LEW 2 REPORT TO The Board of Works for the Lewisham District TO THE END OF THE YEAR 1894, by Dr. S. BLAKE JOLLY, Medical Officer of Health for the District. Gentlemen, The number of deaths registered as having occurred in the Lewisham District during the year 1894 was 1340. Of these 18 were of persons who did not belong to this District, while, on the other hand, 82 persons belonging to the District died in hospitals and asylums outside, making the actual total of deaths 1404, as against 1468 in the previous year, and the corrected death rate for 1894 14-0 per 1000, as compared with 151 per 1000 in 1893. The year 1894 has been, in every respect, more healthy than the previous year. We have had less zymotic disease, and the Influenza was of a much milder type. There have been only 312 cases of scarlet fever, and 172 cases of diphtheria against 524, and 219 in 1893. Enteric fever was very prevalent in London, but in this District during the year there were only 58 cases of this disease notified, against 63 in 1893, and in the great majority of cases there was distinct proof that the disease had been contracted in London 2 and not in this District. There were only 8 cases of smallpox notified, against 28 notifications last year, and there was no death from this disease. The deaths from influenza were only 29, as compared with 58 in 1893, and 74 in 1892. POPULATION The population of the Lewisham District, at the Census of 1891, was found to be 92,647, occupying 15,643 houses, giving an average of 5.9 inmates to each inhabited house. The number of inhabited houses at Midsummer, 1894, was 16,983, and the population was therefore estimated at 100,200. Births. The registered births in the District in the year 1894 amounted to 2,430, or 39 less than in the previous year ; of these 76, or 3.1 per cent., were illegitimate. Males 1,259 Females 1,171 The birth rate to population was 24.2 per 1,000. In England and Wales it was 29.6 per 1,000 of the population. This is the lowest birth rate ever recorded, and is 2 per 1,000 below the mean rate of the previous ten years. The birth rate in London, 30.1 per 1000, was also the lowest yet recorded. Deaths. The total number of deaths for 1894 was 1,404, as against 1,468 in 1893. 3 Males 687 Females 717 The number of deaths in public institutions in the District amounted to 165, an increase of 15 on the previous year. Lewisham Workhouse 127 deaths. Lower Sydenham Home for Sick Children 14 „ St. John's Hospital, Blackheath 13 „ North Surrey District Schools, Penge 8 „ Watermans' Asylum, Penge 3 „ Death rate for 1894, 14.0 per 1000, as compared with 15.1 per 1,000 in the previous year. During the same period the death rate in England and Wales, which in the preceding four years had been successively 19.5, 20.2, 19.0 and 19.7 per 1000, was 16.6 per 1,000, being not only the lowest ever recorded, but so much as 1.5 per 1,000 under the lowest previous rate, viz., 18.1 in 1888. It was also 2.6 per 1,000 below the mean annual rate of the preceding ten years. The death rate in London for 1894 was 17.8 per 1000, also lower by 2.6 than the average of the preceding ten years. The death rate of the "Outer Ring" of suburban districts, with a population of over a million and a-half was only 13.0 per 1,000. The death rate of the thirty-three great towns of England and Wales, with a population of nearly ten and a half millions, averaged 18.1 per 1,000, ranging from 13.2 in Croydon to 23.8 in Liverpool. 4 Zymotic Disease. The number of deaths from Zymotic Disease was 202 as compared with 153 in the previous year. The increase was due to measles and whooping cough, these complaints having caused 108 deaths in 1894 as compared with 29 in the previous year. Scarlet Fever 12 deaths as compared with 14 in 1893. Diphtheria 85 ,, ,, 53 „ Small-pox 0 „ „ 5 „ Typhoid Fever 15 „ „ 10 „ Measles 54 ,, „ 19 „ Whooping Cough 54 „ „ 10 „ Diarrhœa32 „ „ 42 „ Scarlet Fever. There were 312 notifications of this disease received during 1894, with 12 deaths, as compared 524 notifications and 14 deaths in 1893. The cases were scattered over the district. The type was as a rule mild. In no case could milk be traced as a source of infection. Diphtheria. There were 172 cases of this disease reported during the year, with 35 deaths, as compared with 219 notifications and 53 deaths in 1893. Very few cases have been reported from the Freehold, Forest-hill, in which part of the district there were so many cases last year. Most of the houses here have been inspected and redrained, and the small number of cases now occurring there is undoubtedly due to this improvement in sanitation. The treatment of diphtheria 5 by antitoxine is still on its trial; but so far there seems to be good ground for hoping that in it there has been discovered, at any rate, a most valuable help in the treatment of this disease. It should certainly be given a fair trial in all severe cases of diphtheria and diphtheric croup, and the earlier it is used the more chance there seems of its being successful. It is my intention to ask all the medical men in this District to send me intimation of their use of this treatment and its result. Thus the result in cases in private practice may be known as well as in those treated in Hospital. At present the Hospital cases treated by antitoxine appear to have much benefited by this treatment, and many cases have recovered which would generally have proved hopeless. More time and a larger number of cases, however, is necessary before we can look upon antitoxine as a certain specific in diphtheria. Small-pox. There were 8 notifications of this disease with no deaths in 1894, as compared with 28 notifications and 5 deaths in 1893. Most of these 8 cases were mitigated smallpox, and I believe the cessation of the epidemic was owing to the great increase in the number of revaccinations. I have been allowed by the Board to use the Hither-green Fever Hospital as an isolation hospital in small-pox cases, as it is now no longer used as a hospital. Thus, in all cases of small-pox, the friends of the patient, or all those who have been in contact with him, can be isolated till they are proved not to have contracted the disease. This, however, can only be done with their free consent; but, so far, I have found 6 them very willing to avail themselves of the opportunity. It has the double advantage of the isolation of suspected persons, and the more thorough disinfection of their houses in their absence. As an example of the value of vaccination in the prevention of contagion from small-pox, I may mention an instance which occurred this year. A man contracted small-pox, and was removed to hospital, and his wife and children isolated, as they had all been in direct contact with him. They had all been thoroughly vaccinated, and all escaped, while a friend of the patient's, who came in to see him for only a few minutes, when he was first taken ill, contracted the disease ; he, however, had not been vaccinated. Diseases of the Respiratory Organs. The number of deaths from Phthisis show an increase of 5 on the previous year. The total number of deaths from diseases of the respiratory organs was 249, or 86 less than last year. Of this number 29 deaths were attributed directly to Influenza, as compared with 58 in 1893. Inquests. Coroner's inquests were held in 61 cases of death. The causes of death were returned as follows:— Natural causes 34 Violent death 21 Of these latter 16 were accidental, 4 suicidal, and 1 homicidal. Six cases were returned as " Found dead," and 22 deaths were registered as "Not Certified." 7 MARRIAGES. During the year 1894 there were 495 Marriages in the Parish of Lewisham, of which 329 were solemnised in the various Churches, 60 in Dissenting Chapels, and 106 at the Registrar's Office. During the same period there were 157 marriages in the Hamlet of Penge, of which 126 were solemnised in Churches, 18 in Dissenting Chapels, and 10 at the Registrar's Office. Total 652, as compared with 651 in 1893. The marriage rate was equal to 13.0 persons married per 1,000 of estimated population. In London the proportion of persons married to the total population was 17.0 per 1,000. Meteorology. The mean temperature of the air at Greenwich in 1894 was 49.9. The highest reading by day, 86.0, was registered in July, and the lowest reading by night, 12.8, in January. Rain fell on 192 days. The total amount of rainfall was 26.88 inches. I am, Gentlemen, Faithfully yours, S. BLAKE JOLLY, Medical Officer of Health to the Lewisham District. 8 TABLE I.—Shewing the Population, Inhabited Houses, Marriages, Births, and Deaths, for the Year 1894 and 10 years preceding. (GROSS NUMBERS). The Year.* Estimated Population. No. of Inhabited Houses. Marriages. Registered Births. Corrected No. of Deaths. Deaths in Public Institutions. Total All Ages. Under One Year. Under Five Years 1894 100200 16983 652 2430 1404 333 516 247 1893 97160 16468 651 2469 1468 308 459 232 1892 94210 15968 597 2436 1476 345 502 240 1891 92647 15643 581 2521 1355 ... ... ... 1890 90564 15094 576 2259 1320 ... ... ... 1889 90812 14503 538 2319 1126 ... ... ... 1888 88845 14188 510 2287 1226 ... ... ... 1887 86423 13800 566 2354 1191 ... ... ... 1886 85300 13613 473 2324 1150 ... ... ... 1885 82000 13090 531 2451 1128 ... ... ... 1884 79730 12716 503 2316 1110 ... ... ... Average of 10 years, 1884—1893 88769 14508 552 2373 1255 ... ... ... NOTES. 1. Population according to Census, 1891, 92,647. 2. Average No. of Persons in each House at Census 1891, 5 9. 3. Area of District in acres, 6544. *For statistical purposes the Registrar-General estimates the population to the middle of the year on the basis of the rate of increase ruling between the two preceding Census periods. The estimate of population may be checked by the known number of inhabited houses, and by the average number of inmates per house, as ascertained at the preceding Census. 9 TABLE II.—Showing the Annual Birth and Death Rates, Death Rates of Children, and Proportion of Deaths in Public Institutions in a Thousand Deaths for the Year 1894 and 10 years preceding. In the Year Birth Rate per 1000 of the Population. Corrected Death Rate per 1000 of the Population. Deaths of Children under 1 year; per 1000 of Registered Births. Deaths of Children under 1 year; per 1000 of Total Deaths. Deaths of Children under 5 years: per 1000 of Total Deaths. Deaths in Public Institutions; per 1000 of Total Deaths. 1894 24.2 14.00 137.0 327.1 367.5 175.9 1893 25.4 15.10 124.7 209.8 312.6 158.0 1891 25.8 15.60 140.0 245.0 351.4 162.6 1891 27.2 14.62 117.4 218.0 332.1 121.7 1890 24.9. 13.7 139.8 239.3 364.3 109.8 1889 25.5 12.39 126.7 261.1 370.3 123.4 1888 25.6 13.43 126.6 240.6 385.8 92.1 1887 27.2 13.66 121.0 240.1 381.2 115.0 1886 27.2 13.36 124.3 251.3 363.4 87.8 188.5 29.8 13.75 120.3 261.5 390.9 89.9 1884 29.0 13.92 125.2 261.2 409.0 64.8 Average of 10 years, 1884—1893 26.7 13.98 126.6 244.8 366.1 112.5 h-» o TABLE III. Deaths registered from all causes during the year 1894. Note.—The Deaths of Non-residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District, are included. AGES. Totals. 55 to 60* 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. I. Specific Febrile, or Zymotic Diseases 74 96 20 7 14 5 3 3 1 1 ... 224 1 II. Parasitic Diseases ... 2 ... ... ... ... ... ... ... ... ... 2 ... III. Dietic Diseases 1 ... ... ... ... 4 1 ... 1 ... ... 7 ... IV. Constitutional Disease 23 23 21 34 30 35 43 40 27 13 1 290 18 V. Developmental Diseases 79 ... ... ... ... . . . . . . ... 19 40 29 167 ... VI. Local Diseases 115 58 24 26 35 47 54 99 100 68 16 642 38 VII. Deaths from Violence 5 2 2 1 2 1 1 5 1 ... ... 20 3 VIII. Deaths from Ill-defined and Not Specified Causes 36 2 3 ... 1 1 3 4 1 1 ... 52 2 Totals 333 183 70 68 82 93 105 151 150 123 46 1404 62 I. Specific Febrile, or Zymotic Diseases. 1.—Miasmatic Diseases. Small pox Vaccinated ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... . . . ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... ... Measles 12 39 8 .. . ... ... ... ... ... ... ... 54 ... Scarlet Fever ... 5 6 1 ... ... ... ... ... ... ... 12 ... Typhus ... ... ... ... ... ... ... ... ... ... ... ... Cough 24 28 2 ... ... ... ... ... ... ... . 2 22 9 1 ... ... ... 1 ... ... . ntinued or Ill-defined Fever • •• ... ... ... ... ... ... ... ... ... . Typhoid Fever ... 1 ... 4 6 2 1 1 ... ... . smatic Diseases ... ... ... ... ... ... ... ... ... ... . Diseases. ... ... ... ... ... ... ... ... ... ... . 30 1 ... ... 1 ... ... ... ... ... . Diseases. Fever ... . . . ... ... ... ... ... ... ... ... . ... ... ... .. ... ... ... ... ... . us Diseases. nd effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... . seases (e.g., Hydrophobia, rs, Splenic Fever) ... ... ... ... ... ... ... ... ... ... . 1 Diseases. 4 ... ... ... ... ... ... ... ... ... . a, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... . seases. 1 ... ... ... ... ... 2 1 1 1 . Septicaemia 1 ... ... ... 2 1 ... ... ... ... . ... ... ... 1 5 2 ... ... ... ... . this Column the Statistics of Table III. will be made comparable with those of the Weekly and Quar the Registrar-General, and also available for the Reports required by the Local Government Board 12 TABLE III. (Continued.) Deaths registered from all causes during the year 1894. ages. Total. 55 to 60*[/##] 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. II. Parasitic Diseases. Thrush, and other Vegetable Parasitic Dieases ... 2 ... ... ... ... ... ... ... ... ... 2 ... Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... III. Dietic Diseases. Want of Breast Milk, Starvation 1 ... ... ... ... ... ... ... ... ... ... 1 ... Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Alcoholism ... ... ... ... ... 4 1 ... 1 ... ... 6 ... Delirium Tremens ... ... ... ... ... ... ... ... ... ... ... ... ... IV. Constitutional Diseases. Rheumatic Fever, Rheumatism of the Heart ... ... 2 2 1 1 1 1 ... ... ... 8 ... Rheumatism ... ... ... ... ... 1 ... ... l 1 ... 3 ... 13 Gout ... ... ... ... ... 1 1 1 3 1 ... 7 ... Rickets 2 2 ... ... ... ... ... ... ... ... 4 ... Cancer, Malignant Disease ... 1 ... 1 1 11 14 2.6 16 9 ... 79 14 Tabes Mesenterica 10 5 2 ... ... ... ... ... ... ... ... 17 ... Tubercular Meningitis, Hydrocephalus 3 6 7 ... ... .... ... ... ... ... ... 16 ... Phthisis ... 2 4 24 24 17 22 9 5 ... ... 107 3 Other forms of Tuberculosis, Scrofula 7 6 4 6 2 2 1 ... ... 1 ... 29 ... Purpura, Hemorrhagic Diathesis ... 1 ... ... ... ... ... 1 ... ... ... 2 ... Anasmia, Chlorosis, Leucocythsemia 1 ... ... ... ... 2 2 1 1 ... 7 1 Glycosuria, Diabetes Mellitus ... 2 1 2 ... 2 1 1 1 1 11 ... Other Constitutional Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... V. Developmental Diseases. Premature Birth 64 ... ... ... ... ... ... ... ... ... ... 64 ... Atelectasis 4 ... ... ... ... ... ... ... ... ... ... 4 ... Congenital Malformations 11 ... ... ... ... ... ... ... ... ... ... 11 ... Old Age ... ... ... ... ... ... ... ... 19 40 29 88 ... VI. Local Diseases. /.—Diseases of Nervous System. Inflammation of Brain or Membranes 5 2 2 ... ... 1 1 ... ... ... ... 11 ... Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... 2 2 3 9 19 17 17 2 71 9 *By filling in this Column the Statistics of Table III. will be made comparable with those of the Weekly and Quarterly Returns of the Registrar-General, and also available for the Reports required by the Local Government Board. 14 TABLE III. (Continued.) Deaths registered from all causes during the year 1894. ages. Total. 55 to 60* 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. Insanity,GeneralParalysis of the Insane ... ... ... ••• ... 2 2 2 ... 1 ... 7 1 Epilcpsy ... ... 1 1 1 1 1 ... ... ... ... 6 ... Convulsions 30 6 1 ... ... ... ... ... ... ... ... 37 ... Laryngismus Stridulus (Spasm of Glottis) 1 ... ... ... ... ... ... ... ... ... ... 1 ... Diseases of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... ... 2 ... ... ... ... ... 2 ... Other Diseases of the Nervous System ... ... 1 1 2 3 ... 3 1 ... ... 11 1 2.—Diseases of Organs of Special Sense. (e.g., of Ear, Eye, Nose 1 ... 1 ... ... ... ... ... ... ... ... 2 ... 3.—Diseases of Circulatory System. Pericarditis ... ... ... ... 1 1 ... ... ... ... ... 2 ... Acute Endocarditis ... ... 1 7 ... ... ... 1 ... ... ... 2 1 Valvular Disease of the Heart ... ... 2 2 3 5 9 10 8 5 1 50 4 Other Diseases of Heart ... ... ... ... ... ... 3 8 13 6 1 33 3 Aneurism ... ... ... 1 ... ... ... ... ... ... ... ... Embolism, Thrombosis ... ... ... ... ... ... 1 ... ... ... ... 2 ... Other Diseases of Blood Vessels ... ... ... ... ... 1 ... 1 1 ... ... 3 ... 15 4.—Diseases of Respiratory System. Laryngitis 2 1 1 ... ... ... 1 1 ... ... ... 6 ... Croup ... 2 ... ... ... ... ... ... ... ... ... 2 ... Emphysema, Asthma ... ... ... ... ... i ... ... 1 ... ... 2 ... Bronchitis 40 20 2 ... 1 4 7 16 24 21 7 142 5 Pneumonia 11 17 3 ... 6 5 6 6 5 4 2 65 3 Pleurisy ... ... 1 1 ... 1 ... ... ... ... ... 3 ... Influenza 3 1 ... 2 3 3 3 1 9 2 2 29 ... 5.— Diseases of Digestive System— Dentition 6 4 ... ... ... ... ... ... ... ... ... 10 ... Sore Throat, Quinsy l ... ... ... ... ... ... ... ... ... ... 1 ... Diseases of Stomach ... ... 1 5 1 1 1 1 l ... ... 11 1 Enteritis 4 4 ... ... 1 ... ... ... ... ... ... 9 ... Obstructive Diseases of Intestine 2 ... 1 ... 2 2 1 6 3 2 ... ... 19 1 Peritonitis ... ... 1 ... 1 ... ... 1 1 1 ... 6 ... Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver ... ... ... ... ... 1 3 10 4 2 ... 20 3 Jaundice and other Diseases of Liver 4 ... ... ... • •• 1 ... 2 2 3 ... 12 1 Other Diseases of Digestive System ... ... 1 ... ... 2 1 2 2 ... ... 8 1 6.—Diseases of Lymphatic System. (eg. of Lymphatics and of Spleen) ... ... ... ... ... 1 ... ... ••• ... ... 1 ... *By filling in this Column the Statistics of Table III. will be made comparable with those of the Weekly and Quarterly Returns of the Registrar General, and also available for the Reports required by the Local Government Board. TABLE III. (Continued) Deaths registered from all causes during the year 1894, AGES. 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. of Gland-like Organs of in Use. ocele, Addison's Disease) ... ... ... ... ... ... ... 1 1 ... 2 Urinary System. ... ... ... 1 1 2 ... ... 1 ... 1 ease, Albuminuria ... 1 ... 1 3 ... 4 5 2 ... ... ladder or of Prostate ... ... ... ... 1 ... ... 1 1 3 ... ses of the Urinary System 1 ... 2 ... ... 1 ... ... ... ... ... Reproductive System. Organs of Generation. ... ... ... ... ... ... ... ... ... ... ... ns ... ... ... ... 2 1 ... 2 1 1 ... Of Parturition. iscarriage ... ... ... ... ... ... ... ... ... ... ... invulsions ... ... ... ... ... ... ... ... ... ... ... ivia, Flooding ... ... ... ... 2 ... 1 ... ... ... ... jnts of Child Birth ... ... ... 1 1 2 ... ... ... ... ... h-» 10.—Diseases of Bones and Joints. Caries, Necrosis 1 ... 2 1 ... ... ... ... ... ... 4 Arthritis, Ostitis, ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Bones and Joints... ... ... ... ... ... ... ... ... ... ... /1.—Diseases of Integumentary System. Carbuncle, Phlegmon 1 • •• 1 Other Diseases of Integumentary 1 ... ... ... 1 ... ... 1 ... ... ... 3 VII. Deaths from Violence. /.—Accident or Negligence. Fractures and Contusions 1 1 1 1 1 1 2 8 1 Gunshot Wounds ... ... ... ... ... ... 2 . . . ... ... 1 1 Suffocation 3 ... ... 3 ... ... 1 1 2.—Homicide. ... ... ... Murder 1 ... ... ... 1 3.—Suicide. ... ... ... • •• ... ... ... 2 ... 2 1 *By filling in this Column the Statistics of Table III. will be made comparable with those of the Weekly and Quarterly Returns of the Registrar-General, and also available for the Reports required by the Local Government Board. H-* 00 TABLE III. (Continued.) Deaths registered from all causes during the year 1894. ages. Total. 55 to 60* 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 & upwards. Drowning ... ... ... 1 ... ... ... ... ... 1 Hanging ... ... ... ... 1 ... . . . ... 1 ... Otherwise ... ... ... ... ... ... ... ... ... ... ... 4.—Execution. Hanging ... ... ... ... ... ... VIII. Deaths from Ill-defined and not Specified Causes. Dropsy ... ... ... ••• ... Debility, Atrophy, Inanition 30 1 ... ... ... ... 31 ... Mortification ... Tumour ... 1 ... 1 ... Abscess 1 1 ... ... 2 1 5 1 Hremorrage 1 ... ... 1 Sudden Death (cause not ascertained) 1 ... ... 1 1 3 1 7 Causes not Specified or Ill-defined 4 ... i ... ... ... 2 ... ... ... 7 1 *By filling in this Column the Statistics of Table III. will be made comparable with those of the Weekly and Quarterly Returns of the Registrar General, and also available for the Reports required by the Local Government Board. 19 SUMMARY OF TABLE III. I.—Specific Febrile, or Zymotic Diseases— No. of Deaths. 1. Miasmatic Diseases .... 170 2. Diarrhceal „ 82 8. Malarial „ 4. Zoogenous „ 5. Venereal 4 6. Septic „ 18 II.—Parasitic Diseases 2 III.—Dietic Diseases 7 IV.—Constitutional Diseases .... 290 V.—Developmental Diseases VI.—Local Diseases— 1. Diseases of Nervous System 146 2. Diseases of Organs of Special Sense 2 3. Diseases of Circulatory System 92 4. Diseases of Respiratory System 249 5. Diseases of Digestive System 96 6. Diseases of Lymphatic System 1 7. Diseases of Gland-like Organs of Uncertain 1 2 8. Diseases of Urinary System 32 9. Diseases of Reproductive System— (a) Diseases of Organs of Generation 7 (6) Diseases of Parturition 7 — 14 10. Diseases of Bones and Joints 4 11. Diseases of Integumentary System 4 VII.—Violence— 1. Accident or Negligence 15 2. Homicide 3. Suicide 4 4. Execution — VIII.—Ill-defined and not Specified Causes 52 Total Note—The Deaths of non-residents occurring in Public Institutions situated in the District are excluded, and the Deaths of residents occurring in Public Institutions situated beyond the limits of the District are included. 20 TABLE IV. Showing the Number of Deaths at all ages in 1894, from certain groups of Diseases, and proportions to 1000 of Population, and to 10u0 Deaths from all causes ; also the Number of Deaths of infants under one year of age from other groups of Diseases, and proportions to 1000 Births and to 1000 Deaths from all causes under one year. Division I. (Adults). Total Deaths. Deaths per 1000 of Population, at all ages. Deaths per 1000 of Total Deaths, at all ages. 1. Principal Zymotic Diseases 202 2.01 14315 2. Pulmonary Diseases 249 2.48 177.3 3. Principal Tubercular Diseases 170 1.69 121.1 Division II. (Infants under One Year). Total Deaths. Deaths per 1000 of Births. Deaths per 1000 of Total Deaths under 1 Year. 4. Wasting Diseases 95 39.0 285.3 5. Convulsive Diseases 44 18.1 132.1 NOTICE. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Typhus, Enteric (or Typhoid), and Simple Continued Fevers, and Diarrhoea, 21 of the deaths occurred in Hospitals situated beyond the limits of the District. 2. Includes Influenza. 3. Includes Phthisis, Scrofula, Tuberculosis, Rickets, and Tabes. 4. Includes Marasmus, Atrophy, Debility, want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. TABLE V. he number of Deaths from the seven principal Zymotic Diseases, in the 10 years, 1884 ti and in the Year 1894. 14. 1885. 1886. 1887. 1888. 1889. 1890. 1891. 1892. 1893. Annual Average of lO years, 1884- 1893. Proportion of Deaths to 10 (10 Deaths in 10 years, 1884--1893. i 5 0 0 0 0 0 0 0 5 1.1 0.9 41 38 5 40 18 21 34 30 15 19 261 207 8 0 4 6 7 9 4 3 4 12 6.7 4.5 12 13 25 10 37 5 11 10 17 53 19.3 16.3 52 39 32 23 76 23 53 29 67 10 40.4 32.2 ..*... 12 16 6 6 11 6 5 2 4 10 7.8 6.2 31 37 60 31 25 34 29 24 40 42 35.3 281 57 148 132 116 174 98 136 98 147 151 135.7 1081 32 11861 11212 12720 10896 9785 12090 9675 11983 12851 52 57726 62859 64686 50684 61027 59698 53221 56032 73496 22 TABLE VI.—Inspectors' Reports of the Sanitary Work completed in the year 1894. Totals. Penge. , Sydenham and Forent-hlll Blackheath and 1 Lew if ham. Sanitary Districts. 81S 294 305 219 Number of Complaints received during the year. 3146 1518 1126 502 Number of Houses, Premises, &c., inspected. 4597 1963 1876 751 No. of Re-inspections of Houses, Premises, &e. 1804 447 853 504 Orders issued for Sanitary Amendments of Houses, Premises &c. Results of Inspection. 541 106 353 82 Houses, Premises, &c., Cleansed, Repaired, Whitewashed, &e. Houses Disinfected after illness of an Infectious character. 586 54 262 270 1529 704 590 235 Repaired, Cleansed, Trapped, &c. House Drains. 925 447 384 94 Ventilated. 633 345 157 131 Repaired, &c. Privies and Waterclosets. 320 115 69 136 Supplied with Water 570 121 416 33 New provided. 698 256 314 128 New provided. Dust Bins. 77 37 35 5 Repaired, Covered, &c. 11 7 4 Cisterns (new) erected. Water Supply. 624 177 319 128 Cisterns Cleansed, Repaired, and Covered. Waste Pipes connected with Drains, &c., abolished. 448 95 158 195 15 15 No. of Lodging Houses registered under 35th sec. of the "Sanitary Act, 1866," or 90th sect, of " Public Health Act, 1875." Miscellaneous. 171 5 117 49 Dust Removal—No. of Communications received and attended to. Removal of accumulations of Dung, Stagnant Water, Animal and other Refuse. 76 6 32 38 16 1 7 8 Animals Removed, being improperly kept. 92 21 39 32 Bakehouses. Regularly Inspected. 27 5 12 10 Licensed Cowsheds. 23 3 7 13 Licensed Slaughter-houses. 50 15 6 29 Legal proceedings : i.e., Summonses. K2 Semi sham District Board of Barks. (A) Table of DEATHS during the year 1894, in the Sanitary District of Lewi sham, classified according to Diseases, Ages and Localities. Mortality from ali causes, at subjoined ages. " Mortality from subjoined causes, distinguishing Deaths ildren under Fiye Tears of Age. Names of Localities adopted for the purpose of these Statistics; public institutions i 2 3 4 5 6 7 8 9 10 » 1 12 13 14 15 16 17 18 19 20 21 1 22 At all ages. Under 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 60. 60 and upwards. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping j Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. being shown as separate localities. 1 year. ^ Typhus | ' Enteric or Typhoid Continued Relapsing Puerperal Lewisham 430 123 55 21 19 94 118 Under 5 5 upwds. 1 9 1 1 8 20 o jCt 17 1 17 3 28 27 34 27 1 2 86 145 178 252 Do. Workhouse 127 22 5 2 8 42 48 Under 5 5 upwds. ... ... ::: ::: 3 ... ... ... 1 1 20 7 20 9 3 19 44 27 100 Penge 258 64 39 7 6 53 89 Under 5 5 upwds. ... 3 2 ... ... ... 13 1 16 5 ... 1 17 21 26 15 2 1 42 '93 103 155 Blackheath 83 18 8 3 7 17 30 Under 5 5 upwds. 1 ... ... ... ... 2 1 2 1 ... 7 2 7 3 1 19 37 26 57 Sydenham 404 108 52 17 22 102 103 Under 5 5 upwds. 1 7 2 1 4 ... 3 1 3 12 15 8 1 1 30 31 32 25 1 1 83 145 160 244 St. John's Hospital 13 ... 1 ... 1 10 1 Under 5 5 upwds. Under 5 ... ... ... ... ... 2 1 2 1 1 8 1 12 2 North Surrey District Schools. 8 ... 2 5 1 ••• 5 upwds. ... 2 ... 1 ... ... ... ... ... 3 6 Home for Sick Children, | Sydenham ) 14 1 6 5 2 ... ... Under 5 5 upwds. ... 1 1 ... 1 1 1 2 4 3 7 7 Waterman's Asylum, Penge ... 3 ... ... ... ... ... 3 Under 5 5 upwds. ... ••• ... ... ... ... ... ... 2 ... ... 1 3 Totals 1340 336 148 60 65 319 392 Under 5 5 upwds. ... 2 21 5 1 ... 1 14 ... ... ... 1 6 48 4 52 2 30 1 1 6 ... 2 103 89 123 81 4 10 254 479 504 836 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 82 4 10 15 5 29 19 Under 5 5 upwds. 5 5 3 6 ... ... ... ... 1 1 1 3 3 5 1 2 3 43 14 68 Deaths occurring within the District among persons not belonging thereto 18 ... 5 1 1 7 1 4 Under 5 5 upwds. ... 1 ... ... ... ... ... ... 1 ... 1 ... 2 4 ... ... 3 6 5 13 K2 11 Semisham Distict Board of Works (B) Table of POPULATION, and of NEW CASES of INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health during the year 1894, in the Sanitary District of LewiSHam, classified according to Diseases and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Numbek of such Cases Eemoved from their Homes in the several Localities for Treatment in Isolation Hospital. 1 2 3 4 5 6 7 8 9 10 ii 1 2 3 4 5 6 7 8 9 10 11 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Flyers. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. , Fevers. Cholera. Erysipelas. Typhus Enteric or Typhoid Continued Relapsing Puerperal Typhus. Enteric or Typhoid Continued Eelapsing Puerperal Lewisham Under 5 ... 34 25 2 1 ... ... 1 ... 14 5 ... 5 upwds. 1 84 32 1 12 2 33 44 7 3 Lewisham Workhouse Under 5 1 ... ... 1 ... 1 5 upwds. 1 4 2 ... 19 1 4 ... 1 Penge Under 5 13 5 ... ... ... 5 upwds. 1 42 7 13 1 21 ... ... Blackheath Under 5 4 ... ... ... ... 1 ... 5 upwds. ... 8 3 ... 1 ... 1 2 1 ... Sydenham Under 5 23 29 1 2 ... 8 ... 12 9 1 5 upwds. 5 97 68 23 1 45 2 39 19 4 St. John's Hospital Under 5 ... ... ... 5 upwds. ... ... 1 ... North Surrey District Schools Under 5 ... ... ... ... ... ... 5 upwds. ... 1 2 1 ... 1 Home for Sick Children Under 5 ... ... ... ... 5 upwds. ... 3 ... ... ... All Saints' Orphanage Under 5 ... ... 5 upwds. 1 ... ... 1 Croydon Infirmary Under 5 ... ... ... 5 upwds. ... ... 1 ... ... ... ♦St. Bartholomew's Hospital Under 5 ... ... ... ... ... 5 upwds. ... 1 Totals Under 5 75 59 3 3 ... 10 ... 28 14 ... 1 ... ... ... ... ... 5 upwds. 8 237 113 1 55 4 11 121 3 91 27 ... 8 ... ... ... ... ... * From Sydenham. 23 TABLE VII. The number of Inhabited Houses, the Estimated Population, 1893, uitli the Birth and Death Rate in the different Registrars' Sub-districts in Lewisham Parish and the Hamlet of Penge, together comprising " The Lewisham District." Registrars' Sub-districts. Number of Inhabited Houses, Midsummer, 1893. Estimated Population. Number of Births, 1893. Birth Rate per 1000. Number of Deaths 1893. Death Rate per 1000. Blacxheath, the part of) Lewisham Parish in the > Sub-district of Lee J 1174 6925 129 18-6 79 11-40 Lewisham, the part of \ Lewisham Parish in the 1 Sub-district of Lewisham 1 Village J 5804 36028 968 26-8 553 1610 Sydenham Chapelky 6106 34242 930 27-1 539 14-97 Parish of Lewisham 13084 77195 2027 26-2 1171 1516 Hamlet of Penge 3384 19965 442 221 297 14-87 The Lewisham District 16468 97160 2469 25-4 1468 15.10 24 TABLE VIII. Register of Licensed Cows-houses. LEWISHAM. Name. Address. Bellingham Farm, Southend. Loampit Hill (Angel Public House.) Cawston, Saml Bromley Hill. Clarke, S Court Hill Road. Covell, E Beckenham Place. Covell, E "White House Farm, Southend. Ive, S ( George Lane. ( Lady well. Kirby, James Rushey Green. Phillips and Dutton Bridge House Farm, Ladywell. Phillips and Dutton Holloway Farm, Southend. Ride wood, William Shroffields Farm, Hither Green. Truman, \V illiara J ohn Court Hill Road. SYDENHAM. Alliance Dairy Company 195, Stanstead Road. Blundell, Henry Wells Road. Blundell, Thomas Russell Street. Duffin, James (Executors) Dartmouth Road. Morgan, T. D Lower Sydenham. Nevill, Mrs. M. A. S Dalmain Road. Ridgewell, A. G Porthcawe-road. Roberts, Alfred George Wells Road. Rudyard, Mrs Brockley Green Farm. Stimpson, William High Street. Tick, Edgar Bell Green. Walker, R. H Elm Lane, Catford. Webb, Henry Kent House Terrace. PENGE. Ilartfield Giove. Challin Street. Maple Road. Madeline Road. Oakfield Road. 25 TABLE VIII. — Continued. List of Milksellers who have no Cowhouse Licenses, and of the Dairies, Milkstores, and Milkshops in the Lewisham District. LEWISHAM. Address. 1. Railway Terrace. 19. Rusliev Green, Catford. Alliance Dairy Company j 3, The Parade, Perry Vale. \ Woodcote Terrace, Stanstead Road. 98, Brockley Rise. 1, Ely Place, Sydenham Road. Station Parade, Sydenham. Bennett, Arthur "Wells Road, Sydenham. Russell Street, Sydenham. . lo, Porson Street, Lewisham. . 3, Grate's Place, Blackheath. London Road. . 77, Willow Walk, Sydenham. rwAii v. 15. Royal Parade. Debenham, "William 70, Ennersdale-road. 6t,, Wastdale Road. Duffin, James (Executors) 27, High Street, Sydenham. 18, Sunderland-road. 5, Royal Terrace, Bell Green. Express Dairy Co ( Bank Buildings, Sydenham. <! 22, Montpelier Vale, Black heath. ( 196, High Street, Lewisham. 138, Rushey Green, Catford. Friern Manor Dairy Company 86, Loam pit Vale. 10. Garden Row, Lewisham. . 141. High Street. Sydenham Road. 146. Loampit Hill. 4, Alfred Terrace, Lower Sydenham. 198, Lewisham Road. 1, Schuckburgh Road, Catford. 17. Ennersdale Road, Lewisham. Leppard, Frederick 1a, Holly Tree Terrace. 6. Devonshire Road. . Ewart Road, Forest TTill. 116, Rushey Green, Catford. . Kemble Road, Forest Hill. . 20, Rushey Green. Parlrs F .T . 51. Lewisham Road. 11, Rvecroft Road, Lewisham. . 7, Wastdale Road, Foiest Hill. Phillips, Jesse 33, Lethbridge Road, Lewisham. 5. Roval Terrace, Bell Green. 83, Catford Hill. Robinson, R Berlin Road. 26 TABLE VIII. — Continued. Milksellers and Milkstores — Continued. LEWISHAM. — Continued. Name. Address. Smith, Arthur 2, Loampit Yale. Steer, Henry 61, Stan-stead Road. Sullivan, Charles 43, Lethbridge Road. Taylor, Eugene 1, Malham Road, Forest Hill. Tick, W. E Bell Green. Till, Thomas 1, Loampit Yale. Yingo, Richard 20, High Street, Lewisham. "Wade, Samuel 10, Wastdale Road. Weller, William 21, Elvira-street. Wilson, Henry 4. The Terrace, Lady well. PENGE. Ambrose, J 29, Beckenham Road. Apps, William 66, Hawthorne Grove Belgravia Dairy Co 124, Anerley Road. Bird, William 76, Woodbine Grove. 173, Beckenham Road Bray, William 111, Beckenham Road. Clarke, Thos Chaplin Street, Denning, Frank 76, Anerley Road. Green, Geo. 2, Cramp ton Road. Henderson, A 80, Oak field Road. Hook, M 14, Carina Road. Howell, Jas 55, Maple Road. Huggins, W 1, Beckenham Road. Ironside, E Madeline Road. Norman, M. A 131, Maple Road. Palmer, F 12, Hawthorn Grove. Price, F 17, Hawthorn Grove. Rhodes, J 54, Oak field Road. 18, Oak field Road. ( 52, Station Road. (9, Rids dale Road 27 TABLE IX. Register of Licensed Slaughter-houses. LEWISHAM. Name. Address. Airey, G High Street. Balsdon, John High Street. Hardstone, F Rushey Green. Parsons, Wm Blackheath. Powell, William Rennell Street. Sanders, Mrs Loampit Hill. Taylor, W. Rushey Green. King Street. SYDENHAM. Chalk, Frederick Havelock Mews and Wastdale Road. Goldfinch, H. Sydenham Road Nalson, James High Street. Pattenden, Henry High Street. Watkins, Edmund J. High Street. Wilkins, Herbert Dean Terrace. PENGE. Foat, Wm Woodbine Grove. Perry, Wm Maple-road. Beckenham Road.