1 Fever— Canal 1 Brook 3 Chapel 1 Fountain 48 Omnibus 1 London Fever Hospital 1 Hotel 1 Ships 2 River Thames 6 South-Eastern 16 Private Addresses 7 Western 5 17 Summary. I. General Hospitals 144 II. Special and Fever Hospitals 138 III. Infirmaries and Workhouses 12 IV. Asylums 121 V Elsewhere (Unclassifiable) 18 433 Whether we take the corrected or uncorrected death-rate for Lambeth, it is highly satisfactory for the year 1896, being 2.3 or 2.4 per 1,000 less than during the previous year; whilst on examining the death-rate more closely, we shall find cause for even greater satisfaction and congratulation. Table D gives the corrected death-rates during 1896 in the several Registration Sub-districts, with the corresponding birth-rates, and the corrected zymotic death-rates. The mean average death-rate for the four Inner Districts is 218, and for the four Outer 15 05 per 1,000, with corresponding average birth-rates of 44 36 and 27.52 per 1,000 respectively (allowing for the fact that the Lying-in Hospital and the Workhouse are in two of the Inner Districts). The zymotic death-rate is, for the Inner Districts, 325, and for the Outer Districts, 2 03 per 1,000, and the zymotic incidence (cases notified) 10 4 and 9.2 per 1,000 respectively. Reference to Tables G, S and T will shew that the Inner Districts have a larger comparative mortality in children under five years of age, and amongst infants under one year of age (per 1,000 births), but a smaller comparative mortality in persons over 60 years of age. The Phthisis, Tubercular, Diarrhcea and Typhoid death-rates are all higher in the Inner than in the Outer Districts. b 18 19 TABLE d _ TABLE d. Shewing the number of Births and Deaths, with Birth- and 1896. The Deaths are from all causes, and from the chief Death-rates in each of the Registration Sub-Districts of the Parish during outside the Parish by omitting strangers who die within the Zymotic Diseases, and are corrected by adding Lambethians who die into the Districts from which they have been removed during Parish, and by re-distributing persons who die in Public Institutions illness. DISTRICTS. Persons per Acre. Estimated Population (middle 1896). Total Births. Birth-rate per 1000 of the Population. Total Deaths (corrected). General Death-rate per 1000 of the Population. Small Pox. Total Deaths from Total Zymotic Deaths. Zymotic Death-rate per 1000 cf the Population. Zymotic Death-rate per 1000 of the Total Deaths. Diarrhcea Death-rate per 1000 of the Population. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Typhus. Typhoid or Enteric. Ccntinued Fever. Diarrhœa. Waterloo Road, 1st 211 8 14192 502 35.4 296 22.3 2 14 5 2 8 0 1 0 14 46 3.3 147.5 1.0 2nd 141.8 14185 944 66.5 306 2 2.9 0 15 1 10 9 0 3 0 12 50 3.6 155.2 0.9 Lambeth Church, 1st 116.1 18805 649 34.5 344 19.4 0 21 5 6 11 0 1 0 10 54 2.9 150.0 0.5 ,, „ 2nd 220.9 4IO9I 1687 41.05 910 22.6 0 39 11 30 13 1 2 1 32 129 3.2 139.4 o.8 Kennington, 1st 107.3 52581 1886 35.9 882 17.2 0 34 15 14 34 0 7 21 125 2.4 139.2 0.4 2nd 87.2 43429 1125 25.9 727 17.2 0 13 7 24 15 0 2 0 16 77 1.8 103.9 0.4 Brixton 57.5 82247 2137 25.9 1154 I4.3 0 33 13 45 40 0 3 0 33 167 2.04 142.7 0.4 Norwood 29.2 29511 662 22.4 318 11.5 0 15 6 8 9 0 5 0 12 55 1.9 164.6 0.4 District not stated ... ... ... ... 161 ... ... 1 ... 1 1 ... ... • • • 2 5 ... ... ... Lambeth 75.1 296,061 9592 32.4 5098 17.2 2 185 63 140 140 1 24 1 152 708 2.4 38.9 0.5 London 59.2 4,421,955 135796 30.2 81721 18.2 9 3692 940 2663 2931 5 564 13 3192 14009 3.1 171.4 0.7 N.B.- In the 161 cases where the District is not stated the death-rate has been calculated on the assumption that these deaths were subdivided equally in the eight Districts. Census 1891. Return gives the area of Lambeth as 3,941 statue acres(exclusive of tidal water and foreshore). b 2 20 TABLE E. Showing Mortalities in Lambeth at different Age-Periods compared with (i) those for London, 1896, and (2) the averages for London for years 1881—90. Age-Periods. LAMBETH. LONDON. Estimated Populations (middle 1896). Mortality Rates per 1000 Population, 1896. Mortality Rates per 1000 Population, 1896 Uncorrected. Average of Ten Y ears, 1881—90, per 1000. Corrected. Uncorrected. 0—5 35046 58.4 62.4 67.6 68.4 5—20 89697 3.3 3.8 4.3 20—40 99863 6.06 8.1 6.6 8.2 7.7 40—60 51283 18.13 19.06 20.2 60—80 18792 54.07 57.02 63.3 80 and upwards 1380 153.6 60.7 178.7 64. 8 206.2 *Under 1 year 7657 136.9 142.9 160.9 152.0 All Ages 296061 17.2 18.14 18.6 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—15, 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. 21 There is, however, cause for congratulation in the fact that the Inner Districts have during 1896 participated in the lowered mortality and lessened zymotic incidence of Lambeth to as great an extent as the Outer Districts—a condition of things to be desired, and expected with the more careful sanitary supervision that the increased Inspectorial Staff enables the Vestry to exercise. The place that Lambeth takes amongst the Metropolitan Sanitary Authorities is worthy of note there being only eleven other Authorities (out of 43) with a less death-rate, and nine with a less zymotic death-rate. (See Appendix Table.) The 5098 corrected deaths may be further analysed and tabulated according to age-periods, as follows:— of the total deaths took ) 1313, i.e., 25.8% place under 1 yr. of age. 732 „ 14.4 „ „ „ „ between 1 & 5 yrs. 2045 " 40. 1 „ „ " under 5 years. 290 " 5.7 " " " " between 5 & 20 yrs. 605 „ 11.9 „ „ „ „ „ 20 & 40 yrs. 930 „ 18.2 „ „ „ „ „ 40 & 60 yrs. 1016 „ 19.9 „ „ „ „ „ 60 & 80 yrs. 212 „ 4.2 „ „ „ „ over 80 years. 3053 " 59.9 " " " " 5 years. These results must be compared with those for London, given in Table E, which shews the estimated mortalities per 1,000 persons at each age-period for London during 1896, and for the London averages for the 10 years 1881—90. Tables F, G & H, shew the uncorrected returns (male and female) for Lambeth, arranged as to Registration Subdistricts, age-periods, and quarters respectively, for comparison with similar tables in former Reports. 22 TABLE F. Shewing the Uncorrected Mortality, Male and Female, in the different District, and a comparison of the number of deaths in each Quarter during the year 1896. SUB-DISTRICTS. 1st Quarter. 2nd Quarter. 3rd Quarter. th Quarter. Total No. of Deaths in each District. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Waterloo Road, 1st 39 33 72 27 28 55 47 40 87 30 26 56 270 Waterloo Road, 2nd 27 33 60 22 22 44 38 40 78 23 36 59 241 Lambeth Church, 1st 99 72 171 113 102 215 169 92 261 147 97 244 891 Lambeth Church, 2nd 149 148 297 142 137 279 165 130 295 173 176 349 1220 Kennington, 1st 80 81 161 82 84 166 78 77 155 102 99 201 683 Kennington, 2nd 71 86 157 56 61 117 68 58 126 61 81 142 542 Brixton 154 182 336 121 157 278 152 122 274 159 187 346 1234 Norwood 41 43 84 28 34 62 27 28 55 37 51 88 289 Totals 660 678 1338 591 625 1216 744 587 1331 732 753 1485 5370 N.B.—1588 persons died in the Public Institutions, including 705 strangers. 23 TABLE G. Shewing the Uncorrected Mortality (i.e., including that of strangers) at different ages in each District of the Parish (1896). Sub-District. Under I year. 1 year to 5 years. 5 to 6o years. 6o years and Upwards. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Waterloo Road, First 62 53 115 31 17 48 30 40 70 20 17 37 270 Waterloo Road, Second 44 42 86 24 25 49 32 40 72 10 24 34 241 Lambeth Church, First 110 59 169 82 84 166 281 183 464 55 37 92 891 Lambeth Church, Second 141 120 261 68 61 129 235 210 445 182 203 385 1220 Kennington, First 126 106 232 44 47 91 101 81 182 73 105 178 683 Kennington, Second 83 74 157 32 34 66 91 88 179 52 88 140 542 Brixton 160 122 282 103 125 228 205 236 441 115 168 283 1234 Norwood 38 31 69 15 25 40 56 48 104 26 50 76 289 Totals 764 607 1371 399 418 817 1031 926 1957 533 692 1225 5370 24 TABLE H. (Shewing the uncorrected deaths (i.e, parishioners and strangers), at various age-periods in each quarter. 1896. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. M. F. Total M. F. Total M. F. Total M. F. Total Under 1 year 160 133 293 150 128 278 265 200 465 189 146 335 1371 Between 1 and 5 years 123 124 247 87 120 207 105 87 192 84 87 171 817 Between 5 and 60 years 242 231 473 243 229 471 272 178 450 280 283 563 1957 60 years and upwards 135 190 325 110 149 260 102 122 224 180 236 416 1225 Totals 660 678 1338 590 626 1216 744 587 1331 733 752 1485 5370 25 INFANTILE MORTALITY, 1896. Of the 5,098 deaths, 1,313 were infants under one year of age, giving a proportion of 136 9 (corrected) per 1,000 births, the uncorrected rate being 142.9—a highly satisfactory record. The chief causes of these deaths were debility, atrophy and inanition, bronchitis and other diseases of the respiratory organs, diarrhoea and enteritis, premature birth, measles and whooping cough, and convulsions. Table I gives the infantile mortality in different Towns in England and Wales, and in the London Districts. In the Registration Sub-districts of Lambeth the uncorrected infantile mortality varies from 260 4 per 1,000 births in Lambeth Church First to 104 2 in Norwood (the low rate of 911 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) Infantile Mortality per 1000 births (uncorrected) Waterloo Road 1st 502 115 229.08 „ „ 2nd 944 86 91.1* Lambeth Church 1st 649 169 260.4 „ „ 2nd 1687 262 155.3† Kennington 1st 1886 232 123.01 „ „ 2nd 1125 157 139.6 Brixton 2137 281 131.5 Norwood 662 69 104.2 Lambeth 9592 1371 142.9 * Including the Lying-in Hospital. † Including the Workhouse. 26 TABLE I. Shewing the Infantile Mortalities in the Registrar-General's 33 Large Towns of England and Wales (including London), and in Lambeth Parish, during 1896 Corrected Deaths under one year per 1000 Births. Average Ten Years, 1886—95. England and Wales (33 large Towns). 167 167 London 161 155 Brighton 135 151 Lambeth 136.9 Bristol 142 145 Bradford 143 173 Halifax 149 162 Croydon 150 122 Derby 151 150 Portsmouth 154 149 Sunderland 158 167 Swansea 161 l60 Norwich 164 176 Cardiff 165 162 West Ham 165 153 Newcastle 165 165 Huddersfield 166 164 Nottingham 168 171 Bolton 168 180 Leeds 169 177 Burnley 170 216 Blackburn 171 204 Gateshead 172 164 Sheffield 173 178 Hull 173 170 Liverpool 173 189 Manchester 176 185 Birkenhead 177 163 Plymouth 178 167 Wolverhampton 184 183 Oldham 184 178 Leicester 187 202 Birmingham 197 174 Salford 199 195 Preston 203 232 *London Districts— North 150 South 157 West 169 East 167 Central 168 * The figures are corrected for the London Districts. 27 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 diarrhœa; 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 1896 there were registered 819 deaths from the seven zymotic diseases, and of these 203 were strangers belonging to other parishes, and 616 parishioners who died within the Parish. 92 Parishioners, however, died without the Parish. Subtracting the strangers and adding on the parishioners who died without the Parish, there is a corrected total of 708, giving a zymotic corrected death-rate of 2 4 per 1000 inhabitants, the corrected rate for London being 31, varying in the various Metropolitan Districts, as shown on page 6. The zymotic death-rates (corrected) for the different Registration Sub-districts of Lambeth vary also, as shown in Table D, which in addition gives the death-rates and birth-rates for comparison. The zymotic death-rate (average) for the Inner Districts is, we have seen, 3.3, and for the Outer, 2.04—a difference explainable (as before) from the overcrowding and absence of proper means of home isolation and nursing in the former, as compared with the latter, Districts. During the year 1896, under the Notification Clauses of the Public Health (London) Act, 1891, 2801 cases of Infectious Diseases have been reported, and of this number 1206, i.e , 43 per cent. were removed to the Hospitals of the 28 Asylums Board, or to other Hospitals, and 1595, i.e., 57 per cent., remained under treatment at their own homes. These percentages are more satisfactory than last year, when only 30 4 per cent. of the cases were removed. 8125 per cent. smallpox cases, 53.8 per cent. scarlet fever, 43.2 per cent. typhoid, and 40 3 per cent. diphtheria, were removed to Hospital respectively. Table J gives the averages of Notification Certificates received in Lambeth since 1889, and it will be seen that during 1896 the total number is 157 above the average— the greatest number of Notifications being received in 1893—though the incidence per 1000 of the population during 1896 is only T above the average incidence for the six years 1890—95 (i.e., since the introduction of the Compulsory Notification Act). The six cholera cases were probably cholera nostras (English cholera), or infantile diarrhœa. The diphtheria increase is a serious one—a total of 652 notifications being received during the year 1896, i.e., the largest number ever received in one year, and 137 above the average for the last six years. The 652 cases occurred in 567 infected houses, and in only 19.05 per cent. of these were the drains, on testing, found defective. The enteric fever (or typhoid) notifications were below the average, and represent only 153 infected houses, of which 261 per cent. were shewn, on testing, to be defective. 29 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 seven years, 1889-95, and in the year 1896. Disease. 1889 1890 1891 1892 1893 1894 1895 Annual average of 6 years 1890-95. Notifications received during 96. Lambeth. London. Small-Pox 0 15 3 22 99 26 51 36.0 16 304 Cholera 0 7 4 26 23 10 16 14.3 6 13 Diphtheria 286 330 330 504 789 521 614 514.7 652 13941 Membranous Croup 0 46 29 47 49 26 23 36.6 27 Erysipelas 92 24S 258 420 587 315 355 363.8 352 6438 Scarlet Fever 879 1126 858 1832 2275 1198 1339 1446.3 1550 25676 Typhus 0 0 1 3 3 2 0 1.5 1 6 Typhoid or Enteric 64 150 149 117 160 268 201 174.2 162 3200 Continued or Relapsing 0 41 33 34 58 48 20 39.0 16 106 Puerperal 15 13 11 20 27 19 16 17.7 19 279 Totals 1336 1976 1676 3025 4070 2433 2685 2644.2 2801 49963 Average per 1,000 of population 4.9 7.2 6.1 10.9 14.5 8.6 9.4 9.4 9.5 11.08 N.B.—The 1889 Column represents only two months, the Notification Act coming into force on October 31st, 1889. 30 TABLE K Giving number of infected houses with percentages of (1) General Defects, and (2) Defective Drains, during 1896 and the five preceding years. 1891 1892 1893 1894 1895 Average for last 5 years 1891- 95 1896 Number of Infected Houses 1417 2430 3179 2012 2111 2229.8 2417 Number of Houses with defects found 903 1474 1641 1089 993 1220 1177 =63.7% =60.7% =51.67% =54.1% =47.04% =54.7% =43.7 % Number of Houses with defective drains found 316 720 658 464 392 510 423 =22.3% =24.7% =20.6% =23.06% =18.6% =22.9% = 17.5% Number of Houses with no defects found 514 956 1538 923 1118 1009-8 1240 =36.3% =39.3% =48.4% =45.9% =52.96% =45.3% =51.3% 31 In the case of each infected house, an inspection was made, and the drains and sanitary fittings tested, with the results that of the 2417 infected houses— (a) 423 (i.e., 17.5%) were found to have defective drains. (b) 1177 (i.e., 48.7 %) were found to have defective drains, or defective traps, fittings and appliances. (c) 1240 (i.e., 51.3%) gave no result with the tests. (d) 754 (i.e., 31.2%) 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 a Percentage shewing Total Defects. Percentage giving no Defects. Drains. Traps, Fittings and Appliances only. Total. Smallpox 14 1 6 7 50.0 50.0 Cholera* 5 1 ... 1 20.0 80.0 Diphtheria 567 108 180 288 50.8 49.2 Membranous Croup 26 9 12 21 80.8 19.2 Erysipelas 315 39 101 140 44.4 55.6 Scarlet Fever 1302 217 400 617 47.4 52.6 Typhus 1 ... 1 1 100.0 0.0 Typhoid 153 40 43 83 54.6 45.4 Continued or Relapsing 16 6 5 11 68.8 31.2 Puerperal 18 2 6 8 44.4 55.6 Totals 2417 423 754 1177 48.7 51.3 * These were in all probability cases of Diarrhoea or Cholera Nostras. It will be noted that 17 5% of the infected houses shewed, with the test, defective drains, and 312% defective traps, fittings and appliances. Table K gives the average percentages for the last 5 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 1896 is 17.1% below the average in respect of defective drains, though 5.8% above the average in respect of defective traps, fittings, and appliances. 32 The seasonal mortality from the different zymotic diseases is well shown by arranging the deaths quarterly, thus:— 1896. Smallpox. Measles. Whooping Cough. Scarlet Fever. Diphtheria. Membranous Croup. FEVER. Diarrhoea. Erysipelas. Puerperal Fever. Cholera. Influenza. Total. Typhus. Typhoid. Continued. 1st Qr. 2 80 23 22 28 2 ... 5 ... 7 2 3 ... 16 190 2nd Qr. ... 61 65 9 21 2 ... 3 ... 18 3 1 1 16 200 3rd Qr. ... 40 29 13 32 2 1 9 ... 113 4 7 4 3 257 4th Qr. ... 4 23 19 48 5 ... 7 ... 14 9 1 ... 16 147 T OTALS 2 185 140 63 129 11 1 24 1 152 18 12 5 51 794 Taking the zymotic diseases collectively, it is noticed that the 3rd quarter shewed the highest mortality, and the 4th quarter the lowest. Measles and Scarlet Fever reached their maxima in the 1st quarter; Whooping Cough in the 2nd; Typhoid, Diarhœa and Cholera in the 3rd; Diphtheria and Membranous Croup in the 4th; and Influenza had an equally high rate in the 1st, 2nd 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 1896, and for the ten previous years, not only in Lambeth Parish, but also (for comparison) in London. 33 TABLE L. Showing Zymotic seasonal variations (deaths) in Lambeth in the different Registration Sub-districts during 1896. Registration Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4 th Quarter. Year 1896. Zymotic Death-rate per 1000 inhabitants Waterloo Road, 1st 15 9 17 5 46 3.3 Waterloo Road, 2nd 10 5 25 10 50 3.6 Lambeth Church, 1st 7 18 21 8 54 2.9 Lambeth Church, 2nd 17 38 45 29 129 3.2 Kennington, 1st 24 40 44 17 125 2.4 Kennington, 2nd 22 15 20 20 77 1.8 Brixton 52 43 49 23 167 2.04 Norwood 21 11 15 8 55 1.9 District not stated 1 ... 3 1 5 ... Lambeth 169 179 239 121 708 24 34 35 TABLE M. TABLE M. Shewing the number of Deaths from the principal Zymotic Diseases in the ten years 1886—95, and in the year 1896. Disease. 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 Total Deaths in 1896. Proportion of Deaths to 1000 total Deaths 1896. Annual Average of ten years 1886—95. Proportion of Deaths to 1000 Deaths in 10 years. Smallpox 3 1 0 0 0 0 1 5 1 2 2 4 1.3 0.2 Diphtheria (and Membranous Croup) 61 106 103 155 74 78 127 172 138 103 140 27.5 111.7 20.9 Scarlet Fever 56 120 82 73 57 46 76 69 64 53 63 12.2 69.6 12.9 Fever. 'Typhus 0 1 0 1 0 1 0 1 0 0 1 .2 .4 0.08 Typhoid or Enteric 29 39 36 31 31 28 22 36 46 26 24 4.7 32.4 6.05 Simple Continued 6 8 3 5 3 7 2 4 0 2 1 .2 4.0 0.8 Measles 137 152 119 157 183 128 187 113 182 151 185 36.5 150.9 28.2 Whooping Cough 196 187 171 137 194 239 135 151 110 132 140 27.5 165.2 30.9 Diarrhœa 238 278 120 168 154 165 155 197 139 263 152 29.8 187.7 35.05 Lambeth 726 892 634 727 696 692 705 748 680 732 708 138.9 723.2 135.6 London 11121 12684 10503 9709 12270 9675 11983 13223 11544 11467 14009 171.4 11417.9 135.8 c 2 36 TABLE N. Deaths from Zymotic Diseases (Strangers deducted) in Lambeth during 1896. For the 4 weeks ending January. Feb. March. April. May. June. July. August. Sept. J October. Nov. Dec. Total. Small-pox 1 ... 1 ... ... ... ... ... ... ... ... ... 2 Measles 31 11 36 24 23 13 25 10 8 3 1 ... 185 Scarlet Fever 7 10 4 3 4 1 4 5 4 9 8 4 63 Diphtheria 10 14 4 9 8 6 10 10 12 16 10 20 129 Membranous Croup 2 ... ... ... 1 1 1 2 ... ... 1 3 11 Whooping Cough 4 7 12 25 25 14 18 8 3 2 6 16 140 Typhus ... ... ... ... ... ... ... 1 ... ... ... ... 1 Enteric Fever 4 ... 1 ... 2 1 1 4 4 2 3 2 24 Continued Fever ... ... ... ... ... ... ... ... ... ... ... 1 1 Diarrhœa 1 4 ... 2 3 11 53 64 5 5 2 2 152 Chief Zymotic Diseases 60 46 58 63 65 47 112 104 36 37 31 48 708 Erysipelas 1 1 1 3 ... ... 1 3 ... 4 2 2 18 Puerperal Fever 2 ... ... ... ... ... 1 ... 1 ... ... ... 12 37 SMALLPOX At the beginning of the year there was a small outbreak of Smallpox which threatened to spread, but was prevented from so doing by carefully watching the cases. The facts, which are interesting, are as follows:—On December 8th, 1895, Emily F., aged 26 years, and vaccinated in infancy, was notified as suffering from Smallpox, at 39, Wootton Street, and was removed to Hospital the next day. Her husband had been revaccinated, and their only child (Emily F.) aged 9 months, and unvaccinated, was removed to 50, Ethelm Street, where she sickened 12 days after her mother had been removed to Hospital. This child was not, however, removed to Hospital (where it died) until four days after the appearance of the rash, with the result that three other cases arose in the immediate neighbourhood, and, though they could not be definitely traced, it is probable that the patients contracted their disease indirectly from this child. The three Cases were:— Emily R , aged 27 years, vaccinated in infancy, of 30, Ethelm Street (sickened January 9th, 1896); Samuel B., aged 24 years, vaccinated in infancy, of 33, Wootton Street (sickened January 8th, 1896); Caroline R., aged 22 years, vaccinated in infancy, of 19, Wootton Street (sickened January 6th, 1896). One of the disinfecting men (William H., aged 34 years, and vaccinated in infancy), who went to 50, Ethelm Street, on December 27th, 1895, sickened at 2, Sail Street, with Smallpox 14 days afterwards, i.e., on January 10th, 1896, and was removed to Hospital. In connection with this case it is satisfactory to report that all the members of the Disinfecting Staff have now been re-vaccinated, or have 38 had the Smallpox. At 50, Ethelm Street, at the time of the outbreak of Smallpox, there were 12 inmates, 6 adults (vaccinated) and 6 children under 12 years of age (4 vaccinated and 2 who were vaccinated at once) ; no other case occurred. A second outbreak of Smallpox occurred in Ufford Street and is interesting as shewing how easily the disease may spread, and how important it is to follow up and watch those persons who may have come in contact with it The connection of this outbreak with the previous one could not be definitely traced, but was highly probable The facts are as follows:—A child, Lucy A., aged 7 years, and unvaccinated, died at 30, Ufford Street, on Jan, 24th, 1896, after 3 days' illness, and was certified by the medical attendant as having died from "Measles with congestion of the lungs [and cardiac syncope." Another child (William A.), aged 10 years, and vaccinated in infancy, developed spots on Jan. 26th, and was treated for chicken-pox at home, being ill altogether about 10 days; whilst the mother (Sarah A.), aged 30 years, and vaccinated in infancy, also developed a few spots (principally on the face) on Jan. 29th, and was confined of a female child on the following day. The maturation of the spots in the case of Sarah A. left no doubt as to the diagnosis being Small-pox, but unfortunately (owing to the confinement) this patient was not removed to hospital until Feb. 19th, and the infant developed spots on Feb, 14th, i.e., exactly 14 days after it was born and came into contact with its mother, who was suffering from Smallpox at the time, The infant was unvaccinated (vaccination being refused when it was first born), and had a severe attack of confluent Smallpox at the hospital, whither it was removed on Feb, 19th. 39 In the upstairs rooms at 30, Ufford Street were living at the time the N. family—a man, his wife, and 3 children under 10 years of age. The husband and wife had been vaccinated in infancy, and two of the children had also been vaccinated ; none of these sickened, but the unvaccinated child (Emily N.) who was born on Feb. 11th, sickened on Feb, 23rd, i.e., exactly 12 days after it was born into a small-poxinfected house. The mother was re-vaccinated at once, and did not develop the disease, and the infant was taken to the hospital and died. There was evidence to show that the two vaccinated children, aged 2 and 5 years respectively, had been in the midst of Smallpox contagion (actually in the same house) for a period of 4 weeks without contracting the disease, whilst during the same period 2 unvaccinated infants caught the disease (and one died). Henry A. (aged 15 years and vaccinated in infancy) and Phcebe B. (aged 25 years and vaccinated in infancy) sickened at 31, Wake Street with Smallpox on Feb. 25th and March 4th, respectively, and on enquiry it was found that they had visited their sister-in-law (Sarah A.) at 30, Ufford Street, whilst she was suffering from Smallpox. They were removed to the hospital on March 3rd and 9th respectively, and their brother (Sidney A,, aged 17 years, and vaccinated in infancy) sickened March 17th, and was also removed to hospital. In connection with these last cases, the Vestry allowed compensation to the mother for 4 weeks' loss of work at a Jam factory, at 9s. per week. A third outbreak occurred in another part of the Parish, and is equally interesting as showing how Smallpox can be spread, but how important it is to examine the immediate neighbourhood for cases which may otherwise be missed; and if missed, may give rise to a large outbreak. At 51, 40 Warrior Road (a domestic workshop) a child (Christopher A.), aged 7 months and unvaccinated, developed "spots," which were treated by the medical attendant as those of severe chicken-pox, with the result that the child was kept at home (being ill for about 4 weeks from May 20th to June 20th) in a house where articles of clothing were being made and where 3 young women from the neighbourhood "were working. Two of these three young women sickened with Small-pox, viz:—Constance J. (aged 15 years and unvaccinated) of 46, Warrior Road, on June 11th, and Daisy G. (aged 21 years and vaccinated in infancy) of 3, Warrior Road, on June 7th. A house-to-house inspection was made in the immediate neighbourhood, but no other cases were found, though many persons had to be watched during the incubation period of the disease. During the year 2 other cases of smallpox were notified:— 1. Edward B., aged 36 years, vaccinated in infancy, and (?) revaccinated, of 117, Coldharbour Lane, who contracted his disease from abroad (Aden), having sickened August 17th, i.e., 2 days after arriving in England, and who was removed to hospital, where he found an officer (also suffering from Smallpox) of the ship in which they had returned together; 2. Margaret R., aged 23, years and vaccinated in infancy, of 19, Ethelred Street, who sickened on Aug. 29th, and was removed at once to hospital, but the source of whose contagion could not be traced. [In connection with this second case there were 12 other persons in the house, 6 adults and 6 children under 10 years—all vaccinated except 2 children, who were, however, vaccinated at once; no other case occurred. Compensation of 14/- (for 2 weeks) was allowed to the mother for loss of her work as a laundry woman.] 41 There have been 2 deaths (both unvaccinated children) in Lambeth during 1896 from Smallpox, as compared with 2 (also unvaccinated children) during 1895, and an annual average of 11 for the last 10 years (1886 to 1895). Sixteen cases were notified during 1896, as compared with 51 during 1895, and an annual average of 36 for the six years 1890 to 1895. Of the 16 cases notified, 14 were removed to hospital and 2 treated at their own homes (one being practically convalescent before being notified, and the other a case of chicken-pox, or exceedingly mild Smallpox in a vaccinated child of 10 years). The case mortality is, therefore, 12.5 per cent., as compared with 2.9 for London (304 cases notified and 9 deaths). 42 Name. Address. Age. Vacc. or Not Vacc. No. of Marks. Nature of Disease. Mild or Severe Result. Removed to Hospital or not. Emily R. 30, Ethelm St. 27 Vacc. 3 Cohœrens Mild Recovery Yes Caroline B. 19, Wootton St. 22 Vacc. 4 Discrete Mild Recovery Yes Samuel B. 33, Wootton St. 24 Vacc. 1 Discrete Mild Recovery Yes William H. 2, Sail St. 34 Vacc. none Discrete Mild Recovery Yes Sarah A. 30, Ufford St. 30 Vacc. 6 Cohœrens Mild Recovery Yes S. A. (Infant) 30, Ufford St. 21 days Un-vacc. none Confluent Severe Recovery Yes William A. 30, Ufford St. 10 Vacc. 2 ? Varicella Mild Recovery No Emily N. (Infant) 30, Ufford Sr. 15 days Un-vacc. none Confluent Severe Death Yes Henry A. 31, Wake St. 15 Vacc. 4 Discrete Mild Recovery Yes Phoebe B. 31, Wake St. 25 Vacc. 6 Discrete Mild Recovery Yes Sidney A. 31, Wake St. 17 Vacc. 5 Discrete Mild Recovery Yes Constance J. 46, Warrior Rd. 15 Un-vacc. none Confluent Severe Recovery Yes Daisy G. 3, Warrior Rd. 2 1 Vacc. 2 Discrete Mild Recovery Yes Christopher A. 51, Warrior Rd. 7 mon. Un-vacc. none Confluent Severe Recovery No Edward H. B. 117, Coldharbour Lane 36 Vacc. ?Re-vacc. none Discrete Mild Recovery Yes Margaret R. 19, Ethelred St. 23 Vacc. none Discrete Mild Recovery Yes 16 Cases Adult's 12 Children 4 (under 12 years) Vacc. 11 Un-vacc. 1 Vacc. 1 Un-vacc. 3 (1 death) 43 Registration Sub-Districts. Total No. of Cases Notified. Cases Treated at Home. Cases Removed to Hospital. No. of Deaths. Case Mortality period. Bate of Persons Notified per 10,000 Inhabitants. At Home. In Hospital. Waterloo Road, 1st 3 ... 3 ... ... ... 2.1 Waterloo Road, 2nd 4 1 3 ... 2 50 2.1 Lambeth Church, 1st 4 ... 4 ... ... ... 2.1 Lambeth Church, 2nd 1 ... 1 ... ... ... ... Kennington, 1st ... ... ... ... ... ... ... Kennington, 2nd 3 1 2 ... ... ... 0. Brixton ... ... 1 ... ... ... 0.1 Norwood ... ... ... ... ... ... ... Lambeth 16 2 14 ... 2 50 0. Tables. O and P gave the Vaccination Statistics for the year 1895, and the first half of 1896—those for the second half of 1896 not being ready in time for this Report. It will be noticed that during 1895, 23 6 per cent. of the children born are unaccounted for as regards vaccination, and 62 03 per cent. ere successfully vaccinated; whilst during the first half of 1896, 26.5 per ent. are unaccounted for, and 57 8 per cent. ave been successfully vaccinated. 44 TABLE 0.—VACCINATION RETURNS, 1895. 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 517 357 2 62 ... 3 2 84 7 Waterloo Road, 2nd 999 572 3 108 ... 7 *204 *85 20 Lambeth Church, 1st 621 353 2 87 ... 9 6 154 10 Lambeth Church, 2nd 1628 946 9 217 ... 28 †65 †343 20 Kennington, 1st 1753 963 12 221 ... 53 ‡124 ‡311 69 Kennington, 2nd 1099 680 10 122 ... 38 10 142 97 Brixton 2098 1488 6 201 ... 52 8 230 113 Norwood 656 454 2 60 ... 28 3 50 59 Lambeth 9371 5813 46 1078 ... 218 422 1399 395 * Hospital Cases (261) included. † Workhouse cases (133) included. ‡ Maternity Cases (132) included. 45 TABLE P.—VACCINATION RETURNS FOR THE FIRST HALF-YEAR, 1896. 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. III or not otherwise accounted for. Waterloo Road, 1st 262 149 1 33 1 2 2 58 16 Waterloo Road, 2nd 454 238 2 40 ... 4 102* 55* 13 Lambeth Church, 1st 320 170 1 42 ... 11 1 62 33 Lambeth Church, 2nd 856 462 6 91 ... 29 30† 168† 70 Kennington, 1st 895 446 8 87 ... 25 64‡ 144‡ 122 Kennington, 2nd 554 342 2 55 ... 60 5 48 42 Brixton 989 653 4 95 ... 78 7 86 66 Norwood 321 228 ... 18 ... 35 2 12 26 Lambeth 4651 2687 24 461 1 244 213 633 388 The Yearly Returns are not made up for the Local Government Board until the Augu: t in the following year. * Hospital cases (118) included. † Workhouse cases (68) included. ‡ Maternity cases (67) included. 46 SCARLET FEVER. During 1896, 68 deaths were registered from Scarlet Fever, as compared with 53 during 1895, and an annual average of 69 6 for the last 10 years (1886-95). 1,550 cases were notified, and of these 834 were treated in hospital and 716 at their own homes. The case mortality is, therefore, 4.07 %, varying in different Registration Sub-districts, and from 1.7 to 6.1 according as the cases were treated at horrie or in hospital respectively. The age and sex incidence and mortality for scarlet fever cases notified in Lambeth during 1896 are as follows:— Ages. Number of Cases Notified. Deaths. Death rate* per 100. M. F. Total. M. F. Total Under 1 year 17 10 27 2 1 3 9.5 1 to 2 42 26 68 5 3 8 11.02 2 to 3 61 55 116 7 8 15 12.4 3 to 4 70 78 148 4 5 9 5.9 4 to 5 83 69 152 5 4 9 5.7 5 to 6 75 83 158 4 3 7 4.3 6 to 7 71 72 143 3 3 2.03 7 to 8 52 56 108 1 ... 1 0.9 8 to 9 44 48 92 ... ... 0.0 9 to 10 67 83 150 1 1 2 1.3 Over 10 years 162 175 337 4 2 6 1.8 Age not stated 31 20 51 ... Total 775 775 1550 33 30 63 407 * In 51 cases the ages are rot given, but in calculating percentages, these cases have been equally distributed amongst the d fferent age-periods. 47 In London during 1896 there were registered 940 deaths out of a total of 25,676 cases of scarlet fever notified, giving a case mortality of 36 %. The number of scarlet fever cases notified in Lambeth during the year was 1,550, as compared with 1,389 for 1895, and an annual average of 1446.3 for the six years, 1890 to 1895. No scarlatinal milk outbreak occurred during 1896. Registration Sub-Districts. Total No. of Cases notified. Cases treated at Home. Cases removed to Hospital. No. of Deaths. Case Mortality per ioo. Rate of Persons Notified per iooo Inhabitants At Home. In Hospital. Waterloo Road, 1st 92 39 53 4 4.4 6.5 Waterloo Road, 2nd 47 16 31 1 2.1 3.3 Lambeth Church, 1st 128 51 h» i"7 ( / l 3 3.1 6.09 Lambeth Church, 2nd 219 54 ] 65 2 8 4.6 5.3 Kennington, 1st 320 128 192 5 12 5.3 6.09 Kennington, 2nd 279 136 143 1 8 3.2 6.4 Brixton 321 208 113 2 10 3.7 3.9 Norwood 144 84 60 1 5 4.2 4.9 Lambeth 1550 716 834 12 51 4.07 5.2 48 WHOOPING COUGH AND MEASLES. During 1896, 140 and 185 deaths were registered from whooping cough and measles respectively, as compared with 132 and 151 during 1895, and annual averages of 165.2 and 150 9 for the last 10 years (1886-95) in Lambeth. In London, during 1896, there were registered 2,931 and 3,692 deaths from whooping cough and measles, giving corresponding death-rates of 6.6 and 8.4 per 10,000 of the population living. In Lambeth, it will be seen that nearly half of the total zymotic mortality was, during 1896, due to measles and whooping cough together, and recognising this large mortality from diseases that are not notified, the question has often been raised as to whether or not these diseases ought to be notified, and the cases isolated ? Many Health Officers are strongly of opinion that Measles should be included in the list of Notifiable Diseases, and that united action should be taken by the various Sanitary Authorities in London, so as to bring pressure to bear on the Local Government Board with a view to this being done. As Medical Officer for Lambeth I have carefully considered the subject, and am of opinion that, at present, at least, the inclusion of Measles in the list of Notifiable Diseases is not desirable. The whole question becomes one of expense, for it is practically agreed by all that notification in itself would be useless unless followed by isolation and disinfection. The Metropolis does not, at present, possess hospital isolation for Measles, and even if such accommodation were provided there would still be the difficulty of the very young ages of the patients who would have to be isolated, and the consequent dislike and the refusal of the parents to part with their children at 49 such an early age ; whilst the facts that Measles is a disease which is highly infectious in its very early stages [i.e., before the appearance of the rash and, therefore, before the true nature of the disease may be realised), and that medical men are not called in or consulted at all in a large proportion of the cases, must not be forgotten. It is perfectly true that measles causes a large number of deaths yearly, and it is also true that the notification of Measles might be useful in the sense that infected houses would be visited, and insanitary conditions (when found) remedied, children more rigorously (than at present) kept from school, infected houses be disinfected, and the Officers of a Sanitary Authority brought more into contact with the mothers of infected children, and so a process (slow though it might be) of education in sanitary matters, and in the dangers and proper treatment of Measles, result; but whether the good that would accrue in this way would be at all proportionate to the expense, is quite another matter, and one that needs the careful and serious consideration of an Officer of Health before he ventures to advise his Authority to incur it, more especially when we consider the peculiarities of this particular disease and the difficulties, already pointed out, in connection therewith. Further, a large increase in the sanitary staff would be necessary for the purpose of carrying out this additional inspection of Measles-infected houses, and for the proper carrying out of the subsequent disinfection. To sum up the matter shortly, it may be stated that simple notification of Measles is not advisable, and that notification followed by isolation, disinfection, etc., impossible at present (at least in London), conclusions which appear (to me at least) to be borne out by the experience of those Sanitary Districts that have already adopted D 50 Measles Notification. I may add that I am satisfied from my experience that the early closure of schools (more especially the infants' departments) at the commencement of an epidemic is of the very greatest use, and this can be effected by a system of simple notification between the School Authorities and the Medical Officer of Health. Theoretically, notification under the Act is necessary, followed by isolation, disinfection, etc.; practically, it is not advisable, in London at least, at the present time. Much may be said in the same terms in respect to the notification of Whooping Cough—a disease which is infectious certainly in the prodromal stages and may be so long as the characteristic "whoop" persists. Hospital accommodation for isolation would have to be provided on a very large scale to be of any use. Registration Sub Districts. Number of Deaths from Whooping Cough. Number of Deahs from Measles. Whooping Cough. Deaths per 10,000 Inhabitants. es. Deaths per 10000 Inhabitants Waterloo Road, 1st 8 15 5.6 10.6 Waterloo Road, 2nd 9 15 6.4 10.6 Lambeth Church, 1st 11 21 5.9 11.2 Lambeth Church, 2nd 18 39 3.2 9.5 Kennington, 1st 34 34 6.5 6.5 Kennington, 2nd 15 13 3.5 2.9 Brixton 40 33 4.9 4.01 Norwood 9 15 3.1 5.1 District not stated 1 1 ... ... Lambeth 140 186 4.7 6.3 51 Examining more carefully the statistics for Lambeth it is found that 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 32 shows the seasonal mortality incidences of these two diseases—whooping cough at its height in the second, and measles in the first, quarter of the year. An epidemic of measles commenced at the end of 1895, raged through the first and second quarters of 1896, and gradually subsided to the small number of only 4 deaths during the fourth quaiter; whilst whooping cough was sub-epidemic during 1895 and 1896. 52 DIPHTHERIA. During 1896, 129 deaths were registered in Lambeth from diphtheria, as compared with 103 during 1895, and an annual average of 111.7 for the last ten years (1886 to 1895). 652 cases were notified during 1896, as compared with 614 in 1895, and an annual average of 514 7 for the six years, 1890 to 1895. Of the 652 cases notified, 263 were removed to hospital, and 389 were treated at their homes. The case mortality per cent, for the year is, therefore, 19.8, varying from 26.9 to 14.9, 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 1896 are as follows:— Ages. Number of Cases Notified. Deaths. Death-Rate per 100. M. F. Total M. F. Total Under 1 vear 8 7 15 4 2 6 31.6 1 to 5 108 105 213 44 37 81 37.3 5 to 10 98 104 202 22 16 38 18.4 10 to 20 36 77 113 0 3 3 25.7 20 to 40 19 47 66 ... ... ... 0.0 40 to 60 2 10 12 ... 1 1 6.3 60 and over 0 3 3 ... ... ... 0.0 Age not stated 15 13 28 ... ... ... 0.0 Total 286 366 652 70 59 129 19.8 Membranous Croup might with advantage be classified with diphtheria—the tendency of improved methods of diagnosis (i.e., bacteriological) being to show that these two 53 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 23 10 13 ... 3 8.7 1.6 Waterloo Road, 2nd 24 n 13 4 7 41.7 1.7 Lambeth Church, 1st 49 20 29 ... 6 12.2 2.6 Lambeth Church, 2nd 141 70 71 7 21 19.9 3.4 Kennington, 1st 124 67 57 7 7 10.5 2.3 Kennington, 2nd 122 86 36 10 9 15.6 2.8 Brixton 129 91 38 24 17 33.3 1.6 Norwood 40 34 6 6 1 17.5 1.4 Lambeth 652 389 263 58 71 19.8 2.2 diseases have been, or are still often, indistinguishable the one from the other. During 1896 in Lambeth, 27 cases were notified from this disease, and 11 deaths were registered, giving a case mortality of 40.8, as compared with 23 cases notified, and 9 deaths during 1895. 2 of the 27 Lambeth cases of Membranous Croup were removed to Hospital. In London, during 1896, there were registered 2663 deaths out of a total of 18941 cases of diphtheria and membranous croup notified, giving a case mortality of 191%.* * In London Statistics, Diphtheria and Membranous Croup are now grouped together by the Registrar-General. 54 The subject of the diphtheria increase is a burning one, and one that apparently baffles all endeavours to satisfactorily explain it. Many factors, undoubtedly, are at work in Lambeth (and the Metropolis generally) causing the increase, in addition to the "school influence," which certainly plays a more or less important part. Examining the statistics of Lambeth more in detail, it will be seen that Lambeth Church, 2nd, suffered most severely, though it may be noted that Waterloo Road, 1st and 2nd (despite the over-crowding that exists there), suffered as lightly as Norwood and Brixton in respect to the incidence of the disease. The mortality incidence varies, as does also the case mortality, in the different Sub-Districts. Throughout the year the disease has been constantly sub-epidemic, with a slight increase during the last quarter. TYPHUS FEVER. On July 29th William C. aged 10 years, was notified as suffering from typhus fever at 25, Vauxhall Walk, having been taken ill on July 28rd. The patient was removed at once to hospital (where he died), and the house was thoroughly disinfected and cleansed, the walls being stripped of their papers (which were burnt at the Wharf), washed with strong disinfectant and lime-washed, and the bedding, clothing, etc., destroyed. All this work was carried out by the Vestry at a cost of £2 17s. 6d.* No other case arose, nor could the source of the original contagium be definitely traced, though there was a history of the child's uncle having (fourteen days before) returned from Australia. This was the only case notified in Lambeth during 1896, as compared with 6 cases notified in London and 5 deaths (i.e., 83.3% case mortality). * Stripping and cleansing £1.5s. Compensation for clothes, bedding, etc., burnt, £1 12s. 6d. 55 TYPHOID FEVER. During 1896 24 deaths were registered in Lambeth from typhoid (or enteric) fever, as compared with 26 during 1895, and an annual average of 324 for the last ten years (1886 to 1895). 162 cases were notified during 1896, as compared with 201 during 1895, and an annual average of 174.2 for the six years, 1890 to 1895. Of the 162 cases notified, 70 were removed to hospital and 92 were treated at home. The case mortality for the year is, therefore, 14.8, varying from 14.3 to 15.2, 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. Under 1 year M. F. Total M. F. Total 0.0 1 to 5 7 2 9 ... ... ... 0.0 5 to 10 13 9 22 ... ... ... 0.0 10 to 20 18 18 36 5 3 8 21.6 20 to 40 39 32 71 9 2 11 15.2 40 to 60 6 7 13 4 1 5 34.5 60 and over .. 2 2 ... ... ... 0.0 Age not stated 5 4 9 ... ... ... 0.0 Total 88 74 162 18 6 24 14.8 56 In London during 1896 there were registered 564 deaths out of a total of 3200 cases of typhoid notified, giving a case mortality of 17.6%. Registration Sub-Districts. Total No. of Cases notified Cases treated at Home. Cases removed to Hospital No. of Deaths. Case Mortality per 100. Hate of persons Notified per 10,000 Inhabitants. At Home. In Hospital Waterloo Road, 1st 15 8 7 ... 1 6.6 10.6 Waterloo Road, 2nd 9 6 3 2 l 33.3 6.3 Lambeth Church, 1st 13 8 5 1 ... 7.7 6.9 Lambeth Church, 2nd 19 8 11 2 ... 10.5 4.6 Kennington, 1st 28 15 13 3 4 2.5 5.3 Kennington, 2nd 32 16 16 ... 2 6.3 7.4 Brixton 36 25 11 3 ... 8.3 4.4 Norwood 10 6 4 3 2 50.0 3.4 Lambeth 162 92 70 14 10 14.8 5.5 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 1896, a satisfactory return. CONTINUED FEVER. During 1896, 16 cases were notified in Lambeth, and 2 deaths registered, from Continued Fever as compared with 106 cases notified and 13 deaths (ie., 12.3% case mortality) in London. Typhus and Continued Fever are generally bracketted with Typhoid under the heading "fever." 57 PUERPERAL FEVER. During 1896 in Lambeth 12 deaths were registered from puerperal fever (a disease of child-bed), as compared with 13 during 1895, and an annual average of 15.5 during the last 10 years (1886—95). 19 cases were notified, giving a case mortality of 63.2%. In London during 1896 there were registered 225 deaths out of a total of 279 cases notified, giving a case mortality of 80.7% (uncorrected). Registration Sub-Districts. Number of Cases Notified. Number of Deaths. Mortality per 100. Waterloo Road, 1st ... ... ... Waterloo Road, 2nd 1 1 100.0 Lambeth Church, 1st ... ... ... Lambeth Church, 2nd 2 2 100.0 Kennington, 1st 5 4 80.0 Kennington, 2nd 4 1 25.0 Brixton 7 4 57.2 Norwood ... ... ... Lambeth 19 12 63.2 58 ERYSIPELAS. During 1896 ir. Lambeth 18 deaths were registered from Erysipelas, as compared with 10 for 1895 and an annual average of 18.4 during the last 10 years (1886—1895). 352 cases were notified, giving a case mortality of 51% In London, during 1896, there were registered 207 deaths out of a total of 6438 cases notified, giving a case mortality of 3.2% (uncorrected). Registration Sub-Districts. Number of Gases Notified. Number of Deaths Case Mortality per 100. Waterloo Road, 1st 26 — — Waterloo Road, 2nd 9 2 22.2 Lamteth Church, 1st 20 1 5 Lambeth Church, 2nd 93 2 2.2 Kennington, 1st 70 4 5.7 Kennington, 2nd 62 5 8.06 Brixton 48 2 4.2 Norwood 24 1 4.2 Ward not stated — 1 — Lambeth 352 18 5.1 The advantages from the notification of Erysipelas are few. 59 DIARRHŒA. During the year 1896 there were registered in Lambeth 152 deaths from Diarrhœa, as compared with 263 during 1895, and an average of 187.7 for the last 10 years Of these 152 deaths, 141 (i e., 928 per cent.) were in children under five years, and 125 [i.e., 82.2 per cent.) in infants under one year of age. 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, 63°.4; July, 65°.2; August, 59°.2; September, 56°.7; and October, 46°.5; whilst the 4-ft. earth thermometer registered 56° F. on June 7th, rising to 63°.8 F. on July 25th, and sinking to 56° F. again on October 3rd. 56° F. is the so-cailed "critical'' earth temperature for Diarrhoea, i.e., the temperature at which the germs of this particular disease begin to multiply and prove themselves dangerous.* Age mortalities from Diarrhoea were as follows : — Age. Total Deaths. M. F. ntage of Total Deaths from Diarrhœa Under 1 year 66 59 125 82.2 1 to 5 8 8 16 10.5 5 to 20 0 1 1 0.7 20 to 40 — — — 0.0 40 to 60 — 2 2 1.3 Over 60 2 6 8 5.3 Total 76 76 152 100.0 * The 4-fcot 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. 60 In London there were registered during 1896, 3192 deaths from Diarrhoea, giving a rate of 7.2 per 10,000 living, and 39% of total deaths. Registration Sub-Districts. Number of Deaths. hœa Death-rate per 10,000 Inhabitants. Waterloo Road, 1st 14 10.04 Waterloo Road, 2nd 12 8 .7 Lambeth Church, 1st 10 5.5 Lambeth Church. 2nd 32 7.8 Kennington, 1st 21 4.04 Kennington, 2nd 16 3.8 Brixton 33 4.04 Norwood 12 42 District not stated 2 ... Lambeth 152 5.2 In the Inner Wards the average diarrhoea death-rate per 10,000 inhabitants was 8 01, as compared with 4.2 for the Outer Wards, i.e., almost 2 to 1. Under the heading of diarrhœa may be classed the 5 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 104 deaths registered from " Enteritis." 61 Table Q Shewing the Diarrhoea Mortality in Lambeth in each month during the year 1896. Registration Sub-Districts. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Waterloo Road, 1st ... ... ... l ... 3 4 1 3 2 ... ... 14 Waterloo Road, 2nd ... ... ... ... ... 2 3 6 1 ... ... ... 12 Lambeth Church, 1st ... ... ... ... ... 2 6 1 1 ... ... ... 10 Lambeth Church, 2nd ... 2 ... ... 2 4 12 10 ... 1 1 ... 32 Kennington, 1st ... ... ... ... 2 2 4 12 1 ... ... ... 21 Kennington, 2nd ... 1 ... ... ... 2 6 6 ... ... ... 1 16 Brixton 1 ... ... l ... ... 11 17 2 ... ... 1 33 Norwood ... 2 ... ... ... ... 3 7 ... ... ... ... 12 District not stated ... ... ... ... ... ... ... 1 1 ... ... ... 2 Total 1 5 ... 2 4 15 49 61 9 3 1 2 152 62 INFLUENZA. During 1896, 51 deaths were registered from Influenza in Lambeth, as compared with 148 during 1895, and an average of 59.8 for the last 10 years. Of these 51 deaths, 16 each were registered during the first, second and fourth quarters of the year, and 3 during the third quarter. In London there were registered 496 deaths from Influenza during 1896. 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. Table shewing the number of deaths from Epidemic Influenza during the last 10 years in Lambeth and London. 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 Average for 10 years (1886-95) 1896 Lambeth 1 0 0 0 47 131 142 85 44 148 598 51 London (including Lambeth) 5 5 3 5 652 2336 2264 1526 750 2156 970.2 496 63 The 34 deaths from venereal affections (Syphilis, etc.,) are the only other points calling for note in the class of Zymotic Diseases. Classes II. and III.—Parasitic and Dietetic Diseases, 40 deaths were registered in Lambeth in these classes from Alcoholism and Delirium Tremens Class IV,—Constitutional Diseases. Of the total 1017 deaths under this class 269 were due to Cancer, 470 to Phthisis, and 170 to Tubercular Meningitis and other forms of Tuberculosis, Class V.—Developmental Diseases. The total number of deaths in this class was 409, consisting of 156 from Premature Birth, 197 from Old Age, and 56 from Atelectasis and Congenital Malformations. Class VI.—Local Diseases. 1. Diseases of the Nervous System caused 494 deaths, including 67 from Convulsions, 220 from Apoplexy, Softening of Brain, etc., and 23 from Epilepsy. 2. 372 deaths were due to diseases of the Circulatory System. 3. The diseases of the Respiratory Organs caused 851 deaths (463 from Bronchitis, and 182 from Pneumonia), as compared with 1250 last year. 4. Diseases of the Digestive Organs caused 379 deaths, of which 122 were due to Enteritis and Peritonitis, 100 to diseases of the Liver, and 48 to Dentition. 5. Diseases of the Urinary System caused 131 deaths. 64 6. Diseases of the Reproductive System, Integumentary System, Locomotive System, Lymphatics,. Organs of Special Senses, etc., caused together 95 deaths. Class VII.—Deaths from Violence. 211 deaths in all, including 182 from Accidents, 25 from Burns and Ncalds, 13 from Drowning, 50 from Suffocation in bed (45 being infants under 1 year), 21 from Suicide, and 8 from Homicide. Class VIII.— Other Causes. 252 deaths were registered in this class, consisting of deaths from Dropsy, Tumours, Haemorrhages, 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.. Dentition) is the Lambeth rate higher. * (Vide also pages 17—20). 65 TABLE R. Shewing Classification of Causes of Deaths in Lambeth during 1896, compared with London. A.—Total Deaths from all causcs and at all ages, with percentages of deaths to total deaths. Class of Disease. Lambeth Parish. London. No. of Deaths (corrected). Percentage of Total Deaths. No. of Deaths (uncorrected). Percentage of Total Deaths. I.—Zymotic Diseases 837 16.4 15751 18.9 Seven Principal 708 13.9 14100 16.9 Influenza 51 1.0 496 0.6 II.—Parasitic 3 0.6 41 0.05 III.—Dietetic 47 0.9 602 0.7 IV.—Constitutional 1017 19.9 16517 19.8 . Cancer 269 5.3 3864 4.6 Phthisis 470 9.2 7778 9.3 Tubercular Diseases, excluding Phthisis 170 3.3 3258 3.9 Rheumatism (Acule and Chronic) and Gout 50 0.9 670 0.8 V.—Developmental 409 8.02 5496 6.6 Old Age 197 3.9 2294 2.7 VI.—Local Diseases 2322 45.5 38946 46.6 Circulatory System 372 7.3 6881 8.2 Bronchitis 463 9.08 7558 9.05 Pneumonia and Broncho-Pneumonia 280 5.5 5537 • 6.6 Pleurisy and Pleuropneumonia 16 0.3 251 0.3 Respiratory System, excluding Phthisis 851 16.8 14664 17.6 VII.—Violence 211 4.1 3440 4.1 Suicide 21 0.4 427 0.5 VIII.—Other Causes 252 4.9 2719 3.3 E 66 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 1000 Births. From all causes 1313 136.9 21853 161 Diarrhoea 125 13.03 2572 18.8 Convulsions 50 5.2 1658 12.8 Respiratory Diseases 201 20.9 4074 30.0 Premature Births 156 16.3 2534 18.6 Tubercular Diseases (including Phthisis) 70 7.5 1352 9.9 Measles 35 3.6 790 5.8 Whooping Cough 71 7.4 1223 9.0 Suffocation in Bed 45 4.6 626 4.6 Enteritis 74 7.7 1112 8.2 Dentition 27 2.8 300 2.2 67 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. Old Age Rheumatism and Gout. Premature Births. Suffocation in Bed. Waterloo Road, 1st 9.6 3.2 3.5 17.6 3. 5 0.4 1.6 0.95 Waterloo Road, 2nd 11.8 4.1 2.4 19.4 2.8 1.3 3.1 1.8 Lambeth Church, 1st 8.4 3.4 3.6 19.6 2.5 0.0 2.5 1.1 Lambeth Church, 2nd 9.1 3.6 3.4 19.5 2.7 0.7 2.4 1.4 Kennington, 1st 8.5 2.7 6.4 15.8 4.2 1.1 4.3 0.9 Kennington. 2nd 8.9 4.1 7.6 15.9 4.02 1.2 3.7 0.7 Brixton 10.0 3.1 5.8 14.8 4.9 1.3 2.9 0.7 Norwood 7.7 2.7 6.5 15.1 5.3 .97 2.4 0.8 District not stated 9.2 3.3 5.3 16.7 3.9 0.9 3.1 0.9 Lambeth 9.2 3.3 5.3 16.7 3.9 0 9 3.1 0.9 N.B.—Where the Districts are not definitely stated, the deaths have been equally sub.divided amongst the eight Districts. 68 This method of giving the mortality from any given disease as a percentage of the total deaths is fallacious, dealing as it does with cvvo 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. 69 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 of the total births. Phthisis. Per 1000 of the Population. Rheumatism and Gout Per 1,000 Births Tubercular Cancer j Respiratory Diseases Old Age Premature Births Suffocation. Waterloo Road, 1st 2.2 0.7 0.8 3.9 0.8 0.1 9.96 5.97 Waterloo Road, 2nd 2.7 0.9 0.6 4.5 0.7 0.3 10.6 64 Lambeth Church, 1st 1.6 0.7 0.6 3.5 0.5 0.0 13. 9 6.2 Lambeth Church, 2nd 2.05 0.8 0.8 4.4 0.6 0.2 13.04 7.7 Kennington, 1st 1.5 0.5 1.1 2.7 0.7 0.2 20.7 4.2 Kennington, 2nd 1.5 0.7 1.8 2.8 0.7 0.2 24.9 4.4 Brixton 1.4 0.5 0.8 2 1 0.7 0.2 16.7 3.7 Norwood 0.9 0.3 0.7 1.7 0.6 0.1 12.08 4.5 Lambeth 1.6 0.6 0.9 2.9 0.7 0.2 16.3 5.3 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 (expressed in terms of 1,000 births) from premature birth and suffocation. 70 71 TABLE U. TABLE U. Local Government Board Table A.] Table of DEATHS during the Year 1896, in the Lambeth 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 rom subjoined causes, distinguishing dbaths ofchildren 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 65. 65 and upwards. 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. Diarhæa nd Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) Royal Infirmary (Women and Children) Remainder of Waterloo Road First 67 37 16 7 2 5 Under 5 1 11 41 53 5 upwds. 1 1 1 3 8 14 203 78 32 3 5 58 27 Under 5 12 8 11 22 4 53 110 5 upwds. 1 16 17 20 1 7 31 93 General Lying-in-Hospital, York Road Remainder of Waterloo Road Second 22 20 1 1 Under 5 2 18 20 5 upwds 1 1 2 Under 5 4 14 9 10 1 26 5 46 115 219 66 49 4 5 74 21 5 upwds. 1 2 1 1 1 22 19 7 3 8 39 101 St. Thomas's Hospital Remainder of Lambeth Church First 644 83 119 53 57 294 38 Under 5 36 4 7 9 6 12 1 35 92 202 5 upwds. 1 7 8 4 9 1 1 26 18 35 1 69 262 442 1 18 9 9 19 7 69 132 247 86 46 9 8 74 24 Under 5 1 18 20 19 10 45 115 5 upwds. 27 10 1 5 11 Under 5 1 9 10 5 upwds. 1 2 b 9 1 Lambeth Workhouse Lambeth Infirmary Remainder of Lambeth Church Second Clapham Maternity i St. Peter's House 2 2 3 11 27 45 580 2 16 2 10 291 232 5 upwds 1 2 2 1 2 96 124 47 17 243 535 613 223 111 17 13 183 66 Under 5 1 2 2 1 39 12 24 1 59 2 15 169 331 2 1 1 3 43 60 34 4 8 122 279 5 upwds 1 9 Under 5 1 8 9 5 upwds Under 5 | 21 16 5 upwds 1 6 2 12 21 Remainder of Kennington First Under 5 3 3 1 2 31 32 20 1 39 2 5 12 163 314 653 223 91 24 23 172 120 5 upwds 1 3 3 1 2 1 1 7 42 46 49 8 9 168 339 Under 5 6 5 1 11 14 15 1 38 2 2 129 224 Kennington Second 54 15 6 24 17 16i 115 5 upwds 1 5 1 2 1 3 46 41 41 7 6 164 318 72 73 TABLE U. TABLE U. Local Government Board Table A—continued.] table of DEATHS for the Year 1896, in the Lambeth District, classified according to diseases, ages and localities. names 0f localities adopted for the purpose of these Statistics; public institutions being shewn as separate localities. (Columns fur 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 65. 65 and upwards 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 17 18 19 16 20 21 21 Membranous Croup. Typbus. Puerperal. Cholera. Erysipelas. Measles Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Iujuries. all 0 her Diseases. total. Smallpox. Scarlatina. Diphtheria. Enteric or Typboid. Continued Relapsing. (a} (b) (c) Id) (e) (f) (g) (h) (i) South Western Hospital 208 9 95 79 13 12 Under 5 66 35 1 1 1 104 5 upwds. 20 50 1 22 1 1 2 1 6 104 Remainder of Brixton. 1026 272 135 39 21 340 219 Under 5 17 2 1 1 28 38 31 6 51 3 13 213 407 5 upwd.- 2 9 3 3 4 1 2 9 94 80 75 12 10 315 619 Lambeth Old Workhouse Schools 4 3 1 Under 5 5 upwds. 1 3 1 5 Jews' Hospital 1 1 Under 5 5 upwds. 1 1 British Home for Incurables 5 3 2 Under 5 5 upwds 1 3 4 Remainder of Norwood 278 69 40 13 9 84 64 Under 5 5 1 13 8 10 24 1 2 40 109 upwds. 1 1 3 1 2 1 2 1 20 15 24 5 3 9< 170 totals 5370 1371 817 278 187 1763 954 Under 5 71 113 10 5 7 176 13?r 14? 17 316 5 11 99 108.1 2188 5 upwds. 28 76 1 1 45 1 14 16 9 5 9 27 429 451 162 41 148 1519 3182 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 433 40 71 40 34 195 53 Under 5 2 22 26 3 3 3 2 19 ?, 111 5 upwds. 11 13 5 1 3 1 50 9 33 25 171 322 Deaths occurring within the distr.ict among persons not belonging thereto 705 98 156 105 54 238 54 Under 5 49 52 1 4 4 4 12 18 109 253 5 upwds. 20 47 26 2 4 1 1 24 21 28 1 45 228 452 74 75 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 1896, in the Metropolitan Sanitary District of Lambeth, classified according to Diseases and Localities. Local Government Board Table B..] 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. Registration Sub-Districts. Census 1896. Estimated to middle of 1896. 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. Typhoid or Enteric Typhus. . Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Cholera. Erysipelas. (a) (b) (c) (d) Waterloo Road,1st 14186 14192 501 3 92 23 15 26 3 53 13 7 Waterloo Road, 2nd 14210 14185 944 4 47 24 2 9 9 2 31 13 3 Lambeth Church, 1st 18770 18805 649 4 128 49 13 4 20 4 77 2b 5 5 Lambeth Church, 2nd 40994 41091 1687 1 219 141 6 19 1 9 3 1 93 1 165 71 1 1 11 7 Kennington, 1st 52486 52581 1886 320 124 3 28 5 1 70 192 57 13 2 2 Kennington, 2nd 43244 43429 1125 3 279 122 10 32 3 4 62 1 143 36 16 3 Brixton 81825 82267 2139 1 321 129 6 36 1 7 48 2 113 38 1 11 1 3 Norwood 29318 29511 662 144 40 10 24 60 6 4 Totals 295,033 296,061 9592 16 1550 652 27 162 1 16 19 6 352 13 834 263 2 i 70 3 20 76 LAMBETH PARISH. SUMMARY Of VITAL AND MORTAL STATISTICS, &c., FOR 1896. 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 1896)—296,061 (males, 139,841; females, 156,220). Density—75 persons per acre. Inhabited Houses—38,556 at Census, 1891. Rateable Value—£1,680,283. Marriages—2445, being 16'5 per 1000. Births—9,592, being 32 4 per 1,000. Deaths (corrected)—5,098, being 17 2 per 1,000. Infantile Mortality—1,313 under 1 year, or 136 9 per 100 births. Zymotic—Death-Rate 2 4 per 1,000. Increase of population 4,091; but the natural increase or increment (i.e., excess of Births over Deaths) was 4,494. 77 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, 1896. Number of Notices 7475 NOTIFIABLE INFECTIOUS DISEASE. (Public Health, London, Act.) No. of Infected Houses (Notices served) 2417 Smallpox 14 Scarlet Fever . 1302 Typhoid 153 Typhus 1 Continued Fever 16 Diphtheria 567 Membranous Croup 26. Puerperal Fever 18 Erysipelas 315 English Cholera 5 Total 2417 SANITARY WORK IN LAMBETH PARISH. Particulars of Works carried out during 1896, and for 19 years previously. Year. Total Number of Notices. Sanitary Works, Structural and Permanent. Sanitary Work not Structural. 1896 7475 6702 982 1895 7645 8581 1104 1894 6975 7672 1911 1893 8769 9207 2046 1892 7173 6931 2190 1891 5557 7232 3173 1890 5588 5°53 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 3110 1169 2211 1877 3563 1299 2264 78 79 Public Health (London) Act, and Metropolis Local Management Act. Notices served 5058 Works Structural :— Drainage Defective 1073 Intercepting Traps with Fresh Air Inlets required 391 Ventilating Pipes required 360 Indoor Sinks connected with the Drain 406 Rain Water Stack Pipes connected with the Drain 424 Bath Waste connected with the Drain 26 Traps Defective or of Obsolete Pattern 747 Closet Pan and Connections Defective 646 Water Supply to Closet Defective 159 Closet Dilapidated 138 Draw-Off from Main for Drinking Purposes required 345 Dust Bins Defective 631 Premises Dilapidated 62 Ventilation under the Floors required 162 Roofs Dilapidated 178 Soil Pipes Defective 70 Paving Defective 710 Damp and Unwholesome Houses 107 Dung Receptacles required 67 Works not Structural :— Cisterns Dirty 53 Manure Accumulations 67 Underground Rooms occupied 21 Animals improperly kept 23 Stopped Drains 171 Overcrowding 68 Bodies Removed 7 Foul Urinals 11 Through Ventilation provided 1 Refuse Accumulations 31 No Water Supply 187 Dirty Premises . 342 7684 Smoke Nuisances Investigated 21 Housing of the Working Classes Act. Notices served 55 Nature of Work—To put prem ses into proper order and condition. Total No. of Summonses and Orders issued 101 Details as to Summonses and Orders taken out and obtained during 1896. with penalties and costs amounting to £80 2s. are given in full on pages 81-89. 81 OFFENCES UNDER THE PUBLIC HEALTH ACTS, DURING 1896. ADDRESSES OF OFFENDERS, WITH NATURE OF OFFENCE, AND AMOUNT OF PENALTIES AND COSTS IN EACH CASE. F 82 83 1896. Public Health Act. Date. Address of Offender. Offence. Penalty. Costs. Jan. 16 158, Newington Butts. Breaches of L.C.C.'s Slaughterhouse Bye-Laws £ s. d. £ s. d. 2 0 0 Feb. 6 125, London Road, S.E. Non-compliance with Notice of Vestry to put the yard paving into proper order and condition at No. 1, Queen's Place, Newburn Street 2 0 0 0 2 0 99 6 99 99 Non-compliance with Notice of Vestry to provide a metal dust bin at No. 1, Queen's Place 2 0 0 0 2 0 99 6 99 99 Non-compliance with Notice of Vestry to put the water-closet into proper order and condition at No. 1, Quean's Place 0 6 0 99 6 38, Waterloo Road Non-compliance with Notice of Vestry to put the waterclosets into proper order and condition at 38, Waterloo Road. (Order made to do work in 14 days) 0 6 0 Mar. 3 76, Stoke Newington Road Non-compliance with Notice of Vestry to make good defects in the soil pipe at No. 3, Hilda Road 5 0 0 0 2 0 99 6 3, Alderwick Terrace, London Road, Hounslow Non-compliance with Notice of Vestry to repair the paving at 18, Broad Street (work being done the defendent to pay 2s. costs) 0 2 0 99 13 Mabel Lodge, Arthur Street, Margate Non-compliance with Notice of Vestry to provide a metal dust bin at 39, Neville Street. Dust bin having been provided, to pay 4s. costs 0 4 0 99 13 Non-compliance with Notice of Vestry to repair the yard paving at 39, Neville Street 1 0 - 0 0 6 0 99 13 99 99 That at 39, Neville Street, the premises such a dirty and dilapidated state, as to be dangerous to health. (Order made for work to be dose wichin 14 days) 0 4 0 I99 13 99 99 That at No. 35, Neville Street, a closet pan has been fixed not of proper construction and contrary to the Bye-Laws of the L.C.C. (Order made for the work to be done within 14 days) 0 8 0 , 13 99 That at 35, Neville Street the premises are in such a filthy state as to be dangerous to health (Work being done, owner to pay costs) 0 4 0 ,, 13 99 99 Non-compliance with notice of Vestry to repair the yard paving at 35, Neville Street (Work being done, owner to pay costs) 0 4 0 ,, 13 125, London Road, S.E. Non-compliance with Notice of Vestry to provide a metal dust bin at No 6, Queen's Place (Order made to provide a dust bin within 14 days) 0 4 0 13 99 99 That at No. 4 Queen's Place, the premises are in such a state as to be dangerous to health owing to the defective state of the gutters. (Order made for the work to be done within 14 days) 0 4 0 Carried forward 12 0 0 2 18 0 84 85 Date. Address. Offence. Penalty. Costs. Mar. 13 125, London Road, S.E. Brought forward That at 6, Queen's Place the water closet is in such a state as to be a nuisance and dangerous to health. (Order made to do the work within 14 days) 12 0 0 2 18 0 0 4 0 „ 13 99 99 That at 6, Queen's Place the drain is in such a state as to be dangerous to health. (Order made to do the work within 14 days) 0 4 0 „ 13 99 99 Non-compliance with Notice of Vestry to properly pave the yard at No. 6, Queen's Place. (Order made to do the work within 14 days) 0 4 0 ,, 13 99 99 Non-compliance with Notice of Vestry to repair the yard paving at No. 5, Queen's Place. (Order made to do the work within 14 days) 0 4 0 13 99 99 That at 5, Queen's Place, the premises are in such a state as to be dangerous to health, owing to the defective state of the gutters. (Order made to do the work within 14 days) 0 4 0 „ 13 99 99 Non-compliance with Notice of Vestry to repair the yard paving at 4, Queen's Place. (Order made to do the work within 14 days) 0 4 0 „ 13 99 99 Non-compliance with Notice of Vestry to provide a metal dust bin at No. 4, Queen's Place. (Order made for dust bin to be supplied within 14 days) 0 4 0 „ 13 125, London Road, S.E. That at No. 2, Queen's Place, the premises are in such a state as to be dangerous to health, owing to the damp condition (Order made to do the work within 14 days) ... 0 4 0 „ 13 99 99 That at No. 1, Queen's Place, a closet pan has been fixed not of proper construction, and contrary to the Bye-Laws of the L.C.C. (Order made to do the work within 14 days') 2 0 0 April 24 99 99 Non-compliance with Order of Magistrate to provide and fix a proper closet pan and trap, with a sufficient flush of water, at No. 1, Queen's Place, within 7 days 2 0 0 0 3 0 24 99 99 Non-compliance with Order of Magistrate to put the drains into proper order and condition at 6, Queen's Place 2 0 0 0 3 0 „ 24 99 99 Non-compliance with Notice of Vestry to properly pave the yard at No. 6, Queen's Place 2 0 0 0 3 0 99 24 99 99 Non-compliance with Notice of Vestry to provide a metal dust bin at 6, Queen's Place (dust bin now provided) 0 3 0 May g 99 99 Non-compliance with Order of Magistrate to put the water-closet into proper order and condition within 14 days at 6, Queen's Place 5 0 0 0 2 0 Carried forward 25 0 0 5 4 0 86 87 Date, Address of Offender. Offence. Penalty. Costs. May 8 3, Queen's Place » Brought forward Repairing a drain so as to be dangerous to health, at 6, Queen's Place (In default, 14 days' imprisonment) 25 0 0 5 4 0 1 0 0 0 2 0 June 19 125, London Road, S.E. Non-compliance with Order of Magistrate to put the drains into proper order and condition with 14 days at No. 6, Queen's Place 30 0 0 2 5 0 July 10 200, Cambridge Road, N.E. Non-compliance with Notice of Vestry to put the drains into proper order and condition at 25, Hanover Gardens (Notice since complied with) 0 2 0 )) 10 99 99 Non-compliance with Notice of Vestry to provide a proper ash-bin at 25, Hanover Gardens (Notice since complied with) 0 2 0 Aug. 12 186, Kennington Road (occupier) The premises being without a water supply, and unfit for human habitation (Order made to close the premises, and defendant to pay 5/- costs 0 5 0 Oct. 7 5, Foxley Road Non-compliance with Notice of Vestry to put the drainage and paving into proper order and condition, to repair roof, cleanse interior, and provide ash-bin at No. 4, Langton Road (Magistrate made an Order to do the work within 3 months unless a case could be cited for the High Court) 99 8 67, Leroy Street, Bermondsey Removing from Charlotte Place, Launcelot Street, after 10 o'clock in the forenoon, fish offal, contrary to the Bye-laws of the L.C.C. (The Magistrate dismissed the Summons, the employer accepting the carman's responsibility) it 17, Gratwick Street, Bermondsey Removing from Charlotte Place, fish offal, without using a suitable carriage, properly constructed and furnished with a sufficient covering 2 0 0 0 4 0 Nov. 6 91, Tyers Street The top front room being overcrowded, so as to be dangerous to health (Order made for the nuisance to be abated within 7 days) 0 5 0 Dec. 18 4, Tenter Buildings, St. Mark Street, Whitechapel Non-compliance with Notice of Vestry to put drain and soil-pipe in proper order at No. 8, Felix Street (Order made to do the work within 14 days) 0 5 0 Jan. 15 10a, Mayall Road The premises, No. 10a, Mayall Road, being a dwelling house without a water supply, being unfit for human habitation (In default 14 day's imprisonment) 2 0 0 0 5 0 Totals 60 0 0 8 19 0 88 89 1896. Housing of the Working Classes Act. Date. Address of Offender. Offence. Penalty. Costs. Feb. 6 That at Nos. 1, 1a, 2, 3, 4, 5,6,7, 8,9, and 10, Chartley Place, Lower Marsh, the premises are in such a state as to be dangerous or injurious to health so as to be unfit for human habitation. (Order made for the premises to be closed within 21 days, and Owner to pay 4/- costs in each case) £ s. d. £ s. d. 4 0 June 19 9, Whitehall Place That at 90a, 90b, 90c, 90d, 90e, 90f, 90g, 90h, 90i, 90j, and 90k, and 1a, Denmark Street, the premises are in such a state as to be dangerous and injurious to health, and to be unfit for human habitation. (Order made to clcse the premises, and a sum not to exceed £1 to be allowed to each occupying tenant, as expenses for removal) July 3 13, Victoria Street, Westminster That at Nos. 152 and 154, Waterloo Road, the premises are in such a state as to be dangerous or injurious to health, and to be unfit for human habitation. (Order made to close the premises, and to pay 5/costs, and 10/- allowed to each tenant, as compensation for removal) 0 5 0 99 29 c/o Buttanshaw & Co., Solicitors, 26, Budge Row That at Nos. 1, 2, 3, 4, 5, 6, 7, 8, and 9, Fountain Court; Nos. 3, 4, 5, 6, 7, 8, 9, 10, 11, 12. and 13. and the Cottage, Francis Court ; Nos. 1, 2, 3, 4, 5, and 6, Paved Court, Lambeth Walk, the premises are in such a state as to be dangerous or injurious to health, as to be unfit for human habitation. (Orders made to close all the premises, except 4, Fountain Count, and 5, Paved Court, and to pay 6/- costs upon each Order, and a sum not exceeding 10/- to be allowed to each tenant, as compensation for removal) 7 10 0 99 31 c/o Messrs. Brakeridge & Co., Solicitors, 16, Barrett's Buildings, E.G. That at Nos. 1, 2, and 3, Windmill Court, New Cut, the premises are in such a state as to be dangerous or injurious to health, as to be unfit for human habitation. (Adjourned sine die, the owner having meanwhile closed the premise', and given an undertaking not to relet them unless put into thorough repair, and if found occupied, the Vestry to have the right to re-open the case, with seven days' notice. Owner to pay 6/- costs) 0 6 0 Oct 23 125, London Road, S.E. Neglecting to make the premises (after notice) at Nos. 1, 2, 3, 4, 5, and 6, Queen's Plsce, fit for human habitation. (The Magistrate ordered the premises to be closed until they were made fit for human habitation and 3/0 costs to be allowed on each Summons) 0 18 0 Totals 0 0 0 11 3 0 90 INSPECTORIAL STAFF. During the year the Staff has been increased by the addition of 4 new Sanitary Inspectors, whose work in connection with the Inner Wards of the Parish is already beginning to have a satisfactory result; whilst the members of the old Staff, by having smaller areas to supervise, are carrying out better work, in the sense that such work is more thorough a id systematic. The Vestry is to be congratulated upon having raised the status of the Sanitary Inspectors by increasing their salaries and offering a maximum of £170 per annum (with uniform)—the office of Chief Sanitary Inspector having been abolished; whilst the increased and re-organised disinfecting staff is also a credit to the Parish. (See pp. 93-96). With the increased staff the Medical Officer (with the Vestry's approval) redivided the Parish into 11 divisions, each division being under the charge of an Inspector, as follows :— Old Wards.* No. of Houses. Population. Inspector*. North Marsh 2238 20,004 Jackson South Marsh 2059 17,353 Wallis Bishop's 2783 25,229 Hooper Prince's 4579 37,279 Jones Of the four new Inspectors, Messrs. Hooper and Jackson commenced their duties on October 5th, and Messrs. Wallis and Bowden on October 19th, 1896—their appointments * It will be noted that the Old Ward Divisions have been retained as far as possible, as by so doing the Parish has been divided into Districts that for Inspectorial purposes are practically equal—the populations and numbers of inhabited houses being based on the Returns of the 1891 Census. 91 being confirmed of the Local Government Board, on September 24th, 1890. Old Wards. No. of Houses. Population. Inspectors. Vauxhall Stockwell 3936 26,386 Bowden 3936 26,386 Baxter 3934 26,385 Wiggs† Brixton 4544 29,639 Gavin 4545 29,639 Bott Norwood 3001 18,452 Smith 3001 18,452 Barfoot The work that has been done during the year by the Inspectors deserves a detailed examination, and on reference to Tables on pp. 78-79, it will be seen that the nuisances abated and defects in sanitation (house drainage especially) remedied are highly satisfactory, and must have a salutary effect upon the health of the Parishioners; whilst the sanitary advance made in the year augurs well for the position that Lambeth will take, and is rapidly taking, in the Metropolis in respect of Public Health administration. The Sewers and Sanitary Committee was split up by the Vestry into two Committees—the Sewers and the Sanitary; and when the different duties to be relegated to each of these two Committees came to be considered, some important alterations in connection with house drainage were suggested by the Committees, and adopted by the Vestry as follows:—The Medical Officer brought up a Report † Inspector Wiggs has a small District, but still remains Special Inspector for Food and Drugs and Smoke (vide Resolution of Vestry, June 30th, 1892, Minutes, p. 488.) 92 in which he pointed out the incongruity of the drainage of new houses being under the Surveyor and his Staff, and that of old houses under the Medical Officer and the Sanitary Inspectors, suggesting also the advisability of all drainage work being in future under one responsible Officer and one responsible Department. The matter was carefully considered by a joint Sub-committee of these two Standing Committees (the Sewers and the Sanitary), with the result that eventually the Vestry adopted, on November 4th, the recommendations set forth by them, and decided that in future all drainage work in connection with both new and old houses should be carried out under the supervision of the Sanitary Inspectors (the plans being previously approved jointly by the Surveyor and the Medical Officer), and not, as hitherto, partly under the Surveyor's, and partly under the Medical Officer's, Staff. The Vestry also decided that in the event of a difference of opinion arising between the Surveyor and the Medical Officer, the matter should be referred to a Committee, viz., if a new building, to the Sewers, and if an existing building, to the Sanitary, Committee, for decision. It is satisfactory to be able to report that no difference of opinion has cropped up between the two Officers as yet, and no appeal, therefore, been rendered necessary to a Committee, whilst the new arrangement as a whole is working well, and to the satisfaction and advantage of owners of property and of the Ratepayers of the Parish generally—the Vestry in future no longer being placed in the invidious position of one of its Departments being liable to find fault with the work of another, as is the case when Inspectors have to serve Notices on the owners of houses which have become recently (a few months only, it may be) occupied. The arrangement at present is that each Sanitary Inspector now 93 takes charge of all drainage in his own District, and when the work is completed guarantees that " it has been carried out under his personal supervision and in accordance with the plan as submitted, and that the joints and pipes have been water-tested," by signing the plan (previously jointly approved by the Surveyor and Medical Officer), which is then placed in the Record Books of plans belonging to the Vestry. Since this new arrangement 355 such plans have been duly signed and entered in the Records of the Vestry up to the end of 1896, whilst the number of drains tested with smoke or water has been 4760 during the whole of the year. DISINFECTING STAFF. During the year, the Disinfecting Department has been re-organised and increased so that, at the present time, the Vestry may be justly proud of the efficiency of its present Staff, and of the work done as shewn in Tables on pages. 97—100. The Medical Officer brought up a Report at the beginning of the year on the whole subject of Disinfection as carried out in Lambeth Parish, and suggested the following alterations and improvements, all of which were adopted by the Vestry:— 1. Disinfecting chamber to be provided with a second door on the side opposite to the one at present existing, so that infected and disinfected goods can be kept separated and totally distinct. 94 2. The stove attendant to be an employe of the Sanitary Committee (and not, as formerly, of the Wharf), and to be restricted to the infected side of the stove (when altered). 3. Closed places for goods (infected and disinfected) to be provided and kept under lock and key, so as no longer-to be a source of danger to others. 4. Two new disinfecting vans to be purchased at a cost of £53 each, and the two old disinfecting vans to be renovated and repainted, and supplied (like the new ones) with hoods for the protection of the men from wind and weather when driving. 5. Not less than three permanent and one temporary disinfecting men to be appointed—two to fetch infected goods, and two to take back these goods when disinfected — the drivers and horses to be permanently attached to the Sanitary Department. 6. Overalls (mackintosh or alpaca) to be provided for the use of the disinfecting men and drivers who have to come into contract with infection, either by entering infected rooms, or carrying infected goods.* 7. The salaries of the men engaged in disinfecting work to be increased, owing to the nature and extent of their duties, and the extra risk which they run in connection therewith. 8. Temporary accommodation to be provided for the inmates of infected houses whilst their rooms are * Norris contracted small-pox, March 1890; Lcckyear, scarlet fever, April, 1894; and three drivers small-pox in March, 1890, March, 1893, and January, 1896, respectively. 95 being disinfected, in accordance with the requirements of Section 60 (sub-section 4) of the Public Health (London) Act, 1891. With the exception of 1, which is held over until the new Wharf accommodation has been taken over by the Vestry, all the Medical Officer's suggestions have been adopted, and at present the Staff consists of— A. Norris (Superintendent) 42/- per week H. Fuller 80/- W. Lockyer 30/- ,, Extra disinfecting man, as required 30/- „ b W. Bull (Stoveman at the wharf) 32/- „ W. Harris W. Bartlett Permanent Drivers 30/- ,, (each). F. Graves Extra driver, as required 30/- „ These employes being permanent weekly servants, no overtime is allowed for. The two new disinfecting vans cost £53 each, and the two old vans have been altered, re-painted, and practically turned into new ones, at a total cost of £37 19s. 6d. Two of the top rooms of the Superintendent's house at the Wharf, Belvedere Road, have been converted by alterations into a Refuge for the Inmates of Infected Houses, as required by Section 60 (4) of the Public Health (London) Act, 1891, at a cost of £l46 3s. 8d. (including furniture and fittings). There are two sets of rooms—four rooms in all—and in each set of rooms there is a bath-room fitted with bath and lavatory, and a living room fitted with a kitchen range and cupboards. Taking the experience of other Authorities, 96 the Vestry has, for the present, only furnished one set of rooms (with chairs, table, domestic utensils, etc, and a covering of linoleum over the floors), it being an instruction that the other set of rooms be furnished (if required), on the same lines. An attendant is paid 4s. per day to look after the rooms when occupied. From November (when the rooms were first opened) to the end of the year 1896, two families from scarlet fever infected houses have been admitted—in all, 5 adults and 2 children. Izal as a liquid disinfectant and carbolic acid powder (15 %) have been used during 1896 and have given satisfaction; they are distributed to infected houses as required in 4-ounce bottles and 3/4-lb. perforated tins respectively. 97 PARTICULARS AS TO DISINFECTION carried out in Lambeth Parish during 1896. Total number of Rooms disinfected by Vestry 2449 Cases in which bedding has been disinfected at home 36 ,, ,, ,, ,, at Chamber 2447 Cases in which bedding has been destroyed 49 Replaced by the Vestry 10 Premises disinfected and disinfectants supplied 7210 No. of Cleansing Notices served in connection with infected houses 2327 Certificates of Medical Practitioners received in lieu of disinfection by the Vestry 243 For rooms and bedding 124 For rooms only 114 For bedding only 5 Articles of Bedding, etc., disinfected— Beds 2032 Bolsters 1511 Pillows 4075 Mattresses 977 Paliiasses 7 Chair Cushions 1022 Clothing 4156 Blankets 3975 Rugs 66 Counterpanes & Eiderdown Quilts 1299 Carpets 56 Extras (not mentioned above) 1109 Total 20349 G 98 Articles of Infected Bedding Destroyed— Beds 7 Bolsters 0 Pillows 14 Mattresses 23 Palliasses 37 Chair Cushions 15 Clothing 34 Sundries 48 Total 178 No. of Infectious Cases— Notifiable 2801 Non-notifiable (including Cancer and Consumption) 20 Nine Cabs and fourteen dirty Premises have also been disinfected during the year 1896. 66 DISINFECTION STATISTICS. For six years prior, and six years subsequent, to the passing of the Notification of Infectious Diseases Act; and for the year 1896. 1884 1885 1886 1887 1888 1889 Yearly average for 6 years preceding the Notification Act 1890 1891 1892 1893 1894 1895 Yearly average for 6 years succeeding the Notification Act 1896 No. of Cases in which Bedding, etc., has been disinfected. At Home 278 16 62 52 7 144 93.2 179 245 593 343 177 251 298.2 368 At Chamber 162 569 236 722 902 951 590.3 1391 1570 2546 3042 2286 2462 2216.2 2447 No. of Cases in which Bedding, etc., has been destroyed. 62 52 8 57 48 79 51.0 185 275 314 224 119 67 180.7 49 No. of articles of Bedding, etc, disinfected 1895 2275 916 3078 3121 3778 2510.5 3013 6747 9909 11513 8022 13516 8783.3 20349 No. of articles of Bedding, etc., destroyed 114 144 59 92 61 267 122.8 333 467 605 674 544 186 468.2 178 Premises Disinfected and Disinfectants Supplied. 657 727 736 1276 1255 1277 988.0 1722 1816 3157 5896 5742 7146 4246.5 7210 100 Details as to cases in connection with which Disinfection has been carried out by the Vestry's Disinfecting Staff. (Arranged Quarterly). 1st Qr- 2nd Qr- 3 rd Qr- 4th Qr- Total. Notifiable Diseases— Scarlet Fever 298 289 514 449 1550 Diphtheria 137 121 184 210 652 Membranous Croup 7 5 7 8 27 Typhus — — 1 — 1 Continued Fever 4 2 2 8 16 Typhoid 25 29 51 57 162 Erysipelas 101 65 75 111 352 Smallpox 11 3 2 — 16 Puerperal Fever 7 3 4 5 19 Cholera — — 6 — 6 590 517 846 848 2801 Non-notifiable Diseases, etc.— Measles 11 2 1 0 14 Cancer 3 — 1 — 4 Consumption 1 — — 1 2 Cabs 4 1 1 3 9 Dirty Premises 4 2 3 5 14 23 5 6 9 43 Full Total 613 522 852 857 2844 101 With the increase of the Inspectors and Disinfecting Staff it became necessary to enlarge the office accommodation at 333, Kennington Road, so as to give extra and proper rooms for carrying on efficiently the work of the Sanitary Department. By alterations to, and re-furnishing of, the old Offices, together with the building of an extra room at the rear of the main building for the sole use of the Disinfecting Department, the Vestry are now in possession of a Sanitary Office that will serve them with the present Staff for some time to come, and is a great improvement on the old arrangement. The total cost of the alterations to, and re-furnishing (where required) of the Sanitary Department's offices is £33 14s. 6d., and from this is to be subtracted £9 2s., allowed for the old desks and chairs which were sold; whilst the extra room at the rear cost £25 9s. Id. Before leaving the subject of disinfection, mention may be made that the Parish of Lambeth has hitherto depended upon one disinfecting machine for doing the whole work connected with disinfection. This old machine has been in working for the last twelve years, having been erected in 1884, and at the end of the year 1896 broke down and had to be repaired at a cost of £64 13s. 3d. The repairing of the machine took 15 days, during which time the disinfecting work had to be carried out by a private contractor, at a total cost of £89 15s. for 99 cwts. 2 qrs. 25 lbs. of bedding, clothes, etc. The Medical Officer reported to the Vestry as to the advisability of purchasing an extra disinfecting machine for the use of the Parish, so that in the event of another breakdown at any time, it would not be necessary to spend large sums of money in having the disinfecting work temporarily carried out by a private contractor. The 102 saving to the Parish wiil be readily acknowledged when it is mentioned that the charges of a private contractor amounted to (at the rate of) over £2,000 per annum, whereas a good machine can be purchased for £300 to £400, and worked at a weekly cost of less than £2 for labour. The report of the Medical Officer was under consideration at the end of the year.* COMBINED DRAINAGE. This vexed question has engaged the attention of the Vestry during the year, and several combined systems of drainage have been re-constructed at the expense of the Rates. With a staff of Inspectors whose principal duties deal with the drainage of new and old buildings it is only natural to expect that the Vestry's attention will be called at times to defective "combined systems," which in the present state of the law may be 'sewers," and as such require to be repaired or re-constructed (when defective) by the Vestry. Considering the amount of work, however, done by each Inspector during the past year and the number of drains examined (see p.p. 78-79), it is satisfactory to be able to report that only thirty "combined systems" have been repaired or re-constructed by the Vestry (at the expense of the Rates) on a report of their defective condition by the Sanitary Department at a cost of £ * The Vestry has since decided to purchase a new disinfecting machine, working on the saturated (under pressure) steam principle, from Messrs. Defries and Co., of London, at a cost of £342 (inclusive of boiler, record gauge, etc.), and to erect suitable buildings in connection therewith on the Wanless Road Mortuary site. 103 In connection with "combined drainage" an important case was heard before Mr. Justice Hawkins on October 80th, 1896, in connection with the drainage of 85, 87, 89, 91, York Road, and 8 and 9, Addington Crescent. The Vestry were in possession of a plan dated 1838, when it must, presumably, have been approved by the Sanitary Authority of that time, viz., the Kent and Surrey Commissioners of Sewers, but the Court held that a "sewer" is any system of drainage which receives two or more drains, unless such combined system has received the approval and sanction of— (1) A Vestry, or District Board, who came into being by virtue of the Metropolis Local Management Act, 1855, or (2) The Metropolitan Commissioners of Sewers who came into being in 1848. In other words, all combined drainages laid or constructed prior to 1848 are "sewers" repairable by the Sanitary Authority—a condition of things making Metropolitan Authorities answerable for (roughly) two-thirds of their drainage systems The record of the payment to the Commissioners by the owners in respect of the connection with the sewers in York Road, was found in the minutes of the Surrey and Kent Commissioners—a fact in favour of the Commissioners having approved and sanctioned the combined system. The Vestry decided to appeal but lost with costs. Considering the large interests at stake by the Ratepayers in Lambeth and all over the Metropolis, in view of these decisions, an Act to amend the law as to "sewers" and "drains" is much wanted, and will (it is hoped) be now 104 soon passed by the Legislature, it being unjust that Vesties and District Boards should, by the Metropolis Local Management (Amendment) Act, 1862, be answerable only for the Metropolitan Commissioners of Sewers, and combined drains laid or reconstructed before January 1st, 1865, pursuant to the order or direction, or with the sanction or approval, of them; and not for the Sanitary Authority, i.e., the Surrey and Kent and other Commissioners for the Metropolis, who were absorbed when the Metropolitan Commissioners of Sewers came into being in 1848. 105 ANALYSIS OF FOOD AND DRUGS. During the year 1896 more samples have been purchase and submitted to the Public Analyst for analysis than in any previous year. Taking the last ten years (1886:—95), the annual average as to number of samples taken is 361, of which 60 [i.e., 16.7°/0) were found on analysis to be adulterated. The average annual number of summonses issued is 42.8, with the annual average of 42.1 convictions and 18.3 cautions. The annual average amount of penalties is £81 15s. 6d., and of costs £21 Is. 6d. Comparing these averages with the actual numbers and figures for 1896, some idea of the extra amount of work that has been done in this particular Department will be gained, for in 1896 549 samples were purchased, of which 66 (i.e., 12 02 %) were adulterated. In connection with these adulterated samples, 66 summonses* were issued, and in 2 cases the vendors were cautioned, with the result that there were 60 convictions, with £93 in penalties, and £35 lis. 6d. 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 1896, but also for each of the previous ten years (1886—95). * This department is under Inspector Wiggs, who has shewn, by results, how well this particular work is carried out in Lambeth Parish. 0 01 SALE OF FOOD AND DRUGS ACT. Samples procured by Inspector Wiggs, together with the result cf Analyses, during the year 1896. samples. number procured. number adulterated. samples. number procured. number adulterated. Milk 199 22 Brought forward 516 66 Butter 203 36 Rum 1 Coffee 53 8 Pickles 4 Mustard 19 Tapioca 1 Pepper 19 Jam 3 Lemonade 2 Vinegar 5 Soda Water 1 Whisky 5 Tea 3 Iodide of Potassium 1 Arrowroot 3 Ginger Ale 1 Cocoa 5 Tincture of Iodine 1 Flour 2 Ground Ginger 2 Epsom Salts 2 Bread 2 Powdered Rhubarb 2 Lard 4 Brandy 1 Sugar 1 Gin 2 Oatmeal 2 Carried forward 516 66 Total 549 66 Food and Drugs Summonses issued, 64; Convictions, 60; Cautioned, 2. 4 Summonses were dismissed, I withdrawn, and I unable to be served. A Summons was in addition taken out, and conviction obtained, against a person for refusing to sell Butter to the Inspector, and one against a person for obstructing the Inspector in the discharge of his duty in taking a Sample of Milk. Although 66 Samples were certificated as adulterated by the Analyst, in two cases no action was taker.—one a 5 percent. Water-adulterated Milk, and the other a Coffee, with a printed label drawing attention to the fact that the Coffee was a mixture. 107 TABLE Shewing per-centages of different adulterated Samples during 1896, and in the previous ten years. Year. Milk. Butter. Coffee. Bread and Flour. | Cocoa and Chocolate. Cheese and LarJ. Other Groceries. Sundries. Spirits. Brandy. Gin. Rum. Whisky. Ale and Porter. Wines. Aerated Waters. Drugs. 1896 11.06 17.7 15.1 0.0 0.0 — 0.0 0.0 0.0 0.0 0.0 0.0 0.0 — — 0.0 0.0 1895 21.05 14.7 26.4 - 0.0 0.0 0.0 16.6 16.0 - 12.5 25.0 - - 0.0 00 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 — 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 Il.l — 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 - 0.0 means that all Samples were reported to be genuine and unadulterated. means that no Samples were taken during the year. 801 Year. No. of Samples Analysed No. of Samples adulterated Percentage of Samples adulterated No. of Summonses issued No. of Samples Convictions No. of Samples Penalties Costs £ S. d. £ S. d. 1896 549 66 12.02 66 60 2 93 0 0 35 11 6 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 Average of 10 years 1886-95 361.4 60.4 16.7 42. 8 42.1 18.3 81 15 6 27 16 109 OFFENCES UNDER THE FOOD AND DRUGS AND MARGARINE ACTS, DURING 1896. ADDRESSES OF OFFENDERS, WITH PARTICULARS AS TO EACH OFFENCE, AND THE AMOUNTS OF PENALTIES AND COSTS IN EACH CASE. 110 1896. Food and Drugs and Margarine Acts. Date. Address. Offence. Penalty. Costs. 1896 Jan. 24 119, Ferndale Road Selling milk from which the cream had been abstracted to the extent of 45 per cent. Summons dismissed £ s. d. £ s. d. Feb. 12 25, Durham Street Refus.ng to fell milk exposed for sale by retail, and demanded by the Inspector for the purpose of analysis 1 0 0 0 2 0 ,, 18 55, Lambeth Walk Refusing to sell butter exposed for sale and demanded by the Inspector for the purpose of analysis 1 0 0 0 5 6 „ 20 25, Upper Marsh Selling butter containing added margarine to the extent of 70 per cent. 5 0 0 0 12 6 ,, 20 57, Auckland Street Selling milk containing added water to the extent of 9 per cent. 2 0 0 0 12 6 ,, 20 49, Auckland Street Selling butter containing added margarine to the extent of 70 per cent. 3 0 0 0 12 6 „ 20 57, Auckland Street Selling butter containing added margarine to the extent of 82 per cent. 5 0 0 0 12 6 „ 20 5, Upper Marsh Selling butter containing added margarine to the extent of 75 per cent. 0 10 0 0 12 6 111 ,, 26 75, Oakley Street Selling margarine in paper wrapper without having "Margirine" printed on same in accordance with 1 0 0 0 12 6 „ 26 108, Lower Marsh 1 0 0 0 12 6 ,, 26 56, Belvedere Road Selling butter containing added margarine 80 per cent. (1st conviction) 2 0 0 0 12 6 ,, 26 Selling milk containing added water to the extent of 25 per cent. 0 12 6 (1st conviction) 2 0 0 0 12 6 ,, 26 107, Oakley Street Selling milk containing added water 30 per cent. (No previous conviction, but supplied by the Defendant) 0 12 6 ,, 26 75, Oakley Street Selling milk containing added water 25 per cent. (Two previous convictions) 10 0 0 0 12 6 Mar. 6 48, Dalyell Road Selling butter containing added margarine to the extent of 50 per cent. 2 0 0 0 12 6 ,, 19 161, Stockwell Road Selling butter containing adde margarine to the extent of 50 per cent. 2 0 0 0 12 6 ,, 26 18, Clapham Road Selling butter containing margarine to the extent of 83 per cent. (1st conviction) 5 0 0 0 12 6 Carried forward 42 10 0 9 2 6 112 Date. Address. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 42 10 0 9 2 6 Mar. 26 Bradbury Wick, near Swinden Selling milk from which the cream had been abstracted Cheseldon, Wiltshire to the extent of 26 per cent. (1st conviction) 5 0 0 0 12 6 „ 26 Malt House Farm, Highbridge, Selling milk from which the cream had been abstracted Somerset to the extent of 26 per cent. (1st conviction) 5 0 0 0 12 6 April 9 Tracey Street Selling milk containing added water to the extent Of 10 per cent. (2nd conviction) 0 10 0 0 12 6 „ 9 31, Tracey Street Selling coffee containing added chicory to the extent Of 20 per cent. (1st conviction) 0 12 6 „ 9 66, Lambeth Walk Selling butter containing added margarine to the extent of 55 per cent. (1st conviction) 010 0 0 12 6 „ 9 48, Cornwall Road, S.E. Selling butter containing added margarine to the extent of 80 per cent. (1st conviction)" 0 10 0 0 12 6 113 May 6 152, Landor Road Selling butter containing added margarine to the extent of 80 per cent. (1st conviction) 1 0 0 0 12 6 „ 21 21 and 23, Rommany RoadSelling coffee containing added chicory to the extent of 33 per cent. (1st conviction) 0 5 0 0 12 6 June 12 1, Sussex Grove, Brixton Selling milk containing addded water to the extent of 14 per cent. 2 0 0 0 12 6 „ 12 56, Treherne Road Selling milk containing added water to the extent of 23 per cent. 2 0 0 0 12 6 „ 26 11, Newburn Street Selling milk containing added water to the extent of 12 per cent. (1st conviction) 1 0 0 0 12 6 „ 26 486, Brixton Road Selling milk containing added water to the extent of 8 per cent. (1st conviction) 2 0 0 0 12 6 „ 26 37, Tulse Hill Selling milk containing added water to the extent of 8 per cent. (1st conviction) 2 0 0 0 12 6 „ 26 14, Heme Hil1 Road Unlawfully, wilfully, and maliciously destroying sample of milk purchased for the purpose of analysis by the Public Analyst. (Or one month in default of payment) 3 0 0 0 2 0 Carried forward 67 5 0 17 7 0 H 114 Date. Address. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 67 5 0 17 7 0 July 24 131, Lambeth Walk Selling butter containing added margarine to the extent of 90 per cent. (1st conviction) 0 10 0 0 12 6 „ 24 138, Vauxball Street Selling miik containing added water to the-extent of 6per cent. (1st Conviction) 10 0 0 12 6 ,, 24 40, Grange Road Selling milk containing added water to the extent of 11 per cent. (1st conviction) 0 10 0 0 12 6 ,, 24 57, Auckland Street Exposing a parcel of margarine for sale by retail, without having attached to same a label in printed capital letters of not less than 1£ in. square, "Margarine.' (1st conviction) 1 0 0 0 12 6 ,, 24 (2nd conviction) - 0 2 0 Aug. 13 8, The Pavement, Chapel Selling milk containing added water to the extent of Road, W. Norwood 10 per cent. (1st conviction) 0 5 0 0 12 6 115 Oct. 14 77, Lower Marsh Exposing a parcel of margarine for sale by retail without having attached to same a label in printed capital letters of not less than 1 1/2 in. square, "Margarine." ,, 14 120, LoWer Marsh ,, „ 0 5 0 0 12 6 " 14 55, NeW Cut ,, „ 0 5 0 0 12 6 Oct. 23 206, Farmers Road Exposing a parcel of margarine by retal, without having attached to same a label in printed capital letters of not less than 1 1/2 inch square, "Margarine." 0 10 0 0 12 6 ,, 23 ,, Selling butter containing added margarine to the extent of 78 percent 1 0 0 0 12 6 „ 21 70, Clive Road Selling butter containing added margarine to the extent of 70 per cent 0 10 0 0 12 6 Jan. 7 5, Bishop's Terrace Selling coffee containing added chicory 50 per cent. 0 10 0 0 12 6 „ 7 131, Lambeth Walk Selling butter containing margarine (not butter) 82 per cent.— 2 0 0 0 12 6 „ 7 16, Railton Road Selling butter containing margarine (not butter) 85 per cent 1 0 0 0 12 6 „ 7 116, Sussex Road Selling coffee containing added chicory 60 per cent. 1 0 0 0 12 6 ,, 7 5, Milkwood Road Selling butter containing margarine (not butter) 83 per cent 2 0 0 0 12 6 Carried forward 79 10 0 26 16 6 H 2 116 Date. Address. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 79 10 0 26 16 6 Jan. 7 166, Upper Kenning'on Lane Selling butter containing margarine (not butter) 90 per cent. 0 10 0 0 12 6 ,, 7 49, Auckland Street Selling butter containing margarine (not butter) 77 per cent. 1 0 0 0 12 6 ,, 7 5. Goding Street Selling butter containing margarine (not butter) 70 percent. 1 0 0 0 12 6 ,, 7 80, Lower Kennington Lane Selling butter containing margarine (not butter) 75 per cent. 1 0 0 0 12 6 „ 7 5, Wilcox Road Selling butter containing margarine (not butter) 90 per cent. 1 0 0 0 12 6 „ 14 56, Hartington Road Selling butter containing margarine (not butter) 50 per cent. (Defendant failed to appear) 1 0 0 0 12 6 „ 14 155, South Lambeth Road Selling butter contiining margarine (not butter) 80 per cent. 2 0 0 012 6 ,, 14 43, Dorset Road Selling butter containing margarine (not butter) 75 per cent. 2 0 0 0 12 6 117 ,, 14 39, Lambeth Walk Selling milk containing added water 10 per cent. 0 10 0 0 12 6 „ 14 307, Liverpool Road, Islington Selling milk from which cream had been abstracted to the extent of 25 per cent. (Summons dismissed, and £l Is. costs allowed to the Defendant, and a summons granted against the farmer for a false warranty, but not taken out by Resolution of Committee) 0 12 6 ,, 14 62, Brixton Road Selling coffee containing added Chicory 70 per cent. 1 0 0 0 12 6 ,, 14 33, Lower Marsh Selling butter containing margarine (not butter) 50 per cent. 2 0 0 0 12 6 „ 13 39J, New Cut Exposing a parcel of margarine for sale by retail without having attached to same a label in printed and capital letters of not less than 1 1/2 in. square "Margarine" 0 10 0 0 12 6 „ 13 „ „ 0 12 6 Total £93 0 0 £35 11 6 118 HOUSING or the WORKING CLASSES ACT, 1890. 95 houses were represented to the Vestry by the Medical Officer of Health, under Part II. of the Housing of the Working Classes Act, during the year 1896, as being unfit for human habitation, on account of the premises being dirty, damp, dilapidated, defective in drains and sanitary appliances, deficient in light and ventilation, having defective sites, etc. Details are to be found in Tables on pp. 121-123. Records of action taken under this Act in Lambeth Parish shew that:— 6 houses were condemned in 1893. 39 „ „ „ „ 1894. 16 ,, „ „ „ 1895. 96 „ „ „ „ 1896. In connection with the closing of houses, the question naturally suggests itself "What is to become, or what does become, of the displaced tenants?" and the answer is not far to seek, unfortunately. The displaced tenants go into houses which are not bad enough to be condemned at the time, but which rapidly become so, with the result that, in respect of rookeries so-called, some are abolished but others created. This view of the subject is an important one, and one that has given cause to pause, as the Medical Officer is unable to reconcile himself to such a course of action, which leaves matters practically in statu quo, unless he is absolutely compelled by virtue of the conditions of the dwellings themselves. In the Medical Officer's opinion, what is really wanted is for the Vestry to first build or provide suitable accommodation for the class of tenants who will be displaced—a thankless duty, but one that 119 must be faced sooner or later; and until such a course of action is taken by Public Bodies, it is not advisable to make a representation under Part I. (i.e., a representation condemning a large insanitary area containing many houses, and displacing very many people). Much good, however, can be done under Part II., which deals with individual houses unfit for human habitation, and small, unhealthy areas and obstructive buildings, which latter means any building or buildings which, although not in themselves unfit for habitation, by their respective positions stop ventilation, or make other buildings insanitary, or prevent proper measures from being carried into effect for remedying nuisances. Again, in Lambeth (as elsewhere), house accommodation (good or bad) for the poorer classes is scarce, so that it behoves the Vestry to proceed cautiously as to closing of houses in large areas, and only to deal with small areas at a time. Part III. of the Housing of the Working Classes Act, gives the Vestry powers of acquiring or appropriating land for the purpose of erecting suitable lodging houses for the working classes, converting buildings into lodging houses, with powers to fit up and furnish the same, and make bye-laws for their management and charges for their tenancies. Whilst it has been thought necessary to take action under the Housing of the Working Classes Act in respect of 96 houses, it must be remembered that under the Public Health (London) Act much more work has been done in the way of rendering houses habitable, and so dispensing with the necessity for taking action under the more stringent Act, and reference to the Table on page 79 must be made before the whole of the work that has been accomplished during the past year in the way of the better 120 housing of the working classes can be realised. Suffice it to add that the record for Lambeth is satisfactory and one on which the Vestry is to be congratulated. Details as to the cases heard before the Magistrate are to be found on pp. 121.123. London Vestries have immense powers to reform the dwellings of the poor. Before leaving this subject it is a source of satisfaction to the Medical Officer of Health to report that, though the Duchy of Cornwall is outside the pale of the Housing of the Working Classes Act, and, in consequence, as the ground landlord of a large portion of Lambeth Parish might prove troublesome in respect of any action taken under this particular Act of Parliament, the Council of H.R.H. the Prince of Wales have sent a written statement to him to the effect, inter alia, that "they are at all times most desirous of complying with the spirit of any Act of Parliament contemplating improvements on the score of the Public Health, or in the interests of the working classes"— an important admission in connection with sanitary reform in Lambeth. 121 Housing of the Working Classes Act. DETAILS OF HOUSES CONDEMNED IN LAMBETH DURING 1896. Date of representation of M.O.H. to, and of resolution of, Sanitary Authority. Address of Premises. No. of Houses. Date of Service of Notices. Result. Remarks. Dec. 12th, 1895. 1, 2, 3, 4, 5, 6, 7, 8, 9, Fountain Court 9 Jan. 2nd, 1896. 25 closed by order of the Magistrate on July 29th, 1896, and 10/- per tenant allowed as compensation. Two closed voluntarily. The whole site was suggested by the Medical Officer of Health to the Vestry on October 15th, 1896, as an open space in such a congested district, and for a playground for children, who would be thus drawn from dangerous crowded thoroughfares; whilst additional breathing space would be useful for this particular district (the Inner Wards) of Lambeth. 3. 4,5, 6, 7, 8, 9, 10, 11, 12, 13, Francis Court 11 The Cottage, Francis Street 1 1, 2, 3. 4, 5, 6 Paved Court, Lambeth Walk 6 11, 13, 15, 17, 19, Cornwall Read, Brixton Hill Feb. 20th, 1896. 5 No Notices served Voluntarily put into proper order and condition to the satisfaction of the Medical Officer of Health. Premises dirty, damp, and dilapidated, together with defective drams and other sanitary defects. Feb. 20th, 1896. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, Commercial Buildings, Belvedere Road 10 March 6th, 1896. Closed voluntarily as houses for human habitation, and converted into storage places and stables. Defective drains and other sanitary defects, and the premises are dark, dirty, and damp; whilst the position of the houses is such as to make it practically impossible to render them fit for human habitation, sunlight rarely gaining access to the rooms, and there being no through ventilation, the houses having been built originally within the recesses of the archways of Waterloo Bridge. 122 123 Date of sentation of M.O.H. to, and of resolution of, Sanitary Authority. Address of Premises. No. of Houses. Date of Service of Notices. Result. Remarks. Mar. 5th, 1896. 1A, 90B, 90C, 90D, 90E, 90F, 90G, 90H, 90I, 90J, 90K, Denmark Street, Coldharbour Lane 11 March 12th, 1896. Voluntarily put into proper order and condition to the satisfaction of the Medical Officer of Health. (Work nearly completed.) Premises dirty, damp, and dilapidated, with defective sanitary fittings. April 9th, 1896. 1, 2, 3, 4, Hammond Place, Cornwall Road, Lambeth. 4 April 11th, 1896. Works voluntarily carried out so as to render the houses fit for human habitation to the satisfaction of the Medical Officer of Health. April 9th, 1896. 6 and 7, Legrand Place, Waterloo Road. 2 No Notice served. Voluntarily closed and demolished by the owners, as also the other houses in the same court, Nos. 6 and 7, having simply been taken as test cases, being the worst houses. (Duchy of Cornwall Property.) Premises dirty, damp, and dilapidated, with want of sufficient w.c. accommodation. April 9th, 1896. 152, 154, Waterloo Road. 2 Nov. 28th, 1896. Closed by order of the Magistrate on July 2rd, 1896, and 10/- per tenant allowed as compensation. No. 154 has since been re-opened as a fruit store and stall (the basement having been permanently closed and disused, and a new W.C. supplied in an upstairs roorn) Defective drains; w.c.s without proper water supplies, and without proper light and ventilation; basements dark and dangerous to health, and their floors rotten. April 30th, 1896. 1, 2, 3. 4, 5, 6, 7, 8, 9, 10, Isabella Row, Whitehart Street. 10 May 7th, 1896. Voluntarily closed by owner. (Duchy of Cornwall Property). Premises damp and dilapidated. May 14th, 1896. 1, 2, 3, Windmill Court, Windmill Street, New Cut. 3 May 19th, 1896. Closed by order of the Magistrate on Premises dirty, damp, and dilapidated, and so situated that there was little light or ventilation, and no through current of air, which was consequently stagnant. July 9th, 1896. 1, 2, 3, 4, 5, 6, Queen's Place, Newburn Street. 6 July 23rd, 1896. Closed by order of the Magistrate on Premises dirty, damp, and dilapidated, with defective drains. Nov. 26th, 1896. 19 & 39, Cornwall Place, Lambeth. 2 No Notices served. Works voluntarily carried out so as to render the houses fit for human habitation to the satisfaction of the Medical Officer of Health, as also in the case of other houses in the same court, and belonging to the same owner, Nos. 19 and 39 being simply taken as test cases, being the worst houses. Premises excessively damp. Nov. 26th, 1896. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, Cotham Place 10 No Notices served. Works voluntarily carried out so as to render the houses fit for human habitation to the satisfaction of the Medical Officer of Health. Premises dirty, damp, and dilapidated. Nov. 26th, 1896. 42, New Park Road 1 Dec. 28th, 1896. House closed voluntarily by the owner. Premises dirty, damp, and dilapidated. 124 HOUSES LET IN LODGINGS. The Vestry has been in possession of a set of By-laws for Houses-let-in-lodgings since 1895, but these By-laws have not been enforced save in very few instances. It was thought advisable, therefore, to take the opportunity of adopting a new set of by-laws, under Section 94 of the Public Health (London) Act, 1891, and at the suggestion of the Local Government Board, their own model by-laws were adopted by the Vestry on January 23rd, 1896, with the following trifling alterations:— 1. No definite rents for furnished or unfurnished rooms to be mentioned in the exception clause (By-law 2) which is, on the contrary, to read as follows:— "A lodging house shall be exempt from the operation of these By-laws until the landlord of such lodging house shall have been required, in pursuance of By.law 5, to furnish the statement of particulars." 2. The words "wash and colour" to be used instead of "lime wash" in Clause 15 and sub-section e of Clause 2, and not to apply to internal surfaces of walls that are painted or papered—the former only being mentioned in the Model By-laws. 3. In Clause 19, the maximum penalty to be reduced to £2 from £5, and the further maximum penalty from £2 per day to £1 per day. 4. The words "reasonable times" to be used in place of the word "times" in Clauses 6 and 7. 5. In Clause 15, the words "once at least" to be stituted for the words "in the first week of the month of April." 125 6. Clause 17, the following words to be added:—"The landlord of a lodging house to cause to be removed, not less frequently than once in every week, the house refuse produced in the lodging house." The above alterations were considered by the Local Government Board for two months, and they then replied to the Vestry that the word "lime wash" must remain (the requirements as to "colouring" not being within the Act of Parliament); that a definite month (e.g., April) must be stated for the necessary cleansing and lime.washing to be done to premises; and that the addition made to Clause 17, by the Vestry, as to the removal of house refuse, being ultra vires, could not be entertained. The final result was that the Board's suggestions were adopted, and the model By.Laws adopted by the Vestry, with alterations 1, 3, and 4 (mentioned above), which were allowed by the L.G.B. Much good work remains to be done (more especially in connection with the Inner Wards) by registering certain premises under these By.Laws, which, it is to be hoped, the Local Government Board will soon confirm. MORTUARIES. The administration of the Mortuaries in Lambeth was transferred, at the end of the year 1896, by the Vestry to the Medical Officer's Department, which was to be responsible to the Sanitary Committee and the Vestry. There are at present in Lambeth 2 Mortuaries and 2 Inquest Rooms and Coroners' Courts:— 126 1. High Street, Lambeth, recently altered and vated, at a cost of £64. 2, Wanless Road, Loughborough Junction, near to the railway arches of the L. C. & D. Railway, in process of erection, at a cost of £1,539. The Norwood Ward is still unprovided with a separate Mortuary, but after the expression of opinion by the Vestry for some years past as to the necessity of providing one, it is satisfactory to report that a site was sanctioned by the Vestry, at a cost of £400, alongside the Cemetery gates and at the bottom of Auckland Hill, Norwood, on December 10th, 1896. High Street Mortuary (Keeper, Mr. J. Fazey). During 1896, 373 bodies were received into the Mortuary, 221 males and 152 females, as follows:— 1896 Jan. Feb. March April May June July August Sept. Oct. Nov. Dec. Total Males 18 20 16 18 18 18 22 12 12 20 20 27 221 Females 17 10 12 14 12 13 10 10 11 19 8 16 152 35 30 28 32 30 31 32 22 23 39 28 43 373 Registered ages of bodies:— 0—1 121 1—5 22 5—10 12 10—20 9 20—30 24 30—40 35 40—50 37 50—60 46 60—70 35 70—80 22 80—90 7 90 and upwards 3 373 127 253 post-mortems were conducted by 76 medical gentlemen and 2 lady doctors—the highest number of postmortems by one doctor being 24; the lowest, 1. The Coroners' Court sat 110 times (exclusive of adjournments). There were 16 cases of drowning (2 females and 14 males) and 10 cases of suicide-4 by poisoning (3 males and 1 female), 2 by hanging (both men), 2 by cutting their throats (both men), and 2 by jumping off high buildings (both men); 3 deaths were the result of railway, and 3 of street, accidents; 5 deaths were the result of shooting, 2 (females) having been murdered and 3 (males) having committed suicide. 128 INQUESTS. During the year 1896, 528 cases were submitted to the Coroner who, in 71 instances, decided that no further inquiries were necessary; but, in the other 457 cases, held inquests with the following results:— I. Natural Causes 173 II. Accidental Causes 247 Burns and Scalds 41 Drowning 9 Run over 22 Falls, &c. 43 Suffocation 59 Alcoholism 27 Knocked down by Engine 2 Improper Feeding 3 Gunshot Wounds or Fractures 12 Rupture 3 Exposure 1 Misadventure 4 Blow 2 Injury to Thumb 1 Self-neglect 2 Blood Poisoning 11 Crushed 5 III. Homicidal Causes 35 Suicide 27 Murder 6 Manslaughter 2 IV. Open Verdicts 2 Found Drowned 1 Found Dead 1 Total 457 129 UNDERGROUND CONVENIENCES The Vestry decided, on August 6th, 1896, that in future the Medical Officer should be responsible to the Sanitary Committee and to the Vestry for the proper administration of the Underground Conveniences in the Parish of Lambeth, and these new duties were taken up by the Medical Officer and his Staff on November 1st. The nature and extent of these extra duties may be gathered from the following particulars:— There are at present, in the Parish of Lambeth, five Underground Conveniences: 1 Male Vauxhall. 1 Male and 1 Female Hercules Road 1 Male and 1 Female Brixton Oval, In connection with each Convenience there are two Attendants: Vauxhall. Males F. Rodda and A. Beeke. Hercules. Male W. Lockyear and J. Moody. Female Miss E. Davis and Mrs. E. Luckett. Brixton Oval. Male C. Lester and F. Parsons. Female Mrs. C. Carrett and Mrs. C. Carter; whilst a relief man (W. H. Bennett) has been appointed to relieve the six Male Attendants in turn one day a week (working, therefore, six days) and one Sunday in every seven, and a relief woman (Mrs. C. Kimber) to relieve the four Female Attendants in turn one day a week (working, therefore, four days) and one Sunday in every four. There is, in addition, an occasional relief man (Daley) and an occasional relief woman (Mrs. High) who are temporarily 1 130 engaged as required, e.g., in the event of any of the permanent staff being absent from any cause (illness, holidays, etc.). The wages of the Male Attendants, including the relief man, are 28/. per week each; whilst the wages of the Female Attendants are 21/. per week each, the relief woman being paid only 14/., i.e., for four days' work per week, at 3/6 per day. The hours of the Attendants are: Week Days—Males 6 a.m. to 3.30 p.m. ,, ,, 3.30p.m. to 1 a.m. ,, Females 7 a.m. to 3.30 p.m. „ ,, 3.30p.m. to 1 a.m. Sundays—Males 8 a m. to 11.15 p.m. ,, Females 8 a.m. to 11.15 p.m. Arrangements have been made by the Medical Officer for each of the Underground Conveniences to be visited and inspected not less than twice a week and at a time not fixed: and Inspector Bowden has charge of the Vauxhall Convenience, Inspector Wallis of the Hercules, and Inspector Smith of the Brixton (the Conveniences being in these Inspectors' Districts respectively). Arrangements have also been made for a series of Time Sheets to be kept in connection with each Convenience, filled up each week by the Attendants and presented to the Medical Officer at the Sanitary Office every Friday, upon which day the Attendants also bring the dirty towels and dusters, and take in exchange therefore clean ones, and make any special reports, complaints, etc., that may be necessary. A check on the towels and dusters received and given out is kept by a clerk in the Sanitary Office in a book specially provided for the purpose. Stores, as required, are given out by the Superintendent at the Wharf, but only on a written requisition signed by 131 the Medical Officer—the Attendants bringing in their list monthly, except in the case of emergency. One free closct is provided in each of the five Conveniences, in addition to 6 private w.c.s at Brixton (3 for males and 3 for females), 7 at Hercules Road (4 for males and 3 for females), and 4 at Vauxhall (for males only); and in connection with the locks of the private W.Cs. the self.registering system is found to work satisfactorily— each penny received being registered on a little square within the locks themselves, and copied from there into books daily by the Attendants. When a W.C. door is opened by an Attendant with his key, the next number on a square moves half into view, but only fully into view (thus becoming registered) when the door is unlocked by an occupant from the inside. The numbers register up to 999, and then commence again at 000, so that the registration is continuous, and the locks in consequence are not interfered with unless they get out of order. The doors of the water closets are all self.closing. All monies received by the attendants are paid in weekly by them direct to the Accountant at the Vestry Hall. The Male Attendants are each supplied yearly with a cap and 3 jackets (one for winter and 2 for summer), and the Female Attendants each with dark blue serge material for a dress (not exceeding 30/.). In connection with the Hercules and Brixton Underground Conveniences, the Male and Female Attendants are furnished with Police whistles as a means of communication, from one to the other, in case of accident or anything serious happening. 132 COWHOUSES. There are 32 registered Cowhouses (3 not used) in Lambeth, and these have been inspected carefully during 1896, and a complete Register made, with the following particulars under the subjoined headings:— Cowshed No Ward Dale of Inspection for this Registration Name of Inspector Name and Address of Cowshed Name and Address of Occupier Name and Address of Owner Sheds— Material (e.g., brick, wood, iron, etc.) Inner Walls: Hard, Smooth, impervious to what height How often per year cleansed and whitewashed How often per week washed Number of: Sheds Cows kept in each shed Cows allowed in each shed Cubic capacity of each shed (see plan) Square superficial area of each stall (see plan) Amount of overcrowding Shape and height of roof of each shed Paving: Material Impervious or not Is it embedded on concrete and set in cement Is it levelled to properly trapped outside gully and glazed stoneware drain Troughs: Is there one to each shall Materials Impervious or not Is water laid on to each Is there any drain inlet or gully inside shed Are sheds separate from stables Are swine, horses, or other animals kept in sheds Are any offensive accumulations near to sheds General condition as to cleanliness Drainage— Outside or inside Intercepted or not Are there manholes Well ventilated or not Gully Gratings: Inside or outside Fixed or loose Distance apart of bars or holes 133 Sanitary Conveniences — Nature and position Is there sepatate flushing tank to each W.C. or urinal Is any W.C., urinal, etc., inside, or in direct or indirect communication with, a shed Manure Pit or Cage — Material (impervious or not) and position Distance from nearest shed Distance from grain pit Is it covered, drained and ventilated How often is manure removed Is it below level of ground Grain Pit or other Receptacle for Food — Material (impervious or not) and position Distance from manure pit Distance from nearest shed Is it covered, drained, and ventilated Is it below level of ground Water Supply— Kind (constant or intermittent) and position Cisterns or other receptacles: Materials Capacities Are overflow pipes disconnected Are they properly constructed, covered, get.at.able Heights above ground floor How often cleansed Ventilation— General condition Cross or roof and side, louvred openings Lighting— General condition Are there windows or other openings in sides or roof Openings or Windows: Numbers and positions Whether or not made to open and shut Condition of milk vessels, etc.: Clean or otherwise How cleansed and how often Where and how is milk stored The importance of carefully inspecting cowhouses cannot be too much insisted upon, and the powers of control as to 134 registration, drainage, lighting, ventilation and air space, water supply, cleansing and sanitation generally, as given by the Dairies, Cowsheds, and Milkshops Orders of 1879, 1885, and 1886, too rigorously enforced—milk being a very common and generally used article of food, and requiring to be kept consequently as pure and free from pollution as possible. A perusal of the recently.made Register for Lambeth, will shew that the sanitary condition of the Lambeth Cowsheds is good, the air space varying from 501 to 2346 cubic feet, and the floor space from 24 to 34 square feet, per cow respectively. Analysing and tabulating the cubic capacities and floor spaces more in detail, it is found that:— Cubic Capacities. 9 allow between 1000 and 1500 square feet per cow. 8 „ „ 800 „ 1000 „ „ „ „ 15 „ „ 600 „ 800 „ „ „ 1 „ „ 500 „ 600 „ „ „ „ 1 „ „ 400 „ 500 „ „ „ „ i.e., 94.6 per cent. allow over 600 cubic feet per cow. 54.05 „ „ „ „ 800 „ „ „ „ 32.4 „ „ „ „ 1000 „ „ „ „ Floor Spaces. 18 allow between 30 and 35 square feet per cow. 16 „ „ 28 „ 30 „ „ „ ,, 2 „ „ 26 „ 28 „ „ „ „ 1 „ „ 24 „ 26 „ „ „ ,, i.e., 13.3 per cent. allow over 32 square feet per cow. 91.9 „ „ „ „ 28 „ „ „ „ These results are satisfactory, as the London County Council lays down—600 cubic feet per cow in a shed with perfectly efficient means of ventilation, and 800 cubic feet in a shed with imperfect means of ventilation; whilst the 135 superficial space laid down by the same authority is 8 feet by 4 feet (32 square feet) for one cow, and 8 feet by 9 feet (72 square feet) for 2 cows (kept in one stall). LIST OF REGISTERED COWSHEDS IN LAMBETH. No. of No. of Sheds. Cows kept. South Marsh 6, Coral Street, Lower Marsh 1 10 Bishop's Cambria Cottage, Tracey Street 1 13 „ 71, Ethelred Street 1 7 „ 24, Distin Street 2 9 „ 167, Railway Arch, Sail Street 1 12 Prince's Clayland's Dairy, Ashmore Place 1 16 30, Upper Kennington Lane 1 7 „ 17, Denny Street 1 8 Vauxhall 38, Hartington Road 1 22 „ 9, Dawlish Street 1 12 Stockwell 20, Southesk Street 1 — „ 8, Moat Place 1 7 34, Ingleton Street 1 5 Brixton 188, Warham Street 1 — „ Vassall Mews 1 8 „ 1, Elliott Road, Brixton 2 9 Tulse Hill 4, Mill Lane, Brixton 1 2 „ 67, Coldharbour Lane 1 7 „ 1, Lutheran Place, Upper Tulse 2 34 Hill 56, Railton Road 1 5 „ 329, Coldharbour Lane 1 8 „ 26, Somers Road 1 18 Norwood 156, Hamilton Road 3 26 „ 70 and 78, Gipsy Hill 3 27 „ 67, Rosendale Road 1 10 ,, 93, Clive Road 1 4 „ 196, Norwood Road 1 20 „ 40, Gipsy Road 1 5 ,, 99, Woodlands Road 1 — ,, Elder Road 3 35 „ Railway Arch, East Street 1 13 ,, Change Alley 1 11 41 370 136 SLAUGHTER HOUSES. There are 52 registered Slaughter Houses in Lambeth and these have been inspected from time to time during the year. No old license was refused by the London County Council. The Clerical work in connection with the Department during 1896 deserves recognition, and will best be realised in the form of the following statement:— Letters, etc., received (entered in letter book) 7625 Letters, etc., sent out (entered in postal book) 25,980 (Infectious Diseases 2327 Notice servedpublic Health Acts Preliminary 6222 Statutory Cases entered in Inspectors' Report Books 6767 Copies of Infectious Diseases Notifications— (a) Entered in Notification Book 3202 (b) Sent off to Asylums Board 3202 Notices of Infectious Diseases sent to Schools 2576 Workshops (with full particulars) entered up in Register 255 Cowsheds (with full particulars) entered up in Register 32 Water Certificates for New Houses given out 89 Disinfection Certificates given out 109 Summonses taken out Stamps used 20,925 Reports to Committee (Fortnightly) 20 Reports to Vestry (Monthly and Quarterly) 17 Special Reports 6 There are 3 clerks—a chief (W. R. Lawrence), a second (A. L. Baxter), and a junior (W. J. Lawrence)—two of whom are able to type and shorthand write; whilst Inspector Emblin assists also in the clerical work, being engaged chiefly indoors. A typewriting machine has been in use since April 21st, and from that date until the end of the year 1896 there have been 4350 letters typed. 137 Metropolitan Districts. Death-Rate (corrected). Zymotic DeathRate (corrected). Infantile Mortality Rate. Diarrhœa Rate. Typhoid Fever Rate. Diphtheria Rate. Scarlet Fever Rate. Phthisis Rate. Registration London 18.2 3.11 160 .71 .13 .59 .21 1.68 West. Paddington 15.3 2.52 156 .52 .10 .51 .17 1.27 Kensington 16.8 2.65 178 .35 .09 .40 .23 1.42 Hammersmith 17.2 2.80 179 .80 .12 .49 .20 1.40 Fulham 17.6 3.59 175 1.15 .08 .66 .25 1.66 Chelsea 18.8 3.94 168 .67 .10 1.17 .23 1.82 St. George, Hanover Square 13.6 1.39 149 .25 .11 .30 .14 1.28 St. Margaret & St. John, Westminster 18.0 2.15 170 .64 .17 .37 .18 2.24 St. James', Westminster 17.0 2.24 149 .43 .13 .09 .13 1.89 NORTH St. Marylebone 19.9 3.16 141 .47 .14 .52 .18 1.95 Hampstead 11.9 1.83 123 .22 .09 .39 .09 1.12 St. Pancras 18.1 2.47 168 .73 .13 .40 .15 1.93 Islington 17.1 3.04 150 .47 .14 .74 17 1.45 Stoke Newington 12.7 2.35 126 .79 .15 .56 .23 0.82 Hackney 15.7 2.81 146 .88 .17 .47 .17 1.41 Central. St. Giles 19.0 2.29 147 .41 .10 .18 .18 2.91 St. Martin's-in-theFields 16.2 2.28 164 .38 .23 .23 .23 1.97 Strand 22.7 2.44 193 .54 .04 .12 .25 2.89 Holborn 23.4 3.21 194 .70 .16 .38 3.24 Clerkenwell 20.7 3.78 184 1.31 .22 .62 .22 2.16 St. Luke 2.5.1 3.82 154 1.23 .09 .62 .50 2.92 City of London 19.6 1.44 137 .16 .31 .34 .22 1.60 K 138 Metropolitan Districts. Death-Rate (corrected). Zymotic DeathRate (corrected). Infantile Mortality Rate. Diarrhœa Rate. Typhoid Fever Rate. Diphtheria Rate. Scarlet Fever Rate. Phthisis Rate. East. Shoreditch 21.4 4.31 180 1.09 .14 .60 .31 1.87 Bethnal Green 22T 4.25 170 .86 .15 .57 .27 1.80 Whitechapel 20.6 2.62 141 .56 .11 .60 .25 2.41 St. George-in-the-East 24.5 3.26 154 1.24 .10 .62 .37 2.56 Limehouse 22.9 3.99 176 .98 .05 .83 .25 2.24 Mile End Old Town 19.9 3.61 157 .84 .14 .86 .30 1.38 Poplar 20.6 3.70 176 .98 15 .61 .19 1.75 South. St. Saviour's 22.8 3.23 213 .90 .04 .70 .19 3.11 St. George-the-Martyr, Southwark 24.0 4.24 181 1.04 .11 .65 .28 2.69 Newington 20.5 3.35 184 1.03 .15 .58 .24 1.99 St. Olave 23.0 4.81 153 1.43 .17 .76 .42 2.19 Bermondsey 21.6 3.78 160 .60 .13 .84 .23 2.03 Rotherhithe 20.3 3.82 159 .75 .27 .63 .24 2.19 Lambeth 16.9 2.42 136 58 .08 .46 22 1.63 Battersea 17.7 3.64 177 .98 .09 .49 .19 1.44 Wandsworth 14.3 2.71 150 .63 .11 .21 .15 0.97 Camberwell 17.8 3.59 156 .68 .14 101 .20 1.54 Greenwich 18.5 3.72 157 .67 .18 .78 28 1.57 Lee 13.4 1.88 141 .38 .05 .43 .23 1.27 Lewisham (excluding Penge) 14.3 2.56 136 .70 .11 .88 .08 1.04 Woolwich 20.5 3.92 172 .67 .05 .74 .21 2.09 Plumstead 15.4 3.54 133 .54 .07 .91 .30 1.35 N.B.—These returns are taken from the Registrar-General's Annual Summary. INDEX. INDEX OF TABLES. Page. A. The number of Births and the Birth-Rates in each tion Sub.District of Lambeth during 1896 (arranged quarterly)11 B. The estimated Populations, numbers of Inhabited Houses, Marriages, Births, and corrected Deaths for the year 1896 and the ten years preceding, in Lambeth Parish 12 C. The number of Persons per House, the Marriage., Birth. and Death.Rates, and the proportion of Deaths in Public Institutions per 1,000 persons, for the year 1896 and ten years preceding14 D. The number of Births and Deaths, with Birth. and Death. Rates in each of the Registration Sub-Districts of the Parish during 1896. 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 redistributing persons who die in Public Institutions into the Districts from which they have been removed during illness 18-19 E. Mortalities in Lambeth at different age-periods compared with (1) those for London, 1896, and (2) the averages for London for years 1881.90 20 F. The uncorrected mortality, Male and Female, in the different Districts, and a comparison of the number of Deaths in each Quarter during the year 1896 22 G. The uncorrected mortality (i.e., including that of strangers) at different ages in each District of the Parish 23 H. The uncorrected Deaths (i.e., Parishioners and strangers) at various age-periods in each Quarter of the year 1896 . 24 I. The Infantile mortalities in the Registrar-General's thirty. three large Towns of England and Wales (including London), and in Lambeth Parish 26 J. The number of Certificates for the notifiable Zymotic Diseases received since the introduction of the Notification Act (i.e., in the seven years 1889-95, and in the year 1896) 29 K. The number of infected houses, with percentages of (1) General Defects, and (2) Defective Drains, during the years 1896, and the five preceding years 30 L. Zymotic seasonal variations in the different Registration Sub. Districts of Lambeth during 1896, with the Zymotic Death.Rate per 1,000 inhabitants .33 iii. Page. M. The number of deaths from the principal Zymotic Diseases in the ten years, 1886-95, and in the year 1896 34-35 N. Deaths from Zymotic Diseases (strangers deducted) . . 36 O. Vaccination Returns, 1895 44 p. Vaccination Returns for the first half-year, 1896 45 q. The Diarrhoea Mortality in Lambeth in each month during the year 1896 61 R. The classification of causes of Deaths in Lambeth during 1896, compared wiih London — (a.) Deaths from all causes and at 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 .... 65-66 S. Death-Rates for different groups of diseases in the various Registration Sub-Districts, calculated as percentages of the total deaths for each district 67 T. Death-Rates for different groups of diseases in the various Registration Sub-Districts, calculated in terms per 1,000 of the population, or of the total births .... 69 U. Tab'e of Deaths during the year 1896 in the Lambeth Dis- trict, classified according to Diseases, Ages and Localities 70-73 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 1896, in the Metropolitan Sanitary District ot Lambeth, classified according to Diseases and Localities 74-75 Table showing General and Zymotic Death-Rates, and Scarlet Fever, Diphtheria, Enteric, Diarrhoea, Phthisis, Death-Rates for the forty-three different Metropolitan Sanitary Areas, for Registration London, and for Lambeth 137-138 APPENDIX. Mortality Tables, shewing Deaths from all causes in Lambeth during 1896, sub-divided— (a.) As to different Age-Periods 1.7 (4.) As to Registration Sub-Pistricts 9-16 iv. GENERAL INDEX. page Adulteration of Food and Drugs 105-117 Abatement of Nuisances ........ 77"79 Age Distribution of Diarrhoea 59 „ „ „ Typhoid 55 „ ,, „ Scarlet Fever 46 „ „ „ Diphtheria 52 „ ,, ,, Deaths 20, 21, 23, 24 „ „ „ Population 9, 20 Air Temperature 59 Area of Parish 10, 76 Analysis of Food and Drugs 105-117 Bedding, &c., Disinfected 97-99 „ „ Destroyed 97-99 Births and Birth-Rates 11, 12, 13, 14, 19, 76 Bodies received into Mortuary .126-128 Carbolic Acid 9b Cancer 63, 65, 67, 69 Census Returns (Lambeth) 4, 5, 6, 7, 76 „ „ (London) 5, 6 Cholera 28, 60 Clerical Work 136 Combined Drainage 102-104 Convictions under Public Health Acts 81-89 „ „ Food and Drugs and Margarine Acts . . 109-117 Constitutional Diseases 63, 65 Continued Fever . 56 Cow Houses '32-'35 „ .. List of 135 „ „ Cubic Capacities and Floor Spares of 132,134 Costs 79,81-89,105,108-117 Croup 52, 53 Deaths and Death-Rates 12,14-76 Deaths (arranged quarterly) 22, 24 Death-Rates and Birth-Rates—Inter relationship 13 V. PAGE Deaths in Public Institutions 12, 13, 15-17 Deaths under 1 Year 12, 14, 66, 76 „ „ S Years 12, 14 Diphtheria 28, 57, 53, 54 „ Age Distribution of Cases 52 Density per acre, Lambeth 18,76 „ „ London18 Diarrhoea 59, 6o, 61 „ Age Distribution of 59 „ Monthly Mortality 61 Dietetic Diseases 63, 65 Deaths from Violence 64, 65 Deaths from Ill-defined and Non-specified Causes 64, 65 Digestive System—Diseases of ...... 63 Developmental Diseases 63, 65 Disinfection—Details of 93-102 Disinfecting Vans 94, 95 „ Machine 101-102 „ Refuge . 95-96 Drainage 91.92, 93 „ Defects 28, 31, 79 Enteric Fever (see Typhoid). Earth Temperature 59 Enteritis 60,63 Erysipelas58 Food Adulteration 105-117 Food and Drugs—Adulteration of 105-117 Housing of the Working Classes Act 79,88 89 118-123 Houses Condemned . 121-123 Houses let in Lodgings . 124-125 Izal 96 Infantile Diarrhoea 28, 59-61 Infantile Mortality (Lambeth) .25, 26, 66, 76 „ (London, and Thirty-three large Towns of England and Wales) 26 Infectious Diseases Inspection 30-31, 77 Infected Houses 30, 31, 77, c 8-100 Inhabited Houses of Lambeth 10, 12, 14, 76 Influenza . 62,65 vi. page Inques's 126-128 Inner Districts— Mortalities and Birth-Rates . .11, 13, 17, 18, 19, 21, 51, 64, 75 Inspectors—Increase of Staff 90-93 „ Districts of 90-91 Introductory Letter 3 London (County of)—Vital Statistics4-6 Number of Births, Deaths, Marriages, 1896 5, 65 Birth-, Death- and Marriage-Rates 6, 15 Lambeth—Statistics 4, 76 Local Diseases—Nervous System, Heart, Respiratory Organ', Ligestive and Urinary Organs, Reproductive System . . 63, 64, 65 Local Government Board and Inspectors 90-91 „ „ Tables A and B 70-75 Marrbges and Marriage-Rate (Lambeth) 12,14,15,76 „ » (London)5, 15 Magistrates'Orders . 79,82-89, 110-117 Measles 48-51 „ Notification of 48-50 Membranous Croup 52, 53 Mortality Tables . Appendix, 1-15 Mortality Rates (Lambeth and other districts) 137-138 Mortuaries 125-127 Metropolitan Asylums Board 27-28 Natural Increment of Population (Lambeth) 10, 76 „ „ (London) 5 Notices Served 77-79 Nervous System, Di.eases of .63 Notifiable Infectious Diseases 27-29,32-47,52-58,74-/5,77,100 Non-notifiable Infectious Diseases 27-29, 32-36, 48-51, 59, 62, 71-75, 100 Notification Certificates received, 1896 27-29 „ „ 1889-96 28, 29 Number of Persons per House (Lambeth) 14 „ per Acre „ 18, 76 „ „ (London) 18 Outer Districts— Mortalities and Birth-Rates 11, 13, 17, 18, 19, 21, 51, 64, 75 Phthllis 63, 65, 67, 69 Puerperal Fever 57 vii. page Premature Births 63,66-69 Premises Disinfected 97- 99 Public Institution Deaths 12, 13, l5-!7 Population-of Lambeth, 1896 4, 5 7, 10, 12, 76 „ „ „ Sub-Districts 5, 7, 8, 9, 74 „ ,, „ Parliamentary and New Wards . 8 „ „ „ Age periods 9, 20 Population of London, 1896 5, 6, 18, 19 „ „ „ Sub-Districts 6 Parasitic Diseases 63, 65 Prosecutions— Public Health Acts 81-87 Food and Drugs and Margarine Acts 109-117 Housing of Working Classes Act 88, 89 Penalties— Public Health Acts - 79-89 Food and Drugs and Margarine Acts 105, 108-117 Quinquennial Census, 1896 4 Registration Sub-Districts (Lambeth)— General Diseases, deaths 17-22,67-73 Zymotic Diseases, deaths 18-19, 27, 32--33, 70-74 Births and Birth-rates .11, 13, 18-19 Rateable Value of Lambeth 10, 76 Refuge for Infected Households 95-96 Removal of Infectious Diseases 27-28, 74-75 Respiratory Diseases 63, 67 Summary of Vital Statistics (Lambeth) 76 Salaries 90, 94 Sanitary Defects 30-31 Sanitary Offices—Alterations and Enlargement of 101-2 Small-Pox 37-45 „ Details of Cases 37-42 Scarlet Fever 46, 47 „ Age Distribuion of Cases 46 Smoke Nuisances 79 Sanitary Work 77-79 „ Structural 78, 79 „ Not Structural 78, 79 Simple or Continued Fever 56 L Vlll. Slaughter Houses .136 Staff- Clerks 136 Inspectors 90-93 Disinfectors 93-96 Mortuary Attendants 126 Underground Layatory Attendants 129-131 Suffocation in bed 64, 66, 67, 69 Suicide . 64,65 Summonses 79-89, 105-117, 121-123 Typhus 54 Typhoid 28, 55,56 „ Age Distribution of 55 Underground Conveniences 129-131 Venereal Diseases 63 Vital Statistics, London 4, 5, 6 „ Lambeth 4, 5, 7, 8, 9 „ Summary (Lambeth) 76 Vaccination Returns, 1895-96 43-45 Violence Deaths . . 64, 65 Work of Sanitary Staff 77-11'7 Whooping Cough 48-51 Notification of 48-50 Zymotic Diseases 12, 14. 17.19. 27-62, 65, 74-76 „ Principal 12,14,27-61,65,76 „ Arranged Quarterly 32-33 „ Arranged Monthly 36 APPENDIX. 3 2 Lambrth Parish -Deaths Registered from all Causes during the Year 1896. AGES. AGES Under 1-5 Under 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 80 and over. Over 5 Years All Ages. Total. M F M F M F M F M F M. F M. F. M. F. M F. M. F. M. F. M F. M. F. M. F. I. Specific Febrile, or Zymotic Diseases 142 142 167 191 309 333 37 31 3 7 8 1 1 5 17 18 20 15 3 4 12 8 5 2 101 91 413 42 837 11 Parasitic Diseases 1 2 ... ... 1 2 ... ... ... ... ... ... ... ... 5 6 15 9 1 1 ... 2 1 ... 22 18 1 19t 47 5 1 1 ... 6 1 ... ... ... ... 12 19 26 15 139 99 165 145 27 32 47 69 0 6 447 405 537 480 1017 IV Constitutional Diseases 42 39 48 36 90 75 17 9 8 11 ... 1 ... ... ... 1 1 ... 2 1 42 60 21 70 60 133 190 219 409 124 86 ... ... 124 86 ... ... ... 10 10 18 15 23 80 113 269 245 95 98 209 272 36 57 75e 861 1140 1182 2322 VI. Local Diseases 262 195 122 126 384 321 34 25 8 1 7 1 3 2 25 10 35 5 6 2 8 3 1 7 90 32 141 70 211 VII. Deaths from Violence 31 27 14 11 45 38 ... 1 5 ... ... ... ... ... 1 1 1 ... 3 ... 5 4 ... 2 10 12 140 112 252 VIII. Deaths from Ill-defined and not Specified Causes 122 92 8 8 130 100 94 66 24 29 37 40 45 45 267 248 506 424 137 138 323 418 68 144 1501 1552 2590 2508 5098 Totals 729 584 360 372 1089 956 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Smallpox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 Unvaccinated ... 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 3 ... 102 ... No Statement 12 23 64 76 76 99 7 2 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 2 3 58 82 140 Measles 33 38 23 41 56 79 2 3 ... ... 2 ... ... ... ... 1 1 ... ... ... ... ... ... ... 10 9 33 30 63 Whooping Cough 2 1 21 20 23 21 6 7 ...1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 Scarlet Fever ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 Single Continued and Ill-denned ... ... ... ... ... ... ... 1 ... ... 5 ... 1 1 8 1 ... 1 ... ... ... ... ... ... 18 6 18 6 24 Fever ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... 1 ... ... ... ... ... ... ?2 20 70 59 129 Enteric or Typhoid Fever 4 2 44 37 48 39 22 16 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 8 11 Diphtheria ... ... 3 7 3 7 ... 1 ... ... 1 1 ... ... 4 6 ... 7 1 2 6 4 1 1 19 21 25 26 51 Membranous Croup 5 4 1 1 6 5 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Influenza ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 1 5 Other Mrasmatic Diseases 2 1 2 ... 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera, Nostras ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... 3 ... 1 2 9 76 76 152 Cholera, Astic 66 59 8 ... 74 67 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dirrhoea, or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Remittent or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cowpox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 9 ... ... ... ... ... ... ... ... 2 2, 14 13 27 Other Diseases (e.g. Hydrophobia, Glanders, Aplenic Fever) 12 11 ... ... 12 11 ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... 2 ... 2 ... 7 ... 7 ... 7 Sypholis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 3 2 ... 1 1 ... ... 8 4 13 5 18 Gonorrhoe, Structure of Urethra 5 1 1 ... 5 ... ... ... ... ... ... ... ... ... 1 ... 4 ... ... ... 1 ... ... ... 6 ... 8 ... 8 Erysipelas 1 ... ... ... 2 ... ... ... ... ... ... ... ... 1 ... 8 ... 1 ... ... ... ... ... ... ... 12 ... 12 12 Pyaeperal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pyaemia, Septicaemia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 3 Puerperal Fever ... 1 2 ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Thrush, and other Vegetable sitic Diseases. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Worms, Hydatis, and other Animal ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 1 7 Parasitic Diseases ... 5 1 1 ... ... 1 ... ... ... ... ... ... ... 3 6 13 2 1 1 ... 2 1 ... 18 18 18 18 36 Want of Breast Milk, Starvation Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... ... ... 4 ... 4 ... 4 Chronic Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Delirium Tremens ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 6 1 4 4 ... ... ... 1 ... ... 13 10 13 10 23 Rheumatic Fever ... ... ... ... ... ... 2 2 ... 1 ... 1 ... ... 1 2 ... ... ... ... ... ... ... ... 2 4 2 4 6 Rheumatism of the Heart ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4,5 Lambeth Parish.—Deaths Registered from all Causes during the year 1896. AGES. AGES. Total. Under 1 Year. 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 80and over. Over 5 Years. All Ages. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M F ... ... ... ... 1 1 1 1 1 3 1 4 1 ... 5 9 5 9 14 Rheumatism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 ... 2 ... ... 1 6 1 6 1 7 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 6 14 Rickets 3 4 5 2 2 8 6 ... ... ... ... ... ... ... 6 13 47 72 16 20 29 52 5 5 105 162 108 163 269 Cancer, Malignant Disease ... ... 1 ... 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 Cancrum Oris (Noma) ... 1 ... 2 ... 3 ... ... ... 1 ... ... 1 ... ... 1 2 1 ... ... ... ... ... 6 4 25 19 44 Tabes Mesenterica 14 9 5 6 19 15 2 1 1 ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... ... 4 6 41 37 78 Tuber-Meningitis, Hydrocephalus 14 14 23 17 37 31 3 1 1 1 c 10 12 ... 10 119 76 103 55 6 5 9 8 ... ... 282 173 290 180 470 Phthisis 3 5 5 2 8 7 6 2 3 5 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 3 4 3 7 Scrofula 2 ... 1 ... 3 ... ... 1 ... ... 1 2 ... 2 4 4 3 2 ... ... 1 ... ... ... 11 14 23 25 48 Other forms of Tuberculosis 6 5 6 ... 12 11 ... 1 ... 3 ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... 1 2 1 3 4 Purpura, Hemorrhagic Diathesis ... 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 2 3 ... ... ... 2 ... ... 3 6 4 6 10 Anaemia, Chlorosis, Leucocythaemia ... ... 1 ... 1 ... 1 ... ... ... ... ... ... ... 1 ... ... 2 1 3 3 1 ... ... 5 6 5 6 11 Glycosuria, Diabetes Mellitus ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 ... 3 1 1 1 ... ... ... 3 5 4 5 9 Other Constitutional Diseases ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 90 66 156 Premature Birth 90 66 ... ... 90 66 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 12 26 Atelectasis 14 12 ... ... 14 12 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 20 10 30 Congenital Malformations 20 8 ... ... 20 8 ... ... ... ... ... ... ... ... 1 ... 2 1 42 50 21 70 66 131 66 131 197 Old Age ... ... ... ... 1 4 19 3 5 2. 1 1 1 1 1 2 1 ... ... 1 1 ... ... ... 10 10 32 29 61 Inflammation of Brain or Membrane Apoplexy, Softening of Brain, 15 9 ... ... 20 ... ... ... ... ... ... 1 1 1 7 ... 32 34 13 23 42 38 7 15 103 112 105 115 220 Hemiplegia, Brain Paralysis . 1 ... ... ... ... 3 ... ... ... ... ... ... 1 ... 6 6 9 8 6 ... 3 6 1 4 26 24 26 24 50 Insanity, General Paralysis of Insan ... ... ... ... ... ... ... ... ... ... 3 ... 1 1 2 3 3 6 ... ... 1 1 ... 1 10 12 11 12 23 Epilepsy 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 35 32 67 Convulsions 27 23 ... ... 22 30 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Laryngismus Stridulus (Spasm of Glottis) ... ... ... ... ... 3 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 7 4 11 Disease of Spinal Cord, Paraplegia ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 4 2 2 ... 2 1 ... ... 8 6 9 6 15 Paralysis Agitans ... ... ... ... ... 7 1 ... ... ... ... ... ... 1 ... 4 5 6 1 2 6 4 ... ... 13 18 22 25 47 Other Diseases of Nervous System ... ... ... ... 3 7 ... ... 1 ... 1 1 2 2 ... 1 ... ... ... ... ... ... ... 4 4 11 5 16 Diseases of Ear, Eye, Nose ... 5 ... ... ... 1 1 ... ... ... ... ... 2 ... ... ... 1 ... ... ... ... 5 4 5 6 11 Pericarditis ... 1 ... ... ... ... ... ... ... 1 ... 2 1 1 1 3 1 1 ... ... ... 1 ... ... 3 8 3 8 11 Acute Endocarditis ... ... ... ... ... ... ... ... ... ... 1 4 1 4 4 12 14 7 4 5 14 19 2 1 42 56 42 56 98 Valvular Diseases of Heart ... ... ... ... ... 2 ... 4 ... 1 2 3 ... 2 17 17 39 32 8 14 28 46 2 5 99 126 101 126 227 Other Diseases of Heart ... 2 ... ... ... 2 ... ... 2 ... 3 ... ... ... ... 3 1 7 ... ... ... ... ... ... ... 10 1 10 1 11 Aneurism ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... 1 ... 1 ... ... 2 4 2 5 7 Embolism, Thrombosis ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 ... 1 ... 2 2 ... ... ... 2 5 2 5 7 Other Diseases of Blood Vessels . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 6 8 Laryngitis ... ... 1 ... 4 l ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 10 4 14 Croup ... ... ... 3 3 9 1 1 ... ... ... ... ... ... 2 2 1 4 3 ... 4 1 1 ... 11 7 11 7 18 Emphysema, Asthma ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 10 41 38 22 20 55 86 13 18 135 173 212 251 463 Bronchitis 5 49 18 ... 29 7 7 78 1 1 ... 1 1 2 1 12 2 27 12 4 11 7 8 2 4 59 41 112 70 182 Pneumonia 22 1 26 ... 5 3 2 1 4 ... ... ... ... ... ... ... ... 3 ... ... 1 ... 2 ... ... 3 4 6 5 11 Pleurisy ... 1 2 ... 1 3 ... ... ... ... ... ... ... ... 1 1 4 3 2 2 2 2 ... ... 11 8 53 45 98 Bronchopneumonia ... 22 20 ... 4 2 3 7 2 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 1 1 4 5 Pleuropneumonia ... ... ... ... 2 3 ... ... ... ... ... 1 ... 1 ... 9 6 2 ... 5 6 ... ... 20 12 26 26 52 Other Dis. of Respiratory System ... 4 2 2 6 6 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 23 25 48 Dentition 16 ... 1 7 4 2 3 2 5 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 4 ... 4 1 5 Sore Throat, Quinsy ... ... ... ... 1 ... 1 2 ... ... ... ... 1 ... 1 2 1 2 2 1 ... ... 3 1 ... 7 9 11 17 28 Diseases of Stomach 3 3 7 ... 1 4 4 1 ... 1 1 ... 1 ... 4 3 2 1 1 ... 1 2 ... 1 12 7 63 41 104 Enteritis 45 ... 29 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6,7 7 Lambeth Parish.—Deaths Registered from all Causes during the year 1896. AGES AGES. Total. Under 1 Year. 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 25-10 40-60 60-35 68-80 80 anc over. Over 5 Years All Ages. m. F. m F. m. F. m. F. M. F. m F M F m . F M . F M . F M. . F m . F m F. M F Obstructive Diseases of Intestine 4 2 ... ... 4 2 ... 1 ... ... ... ... ... ... 1 1 2 3 3. 1 4 1 2 3 9 10 13 12. 25 Peritonitis 1 1 1 ... 2 1 1 ... 1 2 1 ... ... ... ... 4 2 1 1 ... ... 1 ... ... 6 9 8 10 18 Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... 1 1 ... ... ... ... ... ... 1 ... 1 1 Cirrhosis of Liver ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 6 14 21 21 2 9 6 ... ... 31 35 31 35 66 Jaundice and other Diseases of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 6 7 7 4 4 4 ... ... 14 17 15 19 34 Diseases of the Pancreas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Digestive System 12 6 ... ... 12 6 1 ... ... ... ... ... ... ... 2 1 5 8 8 ... 1 7 ... 2 12 20 24 26 50 Diseases of Lymphatics and of Spleen ... ... 1 1 1 1 3 ... ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... ... 4 4 5 5 10 Dis. of Bronchocele, Addison's Dis. ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 4 1 1 ... ... 3 ... 1 5 8 5 8 13 Bright's Disease, Albuminuria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 19 11 3 4 10 l6 2 2 38 38 38 38 76 Disease of Bladder or of Prostate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 4 ... 4 1 3 ... 12 3 l2 3 15 Calculus (Stone) 2 ... ... ... 2 ... 1 ... ... ... ... ... ... ... 1 1 ... 4 ... 1 ... ... ... ... 1 ... 1 ... 1 Other Dis. of the Urinary System 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 5 ... 4 ... ... 4 ... ... .14 10 16 10 26 Male Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 10 ... 1. ... ... ... ... ... ... 1 ... 1 Female Organs ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 2 ... ... ... 1 ... ... ... 16 ... 16 16 Abortion, Miscarriage ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 5 ... 5 5 Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 Placenta previa, F looding ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... Other Accidents of Child Birth ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... 1 12 1 2 ... ... ... 1 ... ... 2 18 ... 18 18 Caries, Necrosis 1 ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 3 4 3 7 Arthritis, Ostitis, Periostitis 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 ... 3 1 4 Other Diseases of Bones and Joints ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 2 3 3 Carbuncle, Phlegmon ... 2 ... ... 2 2 ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... 2 1 ... 6 3 Other Dis. of Integumentary System 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... 4 4 10 Fractures and Contusions 1 2 3 1 4 3 2 ... 1 ... 2 ... 1 ... 10 1 8 1 1 ... 4 2 ... 3 29 7 33 10 43 Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 ... ... ... ... Cut, Stab ... ... 8 8 9 9 1 ... ... ... ... 1 ... ... ... 3 ... 1 ... ... ... 1 ... ... 1 6 2 ... 2 Burn, Scald 1 ... ... 1 ... l ... ... ... ... ... ... ... ... 2 ... 3 ... ... ... ... ... ... ... 5 ... 10 15 25 Poison ... ... ... ... ... ... ... ... 1 ... 3 ... ... ... 4 ... 2 ... 1 ... ... ... ... ... 13 ... 5 1 6 Drowning ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 4 ... 13 ... 13 Suffocation 23 22 ... ... 23 22 ... 1 2 ... 2 ... 1 1 5 ... 9 ... 2 ... ... ... ... ... 23 1 27 23 50 Otherwise 3 1 3 1 6 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 ... ... 4 1 12 29 14 43 Manslaughter ... ... ... ... 3 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 1 1 1 2 Murder 8 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 2 2 3 3 6 Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... ... ... ... 5 ... 2 Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 1 ... ... ... ... ... ... ... 5 ... ... 5 Poison. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 1 ... ... ... 4 3 4 3 7 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 2 ... 3 ... 3 Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 ... 2 ... Z Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... |1 ... ... ... 3 ... ... ... 2 ... ... Dropsy 117 87 5 ... 122 95 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 122 2 2 Debility, Atrophy, Inanition ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 2 ... 2 97 219 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 ... ... ... 2 ... 2 2 2 Tumour ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 1 ... 1 3 2 4 2 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 3 ... 6 Haemorrhage 1 1 ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 ... 3 1 4 Sudden Death (cause not ascertained ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or 111-defined.. 4 4 2 ... 6 4 ... ... ... ...— ... ... ... ... ... 1 ... 1 ... ... 1 2 ... ... 1 4 7 8 15 APPENDIX. PART II. 10 Lambeth Parish.—Deaths Registered J Waterloo Road 1st. Waterloo load 2nd Lambeth Church 1st. Lambeth Church 2nd. Kenning ton 1st. Kenning ton 2nd. Brixton . Norwood Ward no stated. All Ages. Total. m. F. m. F. M. F. M. f. i. Specific Febrile, or motic Diseases 30 20 24 36 28 35 73 77 M. F. m. F. M. F M. F. m. F. m. F. 11. Parasitic Diseases ... ... ... ... 74 78 50 47 95 101 33 30 6 ... 413 424 837 III. Dietic Diseases 3 1 1 2 1 4 7 ... 1 ... 1 1 ... ... ... ... ... 1 2 3 IV. Constitutional Diseases 32 21 32 29 29 32 89 67 5 5 4 2 3 3 5 ... 1 ... 28 19 47 V. Developmental Diseases 9 9 10 10 21 6 2G 35 99 77 90 79 115 133 32 25 19 17 537 480 1017 VI. Local Diseases 77 60 b9 62 75 6/ 210 230 41 44 27 34 41 66 7 17 8 8 190 219 409 VII. Deaths from Violence 11 4 13 4 17 10 35 10 199 181 150 183 240 275 66 79 51 45 1140 1182 2322 VIII. Deaths from Ill-defined and not Specified Causes 9 10 7 9 17 4 34 13 16 21 17 12 32 28 7 2 1 ... 141 70 211 Totals 171 125 156 150 189 155 471 439 461 421 352 375 544 610 156 162 1 1 140 112 252 Smallpox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 90 21 2590 2508 5098 Unvaccinated ... 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .No Statement ... ... ... ... ••• ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 Measles 9 5 4 11 8 13 18 21 ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 6 2 4 5 3 8 3 10 19 15 6 7 11 22 7 8 1 ... 83 102 185 Scarlet Fever 8 2 ... 1 2 3 8 3 12 22 8 7 17 23 4 5 1 ... 58 82 140 Typhus ... ... ... ... ... ... 1 ... 9 6 2 5 4 9 5 1 ... ... 33 30 63 Simple Continued and Ill-denned Fever ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 Enteric cr Typhoid Fever 1 ... 1 2 1 ... 2 ... ... ... .2 ... ... ... ... ... ... ... ... 1 1 Diphtheria 1 1 5 5 4 2 16 12 5 2 10 ... 2 1 4 1 ... ... 18 6 24 Membranous Croup ... ... ... ... ... ... 1 1 7 6 2 9 24 12 2 5 1 ... / 0 59 129 Influenza 1 ... ... 3 ... ... 2 .2 ... 1 4\ 3 ... 2 ... 1 ... ... 3 8 11 Other Miasmatic Diseases ... ... ... ... ... 1 ... ... 7( 6 ... 5 8 7 3 3 ... ... 25 26 51 Cholera, Nostras ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Cholera, Asiatic ... ... ... ... ... ... ... ... 1 1 ... ... 1 ... ... ... ... ... 4 1 5 Diarrhoea, Dysentery 7 7 5 7 3 7 14 18 ... ... ... ... ... ... ... ... ... ... ... ... ... Remittent or Relapsing Fever ... ... ... ... ... ... ... ... 10 11 7 9 22 11 6 6 2 ... 76 76 152 Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cowpox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis 1 1 2 1 4 1 3 5 ... ... ... ... ... ... ... ... ... ... ... ... ... Gonorrhoea, Stricture of Urethra 1 ... ... ... 1 ... 1 ... ... 3 2 ... 1 2 1 ... ... ... 14 13 27 Erysipelas ... ... 2 ... 1 ... ... 2 1 ... ... 1 3 ... ... ... ... ... 7 ... 7 Pyaemia, Septicaemia ... ... 1 ... 1 ... 2 ... 3 1 4 ... 1 1 1 ... 1 ... 13 5 18 Puerperal Fever ... ... ... 1 ... ... ... 2 ... 4 3 1 1 4 ... ... ... ... 8 ... 8 Thrush, and other Vegetable Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 12 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... 1 1 1 ... ... ... ... ... ... 1 2 3 Want of Breast Milk, Starvation .. ... ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scurvy ... ... ... ... ... ... ... ... ... 1 2 ... ... ... 1 ... ... ... 6 1 7 Chronic Alcoholism 2 1 1 ... 1 1. 2 7 ... ... ... 2 2 3 ... ... ... ... ... ... 36 Delirium Tremens 1 ... ... ... ... ... ... ... 5 4 ... ... 1 ... 2 ... 1 ... 18 18 4 Rheumatic Fever ... ... ... 1 ... ... ... 3 6 1 2 1 4 4 2 ... ... ... 2 10 23 Rheumatism of the Heart ... ... ... ... ... ... ... ... 1 1 ... 1 1 2 2 ... ... ... ... 2 4 6 6 11 12 Lamheth Parish—Deaths Registered from a]| Causes during the Year 1896. Waterloo Road 1st. Waterloc Road 2nd Lambeth Church 1st. Lambeth Church 2nd. Kennington 1st. Kennington 2nd. Brixton. Norwood Ward no stated. All Ages. Total. M. f. M. F. M. F. M. F. M. F. M. F. M. F. M. F M F M F Rheumatism ... 1 1 1 ... ... 2 1 ... 1 ... 3 ... 1 ... ... 2 1 5 9 14 Gout ... ... 1 ... ... ... ... ... ... ... 1 1 3 ... 1 ... ... ... 6 1 7 Rickets 1 ... ... ... 2 2 1 ... 1 1 1 ... 1 2 ... ... 1 ... 8 6 14 Cancer, Malignant Disease 6 3 2 4 2 9 12 l8 26 30 18 37 23 43 8 11 9 1 108 163 269 Cancrum Oris (Noma) ... ... ... ... ... 1 ... ... ... 2 ... ... ... ... ... ... ... 8 ... 3 3 Tabes Mesenterica 1 2 1 3 3 ... 4 5 6 2 3 4 6 2 1 1 ... ... 25 19 44 Tuber-Meningitis, Hydrocephalus 2 2 4 1 3 2 10 6 4 4 7 7 9 ]2 2 2 ... ... 11 37 78 Phthisis 20 9 21 16 14 15 53 30 47 28 50 15 60 56 19 6 ... 1 290 180 470 Scrofula ... 1 ... 1 2 1 2 ... ... ... ... ... ... ... ... ... 6 5 ,4 3 7 Other forms of Tuberculosis 2 1 2 2 2 2 5 3 5 3 4 5 2 6 ... 3 1 ... 23 25 48 Purpura, Hemorrhagic Diathesis ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... ... 1 3 4 Anaemia, Chlorosis, Leucocythaemia ... 1 ... ... ... ... ... 1 2 1 ... 1 2 ... ... 1 ... 1 4 6 10 Glycosuria, Diabetes Mellitus ... ... ... ... ... ... ... ... 1 2 2 2 2 2 ... ... ... ... 5 6 11 Other Constitutional Diseases ... ... ... ... 1 ... ... ... ... 1 2 2 1 1 ... 1 ... ... 4 5 9 Premature Birth 3 2 4 6 6 3 10 12 24 15 17 11 21 14 5 3 ... ... 90 66 156 Atelectasis ... 2 1 ... 2 1 6 4 3 2 1 ... 1 3 ... ... ... ... 14 12 26 Congenital Malformations 1 1 1 1 8 ... 3 3 4 1 1 3 2 1 ... ... ... ... 20 10 30 Old Age 5 4 4 3 5 2 7 16 10 26 8 20 17 38 2 14 8 8 66 131 197 Inflammation of Brain or Membranes 1 1 1 1 1 1 6 7 7 8 5 5 6 3 5 2 ... 1 32 29 61 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis 4 5 4 7 5 7 20 19 15 12 10 15 30 34 6 7 1 9 105 115 220 Insanity, General Paralysis of Insar e 1 1 1 1 ... 1 9 10 1 1 3 2 4 6 1 ... 6 2 26 24 50 Epilepsy ... 1 ... ... ... ... 4 2 2 2 2 ... ... 2 2 2 1 3 11 12 23 Convulsions 6 1 3 ... ... 3 8 8 1 6 3 4 12 9 2 1 ... ... 35 32 67 Laryngismus Stridulus (Spasm of Glottis) ... ... ... ... ... ... ... 2 ... ... 3 2 4 ... ... ... ... ... 7 4 11 Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... 1 ... ... ... 1 ... 2 1 ... 1 4 3 1 ... ... 1 9 6 15 Other Diseases of Nervous System 2 1 1 1 2 4 8 7 3 2 3 5 2 5 ... ... ...; ... 22 25 47 Diseases of Ear, Eye, Nose ... ... ... ... 1 ... 3 2 5 2 ... ... 1 ... 1 1 ... ... 11 5 16 Pericarditis 1 ... 1 ... ... 1 ... 1 1 2 ... ... 2 2 ... ... ... ... 5 5 11 Acute Endocarditis ... ... ... ... 2 1 1 4 ... ... ... ... ... 3 ... ... ... ... 3 6 11 Valvular Diseases of Heart 5 8 2 4 2 4 7 7 8 11 6 10 9 11 2 1 1; ... 42 8 98 Other Diseases of Heart 6 4 9 3 3 11 14 15 20 20 16 21 20 32 10 11 3 9 101 56 227 Aneurism ... ... 2 ... ... ... 2 ... 3 1 1 ... 1 ... 1 ... ... ... 10 126 11 Embolism, Thrombosis ... ... ... ... ... ... ... 1 ... 1 ... 1 1 ... 1 2 ... ... 2 1 7 Other Diseases of Blood Vessels ... ... ... ... ... ... ... 1 ... ... 1 ... ... 3 ... 1 ... ... 2 5 7 Laryngitis ... ... ... ... ... ... 1 3 1 1 ... ... ... 2 ... ... ... ... 2 6 8 Croup ... ... 1 ... 2 ... 1 1 3 ... 2 ... ... 3 1 ... ... ... 1C 4 14 Emphysema, Asthma ... ... 1 ... 2 1 1 ... 1 1 1 1 3 3 1 1 ... ... 11 7 18 Bronchitis 14 14 16 22 19 13 48 47 33 32 28 40 33 52 6 21 15 10 212 251 463 Pneumonia 8 5 12 2 5 5 25 13 17 13 13 9 23 17 5 21 4 4 112 70 182 Pleurisy 1 ... ... ... 2 2 ... 1 ... 1 2 ... ... 1 1 ... ... ... 6 5 11 Bronchopneumonia 3 3 3 1 6 1 14 15 13 7 4 5 6 10 3 2 1 1 53 45 18 Pleuropneumonia ... 1 ... ... ... ... ... ... ... 2 . . . ... ... 1 1 ... ... ... 1 4 5 Other Dis. of Respiratory System 1 ... ... 1 2 1 ... 7 9 4 2 8 10 4 2 1 ... ... 26 26 52 Dentition 4 4 ... 4 3 ... 1 3 5 3 1 1 6 7 3 3; ... ... 23 25 48 Sore Throat, Quinsy ... ... 1 ... 1 ... ... ... ... 1 1 ... 1 ... ... ... ... ... 4 1 5 Diseases of Stomach ... ... ... ... ... ... 2 7 3 2 ... 3 6 4 ... 1 ... ... 11 17 28 Enteritis 5 1 3 2 4 5 12 11 7 4 7 8 24 10 ... ... 1 ... 63 41 104 13 14 15 Lambeth Parish.—Deaths Registered from all Causes during the year 1896. Waterloo Road 1stt Waterloo Road 2nd Lambeth Church 1st. Lambeth Church 2nd. Kennington 1st. Kennington 2nd. Brixton. Norwood Ward not stated. All Ages. Total. M F. M. F. M. F. M. F. M F M F M F. M F M F M F 25 Obstructive Diseases of Intest ne ... ... ... ... 1 ... 2 2 4 4 2 3 2 3 1 1 1 ... 13 12 18 Peritonitis 1 1 ... ... 1 ... 1 1 1 6 3 4 1 ... ... 2 ... ... 8 10 1 Ascites ... ... ... ... I 2 ... 7 ... 4 8 ... 9 9 1 ...' 1 ... 31 1 66 Cirrhosis of Liver 1 ... 1 2 ... 2 4 2 5 ... 1 7 / 4 1 2 I ... ... 15 35 31 Jaundice and other Diseases of Liver 1 1 ... 2 1 1 ... ... 4 10 ... 4 ... ... ... 1 ... ... ... 19 ... Diseases of the Pancreas ... ... 3 ... ... 1 7 4 ... 1 1 ... 2 4 2 ... ... ... 24 ... 50 Other Diseases of Digestive System 1 2 1 ... ... ... 2 2 1 ... ... 2 1 1 ... 3 ... ... 5 26 10 Diseases ot Lymphatics andof Spleen ... ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... ... 1 ... ... 1 5 1 Dis. of Bronchocele, Addison's Dis ... ... 1 ... 1 ... ... 1 8 4 1 ... 3 3 5 ... ... 3 5 ... 13 Nephritis 1 1 ... 1 1 1 1 4 2 1 8 1 ... 10 ... 6 1 ... 38 8 76 Bright's Disease, Albuminuria 4 2 ... 3 ... ... ... ... ... ... 3 5 4 2 ... ... ... ... 12 38 15 Disease of Bladder or of Prostate 1 ... 1 ... 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 3 1 Calculus (Stone) ... ... ... ... 2 ... 3 2 3 ... 4 ... 2 4 ... 1 2 1 16 ... 26 Other Dis. of the Urinary System ... ... ... ... ... ... ... ... ... 4 ... ... ... ... 1 ... ... ... 1 10 1 Male Organs ... ... ... 1 ... ... ... 2 ... 4 ... 5 ... 4 ... ... ... ... ... ... 16 Female Organs ... ... ... 1 ... ... ... 1 ... ... ... 2 ... ... ... 1 ... ... ... 16 5 Abortion, Miscarriage ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 5 I Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Placenta praevia, Flooding ... ... ... ... ... ... ... 4 ... 4 ••• 3 ... 2 ... 2 ... 1 ... ... 18 Other Accidents of Child Birth ... 2 ... ... ... ... ... 1 1 ... 2 1 ... 1 ... ... ... ... 4 18 7 Caries, Necrosis 1 ... ... ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... 3 3 4 Arthritis, Ostitis, Periostitis ... ... ... ... 1 ... i ... 1 ... ... 1 ... ... ... ... ... ... 2 1 3 Other Diseases of Bones and Joints ... ... ... ... ... 1 l ... ... ... ... 1 1 ... 1 ... ... ... ... ... 1 3 Carbuncle, Phlegmon ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 1 ... 4 3 10 Other Dis. of Integumentary System 2 1 ... 1 ... ... ... ... 6 2 6 1 2 2 ... 1 1 ... 33 6 ... Fractures and Contusions 2 ... 2 1 5 2 8 1 ... ... ... ... ... ... 1 ... ... ... ... 10 43 Gunshot Wounds ... ... ... ... ... ... ... ... 2 4 ... ... ... ... ... ... ... ... 2 ... 2 Cut, Stab ... ... ... ... ... 4 2 1 2 1 1 4 1 2 ... ... ... ... 10 ... 25 Burn, Scald 1 ... ... ... 3 ... ... ... 2 ... 1 ... 2 ... ... ... ... ... 5 15 6 Poison ... ... 1 ] ... 3 ... 3 ... ... 1 2 3 1 7 2 1 ... ... 13 1 13 Drowning 3 2 1 2 2 2 8 5 7 5» ... 3 6 2 3 ... ... ... 27 .... 50 Suffocation 1. ... 4 1 3 2 12 1 4 ... ... ... ... ... ... ... ... ... 29 23 43 Otherwise 1 ... 1 ... ... ... ... ... ... 1 1 ... 2 ... ... ... ... ... 1 14 2 Manslaughter ... 1 ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 3 1 6 Murder ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 3 2 Gunshot Wounds ... ... ... ... ... 1 ... ... 1 ... ... ... 3 1 ... ... ... ... 5 ... 5 Cut, Stab ... ... ... ... ... ... 1 2 2 ... 2 ... ... ... ... ... ... ... 4 ... 7 Poison ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 3 Drowning ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 Hanging ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 Otherwise ... ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Dropsy ... ... ... 6 6 16 32 12 ... 20 12 15 25 22 6 9 1 ... 122 2 219 Debility, Atrophy, Inanition 9 10 6 ... ... ... ... ... 15 ... 1 ... ... ... 1 ... ... ... 2 ... 2 Mortification ... ... ... ... ... ... ... 1 ... ... 1 ... 1 1 ... ... ... 1 4 2 4 Tumour ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... 2 6 Abscess ... ... 1 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 3 1 4 Haemorrhage ... ... ... ... ... ... ... ... ... ... 1 ... ... 4 ... ...... ... ... ... ... ... Sudden Death (cause not ascertain ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or lll-defined ... ... ... ... ... ... ... ... ... ... 1 2 6 ... ... ... ... ... 7 8 15 16 SUMMARY OF MORTALITY TABLE. No. of Deaths. Total No. of Deaths. Total. M. F. I.—Specific Febrile, or Zymotic Diseases. M. F. Brought forward VI.—Local Diseases—continued 2217 2208 4425 1. Miasmatic Diseases 291 317 608 6. Diseases of Lymphatic System 5 5 10 2. Diarrhceal „ 80 77 157 3. Malarial „ ... ... ... 7. Diseases of Gland-like Organs of Uncertain Use 1 ... 1 4. Zoogenous „ 5. Venereal „ 21 13 34 8. Diseases of Urinary System. 72 59 131 6. Septic „ 21 17 38 9. Diseases of Reproductive System— II.—Parasitic Diseases 1 2 3 (a) Diseases of Organs of Generation 1 16 17 III.—Dietic Diseases 28 19 47 (A) Diseases of Parturition ... 24 24 10. Diseases of Bones and Joints 9 5 14 IV.—Constitutional Diseases 537 480 1017 11. Diseases of Integumentary System 4 9 13 V.—Developmental Diseases 190 219 409 VII.—Violence. VI.—Local Diseases 1. Accident or Negligence 119 63 182 1. Diseases of Nervous System 247 247 494 2. Homicide 4 4 8 2. Diseases of Organs of Special 11 5 16 3. Suicide 18 3 21 Sense 4. Execution ... ... ... 3. Diseases of Circulatory System 165 207 372 4. Diseases of Respiratory „ 433 418 851 VIII.—Ill-Defined and not Specified Causes. 140 112 252 5. Diseases of Digestive System 192 187 379 Carried forward 2217 2208 4425 Total 2590 2508 5098