LEW 63 REPORT TO The Board of Works for the Lewisham district TO THE END OF THE YEAR 1896, 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 1896 was 1412. Of these 52 were of persons who did not belong to this District, while, on the other hand, 128 persons belonging to the District died in hospitals and asylums outside, making the actual total of deaths 1482, as against 1496 in the previous year, and the corrected death rate for 1896 13.75 per 1000, as compared with 14.44 per 1000 in 1895. During the year 1896 there has been a general epidemic of zymotic disease over the whole of London, as may readily be seen from the fact that during 1896 49,705 notifications of zymotic disease were received, of which number 13,808 were notifications of diphtheria; 25,647 of scarlet fever; and 3,190 of enteric fever There were 2,663 deaths from diphtheria; 940 deaths from scarlet fever; and 564 deaths from enteric fever. These figures, while showing the immense number of cases of both diphtheria and scarlet fever in London during 1896, also clearly show the difference in the mortality from the two diseases. The Lewisham District, as was inevitable, shared, to some extent, in the general epidemic, while the zymotic death rate of this District, of 2.6 per 1000, compares very favourably with 3.1 per 1000— the zymotic death rate for London. There were 360 notifications of diphtheria, with 82 deaths, as compared with 135 notifications and 17 deaths in 1895, and 172 notifications, with 35 deaths, in 1895. All cases were removed at once to Hospitals when possible, 114 in all; but, owing to the great number of cases occurring in London, in many instances it was impossible to get the cases moved, owing to the Asylums Board's Hospitals being full. 2 There were 449 cases of scarlet fever notified, with 11 deaths, as compared with 337 cases notified in 1895, with 9 deaths. There were 67 cases of typhoid notified, with 10 deaths, as compared with 53 cases notified in 1895, with 9 deaths. Small-pox—No notifications; no deaths. Apart from zymotic disease, 1896 was a healthy year in this District. There were only 228 deaths from diseases of the respiratory organs, as compared with 329 in the previous year; and influenza was only responsible for 11 deaths as against 61 in 1895, 29 in 1894, 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, distributed thus — Lewisham Parish, 72,272, occupying 12,317 houses, giving an average of 5.9 persons to each house; and Hamlet of Penge 20,375, occupying 3,326 houses, giving an average of 61 persons to each house. At Midsummer, 1896, there were in Lewisham Parish 14,664 occupied houses, estimated to contain 86,517 persons, and in the Hamlet of Penge 3,492 occupied houses, estimated to contain 21,301 persons. Total, 18,156 occupied houses, and estimated population 107,818, an increase of 15,000 in the last six years. (Lee—1,224 inhabited houses, and population 7,221. Lewisham Village—6,790 inhabited houses, and population 40,061. Sydenham— 6,650 inhabited houses, and population 39,235.) Births. The registered births in the District in the year 1896 amounted to 2,559, an increase of 24 on the previous year; of these 71, or 2.7 per cent., were illegitimate. Of the four divisions of the District Lewisham shows an increase of 102 births. In all the others there is a decrease of the birth rate, most marked in Penge. The birth rate to population was 23.7 per 1000. Males 1,344 Females 1,215 The birth rate in England and Wales in 1896 was 29.7 3 per 1,000 of the population, which is lower than the rate in any oilier year on record, excepting 1894, and 1.3 per 1,000 below the mean rate in the ten years, 1886—1895. Deaths. The total number of deaths in 1896 was 1,482, as compared with 1,496 in the previous year. Males 740 Females 742 Lewisham 1078 births; 650 deaths Sydenham 928 „ ; 490 „ Penge 419 „ ; 260 „ Blackheath 134 , ; 82 „ The number of deaths in public institutions in the District amounted to 185, or 28 more than in the previous year. There were 188 deaths in the Lewisham Union Infirmary, 153 of which were those of persons belonging to the District; of these 117 were residents in Lewisham Village; 28 were of residents in the Sydenham Ohapelry; 8 belonged to Lee; and none to Penge. There were 35 deaths of persons who did not belong to this District. Lewisham Union Infirmary 153 deaths. Lower Sydenham Home for Sick Children 10 St. John's Hospital, Blackheath 13 „ North Surrey District Schools, Penge 2 „ Watermans' Asylum, Penge 7 „ The deaths of 128 residents in the District were registered as having occurred in various hospitals, asylums, &c., outside the District. Of these 75 belonged to Lewisham. 35 ,, to Sydenham. 18 „ to Penge. Death rate for 1896, 13.75 per 1000, as compared with 14.4 per 1,000 in the previous year. The death rate in England and Wales in 1896 was 17.1 per 1.000 of the population, and this also is lower than the rate in any previous year, excepting 1894. Compared 4 with the rate in the ten years, 1886-95, the death rate in 1896 shows a decrease of 1.7 per 1,000. The death rate in London in 1896 was 18.1 per 1000. The death rate of the "Outer Ring" of suburban districts, with a population of over a million and three-quarters, was 13.2 per 1,000. The death rate of the thirty-three great towns of England and Wales, with a population of over ten and three-quarter millions, averaged 18.9 per 1,000, ranging from 14.2 in Croydon to 22.7 in Liverpool. Zymotic Disease. The number of deaths from the 7 principal Zymotic Diseases was 258, as compared with 156 in the previous year, nearly one-third being due to diphtheria. Scarlet Fever 11 deaths, as compared with 9 in 1895. Diphtheria 82 „ „ 17 „ Small-pox 0 „ „ 0 „ TyphoidFever 10 „ „ 9 „ Measles 42 „ „ 13 „ Whooping Cough 26 „ ,, 30 ,, Diarrhoea 87 „ „ 72 ,, Scarlet Fever. There were 449 notifications of this disease received during 1896, with 11 deaths, as compared with 337 notifications and 9 deaths in 1895. The disease was as a rule of a mild type, and not confined to any particular part of the District 129 of these cases were removed to hospital. Diphtheria. There were 360 notifications of this disease, with 82 deaths, in 1896, as compared with 135 notifications and 17 deaths in 1895. 114 of these cases were removed to hospital. Cases of the disease have occurred duiing the whole year; and, as will be seen from the Table, the disease became most prevalent during September and October, during which months diphtheria was raging all over London. 5 Blackheath and Lewisham. Sydenham and Forest-hill. . Notifications. Notifications. Notifications. January 7 9 ... February 8 14 ... March 8 12 2 April 4 10 1 May 17 12 ... June 5 9 ... July 10 4 2 August 9 1 5 September 43 3 4 October 69 14 2 November 34 8 1 December 28 7 ... Total 240 103 17 During September, October, and November the disease was almost entirely confined to the Lewisham portion of the District, and a large number of the cases occurred in an area of about a quarter of a mile, limited on the north to the division between Lewisham and Greenwich; to the east following the River Ravensbourne to its junction with the Quaggy, and then following the Quaggy to the point where that stream crosses High-street, Lewisham. The boundary then follows the High-street to Roiner-place, and proceeds westward, joining the Ravensbourne just below Riverdale Mill. It then follows the course of the river to the South Eastern Railway line, and from there southwards to Ladywell Station; then passing round the slope of the Hilly Fields to the point of junction of the Lewisham and Greenwich Districts. In this area there had been 14 cases of diphtheria notified between July 28 and August 23, and fresh cases kept on occurring, and during the last week in September, and the first three weeks in October the cases kept gradually increasing in number. Every case was moved at once, when possible, and the premises thoroughly disinfected; a house to house inspection was ordered in this area, which was thoroughly carried out by the two Inspectors who were told off especially for this work. One of the great difficulties with which we had to contend, was the delay in moving cases, owing to the Asylums Board Hospitals 6 being full. This was in many cases the cause of fresh spread of the disease; and in order to as much as possible remedy this, the Board of Works allowed one of the wards of the Hither-green Hospital to be used for diphtheria. This was on October 4, and the notifications showed a reduction almost immediately, from 21 in the week ending October 11 to 5 in the week ending October 25. By this date, however, the ward was full, and the area becoming once more congested, the cases again increased in number. A second ward was therefore opened, and cases again removed more quickly, with a corresponding decrease in the notifications. The fact of there being a large Board School—the Lewisham Bridge School—directly in the midst of the infected area, and also the fact that a considerable number of cases occurred in children attending school, naturally drew our attention at once to this school; and I was in constant communication with Dr. Smith, the Medical Officer of the School Board, on the advisability of closing these schools. At no time, however, in my opinion, or in his, was there sufficient evidence as to the schools being the source of infection to make it necessary to close them; and I think that the strongest reason to show that the schools were not the source of the disease, is, that in spite of their not having been closed, the outbreak came to an end as soon as the cases could be quickly removed to hospital. Those in favour of closing the schools argue that the outbreak came to an end through the parents keeping their children away from school, and the schools in consequence being morally closed; but, as a matter of fact, when the abatement began to take place, there were still over 500 children attending school. On October 10th it was decided to thoroughly fumigate and disinfect the schools—the schools being closed from the Saturday afternoon till the Monday morning. On October 15th, Dr. Shirley Murphy, the Medical Officer of Health to the County Council came down, after writing to me to make an appointment. He did not consider that there was any reason to close the schools, as the cases were 7 becoming less in number, but suggested that the throats of all the children attending school should be examined. This was according done, with the result that not a single case of even suspicious throat was found among the children attending. Dr. Shirley Murphy asked if we could arrange for the Assistant M O.H., C.C., to make a thorough enquiry into the prevalence of diphtheria in this neighbourhood, and the part which school influence had in it. After a long enquiry, Dr. Hamer came to the conclusion that closing the schools might have had a good influence in bringing the outbreak to an earlier termination; but that the schools should have been closed at an early period. He does not, however, state at what period he considers the schools should have been closed, and what per centage of infectious disease should make it advisable for the M.O.H. to take the grave step of closing a school Until some definite rule is laid down in this matter, it will always be, as it has been in the past, one of the most difficult questions which a Medical Officer of Health can have to deal with, and one which will be certain to expose him to a considerable amount of adverse criticism, whether he decides to close, or not to close, a school. In the present instance I consider that my action in not closing the school was the right one. Knowing the neighbourhood in which diphtheria prevailed, I believe that the outbreak arose (as is so often the case in low-lying districts such as this) from the long period of excessive wet weather following on a long period of unusually dry hot weather. The class of people whose children suffered were most of them of the class who, in spite of every care possible on the part of the Sanitary Authorities cannot be induced to keep their houses in a thoroughly sanitary condition; and though the origin of diphtheria is still actually unknown, it is known to breed and multiply in insanitary surroundings. What I endeavoured to do in this outbreak, instead of closing the schools, and consequently making the homes in all cases still more congested and consequently unhealthy, was to remedy as soon as possible, all sanitary defects in the houses, and get 8 the patients attacked removed at once to hospital. Closing the schools would have made a panic in the neighbourhood, which, as is well known, has the effect of increasing an outbreak. It would have thrown 900 or 1,000 children suddenly out of school. Mixing, as they certainly would have done, with one another in their own homes, and crowding into one another's small rooms, would have brought them into far closer contact than was the case when they were at school under supervision. This would, in my opinion, have materially increased instead of lessening the outbreak. If the schools could have been closed and the children prevented from mixing with one another, then the closing of the schools would have been necessary; but this is impossible. The mortality caused by this outbreak was 28 up to the end of October, viz.,—2 in August, 7 in September, and 19 in October. The fact is of interest that 50 per cent, of the attacks which began between September 17 and September 30 were fatal, while, on the other hand, of those attacked earlier and also later than these dates, only 13 percent, died. The explanation of this mortality is, I think, entirely that during the period between September 17 and 28 it was impossible, in most instances, to remove the cases till late in the disease, and they therefore did not get the benefit of treatment by antitoxin till too late. The value of this remedy was also Droved in the Hither-green Hospital. Nearly all the cases first removed there died; but after antitoxin treatment had been instituted there was not one death. The extreme value of this treatment is now so well established that whenever the Asylums Board- are unable to take in a case of diphtheria, owing to want of space, the medical man in charge of the case can obtain antitoxin from them free of charge. Finding, however, that a serious delay occurred in many cases, the Board of Works have allowed me to provide a supply of antitoxin at their office, and also a syringe, I have written to all the medical men in the District acquainting them with this fact. The great point in the antitoxin treatment is, that it should be employed early in the case, and by keeping a supply at the Board's Office all delay will be avoided. 9 Typhoid Fever. There were 67 notifications of this disease, with 10 deaths, as compared with 50 notifications and 9 deaths, in 1895. There was no notification of small-pox in this District during 1896. Diseases of the Respiratory Organs. The total number of deaths from diseases of the respiratory organs was 228, as compared with 329 in the previous year. Of this number 11 deaths were attributed directly to Influenza, as compared with 61 in 1895. Inquests. Coroner's inquests were held in 89 cases of death. The causes of death were returned as follows:— Natural causes 43 Violent deaths 46 Of these latter 38 were accidental, 7 suicidal, and 1 the result of hanging by the public executioner. Marriages. During the year 1896 there were 544 Marriages in the Parish of Lewisham, of which 407 were solemnised in the various Churches, 39 in Dissenting Chapels, and 98 at the Registrar's Office. During the same period there were 158 marriages in the Hamlet of Penge, of which 119 were solemnised in Churches, 20 in Dissenting Chapels, and 19 at the Registrar's Office. Total for the year 702, us compared with 642 in 1895. The marriage rate was equal to 13.0 persons married per 1,000 of estimated population. The mean rate in England and Wales for 10 years—1886-1895—was 14.9. Meteorology. The mean temperature of the air at Greenwich in 1896 was 50.1. The highest reading by day, 91.1, was registered in July, and the lowest reading bv night, 24.3, in November. Rain fell on 101 days. The total amount of rainfall was 22.42 inches. I am, Gentlemen, Faithfully yours, S BLAKE JOLLY, Medical Officer of Health to the Lewisham District. 10 TABLE I.—Shewing the Population, Inhabited Houses, Marriages, Births, and Deaths, for the Year 1896 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 1896 107818 18156 702 2559 1482 350 516 313 1895 103549 17434 642 2535 1496 356 515 256 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 ... ... ... Average of 10 years, 1886—1895 15370 578 2395 1321 ... ... ... NOTES. 1. Population according to Census, 1891, 93,046. 2. Average No. of Persons in each House at Census 1891, Penge 6.1, Lewisham 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. 11 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 1896 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 6 years;per 1000 of Total Deaths. Deaths in Public Institutions; per 1000 of Total Deaths. 1896 23.7 18.75 136.7 236.1 348.1 211.2 1895 24.5 14.44 140.4 238.0 345.6 171.1 1894 24.2 14.00 137.0 237.1 367.5 175.9 1893 25.4 15.10 124.7 209.8 312.6 158.0 1892 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 13.97 139.8 239.3 364.3 109.8 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 13.75 124.3 251.3 363.4 87.8 Average of 10 years, 1886—1895 25.7 14.10 129.8 238.0 355.4 131.7 12 TABLE III. Deaths registered from all causes during the year 1896. 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 ot the District, are included AGES. Totals. 56 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 1 85 & upwards. I. Specific Febrile, or Zymotic Diseases 107 89 47 5 10 1 5 2 5 4 ... 275 2 II. Parasitic Diseases 1 ... ... ... ... ... ... ... ... ... ... 1 ... III. Dietic Diseases ... ... ... ... ... 4 2 ... ... ... ... 6 ... IV. Constitutional Diseases 34 13 11 28 42 34 36 44 24 14 ... 280 30 V. Developmental Diseases 58 ... ... ... ... ... ... ... 12 53 27 150 ... VI. Local Diseases 102 56 16 24 49 77 94 112 95 15 674 49 VII. Deaths from Violence 8 0 3 4 7 4 5 2 4 4 ... 46 2 VIII. Deaths from Ill-defined and Not Specified Causes 40 3 ... ... ... 3 ... ... 1 3 ... 50 ... Totals 350 166 77 61 93 95 125 142 158 173 42 1482 83 I. Specific Febrile, or Zymotic Diseases. 1.—Miasmatic Diseases. Small pox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... 42 ... Measles 10 28 4 ... ... ... ... ... ... ... ... 11 ... Scarlet Fever 1 7 2 1 ... ... ... ... ... ... ... ... ... Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Whooping Cough 18 6 2 ... ... ... ... ... ... ... ... 26 ... Diphtheria 2 40 38 ... 1 ... ... 1 ... ... ... 82 1 Simple Continued or Ill-defined Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid Fever ... 1 1 4 2 ... 1 1 ... ... ... 10 1 Other Miasmatic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... 2—.Diarrheal Diseases. Simple Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa, Dysentery 71 5 ... ... 3 ... 2 ... 3 3 ... 87 ... 3. -Malarial Diseases. Remittent Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... 4.—Zoogenous Diseases. Cowpox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... 1 ... ... ... ... ... ... ... ... ... 1 ... 5.— Venereal Diseases. Syphilis 4 1 ... ... ... ... ... ... ... ... ... 5 ... Gonorrhoea, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... 6.—Septic Diseases. Erysipelas ... ... ... ... ... ... 2 ... 2 1 ... 5 ... Pyæmia, Septicæmia 1 ... ... ... 1 ... ... ... ... ... ... 2 ... Puerperal Fever ... ... ... ... 3 1 ... ... ... ... ... 4 ... 107 89 47 5 10 1 5 2 5 4 275 2 *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 1896.  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 Diseases 1 ... ... ... ... ... ... ... ... ... ... 1 ... Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... III. Dietic Diseases. Want of Breast Milk, Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Alcoholism ... ... ... ... ... 3 1 ... ... ... ... ... ... Delirium Tremens ... ... ... ... ... 1 1 ... ... ... ... 2 ... IV. Constitutional Diseases. Rheumatic Fever, Rheumatism of the Heart ... ... 1 1 1 ... 1 ... 1 ... ... 5 ... Rheumatism ... ... ... ... ... 1 ... 1 . . ... ... 2 1 15 Gout ... ... ... ... ... ... ... ... 1 ... ... 1 ... Rickets 1 1 ... ... ... ... ... ... ... ... ... 2 ... Cancer, Malignant Disease ... ... 2 1 5 ... 19 27 16 12 ... 88 20 Tabes Mesenterica 7 8 ... ... ... ... ... ... ... ... ... 15 ... Tubercular Meningitis, Hydrocephalus 20 2 3 1 ... ... ... ... ... ... ... 26 ... Phthisis 1 ... 1 20 33 26 15 12 3 ... ... 111 ... Other forms of Tuberculosis, Scrofula 5 2 2 4 1 ... 1 2 1 ... ... 18 ... Purpura, Hsemorrhagic Diathesis ... ... 1 ... ... ... ... ... ... ... ... 1 ... Anajmia, Chlorosis, Leucocythsemia ... ... ... 1 ... ... ... ... ... ... ... 1 ... Glycosuria, Diabetes Mellitus ... ... ... ... 2 1 ... 2 2 2 ... 9 1 Other Constitutional Diseases ... ... 1 ... ... ... ... ... ... ... ... 1 ... 34 13 11 28 42 34 36 44 24 14 ... 280 30 V. Developmental Diseases. Premature Birth 42 ... ... ... ... ... ... ... ... ... ... 42 ... Atelectasis 6 ... ... ... ... ... ... ... ... ... ... 6 ... Congenital Malformations 10 ... ... ... ... ... ... ... ... ... 10 ... Old Age ... ... ... ... ... ... ... ... 12 53 27 92 ... 58 ... ... ... ... ... ... ... 12 53 27 150 ... VI. Local Diseases. 1.— Diseases of Nervous System. Inflammation of Brain or Membranes 3 1 1 ... 1 ... 1 ... ... ... ... 7 ... Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... 1 1 2 9 26 29 27 3 98 12 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. 16 TABLE III. (Continued.) Deaths registered Jrom all causes during the year 1896. AGES. Total. 65 to 60* 0 to 1 1 to 6 5 to 15 16 to 25 26 to 35 35 to 45 45 to 55 55 to 66 65 to 75 76 to 85 85 & upwards. Insanity,General Paralysis of the Insane ... ... ... ... 3 3 4 3 3 3 ... 19 1 Epilepsy ... ... ... 1 1 1 ... 1 ... ... 1 5 1 Convulsions 22 6 ... ... ... ... ... ... ... ... ... 28 ... Laryngismus Stridulus (Spasm of Glottis) ... ... ... ... ... ... ... ... ... ... ... ... ... Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... 1 ... ... ... ... ... ... 2 1 ... 4 ... Other Diseases of the Nervous System ... 1 ... 1 1 ... 1 1 ... ... 1 6 1 2.— Diseases of Organs of Special Sense. (e.g., of Ear, Eye, Nose) 1 2 1 ... ... 1 ... ... ... ... ... 5 ... 3.—Diseases of Circulatory System. Pericarditis ... ... 2 ... 1 ... ... ... ... ... ... 3 ... Acute Endocarditis ... ... ... 1 ... 1 ... ... ... ... ... 2 ... Valvular Diseases of Heart ... ... 3 5 8 9 15 9 9 12 1 71 4 Other Diseases of Heart, ... ... ... ... ... 3 8 7 6 1 5 1 35 3 Aneurism ... ... ... ... ... 4 1 ... ... ... ... 5 ... Embolism, Thrombosis ... ... ... ... ... ... 2 2 ... ... ... 4 1 Other Diseases of Blood Vessels ... ... ... ... ... ... 1 1 3 ... ... 4 ... 17 4.—Diseases of Respiratory System. Laryngitis 1 ... 1 ... ... ... 1 ... ... ... ... 3 ... Croup ... 8 ... ... ... ... ... ... ... ... ... 3 ... Emphysema, Asthma ... ... ... ... ... ... 2 2 6 1 ... 11 1 Bronchitis 44 21 1 ... ... 2 9 13 26 16 7 139 8 Pneumonia 11 10 1 5 4 3 3 9 6 5 1 58 2 Pleurisy ... ... ... ... ... ... ... ... ... 3 ... 3 ... Other Diseases of Respiratory System —Influenza ... ... 1 ... 3 3 2 1 1 ... ... 11 1 5.— Diseases of Digestive System— Dentition 13 6 ... ... ... ... ... ... ... ... ... 19 ... Sore Throat, Quinsy ... 2 1 ... ... ... 1 ... ... ... ... 4 ... Diseases of Stomach 1 1 ... 1 2 ... 2 ... 1 2 ... 10 ... Enteritis 2 ... ... ... 1 ... ... 1 ... ... ... 4 1 Obstructive Diseases of Intestine 1 ... ... 1 1 1 ... 1 5 2 ... 12 1 Peritonitis 1 ... 2 3 ... 2 ... 4 1 1 ... 16 3 Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver ... ... 1 ... 1 5 3 4 3 ... ... 17 2 Jaundice and other Diseases of Liver 1 1 ... ... ... 2 3 1 ... ... ... 8 1 Other Diseases of Digestive System ... ... ... ... 1 ... ... 1 ... ... ... 2 1 6.—Diseases of Lymphatic System. (e.g of Lymphatics and of Spleen) 1 ... 1 ... ... ... ... ... ... ... ... 2 ... •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. 81 TABLE III. (Continued.) Deaths registered from all causes during the year i896. AGES. 0 to 1 1 to 5 5 to 15 16 to 25 26 to 35 36 to 45 45 to 65 55 to 65 66 to 75 75 to 86 85 & upwards. Total. 65 to 60* 7.—Diseases of Gland-like Organs of Uncertain Use. (e.g., Bronchocele, Addison's Disease) ... ... ... ... ... 1 ... ... 1 ... ... 2 ... 8.—Diseases of Urinary System. Nephritis ... 1 ... 1 ... 1 5 1 1 ... ... 10 1 Bright's Disease, Albuminuria ... ... ... 1 ... 3 2 4 6 4 ... 20 4 Disease of Bladder or of Prostate ... ... ... ... 2 1 ... 2 2 2 2 10 2 Other Diseases of the Urinary System ... ... ... ... ... ... 1 1 ... ... ... 2 1 9.— Diseases of Reproductive System. a. Of Organs of Generation. Male Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Female Organs ... ... ... ... ... 1 2 ... 1 ... ... 4 ... b. Of Parturition. Abortion, Miscarriage ... ... ... 1 1 ... ... ... ... ... ... .2 ... Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... Placenta prævia, Flooding ... ... ... ... ... ... ... ... ... ... ... ... Other Accidents of Child Birth ... :... ... 2 ... ... ... ... ... ... ... 2 ... 61 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... 1 ... ... ... ... ... ... 1 ... Arthritis, Ostitis, Periostitis ... ... ... ... 1 ... ... ... ... ... 1 ... Other Diseases of Bones and Joints ... ... ... ... ... ... ... ... ... ... ... ... ... //.—Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... ... ... ... 1 ... ... ... ... 1 ... Other Diseases of Integumentary System ... ... ... ... ... 1 ... ... ... ... 1 ... VII. Deaths from Violence. 1.—Accident or Negligence. Fractures and Contusions ... 2 ... ... 5 2 2 1 2 3 ... 17 1 Gunshot Wounds ... ... ... 1 ... ... ... ... ... ... ... 1 ... Cut, Stab ... ... ... ... ... ... ... ... ... ... ... 6 ... Burn, Scald ... 2 1 1 1 ... ... ... ... ... ... 5 ... Poison ... 1 ... ... ... ... ... ... ... ... ... 1 ... Drowning ... ... 1 1 ... ... ... ... ... ... ... 2 ... Suffocation 8 ... ... ... ... 1 ... ... 1 ... ... 10 ... Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... 2.—Homicide. Manslaughter ... ... 1 ... ... ... ... ... ... ... ... 1 ... Murder ... ... ... ... ... ... ... ... ... ... ... ... ... 3.—Suicide. Gunshot Wounds ... ... ... ... ... ... 2 ... ... ... ... 2 ... Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... Poison ... ... ... ... ... 1 1 ... ... ... 2 ... *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. 20 TABLE III. (Continued.) Deaths registered from all causes during the year 1896. AGES. Total. 55 to 60* 0 to 1 1 to 0 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 65 to 65 65 to 76 75 to 85 85 & upwards. Drowning ... ... ... 1 1 ... ... ... ... ... ... 2 ... Hanging ... ... ... ... ... ... ... ... 1 ... ... 1 ... Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... 4.—Execution. Hanging ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... VIII. Deaths from Ill-defined and not Specified Causes. 8 5 3 4 7 4 5 2 4 4 ... 46 Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... Debility, Atrophy, Inanition 40 3 ... ... ... 2 ... ... ... ... ... 45 ... Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour ... ... ... ... ... 1 ... ... ... 1 ... 2 ... Abscess ... ... ... ... ... ... ... ... ... ... ... ... Haemorrhage ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... 1 2 ... 3 ... Causes not Specified or Ill-defined ... ... ... ... ... ... ... ... ... ... ... ... ... 40 3 ... ... ... 3 ... ... 1 3 ... 50 ... *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. 21 SUMMARY OF TABLE III. No. of Deaths I.—Specific Febrile, or Zymotic Diseases— 1. Miasmatic Diseases 171 2. Diarrhoeal „ 87 8. Malarial „ — 4. Zoogenous „ 1 5. Venereal „ 5 6. Septic „ 11 II. Parasitic Diseases 1 III.—Dietic Diseases 6 IV.—Constitutional Diseases 280 V.—Developmental Diseases 150 VI.—Local Diseases— 1. Diseases of Nervous System 167 2. Diseases of Organs of Special Sense 5 3. Diseases of Circulatory System 124 4. Diseases of Respiratory System 228 5. Diseases of Digestive System 92 6. Diseases of Lymphatic System 2 7. Diseases of Gland-like Organs of Uncertain Use 2 8. Diseases of Urinary System 42 9. Diseases of Reproductive System— (a) Diseases of Organs of Generation 4 (b) Diseases of Parturition 4 8 10. Diseases of Bones and Joints 2 11. Diseases of Integumentary System 2 VII.—Violence— 1. Accident or Negligence 37 2. Homicide 1 3. Suicide 7 4. Execution 1 VIII.—Ill-defined and not Specified Causes 50 Total 1482 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. 22 TABLE IV. Showing the Number of Deaths at all ages in 1896, from certain groups of Diseases, and proportions to 1000 of Population, and to 1000 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. (All ages). Total Deaths. Deaths per 1000 of Population, at all ages. Deaths per 1000 of Total Deaths, at all ages. 1. Principal Zymotic Diseases 258 2.3 174.0 2. Pulmonary Diseases 228 2.1 153.8 3. Principal Tubercular Diseases 172 1.5 116.0 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 82 32.0 234.3 5 Convulsive Diseases 38 14.8 108.5 NOTICE. 1. Includes Smallpox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Typhus, Enteric (or Typhoid), and Simple Continued Fevers, and Diarrhoea. 61 of the deaths occurred in Hospitals situated beyond the limits of the District. 2. Includes Influenza. 3. Includes Phthisis, Scrofula, Tuberculosis, Rickets, Tabes, and Tubercular Meningitis. 4. Includes Marasmus, Atrophy, Debility, want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. K23 Lemisham District Board of Works. (A) Table of DEATHS during the year 1896, in the Sanitary District of Lewisham, classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Mortality from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths oe Children under Five Years op 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. j Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus Enteric or Typhoid Continued Relapsing Puerperal Lewisham 423 124 57 26 14 112 96 Under 5 1 14 ... ... ... 3 4 37 23 3 90 175 •>!£ 5 upwds. 12 2 ... 2 2 1 11 OZ oy o Do. Workhouse 138 23 5 5 10 81 v 64 | Under 5 ... ... ... ... 2 9 1 2 ... 1 13 28 5 upwds. 1 ... 3 2 4 ... ... 4 28 25 12 10 71 160 Penge 233 47 17 2 14 74 79 | Under 5 ... 2 ... ... ... ... 5 3 5 1 14 2 32 64 5 upwds. 1 1 ... 1 ... z 19 z Blackheath 83 25 10 3 19 26 | Under 5 — ... ... ... 6 1 8 ... ... 6 ... ... 14 35 5 upwds. ... ... 1 1 1 7 6 7 1 24 4o Sydenham 453 120 64 17 19 130 103 | Under 5 1 6 1 1 ... 23 14 19 37 6 77 185 5 upwds. 3 i 6 1 I 1 2 2 1 26 41 30 7 147 268 St. John's Hospital 13 2 3 2 2 4 i -1 Under 5 ... ... ... ... ... 2 3 c 5 o 5 upwds. ... ... 1 North Surrey District Schools. 2 1 ... 1 -{ Under 5 ... ... ... 1 1 5 upwds. ... ... ... ... ... ... ... ... 1 1 Home for Sick Children, Sydenham 10 3 5 2 ... "I Under 5 ... ... ... ... ... ... ... 7 7 5 upwds. ... ... ... 1 ... 2 3 Waterman's Asylum, Pcnge 7 ... ... ... ... ... 7{ Under 5 ... ... ... ... ... ... ... 1 ... ... ... 5 upwds. ... ... ... ... ... 1 ... 1 4 7 Totals 1412 344 157 57 59 420 375 | Under 5 2 22 1 ... 1 ... 37 24 78 2 84 12 237 501 5 upwds. . 2 16 10 6 ... 6 4 2 10 4 108 125 106 26 486 1)11 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 128 4 24 27 8 55 10 Under 5 ... 6 18 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 2 28 5 upwds. ... 2 25 ... ... ... ... ... ... ... ... ... ... 1 1 ... 11 5 2 7 46 100 Deaths occurring within the District among persons not belonging thereto 52 7 5 4 4 22 10 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... 9 12 5 upwds. ... 1 ... ... ... 1 ... ... 2 ... 1 ... ... ... ... ... 4 4 1 1 25 40 K211 Lemisham district 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 1896, 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 op Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. 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. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus Enteric or Typhoid Continued Relapsing | Puerperal J Typhus. Enteric or Typhoid Continued j Relapsing Puerperal Lewisham Under 5 1 32 72 3 ... 1 ... ... ... ... 2 ... 5 27 ... ... ... ... ... ... ... ... 5 upwds. ... 90 158 ... ... 30 ... ... 5 ... 34 ... 28 56 ... ... 2 ... ... ... ... ... Lewisham Workhouse Under 5 • •• ... 7 ... ... ... ... ... ... ... ... ... 1 4 ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... 2 ... ... 1 ... 6 ... 2 ... ... ... ... ... ... ... ... ... Penge Under 5 ... 17 7 ... ... ... ... ... ... ... 1 ... ... ... ... ... ••• ... ... ... ... ... 5 upwds. 1 82 10 ... ... 5 ... ... 2 ... 13 ... 3 ... ... ... 1 ... ... ... ... ... Blackheath Under 5 ... 10 1 ... ... ... ... ... • •• ... ... ... 8 1 ... ... ... ... ... ... ... ... 5 upwds. ... 29 2 ... ... 5 ... ... ... ... 3 ... 10 1 ... ... ... ... ... ... ... ... Sydenham Under 5 • • • 43 24 ... ... 2 ... ... ... ... 4 ... 14 8 ... ... 1 ... ... ... ... ... 5 upwds. 1 140 79 ... ... 22 ... ... 4 ... 29 ... 56 17 ... ... 6 ... ... ... ... ... St. John's Hospital Under 5 • •• ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... North Surrey District Schools Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 5 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Home for Sick Children Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... All Saints' Orphanage Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... Croydon Infirmary Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... *St. Bartholomew's Hospital Under 5 • •• ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ••• ... ... ... ... ... ... ... ... ... ... ... ... ... Totals Under 5 ... 102 111 3 ... 3 ... ... ... ... 7 ... 28 40 ... ... 1 ... ... ... ... ... 5 upwds. ... 347 249 ... 1 69 ... ... 12 ... 86 ... 101 74 ... ... 9 ... ... ... ... ... 23 TABLE V. Showing the number of Deaths from, the seven principal Zymotic Diseases, in the 10 years, 1886 to 1895, and in the Year 1896. Disease. 1886. 1887. 1888. 1889. 1890. 1891. 1892. 1896. 1894. 1895. Annual Average of 10 years, 1886—1895. Proportion of Deaths to 1000 Deaths in 10 years, 1886—1895. Total Deaths in 1896. Proportion of Deaths to 1000 Deaths in 1896. Smallpox 0 0 0 0 0 0 0 5 0 0 0.5 0.3 0 0 Measles 6 40 18 21 34 30 15 19 54 13 24.9 18.9 42 27.6 Scarlet Fever 4 6 7 9 4 3 4 12 12 9 7.0 5.3 11 7.2 Diphtheria 25 10 37 5 11 10 17 53 35 17 22.0 17.2 82 53.9 Whooping Cough 32 23 76 23 53 29 67 10 54 36 40.2 34.0 26 17.1 Fever Typhus ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Enteric 6 6 11 6 6 2 4 10 15 9 7.4 5.6 10 6.5 Simple continued. ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Diarrhoea 60 31 25 34 29 24 40 42 32 72 38.9 29.4 87 57.2 Totals 132 116 174 98 136 98 147 151 202 156 141 ...... 268 174 Totals—London 11212 12720 10896 9785 12090 9675 11983 12851 11544 11545 14098 Totals—England and Wales 62859 64686 50684 61027 59698 53221 56032 73496 52771 66936 125 24 TABLE VI.—Inspectors' Reports of the Sanitary Work completed in the year 1896. Totals. Penge. Sydenham and Forest-hill Black heath and Lewisham Sanitary Districts. 1043 295 377 371 Number of Complaints received during the year. 4861 1803 1730 1328 Number of Houses, Premises, &c., inspected. 11980 3473 4195 4312 No. of Re-inspections of Houses, Premises, &c. 1490 608 435 447 Orders issued for Sanitary Amendments of Houses, Premises &c. •uoiioadsuj jo's unsay 1023 104 497 422 Houses, Premises, &c., Cleansed, Repaired, Whitewashed, &e. 729 125 294 310 Houses Disinfected after illness of an Infectious character. 2011 672 635 704 Repaired, Cleansed, Trapped, &c. •buibjq 08iioj£ 1032 430 324 278 Ventilated. 498 193 145 160 Repaired, &c. s;asoioj0;B^ pun saiauj 391 91 46 254 Supplied with Water 1919 531 745 643 New provided. 1222 531 306 385 New provided. •guig ;sng 97 65 9 23 Repaired, Covered, &c. 36 22 14 ... Cisterns (new) erected. •aiddng 896 397 316 183 Cisterns Cleansed, Repaired, and Covered. 25 15 2 8 Waste Pipes connected with Drains, &c., abolished. 15 15 ... ... No. of Lodging Houses registered under 35th sec. of the "Sanitary Act, 1866," or 90th sect, of " Public Health Act, 1875." Miscellaneous. 93 8 37 48 Dust Removal—No. of Communications received and attended to. 91 17 33 41 Removal of accumulations of Dung, Stagnant Water, Animal and other Refuse. 21 6 12 3 Animals Removed, being improperly kept. 93 22 38 33 Bakehouses. Regularly Inspected. 29 5 11 13 Licensed Cowsheds. 18 3 7 8 Licensed Slaughter-houses. 41 18 17 6 Legal proceedings : i.e., Summonses. 25 TABLE VII. The number of Inhabited Houses, the Estimated Population, 1896, with 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, 1896. Estimated Population, 1896. Number of Births, 1896. Birth Rate per 1000. 1896. Number of Deaths 1896. Death Kate per 1000. 1896. Blackheath, the part of Lewisham Parish in the Sub-district of Lee 1224 7221 134 18.6 82 11.3 Lewisham, the part of Lewisham Parish in the Sub-district of Lewisham Village 6790 40061 1078 26.9 660 16.2 Sydenham Chapelry 6660 39235 928 23.6 490 12.4 Parish of Lewisham 14664 86517 2140 23.6 1222 14.1 Hamlet of Penge 3492 21301 419 19.2 260 12.2 The Lewisham District 18166 107818 2669 23.7 1482 14-7 26 TABLE VIII. Register of Licensed Cow-houses. LEWISHAM. Name. Address. Allen, W. J Bellingham Farm, Southend. Attwater, G Loampit Hill (Rear of No. 87). Cawston, Saml Bromley Hill. Clarke, S Court Hill Road. Covell, H Beckenham Place. Covell, H. White House Farm, Southend. Ive, S George Lane. Ladywell. Kirby, James Rushey Ureen. Phillips and Dutton Bridge House Farm, Ladywell. Phillips and Dutton Hollowav Farm, Southend. Ridewood, William Shroffields Farm, Hither Green. Rudyard, Mrs Brockley Greeu Farm. Truman, William John Court Hill Road. SYDENHAM. Alliance Dairy Company 195, Stanstead Road. Blundell, Thomas Russell Street. Dufiin, James (Executors) 33, Dartmouth Road. Morgan, T. D Lower Sydenham. Nevill, Mrs. M. A. S. 117, Dalmain Road. Roberts, Alfred George 82, Wells Road. Stimpson, William High Street. Tick, Edgar Bell Green and Porthcawe Road. Walker, R. H Elm Lane, Catford. Webb, Henry Kent House Terrace. PENGE. Apps, W Hartfield Grove. Clarke, T Challin Street. Norman, M. A Maple Road. Ironside, Ed Madeline Road. Rogers, Geo Oakfield Road. 27 TABLE VIII.—Continued. List of Milksellers who have no Cowhouse Licenses, and of the Dairies, Milkstores, and Milkshops in the Lewisham District. LEWISHAM. Name. Address. Ade, Mary 1, Railway Terrace. Aldridge, Charles 19, Rushey Green, Catford. Alliance Dairy Company 3, The Parade, Perry Yale. 195, Stanstead Road. Angold, John 144, High Street Lewisham. Austin, Fredk 98, Brockley Rise. Beckham & Ball 83, Catford Hill. Beeston & Co 7, Crofton Park Terrace. Belgravia Dairy Company 8, Sydenham Road. Bennett, Arthur 93, Wells Road, Sydenham. Blundell, Thomas Russell Street, Sydenham. Brann, John R. 3, Grote's Place, Blackheath. Cansdale, — London Road. Challow Dairy Farmers' Co 77, Willow Walk, Sydenham. Chipps, G 102, Brookdale Road. Cooney, A. 23, Elthruda Road. Covell, H. C 15, Royal Parade. Debnam, William 44, Ennersdale-road. Delahoy, Michael 6½, Wastdale Road. Dibdin, E 24, Loampit Hill. Duffin, James (Executors) 27, High Street, Sydenham. Edwards, John 18, Sunderland-road. Ellis, W. R 49, High Street, Sydenham. Evans, Mrs 5, Royal Terrace, Bell Green. Express Dairy Co Bank Buildings, Sydenham. 22, Montpelier Yale, Blackheath. 196, High Street, Lewisham. Finch, Thomas 138, Rushey Green, Catford. Gibbons George 10, Garden Row, Lewisham. Greenhill, Sydney 141, High Street. Griffin & Co. 46, Wells Road. Grubb, J 2, Ewart Road. Harris, Robert 146, Loampit Hill. Hinks, Ellen 8, Drysdale Road. Howarth, Thomas 2, Silvermere Road, Catford. Jarratt, Alfred 117, Ennersdale Road, Lewisham. Jull, James 296, Brockley Road. Leppard, Frederick 1a, Holly Tree Terrace. Martin, Albert 6, Devonshire Road. Martin, Luther Ewart Road, Forest Hill. Matthews, May 15, Porson Street. Mills, C. L 19, Catford Hill. Milton, Edward 116, Rushey Green, Catford. Munday, Edwin Kemble Road, Forest Hill. Norman, C. W. 8, Wildfell Road. Parish, W. G 11, Ryecroft Road, Lewisham. Pearcey, Henry 7, Wastdale Road, Forest Hill. Phillips, Jesse 33, Lethbridge Road, Lewisham. Philips, W. A 198, Lewisham Road, and 130, Hither Green Lane. 28 TABLE VIII.— Continued. Milksellers and Milkstores—Continued. LEWISHAM.—Continued. Name. Address. Revil,- 97, Dartmouth Road. Reynolds,- 24, Catford Hill. Robert, A.G. 82, Wells Road. Robinson, R. Berlin Road. Sherwood, A. Dillwyn Road. Slade, A.H. George Lane. Starboro Castle Dairy Co. 38, Kirkdale, Sydenham. Stevens, Charles 122, High Street. Steer, Henry 61, Stanstead Road. Stirling, Alferd 51, Lewisham Road. Taylor, Eugene 1, Malham Road, Forest Hill. Tew, J. 1, Royal Terrace, Bell Green. Tick W. E Bell Green. Till, Thomas 1, Loampit Vale. Vingo, Richard Herbert 20, High Street, Lewisham. Waston, W. 412, Stantead Road. Weller, William 21, Elmira-street. Willison, R. 17, Sydenham Road. Wilson, Hery 4, The Terrace, Ladywell. PENGE. Ambrose, J. 29, Beckenham Road. Apps, William 66, Hawthorne Grove Belgravia Dairy Co. 124, Anerley Road. Bird, William 76, Woodbine Grove. Bloomfield, 173, Beekenham Road Bray, William 111, Beekenham Road. Clarke, Thos. Challin Street, Denning, Frank 76, Anerley Road. 52, Station Road. 9, Ridsdale Road. 123, Anerley Road. Eve, Wm. 89, Woodbine Grove. Hook, M 14, Clarina Road. Howell, Jas. 55, Maple Road. Huggins, W. 1, Beekenham Road. Ironside, E. Madeline Road. Norman, M.A. 131, Maple Road. Pamment, 80, Oakfield Road. Price, F. 17, Hawthorn Grove. Rogers, Geo. 18, Oakfield Road. Smith, W. 2, Belvedere Road. Yates, Alferd 93, Maple Road. 29 TABLE IX. Register of Licensed Slaughter-houses. LEWISHAM. Name. Address. Airey, G High Street. Balsdon, John 245, High Street. Hardstone, F Rushey Green. Parsons, Wm Montpelier Yale. Powell, William Rennell Street. Sanders, Mrs 60, Loampit Hill. Taylor, W. Rushey Green. Young, H King Street. SYDENHAM. Chalk, Frederick Havelock Mews and 16, Wastdale Road. Goldfinch, H Sydenham Road. Nalson, James 38, High Street. Pattenden, Henry 10, High Street. Watkins, Edmund J 94, High Street. Wilkins, Herbert 3, Dean Terrace. PENGE. Foat, Wm Woodbine Grove. Perry, Wm Maple-road. Warden, Geo Beckenham Road.