32 Sou 2 Perish of Saint George the Martyr, Southwark. REPORT OF THE MEDICAL OFFICER OF HEALTH, For the first Quarter, 1857. No 5 Mr. Chairman and Gentlemen of the Vestry, I beg now to present to you my Report for the first Quarter of this Tear. It consists chiefly of tables, in which are comprised all the particulars necessary to make you acquainted with the healthy or unhealthy condition of this Parish, and of the sanitary works performed or left unfinished during the Quarter. The Mortality is about 50 less than the average of the Quarter for Ten Tears; it is slightly above the numbers recorded for the first Quarter of 1850, 1853, and 1856; but allowing for increase of population, it does not exceed the Mortality of the corresponding Quarters, even of those most favourable Tears. Much attention has of late been given to the subject of over-crowding; it demands our most earnest attention for two reasons. It brings sickness and death upon the poor, and ruinous expense upon the Parish. My present Report shows that the most crowded Boroughroad district suffers one-third more deaths than either of the others, although its actual population is less: the London-road district, with 159 persons to the acre, shows 98 deaths; the Kent-road, with 172 to the acre, 97 deaths; while the Borough-road, with 244 to the acre, shows no less than 136 deaths. The Poor Law books show, for the London-road district, 804 cases of illness among the poor attended during the Quarter; for the Kent-road district, 1,074 cases, while our most crowded district yields 1,731 cases; that is, 900 more cases in one Quarter than in the one district, and 700 more than in the other. I need not say that this represents an enormous call upon your poor-rates, and as I have said, the deaths are one in three in excess. Deaths from zymotic diseases have decreased generally in the Parish one-half; 33 this, as against 63 last Quarter. I have no doubt that some at least of these results are from the 2 Parish of Saint George the Martyr, Southwark. improvements carried out under your orders. Among the most important causes of so much expense and so much mortality in our overcrowded district, I may state this one, that the poor are being gradually driven back upon this and upon certain other poor districts of the Metropolis ; that is, upon places too straight to hold them, and upon people too poor to support them. The illness that occurs in these close places, not only comes more readily, but it is with so much more difficulty got rid of, and does with great facility slide into death. The vice, the indecencies consequent upon such a state of things have been so fearfully and so truthfully pourtrayed by a health officer elsewhere, that I gladly refrain from again touching upon the loathsome subject. I may, however, at least say, that vice in its most abominable shapes has often been under my notice, in these places where as yet privacy and cleanliness are impossible. It seems dreadful to hear any one say there is no remedy for these evils; nor indeed ought any one to say it; true, there is no immediate remedy, nor is there for any great social evil that may gradually grow up, and which may have been first perceived only when it had become quite intolerable. The ordinary duties of your officers will compass much. The last table in the Quarterly Eeport shows cases of houses, unfit for human habitation, cleansed and made fit; houses almost without air, ventilated, and so made fresh and wholesome; foul, rotten water-butts; drains bringing back pestilence to houses, instead of removing it; cesspools overflowing, making the houses intolerable, and causing people, used even to these things, to open their doors and windows at inconvenient and unsafe times; of yards without pavement soaking up privy and drain overflowings, to give them forth again in the heat and sunshine; of refuse kept long and strewed about in close places ; of animals so kept as to be reeking in their own filth; and of owners and others who will have it that all this is wholesome! This, and more, the 7th table sets forth, and is all capable of remedy under the legal authority of the Vestry. If we should ever have the good fortune to be relieved of our excessive poorrate burdens, the question of opening courts, of clearing spaces, of better paving and water supply in courts, and even of parks, may be entertained with a certain prospect of making this a very healthy Parish. Among other salutary changes in progress, not the least, is the great regularity now shown in removing the house refuse; we have 7,000 houses, each for the most part with its refuse heap, and hitherto the poorer and closer places have been in this particular almost entirely neglected: the organization must, however, be rendered still more complete. I have before spoken of the large number of casual cases relieved at the workhouse of this Parish. The Michaelmas Quarter, 5,812 were here relieved; in the next neighbouring Parish, 1,054; the Christmas Quarter 4,018 with us, 523 with them; this Quarter with us 3 Report of the Medical Officer of Health, for the first Quarter, 1857. 3,128, with them 372. The influx towards St. George's is every way great. We import poverty largely notwithstanding we are already full of it. I have to thank Mr. Churchwarden Gilpin for valuable information upon this point. It appears that out of 7,000 houses in this Parish, only 639 rate above £50; 2,265 over £10 and under £50; the remaining 4,000 rate under £10, or are farmed at from £2 10,s. to £5 10s. This proof of the poverty of our Parish shows how little we can spend upon sanitary improvements, while we have to bear not only our own burdens, but the burdens also of the rich men of the City and the West End, and yet as we see by our Mortality Table it is literally death to leave things as they are. Seeing how this stands at the very basis of sanitary improvements in poor Parishes, I may be pardoned for introducing here a contrast between this Parish and three others— Property value. Contribution to the Poor, in 1846. in 1855. City of London £953,300 £53,000 £53,000 St. George's, Hanover-square £1,097,580 £23,709 £26,979 St. James's, Westminster £494,660 £13,788 £18,780 St. George's, Southwark £174,956 £14,396 £21,277 For further information I beg to refer to the table comprised in the Report. I have not thought it necessary to reiterate here the various points mooted in my individual Reports. I have to request your authority for Printing this Report. I receive most valuable papers from other Officers of health, and I am anxious to reciprocate, so far as I am able, the benefit so conferred; I regret much that in several districts Reports are not printed and circulated, the more so as the interchange of the individual thoughts of so many officers practically engaged in advancing the public health cannot but be of the highest value to the communities among which the officers reside. I cannot but add, that I continue to receive the most satisfactory assistance and co-operation from the Inspector. (Signed) WILLIAM RENDLE. TABLE 1.—Quarterly Mortality. 1855 1856 1857 Average Mortality of the Quarters from 1845 to 1854 First Quarter to March, 31 429 304 323 373.6 Second „ ... 291 ... 294.8 Third „ ... 350 ... 431.1 Fourth „ ... 284 ... 391.8 4 Parish of Saint George the Martyr, Southwark. TABLE 2.—Mortality, &c., compared with other Parishes. Conditions of Locality Parish Height above Trinity High Water Mark Area in Acres Population, 1851 Each Person represents Annual Value Each Person pays to Relief of Poor Same Rate as St. Geo.'s Southwark, each should pay Density. Persons to an Acre Average Annual Mortality in 10,000, 1841 to 1850 Mortality from Cholera, to every 10,000 Inhabitants. Mean of 1840 & 1854 The Quarter ending March 28th, 1857 Total Zymotic Mortality Fever Diarrhoea Total Mortality Births Excess of Births over Deaths to Mar. 31 Dense Population. High Level. Wealthy. St. James FEET 58 164 36,406 £ s. d. s. d. s. d. 12 13 4 10 3 30 0 222 206 84.0 19 5 1 182 ... ... 52 Sparse Population. High Level. Medium Circumstances. Hampstead 350 2252 11,986 5 16 0 8 3 13 9 5 178 9.5 6 2 0 67 ... ... 24 Dense Population. High Level. Medium Circumstances. St. Giles 68 245 54,214 5 12 8 5 9 13 4 221 252 37.0 65 7 3 393 ... ... 80 Sparse Population. Low Level. Poor. Camberwell 4 4342 54,667 4 4 0 5 9 10 5 13 231 94.0 36 2 2 335 ... ... 228 St. George's, Southwark,— m. f. Dense Population. Low Level. Poor. Kent-rd. District 1 105 18,126 ... ... ... ... ... 173 252 132.5 7 2 0 ... 102 86 ... Borough-rd. „ 2 65 15,862 ... ... ... ... ... 244 347 13 1 1 ... 88 85 ... London-rd. „ 0 112 17,836 ... ... ... ... ... 159 250 12 5 2 ... 100 71 ... 290 242 Total 0 282 51,824 3 6 4 7 10 7 10 184 281 ... 32 8 3 331 532 196 „ Newington 1 624 64,186 3 15 0 8 1 8 10 104 247 122.5 68 10 2 467 ... ... 204 „ Bermondsey 0 688 48,128 3 0 9 5 4 7 1 70 268 159.5 47 7 4 318 ... ... 255 Dense Population. Medium Height. Very Poor. Betlnal Green 38 760 90,193 1 10 0 3 10 3 6 119 242 550 88 20 8 593 ... ... 421 All London. ... ... 2,480,347 5 16 1 6 4 13 9 ... ... ... ... ... ... ... ... ... ... 5 Report of the Medical Officer of Health, for the first Quarter, 1857. TABLE 3.—Mortality and Meteorology. Week DEATHS, from local weekly returns Barometer corrected Mean Thermometer Dew Point Weight of Vapour in cubic foot of air, grains Wind Rain in inches Total Zymotic Disease Diarrhœa Chest Diseases Total Mortality Average of the weeks for 10 years Highest Lowest 1 2 1 16 29 29.9 29.864 45.1 38.1 36.4 2 6 w. .59 * The amount of Rain was much less than the Average of the Quarter for many years, which, according to Howard, is 5.092; notwithstanding in January it was greatly in excess. Meteorology from Dr. Thomson's reports taken at St. Thomas's Hospital. 2 1 0 8 17 33.3 29.845 43.8 36.0 34.1 2.4 S.W.N.E. 1.02 3 4 0 10 18 33.9 29.745 43.2 35.1 34.9 2.5 variable .47 4 3 1 6 19 29.6 29.704 45.5 37.5 35.9 2.6 SW.NW. .38 5 4 1 18 32 30.0 29.731 37.4 29 5 29.2 2.0 N.E. .20 6 5 0 8 30 28.6 29.894 38.6 30.3 28.5 2.0 N.E.S.W. .04 7 3 0 10 27 26.6 29.970 48.2 37.5 34.7 2.5 s.w. .19 8 3 0 11 34 25.9 30.115 49.8 38.7 38.7 2.9 s.w. .... 9 0 0 9 24 26.5 30.348 49.8 38.0 37.0 2.7 variable ... 10 1 0 13 22 30.8 30.272 51.3 40.7 36.9 2.8 variable .03 11 2 0 11 23 28.2 29.726 45.6 34.4 29.7 2.1 W.S.W .40 12 2 0 17 30 28.1 29.827 55.5 41.9 38.6 2.8 variable .35 13 3 0 7 26 27.7 29.752 45.9 35.1 31.2 2.3 variable ... Summaries and Averages 33 3 144 331 379.1 29.898 46.6 36.8 34.5 2.5 S.W. 3.62 6 Parish of Saint George the Martyr, Southwark. TABLE 4.—Mortality, classified according to Diseases, &c. POPULATION, 1851—51,824. Deaths Males 166 Total 331 Females 165 Births Males 290 Total 532 Females 242 Excess of Births over Deaths 201 Diseases Districts Sex Ages Kent Road, 105 acres Boro' Rd. 65 acres. (including Workhouse deaths) London Road, 112 acres Males Females Total Under 1 year From I to 5 years From 5 lo 10 years Total under 10 years From 10 to 20 years From 20 to 30 years from 30 to 40 years From 40 to 50 years From 50 to 60 years From 60 to 70 years Over 70 years of age Population, 1851 18,126 15,862 17.836 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Measles ... 1 ... 1 ... 1 ... 1 ... 1 ... ... ... ... ... ... ... Scarlatina l 3 1 1 4 5 ... 5 ... 5 ... ... ... ... ... ... ... Malignant Sore Throat Hooping Cough 4 6 4 6 8 14 7 6 1 14 ... ... ... ... ... ... ... Diarrhoea and Dysentery ... ... 3 1 2 3 2 ... ... 2 ... 1 ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever 3 1 4 4 4 8 ... 4 4 1 1 1 1 ... ... ... Rheumatic Fever ... 2 ... 1 1 2 ... ... ... ... 2 ... ... ... ... ... ... Erysipelas ... 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... l Pyaemia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carbuncle and Boils ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Lung Diseases, except Phthisis ... 4 3 4 3 7 ... ... ... ... ... ... 2 1 1 2 l Phthisis 14 13 12 22 17 39 1 6 ... 7 5 6 7 9 4 1 ... Acute Lung Diseases, Bronchitis 16 27 20 37 26 63 9 8 ... 17 ... 2 4 5 8 16 2 Pleurisy ... ... 1 ... 1 1 ... ... ... ... ... ... ... ... 1 ... ... Pneumonia 13 12 7 21 11 32 11 15 ... 26 ... 1 1 ... 2 2 Croup 1 1 ... 1 1 2 2 ... 2 ... ... ... ... ... ... ... Hydrocephalus, Tabes, Scrofula, Spasmodic Croup, and Convulsions of Infants 17 19 16 26 26 52 33 18 1 52 ... ... ... ... ... ... ... Other Diseases, chiefly Chronic 16 33 24 28 45 73 5 5 1 11 4 3 4 11 7 14 19 Violence, Privation, Poison, and Premature Birth 10 11 2 8 15 23 17 ... ... 17 ... 1 1 1 2 1 ... Sudden Deaths 2 2 1 4 1 5 ... ... ... ... ... ... 2 2 ... 1 ... Total 97 136 98 166 165 331 85 70 3 158 12 15 21 31 23 37 34 7 Report of the Medical Officer of Health, for the first Quarter, 1857. TABLE 5.—Cases of Sickness among the Out-door Poor. Weeks Kent Road, Mr. Babbage London Road, Mr. Wakem Borough Road, Mr. Davies Old Cases New Cases Total Old Cases New Cases Total Old Cases New Cases Total 1 55 15 70 17 30 47 60 37 97 2 47 21 68 24 20 44 66 47 103 3 37 33 70 26 20 46 90 54 144 4 39 26 65 37 18 65 103 43 146 5 50 29 79 23 31 54 105 38 143 6 54 44 98 26 34 60 100 38 138 7 68 39 107 29 28 67 90 66 156 8 72 30 102 37 29 66 98 50 148 9 55 39 94 31 30 61 90 47 137 10 49 30 79 35 37 72 96 38 134 11 52 37 89 48 46 94 87 64 151 12 55 29 84 45 34 79 79 42 121 13 45 24 69 44 25 69 73 40 113 Total 678 396 1074 422 382 804 1127 604 1731 Grand Total—Old Cases, 2227, New Cases, 1382, = 3609. N.B.—It should be here remarked, that "Old Cases" means only those cases of illness that remain on the books more than one week, and consequently involve repetitions of the same case. TABLE 6.—State of the Sick Wards in the Workhouse. DISEASES Cases Deaths Small Pox 1 ... Measles 1 ... Scarlatina ... ... Hooping Cough ... ... Diarrhoea and Dysentery ... ... Cholera ... ... Fever ... ... Erysipelas ... ... Puerperal Fever ... ... Lung Diseases, except Phthisis 27 19 Phthisis 5 2 Hydrocephalus, Tabes, Scrophula, Spasmodic Croup, Convulsions of Infants 2 3 Mental Disease 9 ... Infirmity 13 ... Other Diseases, chiefly Chronic 70 17 Violence, Privation, Poison, and Premature Birth 5 5 Labors 24 ... Itch and uncleanly diseases not included above ... ... Total 157 46 Remaining in Sick Wards from preceding Quarter 127 Total Sick in Wards during Quarter 284 8 Parish of Saint George the Martyr, Southwark. TABLE 7.—Sanitary Inspections during the Quarter ending 31st March, 1857. Cases Number of houses or places visited Number of Visits of Medical Officer and Inspector Premises unclean, or dilapidated within Overcrowded Unfit for habitation Insufficient Ventilation Without Water Water receptacle none, bad, or without cover Bad Drainage Foul Cesspool Water Closet without Water Yard badly paved Without Dust-bin Nuisances from animals badly kept ! Slaughter-houses, Manufactories in unwholesome state Burial Vaults requiring improvement 78 129 about 650 29 1 19 16 • 12 72 59 36 17 30 3 6 3 Work completed. 47 81 • 20 1 14 3 • 5 52 35 19 5 18 • 2 • Not begun, or left unfinished 31 48 • 9 • 5 13 • 7 20 24 17 12 12 3 4 3 Names of Places, and Dates of Official or Friendly Notices are annexed, in which the Work ordered leas not completed at the end of the Quarter. The following 9 Cases were reported as unfinished in last Quarterly report:—John's Place, London St.—6 to 11 Spillers' Court—97, Blackfriars Road— 10, Rodney St.—41 & 42, Etham St.—King's Arms, Bath St.—34, King's St., Boro' Road—21, Little Surrey St.—24, Bond St. King's Arms Yard, Old Kent Rd. O.N. 21/1/57 4, Union St. 2nd O.N. 4/3/57 133½, Gt. Suffolk St F.N. 23/3/57 Do.—2 other Cases 2nd O.N. 13/3/57 Parochial School, Boro' Rd. F.N. 11/3/57 O.N. 4/4/57 10& 11, Pitt St., Old Kent Rd O.N. 13/3/57 27 & 28, St. George's Place White St. F.N. 11/3/57 1, Amicable Row F.N. 23/3/57 5, Walker St., Kent St. O.N. 16/3/57 Galloway's Dairy, 75, Kent St. F N 23/3/57 1, 2, 3, 4, 6, Do. O.N. 13/3/57 3 to 10, Wurtemburg Place Blackfriars Rd. F.N. 17/3/57 O.N. 78/4/57 33, Staple St. O.N. 13/3/57 O.N. 18/4/57 6 & 8, Red Cross Ct. F.N. 23/3/57 5, Potier St. O.N. 13/3/57 8, Red Cross Court F.N. 18/3/57 O.N 18/4/57 Elizabeth's Place, Nos. 1,3,4,6, F.N. 10/4/57 O.N. 18/4/57 28, Langsdowne Place F.N. 25/3/57 7, 8,9,10,11,12,14,15,16 O.N. 4/4/57 23, Friar St. O.N. 10/3/57 O.N. 1/5/57 11 & 12 Moreton St. O.N. 13/3/57 80½, Friar St., Dairy F.N. 23/3/57 3, Brighton Place F.N. 26/3.57 12, Bath St. F.N. 19/2/57 O.N. 18/4/57 O.N. 18/4/57 4, Union St. O.N. 4/3/57 33 Parish of Saint George the Martyr, Southwark. No 6 REPORT OF THE MEDICAL OFFICER OF HEALTH, For the Second Quarter, 1857. AUGUST 31st, 1857. Mr. Chairman and Gentlemen of the Vestry, No. 6. I have, during the quarter ending Midsummer, brought five individual reports before you. It is now my duty to present my Quarterly Report, consisting chiefly of Tables somewhat more complete than before; and a summary of the most important matters contained in the five reports alluded to. The first Table shows that, usually, less deaths occur among us in the second quarter, than in either of the others; the averages show the difference in rather an exaggerated form, because of the great mortality in Cholera epidemics. Allowing for increase of population, the quarter's mortality was about 20 less than the average, and 27 less than that of the previous quarter. In the second Table, I compare our Parish with others in similar and different circumstances. One fact that appears, is, that we lose annually 30 in the 1000, the next worse parish 28, the lowest 18. In fact, there are but two parishes that lose more by death than we do, while there are 33 that lose less. This fact should, of course, be kept in mind; for no doubt some at least of this fatality is preventible; if we could keep to the average of all London, we should lose nearly 300 less every year, or even to that of Bethnal-green, we should lose 200 less every year. It is just as well to know this. Few believe we are as bad as we really are, and, if we do not believe it, we shall not of course try to mend it; but it cannot be denied. The healthy standard is 17 in 1,000; we cannot hope to arrive at that. The Registrar General says, "One of the greatest and most prevailing causes of ill health,"and of the deaths in excess of 17 in the 1,000, is the condensation of people in towns without the requisite mechanical and chemical arrangements for removing impurities, for supplying pure water, and for introducing free currents of pure air." That is really our case—we might have stood for the portrait. You will also remark in this table as to the iniquity of the rich Londoners paying a low poor rate, and the poor Londoners paying a high rate; how the city and west-end people buy property, and get a reversion of decreasing rates; and how we get a reversion of increasing rates—a result by no means contemplated in the original compact. This bears hardly upon us, it stifles us,—more and more packed, more and more impoverished, with very little space between the poor ratepayer and the pauper, of course there is more sickness and death. We cannot at present help this, but there is very much that we can help. The third Table is more for the future than the present. It is, however, not without interest, as showing the parallel states of health and weather in this neighbourhood. The fourth Table shows the mortality in the respective districts of theparish. In the Borough-road district, a little less population reside upon a little more than half the space of the other districts, and the mortality and sickness are in proportion uniformly higher; the workhouse is, however, included, and will account for some of it. Here are shown the returns of sickness from several Institutions. We are in this matter much indebted to the courtesy of the respective medical officers. The fifth Table shows the weekly progress of sickness among the poor in the districts. Kent-road, 105 acres, population 19,200,—335 new cases in the quarter, with 60 pauper cases always under treatment. London-road, 112 acres, population 19,000,—304 new cases, and 53 always under treatment. Borough-road, 65 acres, population 16,850,—475 new cases, and 97 always under treatment; so that this density of population brings you more deaths, more sickness, more expense, and you will observe that the people, when they become sick in the crowded district, are much longer on the parish books. Fever has much diminished—less in numbers, and less in severity; no case was sent to the Fever Hospital during the quarter. The sixth Table is in accordance with the Registrar-General's wishes. I cannot but express my gratitude for the advice and assistance I have had from that quarter. This Table gives particulars of diseases, ages, and sexes. Here you will observe that out of 299 deaths during the quarter, 145 were under five years of age, 157 under twenty. More than half took place under ten years of age. 60 persons died from zymotic diseases. Of the six diseases especially noticed, and which may be considered as health gauges, there were 53 as against 47 in the corresponding quarter last year. The diseases vary; 12 Parish of Saint George the Martyr, Southwark. we lost fewer from the more preventible diseases. Then typhus and measles predominated; now hoopingcough and diarrhoea. Small Pox Measles Scarlatina Cough Diarrhoea Typhus Total This Quarter 0 5 4 28 9 7 53 Corresponding Quarter last Year 3 14 5 8 2 15 47 This points to the necessity of making every available opening for currents of air in the closer and sicklier districts, of removing everything promptly that unnecessarily vitiates the air, of encouraging a higher standard of cleanliness in back districts; by the example of public cleanliness and care, and by compelling those refractory persons, who injure their neighbours by their neglect, to put their places in order. A man may, of course, be as filthy as he likes, if he has a taste that way, but he has no right to carry it to the extent of injuring others. In this Table will be seen also, that forty-one persons have been taken off in the very prime of life by consumption: although the disease is hereditary, everything that tends to purify and freshen the atmosphere will diminish its ravages. Open spaces to which children can readily be taken, will do very much to eradicate the seeds of the disease in early life. I have seen children with all the symptoms hinting at decline, become quite well by judicious and regular exposure to the air. The dreadfully vitiated air of our courts, alleys, and close rooms, produces and fosters this disease, which destroys more lives than any other. I need not say any more at present about parks; of course they are necessary, and the nearer the better. Two cases have been brought before you,—one the rare opportunity with little effort and little expense of preserving the open space of ground in Red-cross-court. This court alone costs the parish, as I believe, at least £100 a-year in pauperism. The other is Henry-street and Etham-street; a small opening is greatly needed here, it was reported upon some months ago. The landlords of this small, densely-packed neighbourhood greatly desire the opening of these thoroughfares, and the 2,000 poor people that live in this small space, can scarcely have a greater boon bestowed upon them. The seventh Table shows the extent of sanitary work during the quarter. About half the cases ordered, are reported as unfinished at the end of the quarter, and some remain from previous quarters; the cases are specified; some may perhaps have been done since, but there are great arrears. This Table is partly constructed from the Inspector's book, and the work is chiefly his. I am, however, acquainted with the particulars of every case, and advise with him upon each. One of the earliest and most special orders of the Vestry was that he should act thoroughly with me. I am most glad to say, that he does so to my perfect satisfaction. I have lately visited all the cow-yards, 18 in number, containing 207 cows. The cows, with some exceptions, look healthy. In the most neglected cow-houses I find the most unhealthy, sickly cows. These cows are generally quickly got rid of. It appears to pay some persons to call round and purchase sickly, diseased, or dying animals; the cows may, therefore, look well, and a quick succession of sickness take place, and be in this manner removed. One cow-keeper had lost a large number, and had given up the business. Another had lost a few, and some of the cows looked as if they were becoming sick. Many of the cow-yards require great improvement—periodical cleansing, improved paving and drainage, and a better water supply; the dung-pits are defective, open, and in hot weather steaming up and infecting the air. As the principle of draining over or under the service is of the utmost importance, the decision of a full Vestry upon the principle is desirable before proceeding; sure I am that the existence of many thousands of feet of almost stagnant foul liquid, slowly running from cow-sheds and piggeries, cannot be right in close neighbourhoods, when perhaps half of it would be evaporated by the heat of the sun before it could arrive at the distant sink. The first dairy authorities agree that "hot, close cow-houses are disgraceful affairs." Mr. Martin, one of the first, says, "As the slightest acidity and putrescence affects the milk, it is of the utmost importance that the place should be as pure and clean as possible." Recollect also how the question of good milk bears upon the deaths of children, which are so enormous with us. I have visited all the lodging-honses in this parish with Inspector Price and Mr. Wellman. They were 25 in number, containing 714 rooms and 827 lodgers. The police regulations, for order, cleanliness, and prevention of disease, are in the highest degree satisfactory. That the amount of disease, and of the worst kinds, was formerly enormous, I, as an old parish surgeon, well know. It rapidly infected others; not so now. The open indecencies have almost passed away. The expense to the parish, of these places, occupied by the most improvident and the filthiest of people, must have been enormous. I saw but two cases of illness in all the houses, and one of them was from intemperance. Fever, small-pox, and the like, cannot spread; they are immediately reported and removed, and the places are cleansed before others are allowed to. occupy. The benefits are so great, that the employment of the same regulations in the more crowded and filthier houses of the poor, can only be a question of 3 Report of the Medical Officer of Health, for the second Quarter, 1857. time. It is the highest humanity to quicken the progress. Vestries have power, under the Local Management and Disease Prevention Acts, sufficient for the purpose; and such acts as these, in my humble opinion, ought to be done by Vestries; and not by extending the powers of the police, as in the recent bill was attempted. But the need is so great, so undoubted by those who have seen the evils with their own eyes; and the benefit to be obtained so certain; that if local authorities do not enforce the improvements, the police will have to do it, and we shall have ourselves to thank for throwing the duty upon them. We have had but four deaths from scarlatina; but of these four, in the opinion of every one concerned, two became malignant and fatal from the house being filled with privy stench in hot weather. The work was promptly done—too late to save the children, but not too late to warn us of the fatal character of sulphuretted hydrogen and like gases, that are the components of privy stenches. As to the overcrowding, I have brought many cases before you, in each my attention has been called on account of illness resulting; difficult of cure, and constantly reeurringr. "I can never get out of that house," said the district surgeon of one of them. The eight rooms of this house were always full, the receipts £2 2s. per week; yet it was dirty, neglected, and overcrowded. So the poor live, and, I may say, so they die. As to some manufactories, the more offensive should no doubt be compelled to improve. Some of them are very bad, and their pernicious influence spreads widely. I do not think any manufacturer should be obliged to leave; trades must be, of course, protected; but one man must not, to save a little expense in his building and machinery, be allowed to poison a neighbourhood containing, as this does, some thirty thousand people. There are various ways of making almost all of them bearable. One of the most practical men of the day says of one plan, "It has been applied in order to get rid of the offensive effluvia arising from the coppers of the soap-boilers, tallow-melters, and similar occupations, which often become a nuisance to a whole neighbourhood." He further states, "that it was said to have answered perfectly;" so that a factory which was formerly most offensive, became entirely free from offensive odours. I believe where the apparatus is inapplicable, as in bone lofts, cat-gut manufactories, and the like very offensive trades, there appears to be no way but completely enclosing such premises, providing inlets for fresh air below, and with outvents only through tall shafts; the offensive air to be forced through these shafts by blowers, to be depurated in its passage by fire or chemical agency. Lastly, as to ventilating sewers, I think no more gullies should be trapped, unless a sufficient vent be applied elsewhere. Clearly we must not close the vents in objectionable places, unless we open enough in unobjectionable places. The evils will be—the forcing back the foul gases into houses, and rendering sewers dangerous to workmen. I have spoken of cross roads, or places where four or more ways meet, as apparently the least objectionable: one such I see is now laid down in White-street, and I therefore suppose the principle is recognised. On this side the river, the caution is especially necessary, as 16 hours out of the 24, the sewers have no flow, and consequently become overcharged. Seven or eight men have lately lost their lives from foul sewers. The verdict of the jury in the Wapping case was, "That the four men were suffocated by the noxious gases and mephitic air of the sewer." In the Whitechapel-road case, last week, three men were killed—verdict "That they died from the noxious and mephitic vapours emitted from a sewer." The gas was principally sulphuretted hydrogen, and it is powerful enough to cause instant death. One of the principal witnesses in the case stated that no doubt "measures might have been adopted to prevent the deaths of the three persons by better ventilation." Upon these grounds, and upon the fact that in many parts of this parish, regurgitation of these very gases takes place into houses, I beg to urge the question of ventilation of our sewers in every possible and unobjectionable place, but especially where thoroughfares meet; and to advise that no more external guliies be stopped, (Signed) WILLIAM RENDLE. TABLE 1.—Quarterly Mortality. 1855 1856 1857 Average Mortality of the Quarters from 1845 to 1854 First Quarter ... 304 323 373.6 Second ,, to June 30 333 292 296 294.8 Third ... 350 ... 431.1 Fourth ... 284 ... 391.8 4 Parish of Saint George the Martyr, Southwark. TABLE 2.—Mortality, &c., compared with other Parishes. Conditions of Locality Parish Height above Trinity High Water Mark Area in Acres Population, 1851 Each Person represents Annual Value Each Person pays to Relief of Poor Same Pate as St. Geo.'s Southwark, each should pay Density. Persons to an Acre Average Annual Mortality in 10,000, 1841 to 1850 Mortality from Cholera, to every 10,000 Inhabitants. Mean of 1840 & 1854 The Quarter ending June 27th, 1857 Zymotic Mortality Fever Diarrhoea Total Mortality Deaths to 1000 Living Births Excess of Births over Deaths to June 30 Dense Population. High Level. Wealthy. St. James FEET 58 164 36,406 £ s. d. s. d. s. d. 12 13 4 10 3 30 0 222 206 84.0 15 0 l 166 22 ... ... 95 Sparse Population. High Level. Medium Circumstances. Hampstead 350 2252 11,986 5 16 0 8 3 13 9 5 178 9.5 10 3 0 58 18 ... ... 29 Dense Population. High Level. Medium Circumstances. St. Giles 68 245 54,214 5 12 8 5 9 13 4 221 252 37.0 70 7 7 335 27 ... ... 96 Sparse Population. Low Level. Poor. Camberwell 4 4342 54,667 4 4 0 5 9 10 5 13 231 94.0 25 8 3 298 24 ... ... 195 St. George's, Southwark,— M. F. Dense Population. Low Level. Poor. Kent-rd. District 1 105 18,126 ... ... ... ... ... 173 252 132.5 22 5 3 94 ... 76 79 ... Borough-rd. ,, 2 65 15,862 ... ... ... ... ... 244 347 16 2 3 114 ... 82 70 ... London-rd. ,, 0 112 17.836 ... ... ... ... ... 159 250 15 1 3 91 ... 92 76 ... 250 225 Total 0 282 51,824 3 6 4 7 10 7 10 184 281 ... 53 8 9 299 30 475 176 „ Newington 1 624 64,186 3 15 0 8 1 8 10 104 247 122.5 38 9 3 327 26 ... ... 369 „ Bermondsey 0 688 48,128 3 0 9 5 4 7 1 70 268 159.5 40 4 7 249 28 ... ... 283 Dense Population. Medium Height. Very Poor. Bethnal Green 38 760 90,193 1 10 0 3 10 3 6 119 242 55.0 113 23 12 488 26 ... ... 462 All London ... ... 2,480,347 5 16 1 6 4 13 9 ... ... ... ... ... ... ... 25 ... ... ... 5 Report of the Medical Officer of Health, for the second Quarter, 1857. TABLE 3.—Mortality and Meteorology. Week DEATHS, from local weekly returns Barometer corrected Mean Thermometer (Averages) Dew Point Weight of Vapour in cubic foot of air, grains Wind Rain in inches Total Zymotic Disease Diarrhoea Chest Diseases Total Mortality Average of the Weeks for 10 years of Highest of Lowest Phthisis All other 1 3 0 2 6 25 23.9 29.457 54.9 44.9 34.8 3.0 S.W. 0.39 * The amount of Rain was less than the Average of the Quarter for many years, which, according to Howard, is 5.719; in the corresponding Quarter last year 6.25. Highest temparature June 28th, 92.5. Meteorology from Dr. Thomson's reports taken at St. Thomas's Hospital. 2 2 0 8 3 26 24.6 29.651 60.2 47.5 44.2 3.6 variable 0.51 3 3 0 6 7 28 21.9 29.576 53.7 39.3 35.1 2.6 variable 0.48 4 2 1 1 4 14 24.3 30.004 59.3 44.0 38.1 2.8 N. 0.10 5 6 0 4 4 22 22.9 30.149 48.9 39.1 32.1 2.3 N.E. 0.16 6 9 1 1 8 31 22.7 30.094 54.5 39.2 33.1 2.5 N.E. 0.00 7 7 1 3 5 25 21.7 29.931 67.4 51.7 46.2 3.8 variable 0.33 8 3 0 3 3 18 24.5 29.834 71.9 53.2 47.2 3.9 W. 0.58 9 9 1 1 4 29 25.7 29.723 69.5 51.7 43.9 3.5 variable 0.08 10 3 2 4 1 21 24.1 29.998 73.3 53.9 48.3 4.0 S.W. 0.01 11 3 1 3 3 22 23.3 29.879 69.9 52.4 43.9 3.6 S.W. 0.99 12 6 1 1 2 18 20.3 30.016 71.1 49.7 42.1 3.2 E. 0.92 13 4 1 4 3 20 21.9 30.158 82.2 59.7 52.1 4.6 E. 0.19 Summaries and Averages 60 9 41 53 299 301.8 29.864 65.3 48.8 42.9 3.4 S.W. and E. 4.74 94 6 Parish of Saint George the Martyr, Southwark. TABLE 4—Mortality and Sickness in Districts, &c. DISEASES District Mortality NEW CASES OF SICKNESS DURING THE QUARTER Estimated present Population, 55,000 Out and In-door Poor INSTITUTIONS, 9 Weeks, April 26th to June 27th Kent Road 105 Acres. Ppn. 1851, 18,126 London Road, 112 Acres Ppn. 1851, 17,836 Boro' Road, 65 Acres. Ppn. 1851, 15,862 Workhouse. Average Inmates, 427 Kent Road, Mr. Babbage London Road, Mr. Wakem Boro' Road, Mr. Llewellyn Workhouse, Mr. Brown Royal South London Dispensary Bethlehem Hospital, &c. Av. Inmts. 600 Queen's Bench Prison School for Indigent Blind Asylum for Deaf & Dumb Magdalen Hospital Sickness Total Small Pox - - - Included in the Boro' Road District - - - - - - Returns refused. No Sickness of any importance. - - - Chicken Pox - - - - 1 - - 1 - - - 2 Measles 2 3 - 3 7 2 1 - - - - 13 Scarlatina, Malignant Sore Throat - - 4 - 3 6 - - - 4 - 13 Hooping Cough 12 9 7 11 6 17 - 15 - - - 49 Diarrhœa 3 2 3 12 10 25 5 20 - - 5 77 Dysentery - 1 - - 1 1 - 2 1 - - 5 Cholera - - - - - - - 1 - - - 1 Fever 5 1 2 47 20 65 3 5 - - 1 141 Ague - - - 1 - - - 1 - - - 2 Rheumatic Fever - - - - 2 - - - - - 1 3 Rheumatism - - - 17 7 12 7 - - - - 43 Erysipelas 1 - - 1 2 1 1 - - 1 - 6 Pyæmia - - - - - - - - - - 2 2 Puerperal Fever - - - - - - - - - - - - Carbuncle - - - - 1 - - 2 - - - 3 Chronic Lung Diseases, (except) Phthisis 2 - 2 - 57 11 20 - - - - - 88 Phthisis 12 15 13 8 9 9 4 6 - 1 - - 29 Acute Lung Diseases Bronchitis & Catarrh 9 11 15 5 14 19 3 11 25 - - - 72 Pleurisy - 1 - - - 2 - - - 1 - - 3 Pneumonia 4 7 3 - 11 9 2 - - - - - 22 Croup 1 - - - - - - 1 - - - - 1 Hydrocephalus, Tabes, Scrophula, Spasmodic Croup, Convulsions of Infants 23 17 15 1 6 3 - - - - - - 9 Other Diseases, chiefly Chronic 19 19 42 19 145 189 315 36 543 50 12 - 1290 Violence, Privation, Poison, and Premature Birth 1 3 7 1 1 2 2 - - - - 5 Sudden Deaths - 2 1 1 - - - 1 - - - - 1 TOTAL 94 91 114 35 335 304 475 72 615 53 - - 17 9 1880 7 Report of the Medical Officer of Health, for the second Quarter, 1857. TABLE 5.—Cases of Sickness among the Out-door Poor. Weeks Kent Road, Mr. Babbage London Road, Mr. Wakem Borough Road, Mr. Llewellyn Old Cases New Cases Total Old Cases New Cases Total Old Cases New Cases Total 1 45 45 90 31 34 65 68 35 103 2 43 23 66 40 17 57 65 35 100 3 38 25 63 31 29 60 68 37 105 4 44 26 70 40 26 66 85 36 121 5 35 17 52 29 18 47 70 35 105 6 31 14 45 28 23 51 72 39 111 7 30 30 60 30 17 47 62 47 109 8 29 21 50 42 13 55 66 34 100 9 23 21 44 28 21 49 52 28 80 10 33 38 71 24 32 56 44 43 87 11 39 16 55 26 17 43 65 29 94 12 33 23 56 18 28 46 44 22 66 13 31 36 67 21 29 50 31 55 86 TOTAL 454 335 789 388 304 692 792 475 1267 Grand Total—Old Cases, 1634, New Cases, 1114 = 2748. N.B.—It should be here remarked, that "Old Cases" means only those cases of illness that remain on the hooks more than one week, and consequently involve repetitions of the same case. 8 Parish of Saint George the Martyr, Southwark. Table 6.—DEATHS Registered in St. George's, Southwark, during the Quarter ending June 27th, 1857. (13 Weeks.) CAUSES OK DEATH ALL AGES AGES M. F. T. Under 1 1.— 2.— 3.— 4 5.— All under 5 5 to 10 10.— 15.— All under 20 20.— 40.— 60.— 8O and upwda. All Causes 148 151 299 76 30 20 10 4 5 145 6 2 4 157 42 37 52 11 I. Zymotic 24 36 60 19 10 13 5 3 3 53 1 - - 54 2 3 - II. Dropsy, &c. 4 9 13 I 1 - - - - 2 - - - 2 3 2 5 1 III. Tubercular 38 22 60 11 4 3 2 - 1 21 1 - 1 23 21 1.1 3 - IV. Brain and Nerves 20 25 45 16 3 - 1 - 1 21 1 - 3 25 5 6 8 1 V. Heart, &c. 5 6 11 - - - - - - - - - - - 3 3 4 1 VI. Lungs, &c. 26 27 53 10 7 4 1 1 - 23 1 2 - 26 7 7 12 1 VII. Digestive Organs 6 4 10 4 2 - 1 - - 7 1 - - 8 1 - 1 - VIII. Kidneys. &c. 1 - 1 - - - - - - - - - - - - - 1 - IX. Childbirth, &c. - 1 1 - - - - - - - - - - - - 1 - - X. Joints, &c. - - - - - - - - - - - - - - - - - - XI. Skin, &c. - - - - - - - - - - - - - - - - - - XII. Malformation - - - - - - - - - - - - - - - - - - XIII. Prem, Birth & Debility 5 4 9 8 1 - - - - 9 - - - 9 - - - - XIV. Atrophy 2 4 6 4 1 - - - - 5 - - - 5 - - 1 - XV. Old Age 10 9 19 - - - - - - - - - - - - - 13 6 XVI. Sudden 1 1 2 - - - - - - - - - - - - 2 - - XVII. Violence, Privation, &c. 4 3 7 2 1 - - - - 3 - - - 3 1 1 1 1 XVIII. Not specified 2 - 2 1 - - - - - 1 1 - - 2 - - - - 1. Small pox - - - - - - - - - - - - - - - - - - Measles 2 3 5 2 1 2 - - - 5 - - - 5 - - - - Scarlatina 1 3 4 - - 2 - - - 3 1 - - 4 - - - - Hooping Cough 9 19 28 7 7 8 3 2 1 28 - - - 28 - - - _ Croup 1 - 1 - - - - - 1 1 - - - 1 - - - - Thrush - - - - - - - - - - - - - - - - - - Diarrhœa 7 2 9 6 2 - - - - 8 - - - 8 - 1 - _ Dysentery - - - - - - - - - - - - - - - - - - Cholera - - - - - - - - - - - - - - - - - - Influenza - - - - - - - - - - - - - - - - - - Scurvy and Purpura - - - - - - - - - - - - - - - - - - Ague - - - - - - - - - - - - - - - - - - Remittent Fever - 1 1 _ - 1 - - - 1 - - - 1 - - - - Infantile „ - - - - - - - - - - - - - - - - - - Typhus „ 3 4 7 - - - 1 1 1 3 - - - 3 - 1 3 - Puerperal „ - - - - - - - - - - - - - - - - - - Rheumatic „ - - - - - - - - - - - - - - - - - - Erysipelas - 1 1 1 - - - - - 1 - - - 1 - - - - Pyæmia - - - - - - - - - - - - - - - - - - Syphilis 1 3 4 3 - - - - - 3 - - - 3 1 - - - Noma - - - - - - - - - - - - - - - - - - Hydrophobia - - - - - - - - - - - - - - - - - - II. Hœmorrhage - - - - - - - - - - - - - - - - - - Dropsy 2 6 8 - - - - - - - - - - - 3 1 3 1 Abscess - - - - - - - - - - - - - - - - - - Ulcers - - - - - - - - - - - - - - - - - - Fistula - - - - - - - - - - - - - - - - - - Mortification 2 - ? 1 1 - - - - 2 - - - 2 - - - - Cancer - 2 2 - - - - - - - - - - - - 1 1 - Gout - 1 1 - - - - - - - - - - - - - 1 - III. Scrophula 1 - 1 - 1 - - - - 1 - - - 1 - - - - Tabes Mesenterica 9 1 10 7 1 2 - - - 10 - - - 10 - - - - Phthisis 22 19 41 - 1 I - - - 2 1 - 1 4 21 13 3 - Spasmodic Croup - - - - - - - - - - - - - - - - - - Hydrocephalus 6 2 8 4 1 2 1 8 - - - 8 - - - - IV. Cephalitis 2 2 4 - - - - - - - 1 - - 1 - 2 1 - Apoplexy 1 2 3 - - - - - - - - - 1 1 1 1 - - Paralysis 2 4 6 - _ - - - - - - - - - - 1 4 1 Delirium Tremens 1 1 2 - - - - - - - - - - - - 2 - - Chorea - - - - - - - - - - - - - - - - - - Epilepsy 1 2 3 - - - - - - - - - 2 2 1 - - - Tetanus - - - - - - - - - - - - - - - - - - Insanity - 1 1 - - - - - - - - - - - - - 1 - Convulsions 9 10 19 15 2 - 1 - 1 19 - - - 19 - - - - Disease of Brain, &c. 4 3 7 1 1 - - - - 2 - - - 2 3 - 2 - 9 Report of the Medical Officer of Health, for the second Quarter, 1857. Births M. 250. F. 225. Total 475. Excess of Births over Deaths 176. Deaths M. 148. F. 151. Total 299. CAUSES OF DEATH ALL AGES AGES M. F. T. Under 1 1.— 2.— 3.— 4.— 5.— All under 5 5 to 10 10.— 15.— All under 20. 20.— 40.— 60.— 80 and upwds. V. Pericarditis - - - - - - - - - - - - - - - - - - Aneurism 1 1 2 - - - - - - - - - - - - 1 1 - Disease of heart, &c. 4 5 9 - - - - - - - - - - - 3 2 3 1 VI. Laryngitis - - - - - - - - - - - - - - - - - - Bronchitis 14 20 34 5 3 3 - - - 11 - 1 - 12 5 6 10 1 Pleurisy 1 - 1 - - - - - - - - - - - 1 - - - Pneumonia 8 6 14 5 4 1 - 1 - 11 1 1 - 13 - - 1 - Asthma 2 - 2 - - - - - - - - - - - 1 1 - - Disease of Lungs 1 1 2 - - - 1 - - 1 - - - 1 - - 1 - VII. Teething 1 2 3 1 2 - - - - 3 - - - 3 - - - - Quinsey - - - - - - - - - - - - - - - - - - Gastritis - - - - - - - - - - - - - - - - - - Enteritis 1 2 3 1 - - 1 - - 2 1 - - 3 - - - - Peritonitis - - - - - - - - - - - - - - - - - - Ascites - - - - - - - - - - - - - - - - - - Ulceration of Intestines - - - - - - - - - - - - - - - - - - Hernia 1 - 1 1 - - - - - 1 - - - 1 - - - - Ileus - - - - - - - - - - - - - - - - - - Intussusception - - - - - - - - - - - - - - - - - - Stricture of Intestinal Canal - - - - - - - - - - - - - - - - - - Dis, of Stomach, &c. - - - - - - - - - - - - - - - - - - Dis. of Pancreas - - - - - - - - - - - - - - - - - - Hepatitis - - - - - - - - - - - - - - - - - - Jaundice 1 - 1 1 - - - - - 1 - - - - - - - - Disease of Liver 2 - 2 - - - - - - - - - - - 1 - 1 - Disease of Spleen - - - - - - - - - - - - - - - - - - VIII. Nephritis - - - - - - - - - - - - - - - - - - Nephria (Bright's Dis.) - - - - - - - - - - - - - - - - - - Ischuria - - - - - - - - - - - - - - - - - - Diabetes - - - - - - - - - - - - - - - - - - Stone - - - - - - - - - - - - - - - - - - Cystitis 1 - 1 - - - - - - - - - - - - - 1 - Stricture of Urethra - - - - - - - - - - - - - - - - - - Disease of Kidneys, &c. - - - - - - - - - - - - - - - - - - IX. Paramenia - - - - - - - - - - - - - - - - - - Ovarian Dropsy - 1 1 - - - - - - - - - - - - 1 - - Childbirth (See Metria) - - - - - - - - - - - - - - - - - - Disease of Uterus, &c. - _ - - - - - - - - - - - - - - - - X. Rheumatism - - - - - - - - - - - - - - - - - - Arthritis - - - - - - - - - - - - - - - - - - Disease of Joints, &c. - - - - - - - - - - - - - - - - - - XI. Carbuncle - - - - - - - - - - - - - - - - - - Phlegmon - - - - - - - - - - - - - - - - - - Diseases of Skin, &c. - - - - - - - - - - - - - - - - - - XIII. Cyanosis - - - - - - - - - - - - - - - - - - Spina Bifida - - - - - - - - - - - - - - - - - - Other Malformations - - - - - - - - - - - - - - - - - XVII. Intemperance - - - - - - - - - - - - - - - - - - Privation of Food - - - - - - - - - - - - - - - - - - Want of Breast Milk 1 1 2 2 - - - - - 2 - - - 2 - - - - Neglect - - - - - - - - - - - - - - - - - - Cold - - - - - - - - - - - - - - - - - - Poison - - - - - - - - - - - - - - - - - - Burns and Scalds - - - - - - - - - - - - - - - - - - Hanging - - - - - - - - - - - - - - - - - - Suffocation - - - - - - - - - - - - - - - - - - Drowning - 1 1 - - - - - - - - - - - 1 - - - Fractures and Contusions 2 - 2 - - - - - - - - - - - - 1 1 - Wounds - - - - - - - - - - - - - - - - - - Other Violence 1 1 2 - 1 - - - - 1 - - - 1 - - - 1 10 11 Parish of Saint George the Martyr, Southwark. Report of the Medical Officer of Health, for the second Quarter, 1857. TABLE 7.—Sanitary Inspections during the Quarter ending 27th June, 1857. Cases Number of Houses or Places visited Number of Visits of Medical Officer and Inspector Premises unclean, or dilapidated within Overcrowded Unfit for habitation Insufficient Ventilation Water Water receptacle none, bad, or without cover Bad Drainage Foul Cesspool Water Closet defective, or without Water Yard badly paved Refuse accumulated Dustbin, none or imperfect Nuisances from animals badly kept Slaughter-houses, Manufactories in unwholesome state Burial Vaults requiring improvement Deficient No supply 142 211 about 850 35 6 1 10 5 8 18 144 132 27 49 8 75 13 2 3 Work completed 73 88 . 21 6 1 8 2 5 14 46 42 13 9 5 19 5 . . Not begun, or left unfinished 69 123 . 14 . . 2 3 3 4 98 90 14 40 3 56 8 2 3 Names of Places, and Dates of Official or Friendly Notices are annexed in which the Work ordered was not completed at the end of the Quarter. The following are old cases reported last year :— 23 and 24, London-street F.N. 20 4 57 Mr. Able, Bone-boiler, Green-street—Mr. Ray, Bone-boiler, Green-street.-34 Little Duke-street. O.N. 16 5 57 The following from the fourth quarterly report:— 34, Bean-street F.N. 5 5 57 4, Potier's-place, F.N. 30 4 57 John's-place, London-street-6 to 11, Spiller's-court-34, King-street, Borough-road. O.N. 12 6 57 Do. (Second) O.N. 27 6 57 The following from the last or fifth quarterly report:— 1, 2, 4, 5, 6, and 7, Delph-street O.N. 1 5 57 King's Arms, Old Kent-road—Ditto two other cases—5, Walker-street, Kent-street 12, Bath stree- 80½ Friar-street, (Dairy)-l, 2, 3, 4, and 6, Walker-street, Kent-street 4, Union-street, Borough road—75, Kent-street, (Dairy) —5, Potier-street— 33, Staple-street—27, 28, St. George's-place, White-street. 32, Staple-street O.N. 1 5 57 1 and 2, White Horse-yard F.N. 4 5 57 O.N. 27 6 57 Kent-street O.N. 5 5 57 The following are cases taken in hand during this (the sixth) quarter, and not reported as finished at the end of the quarter:- ??? Green-street „ Date 10, Green-street F.N. 11 5 57 Dairy, White-street F.N. 4 4 57 O.N. 18 5 57 O.N. 1 5 57 39 and 40, White-street O.N. 14 5 57 Do. Summons 19 5 57 Do. (Second) O.N. 27 6 57 Caroline-crescent F.N. 6 4 57 43, White-street O.N. 14 5 57 O.N. 18 4 57 90, Webber-row F.N. 13 5 57 2, Providence-place, Market-street F.N. 8 4 57 89, Webber-row O.N. 12 6 57 3 and 4, Providence-place, Market-street F.N. 8 4 57 Do. (Second) O.N. 29 6 57 O.N. 27 6 57 1, 2, 3, 4, 5, 6, 7, 8, and 9, Castle-yard F.N. 21 5 57 24, Market-street F.N. 8 4 57 14½, King's Bench-walk, (Bone-boiler) F.N. 21 5 57 O.N. 27 6 57 O.N. 13 6 57 25, Market-street F.N. 8 4 57 1, 2, 3, and 7, Hendre-terrace F.N. 21 5 57 27, and 28, Market-street F.N. 8 4 57 127, High-street F.N. 2 6 57 O.N. 27 6 57 O.N. 27 6 57 1, 2, 3, 4, and 5, St. George's-passage, Market-street F.N. 9 4 57 77, Borough-road F.N. 3 6 57 29 and 30, Market-street F.N. 9 4 57 O.N. 7 6 57 O.N. 27 6 57 86, Borough-road F.N. 6 6 57 31, Market-street F.N. 8 4 57 6, George-street F.N. 3 6 57 32, Market-street F.N. 8 4 57 75, St. George's-road, Cow Shed F.N. 12 6 57 O.N. 27 6 57 27, Valentine-place, Cow Shed „ 33, Market-street F.N. 8 4 57 33, Gray-street, Cow Shed „ O.N. 11 7 57 St. George's Market, Cow Shed O.N. 11 7 57 36, 37, 38, and 39, Market-street F.N. 9 4 57 Skin Market, Cow Shed F.N. 12 6 57 O.N. 27 6 57 George-street, Cow Yard „ 1, 2, 3, 4, and 7, Parliament-street, Market-street F.N. 9 4 57 5, Red Cross-street, Cow Yard „ O.N. 27 6 57 Southwark Bridge-road F.N. 17 6 57 5 and 6, Parliament-street F.N. 9 4 57 Red Cross-court, Open Space F.N. 19 6 57 46, Market-street—l7, 18, 19, 20, 21, 22, 23, 24, 25, and 26, Butcher-row, Market-street F.N. 9 4 57 78, Borough-road „ O.N. 27 6 57 99, London-road „ 9, 10, 11, 12, 13, and 14, Butcher-row, Market-street F.N. 9 4 57 92, St. George's-road „ 15 and 16, Butcher-row, Market-street F.N. 9 4 57 29, London-road F.N. 20 6 57 O.N. 27 6 57 O.N. 11 7 57 15 and 16, Butcher-row, Market-street F.N. 9 4 57 Northampton-row, Old Kent-road F.N. 22 6 57 O.N. 27 6 57 Dover-place, West F.N. 22 6 57 25, 26, 27, and 28, York-street F.N. 17 4 57 O.N. 11 7 57 O.N. 18 5 57 King's Arms-yard, Cottage F.N. 22 6 57 10, Rodney-street O.N. 18 4 57 O.N. 11 7 57 36, Waterloo-road F.N. 17 4 57 47, Wellington-street F.N. 26 6 57 O.N. 1 5 57 LONDON: Printed by G. Head and W. P. Gri???th, Printers to Her Majesty's Stationery Office, 5, Langley Street, Long Acre. w. c. Royal College Infest Uscohe in Juls m No 7. 34 Parish of Saint George the Martyr, Southwark. REPORT OF THE MEDICAL OFFICER OF HEALTH, For the Third Quarter, 1857. November 30th, 1857. Mr. Chairman and Gentlemen of the Vestry, I beg now to present my report for the quarter ending Michaelmas. I have, daring the quarter, brought before you six individual reports; the recommendations contained in them have, for the most part been dealt with, or are in progress. This report consists chiefly of tables, similar to, and fit to l r compared with those presented with previous quarterly reports. The first Table shews a very satisfactory state of things; notwithstanding, in one of the beforementioned reports I stated that the cases of sickness among the poor were more numerous than usual; last quarter I reported 1880 eases, this quarter 2787. There has been much sickness lately from diarrhœa, and still more lately from influenza; the attacks have, however, been very slight, and the death list consequently low; about 70 less have died than in the corresponding quarter last year, and 152 less than the average of the quarter for many years. If we exclude from the calculation the deaths by cholera epidemics, we yet have lost 100 less than the average of the quarter. London altogether has lost more 212 than in the corresponding quarter last year, and 1386 more than in the corresponding quarter of 1855. You will thus see that our usually unhealthy district has been much favoured. I have not the least doubt that if we honestly carry out the common sense improvements suggested to us from time to time, we shall materially and permanently lessen our death list, and, what must not be overlooked, make life much more comfortable and hopeful for large masses of people who now pass through a most Miserable and degraded existence; and allow me to add the practical testimony of some of your own body, given in your hearing, that it pays to make these improvements in hitherto neglected districts. In the second Table this parish is compared with the same parishes as before; which, to make the comparison as complete and as instructive as possible, are parishes selected as fair specimens of various conditions and circumstances. The fourth figure column is from a circular of the RegistrarGeneral's; if calculated upon the latest rateable value of property, a difference would be shown, so slight however as not to vitiate the calculation—it is therefore left as it was. 2 Parish of Saint George the Martyr, Southwark. The third Table affords materials for comparing classes of disease with meteorological conditions. The temperature of the quarter was considerably above the average for 86 years ; since 1771 no August has been so hot. It will be remarked that about a fourth more than average rain fell during the quarter; the excess entirely in September. The number of deaths as reported weekly is here shewn; it shews also the fatal weekly progress of zymotic disease and of diarrhoea, and at the close of the quarter a great increase of deaths from chest diseases,—no less than 39 out of 60 deaths from chest diseases being from consumption alone. The fourth Table shews the mortality in districts. The Boro'-road district is always the most unhealthy, and shews the largest death rate. The Kent-road comes next. The London-road district is as usual the least unhealthy ; its streets, bad as many of them are, are better ventilated, and it has the great advantage of 22 acres, a fifth of its area, of well managed open grounds belonging to Bethlehem Hospital, the Blind School, and the Magdalen Hospital. These may be considered as lungs to the London-road district. Connected with this subject, I may be allowed to express a hope that the contemplated Southwark Park, on this side the river, will be brought as near to our doors as possible. In this parish are at least 4000 houses, rated under £10 per annum, and containing about 30,000 poor people: in some neighbouring parishes are equally large numbers of the same class of people: of what benefit to such as these, on whose account we chiefly urge the establishing such open places, will a Park be, placed far off?—they may visit it upon a holiday, very occasionally, but not frequently for health. The Kent-road, where the opening of the Park might be, is close to us and to 300,000 people, but a more distant place has apparently been chosen; I trust that a strong effort will be made to secure the nearer ; which once lost to us is always lost, and by which we shall incur expense, without reaping any corresponding benefit. I am afraid that other than sanitary reasons have been allowed to decide the question with the upper Board. The Kent-road tract of land is near to us, is in use as garden ground, is low, dampand unfit for healthy houses,—in this district only have I seen ague beginning within London the class of houses to be placed on it will be of the poorer sort, and densely inhabited ; and we, down to the very spot, are too crowded already : but preserve it open, drain and plant it well, and nothing could be better for the health of these over-crowded districts, or more convenient for the people w ho live in them. In the fourth Table are recorded 682 cases of diarrhœa; there were only 77 last quarter; and 56 deaths from this disease as recorded against only 8 last quarter. This, with three deaths from cholera, and the presence of the disease in its worst form hovering about us at no great distance, is enough to make us reflect and set our places in order. Consumption always troubles us : there were 40 deaths from this disease last quarter, and 39 this. Opening thoroughfares through the most densely crowded courts; — establishing a Park near, to which children, now rarely out of doors, can be readily taken; ventilating sewers in more and better places, so as to relieve the back pressure upon house drains;— greater attention to cleanliness; inclosing and covering dust-heaps; and insisting that animals shall be kept in a cleaner manner, cannot fail to make the air more pure and refreshing. The sickness and deathrate will infallibly lessen when we have compassed these ends. The fifth Table shews the amountof sickness among the poor week by week. I am endeavouring to make the tabular part of these reports as perfect as possible; if I succeed, and they are continued year after year, they will become useful not only for present purposes, but also as local records and for comparison. The sixth Table gives particulars of causes of death, ages and sexes. You will observe that of 276 deaths, 135 are males, and 141 females; that 158 died under five years of age-an immense 3 Report of the Medical Officer of Health, for the third Quarter, 1857. proportion of children, and which, without doubt, can be largely diminished by sanitary precaution— that 95 died from zymotic disease, including 56 from diarrhœa—15 from typhus fever, or rather fever; for many cases are included under this head that are not really typhus. No Typhoid cases have been sent from among the poor to the Fever Hospital, and but one has died in the Workhouse; the disease does not, therefore, press. It is one, however, of those diseases that may be almost banished by precautionary measures, chiefly by those which insure pure air, and greater cleanliness. 465 births are recorded, and 276 deaths,—our population has, therefore, other circumstances being equal, increased by 189. The last Table, taken from the Inspector's book and my own diary, shews the amount of sanitary work done during the quarter. About 900 visits have been made to 227 houses, manufactories, &c., found defective more or less, in various ways, and here recorded; in 137 of these places your orders have been obeyed, the places put into good condition, and the evils likely to produce sickness, abated. The places are here recorded, where the work is not yet done. I have, during the quarter, visited with the Inspector, 33 slaughter-houses; for the most part they were in good condition; slight improvements were recommended in 16, and carried out. 30 had their licences granted; three lost their licences, chiefly through informality. I am convinced that an annual supervision of these places is for health's sake necessary, especially when they are situated, as with us, in densely populated districts; I only regret that other places, such as rag and bone warehouses, cow-houses, piggeries, and the like, are not subjected to the same regulations. Two or three of the slaughter-houses appeared to me to be too often used for the reception or slaughtering of very bad meal; in one I authorized the immediate seizure and removal of several carcases unfit for food—they were condemned by the Magistrate and destroyed; another Butcher has been warned. I cannot but say that I have been disgusted at the filthy and unwholesome condition of the premises, and of the materials, used by the lower class of Sausage Makers; they require, and will have, an occasional visit. I continue to receive the most zealous assistance and co-operation from the Inspector, Mr. Wellman. (Signed) WILLIAM RENDLE. TABLE 1.—Quarterly Mortality. 1855 1856 1857 Average Mortality of the Quarters from 1845 to 1854 First Quarter ... 304 323 373.6 Second „ ... 292 296 294.8 Third ,, to September 30 ... 350 279 431.1 or 383.1 excluding Cholera. Fourth „ ... 284 ••• 391.8 4 Parish of Saint George the Martyr, Southieark. TABLE 2.—Mortality, &c., compared with other Parishes. Conditions of Locality Parish Height above Trinity High Water Mark Area in Acres Population, 1851 Each Person represents Annual Value Reg. General's Report Each Person pays to Relief of Poor Pop. 1851, rates 1856 Same Rate as St. Geo.'s Southwark, each should pay Density. Persons to an Acre Average Annual Mortality in 10,000, 1841 to 1850 Mortality from Cholera, to every i 10,000 Inhabitants, j Mean of 1840 & 1854 j Deaths to 1000 Living 1841—50 The Quarter ending September, 1857 Zymotic Mortality Fever Diarrhoea Total Mortality to Sept. 30 Births Excess of Births over Deaths to Sept. 30 £ s. d. s. d. s. d. Dense Population. St. James 58 164 36,406 12 13 4 10 3 30 0 222 206 84.0 22 47 7 26 182 ... 48 High Level. Wealthy. Sparse Population. Hampstead 350 2252 11,986 5 16 0 8 3 13 9 5 178 9.5 18 17 1 9 72 ... 18 High Level. Medium Circumstances. Dense Population. St. Giles 68 245 54,214 5 12 8 5 9 13 4 221 252 37.0 27 100 6 58 325 ... 116 High Level. Medium Circumstances. Sparse Population. Camberwell 4 4342 54,667 4 4 0 5 9 10 5 13 231 94.0 24 68 10 34 290 ... 204 Low Level. Poor. St. George's, Southwark,— M. F. Dense Population. Kent-rd. District 1 105 18,126 ... .. . 173 252 1132.5 33 5 20 68 69 ... Low Level. Borough-rd. „ 2 65 15,862 ... ... 244 347 ... 34 7 21 76 87 ... Poor. London-rd. „ 0 112 17,836 ... ... 159 250 19 3 13 ... 90 75 ... 234 231 Total 0 282 51,824 3 6 4 7 10 7 10 184 281 ... 30 86 15 54 279 465 184 „ Newington 1 624 64,186 3 15 0 8 1 8 10 104 247 122.5 26 79 9 56 385 ... 257 Bermondsey 0 688 48,128 3 0 9 5 4 7 1 70 268 159.5 28 67 7 44 253 ... 226 Dense Population. Bethnal Green 38 760 90,193 1 10 0 3 10 3 6 119 242 55.0 26 195 26 88 588 ... 295 Medium Height. Very Poor. All L.ondon ... ... 2,480,347 5 16 1 6 4 13 9 ... ... ... 25 ... ... ... ... ... ... Report of the Medical Officer of Health, for the third Quarter, 1857. 5 TABLE 3.—Mortality and Meteorology. DEATHS, from local weekly returns Barometer corrected Mean Thermometer ( Averages) Dew Point. Mean. Wind Rain in inches Week Total Zvmotic Disease Diarrhoea Chest Diseases Total Mortality Average of ths weeks for 10 years of Highest of Lowest Phthisis All other 1 4 2 4 0 20 21.5 29.529 92.5 54.8 52.0 S.W. 0.61 The amount of Rain was much more than the Average of the Quarter for many years, which, according to Howard, is 6.370; in the corresponding Quarter last year 6.89. Meteorology from Dr. Thomson's reports taken at St. Thomas's Hospital, except *, which is an average for London. 2 5 4 3 5 21 23.7 29.871 78.4 51.0 49.3 S.W. 0.15 3 6 5 0 1 20 28.8 30.132 86.6 57.0 51.5 W. 0.16 4 8 2 1 1 18 29.5 29.948 86.1 57.4 50.7 Wy. 0.03 5 9 6 2 1 23 37.7 29.993 82.1 56.3 52.0 Wy. 0.42 6 9 6 3 0 17 37.0 29.767 77.9 61.8 49.1 S.W. 1.42 7 8 5 5 3 26 34.4 29.859 75.4 56.0 56.4 s.w. 1.59* 8 10 9 4 0 22 31.9 30.151 74.5 58.8 53.0 N.E. 0.08 9 10 4 0 2 27 37.1 30.070 78.4 62.1 54.9 variable ... 10 13 8 1 1 24 40.1 29.746 71.3 56.8 49.3 variable 1.08 11 2 0 3 1 13 44.2 29.738 67.7 56.9 53.9 S.W. 2.15 12 9 5 3 2 21 40.0 30.365 70.3 56.9 53,1 S.W. 0.23 13 2 0 10 4 24 31.8 29.937 67.2 55.6 49.7 E. 0.42 Summaries and Averages 95 56 39 21 276 437.7 29.932 77.5 57.0 59.1 S.W. 8.34 60 6 Parish of Saint George the Martyr, Soutkimrk. TABLE 4.—Mortality and Sickness in Districts, &c. DISEASES District Mortality NEW CASES OF SICKNESS DURING THE QUARTER Estimated present Population, 55,000 Out and In-door Poor INSTITUTIONS Kent Road London Road, Boro' Road, Workhouse. Kent Road, Mr. Babbage London Road, Mr. Wakem Bcro' Road, Mr. Llewellyn Workhouse, Mr. Brown Royal South London Dispensary Bethlehem Hospital, &c. 15 Acres Av. Inmts. 600 Queen's Bench Prison School for Indigent Blind Acres, 3.3.10 Av. In.,&c., 175 Asylum for Deaf Sc Dumb 4 Acres Av. Inmtg. 340 Magdalen Hospital 3£ Acres Av. Inmts. 130 Sickness Total Ppn. 1851, 18,120 Ppn. 1851, 17,836 Ppn. 1851, 15,862 Average Inmates, 450 Small Pox - - - - Included in the Boro' Road Dis¬trict-- - - - - - All probably Mental Diseases. - Returns refused. - - - - - - - Chicken Pox - - - - - 2 1 - 1 - - - - - - - 4 Measles 1 - 1 1 - 1 I - 1 - - - - - - - 4 Scarlatina, Malignant Sore Throat 2 1 - - 1 2 - - - - - - - - - 3 Hooping 5 2 5 13 5 10 - 2 - - - - - - - 30 Diarrhoea 22 14 20 3 172 106 210 11 133 39 4 - - - 682 Dysentery - 2 2 - 5 - - - - - - 9 Chopra 1 1 1 - I - - 4 - - - - - - - 5 Fever 4 7 1 46 20 27 3 - - I - - - - 97 Ague - - - 1 I 1 7 - 1 - - - - - 11 Rheumatic Fever - - - - 2 - - - \ 1 - 1 - - - - - 4 Rheumatism - - - - 10 11 7 15 - - - - - - - - 43 Erysipelas - * 1 - - 2 - 3 - - 1 1 1 1 - - - 9 Pyemia - - - - - - - - - - - - - - - - Puerperal Fever - - - - - - - - - - - - - - - Carbuncle - - - 1 - - 1 2 - - - - - - - 4 Chronic Lung Diseases, (except) Phthisis) - - 1 - 21 10 17 1 - - - - - - - - 49 Phthisis} 14 17 8 1 8 4 6 3 ! - 1 - - - - - 22 Acute Lung Diseases Bronchitis & Catarrh 2 4 5 2 18 16 3 4 6 - 25 - 6 - - - 78 Pleurisy - - - - 1 - 1 - 1 - - - - - - - 3 Pneumonia 4 2 3 4 3 - - 3 - - - - - - 10 Group - 1 - — — 1 — — 1 — - - — — - - 2 Hydrocephalus, Tabes, Scrophula, Spasmodic Croup, Convulsions of Infants W 15 19 16 5 2 1 - - - - - - - - 24 Other Diseases, chiefly Chronic 18 14 25 14 236 155 293 CO 833 51 22 10 - - - - 1666 Violence, Privation, Poison, and Premature Birth 5 3 8 2 1 2 3 1 - - - - - - 7 Sudden Deaths - - - - - - - - - - - - - - - - - Mental Disease - - 1 - - 2 ' 1 12 - 4 - - - - - - 21 TOTAL 93 79 104 27 556 1 348 538 119 1000 96 - 57 i 12 11 - - -- 2787 Report of the Medical Officer of Health, for the third Quarter, 1857. 7 TABLE 5.—Cases of Sickness among the Poor. Weeks OUT - DOOR WORKHOUSE Kent Road, Mr. Babbage London Road, Mr. Wakem Borough Road, Mr. Llewellyn Mr. Brown Old Cases New Cases Total Old Case3 New Cases Total Old Cases New Cases Total Old Cases New Cases Total 1 32 33 65 30 25 55 50 43 93 108 20 128 2 37 40 77 13 24 37 52 49 101 117 18 135 3 30 42 72 19 55 74 54 50 104 118 13 131 4 44 46 90 1 43 29 72 55 61 116 112 8 120 5 18 63 81 30 35 65 43 59 102 108 9 117 6 27 47 74 29 27 56 55 43 98 104 6 110 7 23 56 79 26 35 61 40 45 85 105 9 114 8 31 50 81 23 31 54 40 58 98 101 7 108 9 49 36 85 14 13 27 61 37 98 98 9 107 10 47 39 88 19 23 42 36 44 80 100 8 108 11 51 33 84 19 16 35 10 32 72 104 4 108 12 53 34 87 15 24 39 40 39 79 101 2 103 13 40 37 77 25 11 36 56 28 84 ! 97 6 103 TOTAL. 482 556 Average under ! care weekly, 80 305 348 Average under care weekly, 50 622 588 Average under care weekly, 84 1373 Average under care weekly, 114 Grand Total Out-door—Old Cases, 1409, JTew Cases, 1492 = Average under care weekly—Out-door, 214—In-door, 114. N.B.—It should be here remarked, that " Old Cases" means only those ca. cs of illness that remain on the books more than one week, and consequently involve repetitions of the same case. Corresponding Quarterof lastv year 437 374 62 489 494 75 590 402 76 8 Parish of Saint George the Martyr, Southwark. TABLE 6.—DEATHS Registered in St. George's, Southwark, during the Quarter ending September 26th, 1857. (13 Weeks.) CAUSES OF DEATH ALL AGES AGES M. F. T. Under 1 1.— 2.— 3.— 4— All under 5 5 to 10 10- 15.- All under 20 20.— 40.— 60.- 80 and upwds. All Causes 135 141 276 94 32 24 a 3 - 158 8 3 1 170 28 35 35 8 I. Zymotic 46 49 95 40 14 12 1 1 74 4 1 1 80 5 1 7 2 II. Dropsy, &c 7 6 13 - - 1 - - - I I - - 2 2 7 2 - III. Tubercular 35 33 68 17 12 5 1 — — 3o 2 — — 37 14 14 3 - IV. Brain and Nerves 13 15 28 115 - - 1 1 - 17 - - - 17 - 2 7 2 V Heart, &c 2 3 b - - - - - - - - 1 - 1 2 1 - VT. Lungs, &c 12 9 21 4 2 6 - 1 - 13 1 - - 14 1 2 4 - VII. Digestive Organs 9 7 16 5 3 - - - - 8 - 1 — 9 2 4 1 - VIII. Kidneys, &c - - - - - - - - - - — - - - - - - - IX. Childbirth, &c - 2 2 - - - - - - - - - - - 1 1 - - X. Joints, &c - - - - - - - - - - - - - - - - - - XT. Skin, &c - - - - - - - — - - - - — - - - - - XII. Malformation - - - - - - - - - - - - - - - - - - XIII. Prem. Birth & Debility — 3 3 3 — — — - — 6 — — — - — - XIV. Atrophy - - - - - - - - - - - - - - - - - - XV. Old Age 3 8 11 1 6 XVI. Sudden — — - - — — — — — — — — - - - - XVII. Violence, Privation, &c 7 5 12 3 1 - 2 - - 6 _ - 6 1 1 4 - XVIII. Not specified 1 1 2 1 - - - - - 1 - - - 1 - 1 - - 1. Small Pox - - - - - - - - - - - - - - - - - - Measles - 2 2 - - 2 - — - 2 - - - 2 - - - - Scarlatina 1 2 3 - 1 - 1 - - 2 1 - - 3 - - - - Hooping Cough 7 5 12 b 1 4 - - - 11 1 - - 12 - - - - group 1 - 1 - 1 - — - - 1 - - - 1 — - - Thrush - - - - - - - - - - - - — - - - - - Diarrhoea 28 28 58 37 7 6 - - - 60 - - - 50 - 1 4 1 Dysentery - - - - - - - - - - - - _ - - - - - Chopra - 3 3 1 - - - - - 1 - - - 1 — - 1 1 Influenza - - - - - - - - - - - - - - - - - - Scurvy and Pupura - - - - - - - - - - - - - - - - - - Ague 1 - - - - - - - - - 1 - - - - - - - Remttent Fever - - - - - - - - - - - - - - - - - - Infantile „ - 1 1 - 1 - - - - 1 - - - I - - - - Typhus „ 8 7 15 2 3 - - 1 - 6 1 1 1 9 4 - - - Puerperal „ - - - - - - - - - - - - - - - - - - Rheumatic „ - - - - - - - - - - - - - - - - - - Erysipelas - 1 1 - - - - - - - - - - - - - - - Pyaemia - - - - - - - - - - - - - - - - - - Syphilis - - - - - - - - - - - - - - - - - - Noma - - - - - - - - - - - Hydrophobia - - - - - - - - - - - - - - - - - - II. Hoemorrhage 1 1 2 - - - - - - - - - - - - 1 1 -- Dropsy 3 1 4 - - 1 - - - 1 - - — 1 - - - - Abscess i I 2 - — - — - - — 1 - - 1 - - - - Ulcers - - - - - - - - - - - - - - - - - - Fistula - - - - - - - - - - - - - - - - - - Mortification - - - - - - - - - - - - - - - - - - Cancer 2 3 5 - - - - - - - - - - - - - - - Gout - - - - - - - - - - - - - - - - - - III. Scrophula - - - - - - - - - - - - - - - _ - - Tabes Mesenterica 8 23 14 22 13 5 3 - - - 21 1 - - - - - - - Phthisis 16 39 1 4 1 1 - - 7 1 - - - - - - - Spasmodic Group 1 - 1 6 - 1 - — - - 1 - - - - - - - - Hydrocephalus 3 3 3 2 1 - - - 6 - - - 6 - - - - IV. Cephalitis 1 _ 1 1 _ _ _ _ _ 1 - - - 1 - - 2 1 Apoplexy - 3 3 - - - - - - - - - - - - - 9. I Paralysis 4 - 4 - - - - - - - - - - - - - - - Delirium Tremens - - - - - - - - - - - - - - - - - - Chorea - - - - - - - - - - - - - - - - I - Epilepsy - 1 1 - - - - - - - - - - - - - - - Telenus - - - - - - - - - - - - - - - - 1 - Insanity 1 2 - - - - - - - - - - - - - - - Convulsions 7 9 16 14 - - 1 1 - - - - - - - - I - Disease of Brain, &c - 1 I - - - - - - - - - - - - - - - 9 Report of the Medical Officer of Health, for the third Quarter, 1857. 9 Births M. 234. P. 231. Total 465. Excess of Births over Deaths 189 Deaths M. 135. P. 141. Total 276. CAUSES OF DEATH ALL AGES AGES M. F. T. Under 1 1.— 2. V 3.— 4.— All under 5 5 to 10 10.— 15.— All under 20. 20.— 40.— 60.— 80 and upwds. V. Pericarditis - - - - - - - - - - - - - - - - - - Aneurism - - - - - - - - - - - - - - - - - - Disease of Heart, &c 2 3 5 - - - - - - - - 1 - l 2 1 I - VI. Laryngitis 2 2 1 1 - - - 2 - - - 2 - - - - Bronchitis 6 3 V I 1 1 - _ - 3 1 _ _ 4 _ 1 4 - Pleurisy - _ - _ _ _ _ _ _ _ _ _ - Pneumonia 6 3 9 2 - 4 - 1 - 7 - - _ 7 1 1 _ _ Asthma - - - - — - - - - - _ _ _ _ _ _ _ - Disease of Lunge ~ 1 1 I - - - - - 1 - - 1 - - - VII. Teething 2 2 4 2 2 - - - - 4 - - - - - - - - Quinsey - - - - - — - - - - - - _ _ _ _ _ Gastritis _ - — — _ _ _ _ _ _ _ _ _ - - - - Enteritis 2 - 2 1 1 - - - - 2 - _ _ 2 _ - _ - Peritonitis - 1 1 - _ - _ _ _ - _ 1 _ 1 - - - - Ascites _ _ _ _ _ _ _ _ - - - - - - - - Ulceration of Intestines - - - - - - - - _ _ _ _ _ _ - - _ - Hernia - - - - - - - - - - - - - - - - - - Ileus — — — — — — — — — — _ - - - - _ _ Intussusception 1 _ 1 - - - - - - - - - - - - - - - Stricture of Intestinal Canal - - - - - - - - - - - - - - - - - - Dis, of Stomach, &c _ 1 1 - - - - - - - - - - - 1 - - - Dis. of Pancreas _ _ _ _ _ _ _ _ _ _ - Hepatitis - - - - - - - - - _ _ - - - - - - - Jaundice 3 1 4 2 - - - - - 2 - - - 2 _ 1 1 _ Disease ol Liver I 1 2 - - - - - - - - - - - 1 1 - _ Disease of Spleen ' - - - - - - - - - - - - - - - - - VIII. Nephritis _ _ _ . - - - . . _ - - - - - - - - kephria (Bright's Dis.) - - - - - - - - - - - - - - - - - - Iscnuria - - - - - - - - - - - - - - - - - - Diabetes - - - - - - - - - - - - - - - - - - Stone - - - - - - - - - - - - - - - - - - Cystitis - - - - - - - - - - _ _ _ _ _ _ _ _ Stricture of Urethra - - - - - - - - - - - - - - - - - - Disease of Kidneys, &c - - - - - - - - - - - - - - - - - - IX. Paramenia - - - - - - - - - - - - - - - - - - Ovarian Dropsy - - - - - - - - - - - - - - - - - - Childbirth (See Metria) - 1 1 - - - - - - - - - - - 1 _ _ _ Disease of Uterus, &c - 1 1 - - - - - - - - - - - - 1 - - X. Rheumatism - _ - - _ - . - - - - - - - - - - - Arthritis - - - - - - - - - - - - - - - - - - -Disease of JOints, &c - - - - - - - - - - — - - - - - - - XI. Carbuncle - - - - - - - - - - - - - - - - - - Phlegmon - - - - - - - - - - - - - - - - - - Diseases of Skin, &c - - - - - - - - - - - - - - - - - - XII. Cyanosis - - - - - - - - - - - - - - - - - - Spina Bifida - - - - - - - - - - - - - - - - - - Other Malformations - - - - - - - - - - - - - - - - - - X\ II. Intemperance 1 - 1 - - - - - - - - - - - - - 1 - Privation of Food - - - - - - - — - - - - - - - - - - Wantof Breast Milk - - - - - - - - - - - - - - - - - - Neglect - - - - - - - - - - - - - - - - - - Gold - - - - — - - - - - - - - - - - - Poinson - - - - - - - - - - - - - - - - - - -Burns and Scalds - 1 1 - - - 1 - - 1 - - 1 - - - - Hanging 1 - 1 - - - - - - - - - - - - - 1 _ Suffocation 2 2 4 3 - - - - - 3 - - - 3 - - 1 - Drowning - - - - - - - — - - - — - ■ - - - - - Fractures and Contusions 1 1 2 - - - 1 - - 1 - - - 1 - - 1 - Wound j — 1 - - - - - - - - - - - - 1 — — Other Violence 1 1 2 - - - - - - 1 _ - 1 1 - - - 11 10 Parish of Saint George the Martyr, Southwark. Report of the Medical Officer of Health, for the third Quarter, 1857. 11 TABLE 7.—Sanitary Inspections during the Quarter ending 26th September, 1857. Cases Number of Houses or Places visited Number of Visits of Medical Officer and Inspector Premises unclean, or dilapidated within Overcrowded Unfit for habitation Insufficient Ventilation Water Water receptacle, none, bad, or without cover Bad Drainage Foul Cesspool Water Closet defective, or without Water Insufficient Privy accommodation Yard badly paved Cellar badly paved Refuse accumulated Dustbin, none or imperfect Nuisances from animals badly kept Slaughter-houses, Manufactories in unwholesome condition Burial Vaults requiring improvement Deficient No supply 119 227 about 900 38 . 1 2 32 . 25 135 114 30 5 46 3 Not regularly recorded. I'robably one in three of all cases visited. 75 3 4 3 Work completed 79 137 . 20 . 1 2 31 . 10 G6 39 27 # 17 3 30 1 Not begun, or left unfinished. 40 90 • 18 • • • 1 • 15 09 75 3 5 29 • 45 2 4 3 Names of Places, and Dates of Official or Friendly Notices are annexed, in which the Work ordered leas not completed at the end of the Quarter. Date The following are old cases reported last year:- Mr. Able, Bone-boiler, Green-street—Mr. Ray, Bone-boiler, Green-street. 24, Mint-street F.N. 21 8 57 O.N. 27 10 57 The following are from the fourth quarterly report:— 3 and 4, Staple-street F.N. 6 to 11, Spiller's-court—34, King-street, Borough-road. 21 8 57 0 57 The following are from the fifth quarterly report:— King's Arms, Old Kent-road—4, Union-street, Borough-road—75, Kent-street, (Dairy). 10, William-street, Suffolk-street 57 9 1 1 57 The following are from the sixth quarterly report:— Bone-boiler, 25, Green-street ^ F.N. 26 8 57 1 O.N. 9 1 1 57 Coroline-crescent. - 1 to 7, Parliament-street-46, Market street, -17to 26, Butcher-row, Market-street:- 30, Green-street.—1 to 9, Castle Yard; Northampton-row, Old Kent-road. 15, London-street 5 F.N. 27 8 57 The following are cases taken in hand during this (the seventh) quarter, and not reported as finished at the end of the quarter:— 57 Date 5 to 7, Nelson-place F.N. 28 8 57 1 to 13, East-place, West-square F..N. 29 6 57 O.N 15 9 57 1 to 5, Chapel-court, Hight-street F.N. 29 6 57 10 to 19, Union-street, Borough-road F. N 28 8 57 O.N. 29 10 57 24, Valentine-place F.N. 10 7 57 O.N. 24 10 57 6, London-street F.N. 11 9 57 29, Bond-street, Borough-road F.N. 10 7 57 O.N. 22 9 57 O.N. 22 9 57 2, surrey-square F.N. 4 9 57 do summons 7 10 57 O.N. 22 9 57 F.N. 6 9 57 F.N. 10 7 57 1, Northampton-street O.N. 97 1 11 57 34 and 35, Pitt-street,l St. George's-road O.N. 4 9 57 F.N. 6 9 57 2, 3, 4, 5, and 6, York-street F.N. 16 7 57 33 to 37, Surrey-place, Old Kent-road O.N 9 9 11 57 O.N. 4 9 57 O.N. 27 11 57 Cow shed, Noel-street F.N. 11 7 57 F.N. 15 9 57 O.N. 27 10 57 1, Nelson-yard O.N. 9 11 57 9 to 14, York-street 5 F.N. 1G 7 57 13 and 14, William-street F.N. 57 I O.N. 4 9 57 h> 1 57 37, Bridge house-place F.N. 17 7 57 158, High-street F.N. 25 0 57 O.N 9 1 1 57 18, Upper Green-street F.N. 28 7 57 F.N 26 9 57 O.N. 7 y 57 117, Kent-street O.N. 9 11 57 1 to 6, Elizabeth's-place F.N. 6 8 57 9 to 13, Frederick-place, old Kent-road F.N. 9 11 57 O.N. 17 9 57 Atlas Work, Borough-road F.N. 8 8 57 14 to 19, Potier-street F.N. 28 9 57 O.N. 22 9 57 O.N. 26 10 57 33, Market-street F.N. 22 8 57 1 to 4 Hunter-place F.N. 28 9 57 O.N. 7 9 57 5 to 7 O.N. 27 10 57 13, Potier-street F.N. 28 9 57 errata. In last Report, page 3, £2 2s. 0d. are the Receipts for three houses, of which that specified is one. Table (i. Add column "5.—" in each ease to column "5 to 10" and deduct from column '' All under 5." LONDON: Printed by 0. Read and W. P. Gbiffith, Printers to Her Majesty's Stationery Office, 5, Langley Street, Long Acre, w, c, 35 No. 8. Parish of Saint George the Mortor, Sonthwork. REPORT OF THE MEDICAL OFFICER OF HEALTH, For the Fourth Quarter, 1857 . March 1st, 1858. Mr. Chairman and Gentlemen of the Vestry, I am now prepared with my report for the quarter eiffiting Christmas. I have, during the quarter, brought before you six individual reports; the matters coruined; therein have, for the most part, been dealt with, or are under process: I fear, however, that the true prtiiefptes of sanitary action are not sufficiently known or recognised, for the work is often found to be so done, as to promise no lasting or good effect. There can be no question as to supplying water to water-closets; yet how frequently, even in new and "finished" work, we find either no contrivance at all for water supply, or a mere makeshift. The disgusting consequences of leaving them without water, can only be appreciated by those who visit the places. I would at once rather advise a return to the abominable cesspool, than have these closets badly panned and trapped, unprovided with water, and the contents allowed slowly to run through old imperfect drains. In this way, the contents force through or leak through, saturating the ground, tainting the atmosphere about, and making the houses very disgusting and unhealthy to live in. In these cases, I have often perceived the privy smells at the front doors of the houses. At this very time, in John-street and William-street, are houses apparently properly panned and trapped, connected with high level old brick drains, never intended for this purpose, in which the people complain of the smells that continually assail them. I believe these vestry premises to be another case in point. When we enter old or defective drains, (putting our new work upon an old garment as it were,) the more perfect the trap, the more are the gaseous and liquid contents forced out in other directions ; that is, in the yards and basements, in the soil immediately under or around the houses. I, of course, can only judge by repeated illness, and repeated complaints, which must be noticed and reported upon by me as often as they occur;—with the sick reports that come before me weekly, I am sure to hear again of these patched-up places. All these are most weighty reasons why the work ordered should be perfectly done, and done at once. Again, the conditions necessary to produce or quicken decay are known to all chemists, and, indeed, to every one. To make your dung-heap and ash-heap ferment, and give forth foul vapours continually, you require moisture, free exposure, and the sun's or other heat;—keep it close, keep it dry, and keep it cool, you as far as possible prevent decay. In a parish like this, with thousands of refuse heaps, and a soil already saturated with foul matter, the importance of this cannot be over-rated. Yet, with this knowledge so widely spread, our dust-bins and refuse inclosures are so often found constructed without covers; open to the sun and to the rain, to produce the evil; and to the wind to disperse it among the inhabitants. It is, doubtless, because of these well-known principles, that the Act of Parliament orders proper doors and coverings. The refuse is not collected in the poorer districts with regularity, nor according to the plan laid down some time since by this vestry; nor do we sufficiently press upou the poorer classes the duty of caring for health and for the property they occupy. I now merely mention these matlers. I will endeavour to place them clearly before you in an annual report. This quarterly report consists chiefly of tables, as usual. The first Table shews an increased mortality as compared with corresponding quarters of 1855 and 1856; it is, nevertheless, considerably below the average of the quarter; less deattis, that is, by 61. It shews also considerably less than the actual deaths of the corresponding quarters of nine out of the last twelve years; and it is more 2 Parish of Saint George the Martyr, Southwark. favourable than the figures shew; in this, that the deaths now recorded are in an increased population. Considering that the causes of increased mortality have been very wide spread, this state of things is not unfavourable. We must not forget that during this quarter, in England, 13,675 persons have died more than in the corresponding quarter of 1855, and 14,176 more than in 1856. In London, 1,293 more than in the corresponding quarter of 1855, and 928 more than in 1856. In the same ratio as all England, our increase would have been 40; it was 39. In the same ratio as London, it would have been 24; it was 39—the excess owing almost entirely to diseases of the breathing organs. In the second Table are the usual calculations, shewing the enormous pressure of the poor rate in this parish over and above the pressure of the rate in other parishes. We still continue to relieve largely the poor of other parishes, as well as our own, in the shape of casuals—4,794 in the Michaelmas quarter; 4,866 in the Christmas quarter. Most other parishes number their casuals by tens and hundreds only. I have, in previous reports, shewn how this increases disease, and diminishes the chance of a proper provision for the sick poor. I would also draw your attention to that column of this Table which shews our annual mortality as 30 to every thousand living; if we could lose at the rate of Bermondsey, we should lose 110 persons less every year; if at the rate of Ilampstead, 650 would every year be saved from death; and the living would, of course, be more healthy. We cannot expect to be as Hampstead; but why should our people die so much faster than those of Bermondsey, St. Giles's, and Bethnal Green ? I, as I think, see the reasons clearly enough; I wish I had the power to convince others. The third Table shews the total deaths from zymotic disease to have been 56—10 less than in the corresponding quarter last year. Diarrhoea, 12 deaths as against 8 then; this maybe considered slight, but it is enough to warn us; especially as we have had a full share of every epidemic, and have lost in all 2,300 persons by cholera. The sprinkling comes before the shower. I would not willingly prophecy evil, but I earnestly and respectfully warn you to have those places where cholera has appeared before, thoroughly cleansed and amended. Of chest diseases, 136 died in 14 weeks, 47 of them from consumption. I shall have something to say in a future report of this disease, and its preventable causes. The weekly average temperature at no time dropped to freezing; it was not, then, the severity of weather, or many and violent changes, that produced so much mortality from chest diseases. The changes were not great, but the weather was not invigorating ; the bracing and hardening effect of a healthy winter was wanting. It may be here remarked that rain fell on Thursday, 22nd October, to the extent, on this one day, of one-tenth the average rainfall for a year—about 58,000 gallons to the acre.* The fourth Table shews the mortality in districts. 109 in the Kent Road district, or one death in 166 living. 105 in the London Road district, or one in 170 living. 129 in the Borough Road district, or one in 122 living. As to sickness, bearing upon a previous hint, 125 cases of diarrhcea are here recorded, and 535 cases of various chest diseases. 1 have been favoured with returns from eight institutions, which will be found in this Table; and I have to thank the Officers of these respective institutions for the trouble they have taken to oblige me, and which does not necessarily come within the sphere of their duties. The poor have suffered much more than in the corresponding quarter last year, an excess of 472 cases is shewn, or 370 in 13 weeks. 91 cases of fever are here recorded; the great majority are happily rather feverish cases than fever. The Relieving Officers inform me that no cases have been sent to the Fever Hospital. I have no doubt that shortly the books will be so kept, that I shall be able to distinguish between one and the other. The sixth Table gives, as usual, the births, the causes of death, ages and sexes. Of 501 births, 251 were males and 250 females. Of the 343 deaths, 177 were males and 166 females. Other • Registrar General's Report. Report of the Medical Officer of Health, for the fourth Quarter, 1857. 3 circumstances being equal, we have gained in population 158 during the quarter, that being the excess of births over deaths. 170 died under ten years of age—that is, half the total deaths;—the diseases I need not farther specify, they are all recorded. I have been curious to note the number of very aged persons who died in this quarter: there were 22 from 70 to 80; eight from 80 to 90; three at 93; and two at 94 years of age. Twenty-nine of these were, so far as I can gather, of the poorer or hard working class, so that hard work and a certain amount of privation, are more favourable to a long life than the being in so-called "easy circumstances." 1 append the analyses of the waters supplied by the Companies to this Parish. November. Total Impurity. Organic Impurity. Lambeth Company 21.56 1.48 Southwark Company 22.66 1.56 December. Lambeth Company 20.84 56 Southwark Company 20.72 1.24 The seventh Table shews the amount of Sanitary work under hand during the quarter. There are considerable arrears, partly, no doubt, because of unavoidable difficulties, and the reluctance of parties to do the required work; partly because we are very properly slow to coerce, and prefer to call again and again ; giving, indeed, more than sufficient time. The reluctance arises, no doubt, from a belief in the minds of some persons that, with enough delay and obstruction, they may escape the work altogether. This, of course, brings a very large amount of work upon us, and occasionally goes far to embarrass us. As to burial vaults, noticed in this Table, and which have been reported as without improvement from the first: one is in good condition, one requires very slight improvement, but the third, namely, the parish church, requires a speedy and complete alteration. The addresses of places where the work is unfinished, are appended, as usual. (Signed) "WILLIAM BENDLE. • Dr. Thomson. TABLE 1.—Quarterly Mortality. / 1855 1856 1857 Average Mortality of the Quarters from 1845 to 1854 First Quarter ... 304 323 373.6 Second ... 292 296 294.8 Third ... 350 279 431.1 or 383.1 fourth „ to December 31 290 284 326 excluding Cholera. 391.8 4 Parish of Saint George the Martyr, Southwark. —— -r . TABLE 2.—Mortality, &c., compared with other Parishes. Conditions of Locality Parish Height above Trinity High Water Mark Area in Acres Population, 1851 Each Person represents Annual Value Reg. General's Report Each Person pays to Relief of Poor Pop. 1851, rates 1856 Same Rate as St. Geo.'s Southwark, each should pay Density. 1 Persons to an Acre Average Annual Mortality in 10,000, 1841 to 1850 Mortality from Cholera, to every 10,000 Inhabitants. Mean of 1840 & 1854 Deaths to 1000 Living ' 1841-50 The Quarter ending January 2, 1858, 14 weeks Zymotic Mortality Six Diseases Fever Diarrhoea Total Mortality Births Excess of Births over Deaths to Dec. 31 £ S. d. s. d. s. d. 1. 1 Dense Population. St. James *58 164 36,406 12 13 4 10 3 30 0 222 206 840 22 27 5 2 199 ... 67 HiGH Level Wealthy. Sparse Population, Hampstead 350 2252 11,986 5 16 0 8 3 13 9 5 178 9-5 18 21 3 1 84 ... 35 High Level. Medium Circumstances. Dense Population. St. Giles 68 245 54,214 5 12 8 5 9 13 4 221 252 370 27 64 16 10 410 ... 76 High Level. Medium Circumstances. Sparse Population. Camberwell 4 4342 54,667 4 4 0 5 9 10 5 13 231 940 24 33 10 11 341 ... 192 Low Level. Poor. St. George's, Southwark,— M. p. Dense Population. Kent-rd. District 1 105 18,126 ... ... ... 173 252 1325 13 4 3 ... 82 88 ... Low Level. Borough-rd. „ 2 65 15,862 .. . ... 244 347 ... 19 3 8 ... 91 86 ... Poor. London-rd. „ 0 112 17,836 ... ... 159 250 ... 9 2 1 ... 78 76 ... Total 0 282 51,824 3 6 4 7 10 7 10 184 281 ... 30 41 9 12 343 251 250 149 501 Newington 1 624 64,186 3 15 0 8 1 8 10 104 247 122.5 26 41 13 9 465 ... 245 Bermondsey 0 688 48,128 3 0 9 5 4 7 1 70 268 159.5 28 53 7 16 330 ... 264 Dense Population. Medium Height. Bethnal Green 38 760 90,193 1 10 0 3 10 3 6 119 242 55.0 26 147 35 23 638 ... 376 Very Poor. All London ... ... 2,480,347 5 16 l 6 4 13 9 ... ... ... 25 ... ... ... ... ... ... 5 TAJBX/E 3.—Mortality and Meteorology. Report of the Medical Officer of Health, for the fourth Quarter, 1857. Week DEATHS, from local weekly returns Barometer corrected Mean Thermometer (Averases) Dew Point. Mean. Wind Bain in inches Total Zymotic Disease Diarrhoea (Jhest Diseases Total Mortality Average of the eeks for 10 years of Highest of Lowest Phthisis All other 1 6 5 3 3 22 25.0 30.001 65.8 55.0 52.8 S.W. 0.07 The amount of Rain was much less than the Average of the Quarter for many years, which, according to Howard, is 7.998; in the corresponding Quarter last year 4.54. Meteorology from Dr. Thomson's reports taken at St. Thomas's Hospital. 2 3 1 2 2 16 28.4 29.258 59.6 48.9 45.4 s.w. 0.75 3 3 0 5 4 20 27.7 29.893 61.8 52.4 50.6 variable 0.10 4 0 0 1 3 11 25.4 29.687 58.5 50.4 49.6 variable 3.15 5 7 3 3 5 28 26.3 29.848 58.4 48.8 45.7 S.W. 0.10 6 4 1 5 13 33 27.3 29.867 59.0 52.4 51.4 variable 0.58 7 7 1 2 9 31 27.4 30.487 53.4 44.2 42.5 N.E. 0.00 8 3 0 3 14 27 30.8 30.220 51.3 43.4 40.9 Easterly 0.00 9 4 1 5 10 30 30.3 29.729 49.2 40.7 39.2 Northerly 0.00 10 7 0 3 10 27 35.0 29.958 52.0 43.6 43.4 S.W. 0.37 11 2 0 1 6 25 31.2 30.482 52.5 44.4 45.0 s.w. 0.00 12 5 0 7 4 31 28.3 30.184 51.3 45.4 42.8 S.W. 0.28 13 2 0 1 0 11 29.7 30.204 53.3 45.7 42.8 Westerly 0.05 14 3 0 6 6 31 31.5 30.483 46.0 38.3 38.4 W. 0.00 Summaries and Averages 56 12 47 89 343 404.3 30.021 . 55.1 46.7 45.0 S.W. 5.45 136 6 Parish of Saint George the Martyr, Southwark. TABLE 4.—Mortality and Sickness in Districts, &c. DISEASES District Mortality NEW CASES OF SICKNESS DURING THE QUARTER Estimated present Population, 55,000 Out and In-door Poor INSTITUTIONS Kent Road 105 Acres. London Road, 112 Acres Boro' Road, 65 Acres. Workhouse. Kent Road, Mr. Babbage London Road, Mr. Wakern j Boro' Rond, Mr. Llewellyn Workhouse, Mr. Brown Royal South London Dispensary Bethlehem Hospital, &c. A v. Inmts. 337 la Acres House of Occupations, Av. Inmts. 192 Queen's Bench Prison School for Indigent Blind Acres, 3.3.10 Av Inmate*. 17^ Asylum tor Deaf Ac Dumb 4 Acres Av. lnm*P. 340 Jtlagrialen Hospital 3£ Acres Av. Inmts 130 British Schools, | Acre, Av. Inmts. 84 Yorkshiie Schls Westminster Rd. f Acre, Av. Inmts. 38 Sickness Total Ppn. 1851, 18,126 Ppn. 1851, 17,836 Ppn. 1851, 15,862 Average Inmates, 475 - 1 - - Included in the Boro' Road District - 1 - 2 - - - - - - - No serious Illness. Slight tendency to Diarrhoea and Boils - Two Deaths reported in Forty Years- - 3 Chicken Pox - - - - - 1 - - - - - - - - - - Measles - - - - 3 2 - - - - - - - - - 5 Scarlatina, Malignant Sore Throat . 4 a - - 8 4 - 30 - - - - - - 42 Hooping cough 6 1 3 - 10 8 2 - 21 - - - - - - - 41 Diarrhoea 3 1 8 3 33 19 40 3 27 Dysentery 1 - - - - - - 2 Cholera - - - - - - - - — - - - - - - — - Fever 4 2 3 1 41 5 35 3 - 1 - - Ague 10 Rheumatic Fever - - • - - 1 - 10 - - - - 11 Rheumatism - 1 2 1 14 18 17 16 - - - - 1 - - 66 Erysipelas - - 1 - - 5 4 - - - - - - - 9 Pyaemia — - - - - - - - - - - - - Puerperal Fever - - - - - - - - - - - - - - Carbuncle - - - - - - - - 3 - - - - - - - 3 Chronic Lung Diseases, (except Phthisis) 3 4 2 - 51 8 44 1 - - - 2 - - - - 106 Phthisis 13 18 17 4 9 14 8 5 - 1 - 1 1 1 - - 40 Bronchitis 16 12 20 5 90 52 109 19 73 22 - 6 27 - 398 Acute Lung Diseases J Pleurisy - - 1 - 2 - - - 3 - - - - - - 5 Pneumonia 15 13 8 - 9 19 2 - 24 - - - - - - - 54 Group 1 2 Hydrocephalus, Tabes, Scrophula, Spasmodic Croup, Convulsions of Infants 22 14 13 1 22 5 15 - - " 2 - - - -• " 44 Other Diseases, chiefly Chronic 21 25 35 18 208 232 316 60 748 27 1 2 4 12 1616 Violence, Privation, Poison, and ^ Premature Birth 4 6 8 4 3 3 - 1 - - 7 sudden Deaths 1 — 1 1 - - - - - - - Mental Disease - 2 - - 2 2 - 11 - 63 - - - - - - 78 Deptheritis 1 — - 1 - ~ - ~ - - - - - - 1 TOTAL 109 105 129 34 505 403 597 129 950 113 3 - 11 G 45 - 0 2762 Report of the Medical Officer of Health, for the fourth Quarter, 1857. 7 TABLE 5.—Cases of Sickness among the Poor. Weeks OUT - DOOE WORKHOUSE Kent Road, Mr. Babbage London Road, Mr. Wakem Borough Road, Mr. Llewellyn Mr. Brown Old Cases New Cases Total Old Cases New Crises Total Old Cases New Cases Total Old Cases New Cases Total 1 27 35 62 15 19 34 51 27 78 97 9 106 2 25 41 66 17 29 46 52 33 85 100 7 107 3 24 42 66 19 23 42 55 56 111 104 13 117 4 37 41 78 20 37 57 63 48 111 109 12 121 5 42 57 99 60 35 95 59 57 116 113 12 125 6 43 51 94 30 29 59 75 60 135 116 11 127 7 36 41 77 29 28 57 78 49 127 121 11 132 8 44 25 69 30 49 79 78 36 114 120 10 130 9 44 31 75 53 25 78 68 Si 105 120 5 1J5 10 44 35 79 34 22 56 69 40 109 115 10 125 11 25 17 42 23 15 38 73 40 113 118 6 124 12 27 31 58 30 29 59 70 43 113 114 / lzi 13 30 26 56 21 28 49 64 27 91 117 8 125 14 28 32 60 45 35 50 56 44 100 1 Zo O lol TOTAL. 476 , Average under Average und°r Averas" under 505 70 426 403 59 911 597 107 129 122 Grand Total Out-door—Old Cases, 1813, New Cases, 1505 == Average under care weekly—Out-door, 236—In-door, 122. N.B.—It should be here remarked, that " Old Cases" means only those eases of illness that remain on the books more than one week, and consequently Involve repetitions of the same case. Corresponding Quarter of last 408 326 56 j 532 342 67 848 365 93 I 8 Parish of Saint George the Martyr, Southieark. TABLE 6.—DEATHS Registered in St. George's, Southwark, during the Quarter ending January 2nd, 1858. (14 Weeks.) CAUSES OF DEATH ALL AGES AGES M. F. T. Under 1 2.— 3.— 4 All under 5 5 to 10 10.— 15.— All under 20 20.— 40.— GO.— | 80 and upwdi. 177 166 343 92 29 23 5 5 154 13 1 2 170 46 02 64 11 I. Zymotic 28 28 56 16 6 7 3 32 7 1 40 8 3 4 1 II. Dropsy, &c. 2 5 7 - - - - - - - - - 3 2 1 1 III. Tubercular 38 32 70 12 8 5 1 3 99 2 - 1 32 15 17 6 - IV. Brain and Nerves 25 25 .01 14 5 2 - 1 22 - - - 22 7 10 10 2 V. Heart, &c 3 5 8 - - - - - 1 - - 1 1 3 3 - VI. Lungs, &c 50 39 89 28 9 9 1 1 48 2 - 1 51 5 18 14 1 VII. Digestive organs 8 5 13 1 1 - - - 2 I - - 3 6 2 2 - VIII. Kidneys, &c 1 i 2 - - - - - - - - - - - 1 1 - IX. Childbirth, &c - 2 2 - - - - - - - - - 2 - - X. Joints, &c - 3 3 - - - - - - - - - - 1 - 2 - XI. fSkin, &c - - - - - - - - - - - - - - - - XII. Malformation - - - - - - - - - - - - - - - - - XIII. Prem. Birth & Debility 8 2 10 10 - - - 10 - - - 10 - - - XIV. Atrophy 1 1 2 2 - - - - 1 - - - 2 - - - - XV. Old Age 7 5 12 - - - - - - - - - - - 1 6 5 XVI. Sudden - - - - - - - - - - - - - - - - - XVII. Violence, Privation, &c 1 10 11 7 - - - - 7 - - - 7 - 1 2 1 XVIII. Not specified 4 3 7 2 - - - - 2 - - 2 2 3 - 1. Small Pox - 1 1 - - - - - - - - - - 1 - - - Measles - - - — - - - - - - — - - - - - Scarlatina 5 4 9 2 1 2 1 - 6 3 - - 9 - - - - Hooping Cough 4 6 10 4 1 3 - - 8 2 - - 10 - - - - Croup — 2 2 — — — 2 — 2 - - — 2 - — - I - Thrush - 1 1 1 - - - - 1 - - - 1 - - - - Diarrhoea 8 4 12 6 3 - - - 9 - - - 9 2 - 1 - Dysentery - - - - - - - - - - - - - - - - - Cholera — — - — — — - — - - - - - - — - - Influenza 3 3 6 - - 1 - - 1 - 1 - 2 1 1 1 - Scurvy and Purpura - - - - - - - - - - - - -- - - - - Ague - - - - - - - - - - - - - . - - - - Remittent Fever - — — — — - - - - - - - - - - - Infantile „ - - - - - - - - - - - - - - - - - Typhus „ 4 5 9 - - - - - - 2 - - 2 4 2 1 - Puerperal „ - - - - - - - - - - - - - - - - - Rheumatic - - - - - - - - - - - - - - - - - Erysipelas 1 1 *2 1 - — - - 1 - - - 1 - - 1 - Pyasmia - - - — - - - - - - - - - - - - - Syphilis 3 - 3 2 1 - - - 3 - - - 3 - - - - Noma - - - - - - - - - - - - - - - - - Hydrophobia - - - - - - - Diptheritis - 1 1 - - 1 - - 1 - - - 1 - - - - II. Hcemorrhage 1 - - - - - - - - - - 1 - - - 1 V 3 - - - - - - - - - - 2 1 - - Abscess - - - - - - - - - - - - - - - Ulcers - - - - - - - - - - - - - - - - Fistula - - - - - - - - - - - - - - - ~ - Mortification - - - - - - - - - - - - - ' . - Cancer 1 2 3 - - - - - - - - - - - I - Gout - - - - - - - - - - - - - - - - III. Scrophula - - - - - - - - - - - - - - - - - Tabes Mesenterica 8 9 17 6 7 3 - - 16 1 - - 17 - - - Phthisis 26 21 47 3 I 1 - 2 7 1 - 1 9 15 - - - Spasmodic Croup - - - - - - - - - - - - Hydrocephalus 4 2 6 3 - 1 1 1 6 1 - - - 6 - - - IV. Cephalitis 1 1 2 - - - - 1 1 - - 1 - - - Apoplexy 8 7 15 - - - - - - - - - - 3 - I - Paralysis 1 3 4 - - - - - - - - - - - - - Delirium Iremens - - - - - - - - — - - - - - - Chorea - - - - — - - - - - - - - - - - Epilepsy 1 - 1 - - - - - - - -- - - - - Tetanus - - - - — - - - - - - - - - j - Insanity - 2 2 - - - - - - - - - - - - - Convulsions 12 7 19 13 4 2 - - 19 - - - - - - 1 - Disease of Brain, &c 3 5 8 1 1 - - - 2 - 1 - - - - - - Report of the Medical Officer of Health, for the fourth Quarter, 1857. 9 Births M. 251. F. 250. Total 501. Excess of Births over Deaths 158. Deaths M. 177. E. 166. Total 343. CAUSES OF DEATH ALL AGES AGES M. F. T. Under 1 1.— 2.— 3.— 4.— All under ft 5 to 10 10.— 15.— All under 20. 20.— 40.— 60.— 80 and upwds. V. Pericarditis - - - - - - - - - - - - - - - - - Aneurism - - - - - - - - - - - - - - - - Disease of Heart, &c 3 6 8 - - - - - - 1 - 1 1 3 3 - VI. Laryngitis 3 3 1 1 - - - 2 - - - 2 - - - - Bronchitis 21 19 40 8 3 2 1 1 15 1 - 1 17 2 11 - - Pleurisy 1 - 1 - - - - - - - - - - - - - - Pneumonia 21 14 35 17 11 11 - - 28 1 - - - - - - - Asthma 2 '2 4 - - - - - - - - - - - - - - Disease of Lungs 2 4 6 2 - 1 - - 3 - - - 3 1 1 1 - VII. Teething I 1 - - - - - 1 - - - - - - - - Quinsey - - - - - - - - - - - - - - - - Gastritis - - - - - — - - - - - - - - - - - Enteritis 2 1 3 1 - - - - 1 - - - 1 - 1 1 - Peritonitis - 1 1 - - - - - - - 1 Ascites - - - - - - - - - - - - Ileus - - - - - - - - - - - - - - - I ntussusception - - - - - - - - - - - - - - - - Stricture of Intestinal Canal - 1 1 - - - - - - - - - - - - - - Dis. of Stomach, &c 1 1 2 - - - - - - 1 - - - - - - - Dis. of Pancreas - - - - - - - - - - - - - - - - - Hepatitis 1 1 2 - - - - --- - - - - - - - - - Jaundice 1 - 1 - - - - - - - - - - - - - - Disease of Liver 2 - 2 - - - - - - - - - - - - - - Disease of Spleen - - - - - - - - - - - - - - - - - VIII. Nephritis - - - - - - - - - - - - - - - - - Nephria (Bright's Dis.) - - - - - - - - - - - - - - - - - Iscnuria - - - - - - - - - - - - - - - - - Diabetes - 1 1 - - - - - - - - - - - - - - Stone - - - - - - - - - - - - - - - - - Cystitis - - - - - - - - - - - - - - - - - Stricture of Urethra - — - - - - - - - - - - - - - - - Disease of Kidneys, &c 1 - 1 - - - - - - - - - - - 1 - - IX. Paramenia - - - - - - - - - - - - - - - - - Ovarian Dropsy - I 1 - - - - - - - - - - - - - - Childbirth (See Metria) — — - - - - - - - - - - - - - - - Disease of Uterus, &c - 1 1 - - - - - - - - - - - 1 - - X. Rheumatism 2 2 - - - - - - - - - - - - - - Arthritis - - - - - - - - - - - - - - - - - Disease of Joints, &c - 1 1 - - - - - - - - - - 1 - - - XI. Carbuncle - - - - - - - - - - - - - - - - - Phlegmon - - - - - - - - - - - - - - - - - Diseases of Skin, &c - - - - - - - - - - - - - - - - - XII. Cyanosis - - - - - - - - - - - - - - - - - Spina Bifida - - - - - - - - - - - - - - - - - Other Malformations - - - - - - - - - - - - - - - - - XVII. Intemperance - - - - - - - - - - - - - - - - - Privation of Food - 1 1 - - - - - - - - - - - - - - Want of Breast Milk - 3 3 3 - - - - 3 - - - 3 - - - - Neglect - - - — - - - - - - - - - - - - - Cold - 1 1 1 - - - - - - - - - - - - - Poison - - - - - - - - - - - - - - - - - Burns and Scalds - - - - - - - - - - - - - - - - - Hanging - 1 1 - - - - - - - - - - - - - - oufFocation - 3 3 3 - - - - 3 - - - - - - - - Drowning - - - - - - - - - - - - - - - - - 1* ractures and Contusions 1 1 2 - - - - - - - - - - - - - - wounds - - - - - - - - - - - - - - - - - Other V iolence - - - - - - - - - - - - - - - - - 110 11 I 10 Parish of Saint George the Martyr, Southwark. Report of the Medical Officer of Health, for the fourth Quarter, 1857. 11 TABLE 7.—Sanitary Inspections during the Quarter ending December 31, 1857. Cases Number of Houses or Places visited Number of Visits of Medical Officer and Inspector Premises unclean, or dilapidated within Overcrowded Unfit for habitation Insufficient Ventilation Water Water receptacle, none, bad, or without cover Bad Drainage Foul Cesspool Water Closet defective, or without Water Yard badly paved Cellar badly paved Refuse accumulated Dustbin, none or imperfect Nuisances from animals badly kept Slaughter-houses, Manufactories in unwholesome state Burial Vaults requiring improvement Deficient No supply 205 323 About 950.—The calculation i*, that each place is visited on ihc average three times. 59 4 18 2 . 94 111 68 63 9 2 Not regularly recorded. Probably one in three of all cases visited. 134 I 4 3 Work completed 134 189 28 2 2 2 • • 58 56 22 40 55 2 70 I • • Not begun, or left unfinished. 71 134 31 2 16 • • • 36 55 46 23 37 • 64 • 4 2 Names of Places, and Dates of Official or Friendly Notices are annexed, which the Work ordered was not completed at the end of the Quay ter. The following are from the fourth quarterly report:— 1 The following are cases taken in hand during this, the eighth quarter :— 6 to 10, Spiller's-court. Date Bone-boiler, 24, Green-street .O.N. 24 10 57 The following are from the fifth quarterly report:— do summoned 7 11 57 King's Arms, Old Kent-road. Bone-boiler, 30, Green-street O.N. 24 10 57 do summoned 7 11 57 The following are from the seventh quarterly report:— Thomas-court, Great Suffolk-street, 1, 2, 3, 4, 5, 6, 8, 9, 10 F.N. 11 11 57 Date O.N. 6 12 57 1 to 13, East-place, West-square .... F.N. 29 | 6 57 Do. Summoned Upper Green-street, 1,2,3,4,5,6,7,9,10 F.N. 11 11 57 1 to 5, Chapel-court, High-street F.N. 29 6 57 O.N. 3 12 57 34 and 35, Pitt-street, St. George's-road F.N. 10 7 57 Upper Green-street, 11 to 21 inclusive .F.N. 11 11 57 O.N. 4 <i 57 7, Drinkwater-place, waterloo-road F.N. 13 11 57 O.N. 5 12 57 2, 3, 4, 5, and 6, York-street F.N. 16 7 57 do summoned O.N. 4 y 57 9 to 14, york-street F.N. 16 7 57 Bond-street, 19, 20, 20, 21, 22, 23, 24, 25, 26, 27, 28, 30 F.N. 19 11 57 8, gloster-place, old Kent-road F.N. 71 11 57 O.N. 4 9 57 O.N. 21 12 57 37, Bridge House-place F.N. 17 7 57 do summened 18, Upper Green-street F.N. 28 7 57 Elizabeth-place, Waterloo-road F.N. 27 11 57 O.N. 7 9 57 O.N. 16 1 58 Atlas Works, Borough-road 8 57 Do. Summoned O.N. 22 9 57 Edden-court, 1 to 7 2 12 57 Bone-boiler, 25, Green-street F.N. 26 8 57 Do. Summoned | O.N. 9 11 57 Warwick-street, 43, 44, 45 O.N 2 12 57 Do. Summoned 2, Surrey-square F.N. 4 9 57 96, London-road .F.N 5 12 57 O.N. 22 9 57 F.N 6 <) 57 John-street, Greet suffolk-street, 1,2,3,4,5,6,7,10 F.N 10 12 57 1, Northampton-street O.N. 27 11 57 John-street, 8,9 F.N. 10 12 57 O.N. 4 2 58 9 to 13, Frederick-place, old Kent-road F.N. 26 9 57 John-street, 12, 15 F.N 12 12 57 14 to 19, Potier-street F.N. 28 9 57 William-street, 1,2,3,5 F.N 12 12 57 O.N. 26 10 57 Lower Rodney-street, 4,8,9 .F..N. 1?. 12 57 1 to 4} Hunter-place F.N. 28 9 57 Valentine-place, 1,2 F.N. 12 12 57 5 to n O.N. 27 10 57 O.N. 4 2 58 13, Potier-street F N. ?8 9 57 70, Webber-row F.N. 12 12 57 O.N. 16 1 58 LONDON: Printed by G. Head and W. P. Gbiffith, Printers to Her Majesty's Stationery Office, 5, Langley Street, Long Acre. w. c.