STOL 1 THE BOARD OF WORKS FOR THE ST. OLAVE DISTRICT. ANNUAL REPORT ON THE Sanitary Condition of the District. FOR THE YEAR 1893, BY FALLON PERCY WIGHTWICK, M.D., D.P.H. Medical Officer of Health for the St. Olave District. Fellow & Hon. Sec. Incorporated Society of Medical Officers of Health, Fellow & Member of the Council of the British Institute of Public Health. LONDON: PRINTED BY C. TALBOT, 101, TOOLEY STREET, SOUTHWARK, S.E. THE BOARD OF WORKS FOR THE ST. OLAVE DISTRICT. ANNUAL REPORT ON THE Sanitary Condition of the district. for the year 1893, BY FALLON PERCY WIGHTWICK, M.D., D.P.H., Medical Officer of Health for the St. Olave District. Fellow & Hon. Sec. Incorporated Society of Medical Officers of Health, Fellow & Member of the Council of the British Institute of Public Health. LONDON: PRINTED BY C. TALBOT, 101, TOOLEY STREET, SOUTHWARK, S.E. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, Being the Report for the Year 1893. To the Members of the Board of Works for the St. Olave District, SoutHvark. Gentlemen, I have the honour to place before you my fifth Annual Report. This report, in accordance with the regulations of the Local Government Board, deals with the twelve months ending December 31st, 1893. The year has been one of marked progress in sanitary matters, and the work has been carried on, by the aid of recent Acts of Parliament, in a quiet, methodical manner, much easier than formerly, and consequently with less attention being drawn to it. The most marked feature in sanitary progress this year is the purchase by the Board of its own steam disinfector, which is now being manufactured for the Board by Messrs. Manlove and Alliott. It will be remembered that I have frequently in my reports 4 urged upon the Board the desirability of having their own disinfecting apparatus. Many difficulties hindered the Board from acting on my advice, and chiefly that of obtaining land on which to erect the necessary machinery. This latter difficulty has, however, been overcome, by making arrangements with Guy's Hospital, mainly owing to the instrumentality of Dr. Perry. Very shortly this District will have the advantage of being able to disinfect all infected articles by means of steam under high pressure, and this is undoubtedly the only reliable method of disinfection. Of hardly secondary importance to the disinfector is the Board's action whereby they obtained a shelter in accordance with the provisions of the Public Health (London) Act. Section 60, sub-sec. 4, of this Act states that "the sanitary authority shall provide, free of charge, temporary shelter or house accommodation, with any necessary attendants, for the members of any family in which any dangerous infectious disease has appeared, who have been compelled to leave their dwellings, for the purpose of enabling such dwellings to be disinfected by the sanitary authority." When bringing: this section under the notice of the Board, I pointed out the desirability of obtaining at the same time house accommodation to which we could remove the non-infected inmates from a house where cholera had broken out. The Board, on this advice, have taken four cottages on lease, and have completely furnished one as a shelter, the others being ready in the event of cholera arising in this District. We are consequently in a very much better position to cope with any serious outbreak of infectious disease than we have ever been before. 5 Members of the Board will remember that the years 1891 and 1892 were chiefly occupied by putting in force the powers given to local authorities by the Housing of the Working Classes Act, 1890, and the Public Health Act, 1891. The Board, on my advice, caused the demolition or closing of a large number of houses which were unfit for human habitation. In 1891 I gave certificates in the case of 67 houses, 52 of which were closed by a magistrate's order, 45 being afterwards demolished; 15 were closed, or the work done, without the magistrate's order, and 4 of these were voluntarily demolished by the owners. In 1892 the Public Health Act much altered our procedure, when 12 houses were closed under the Housing of the Working Classes Act, 9 being subsequently demolished, and no less than 49 houses Were closed under the Public Health (Loudon) Act, 19 being by a magistrate's order. I am of opinion that the Public Health (London) Act, 1891, has, to a great extent, replaced the Housing of the Working Classes Act, 1890. I now only give a certificate under the latter Act when I am of opinion that the case is one for demolition. It is obvious that a house may be unfit for human habitation at the time of inspection, and yet it may be quite possible, by spending sufficient money, to make it habitable. Under these circumstances I should proceed under the Public Health (London) Act; if on the other hand, from want of air space or from general structural arrangement, no amount of expenditure could make the house habitable, I proceed under the Housing of the Working Classes Act. This year most of the work has been taken under the Public Health (London) Act, and consequently an enormous amount of work, chiefly with regard to drainage, 6 has been effected without any special reports or certificates being necessary, and consequently without much attention being paid to the subject. Most of this work, being chiefly concerned with drainage, has fallen almost entirely on your sanitary inspector, Mr. Ashdown, and too great credit cannot be given to him for the careful and conscientious manner in which he has carried out these duties. In every case during this year, where the Board have ordered premises to be re-drained, the works have been carried out directly under the inspector's supervision, and every drain has been tested by the water test before being covered in ; and this test has on very many occasions to be freqnently repeated before the work is passed as satisfactory by the inspector. The benefit to the district that will eventually accrue, cannot be over estimated, and I am certain that in a short period of time there will be no district in London that is better drained than St. Olave's. In the early part of the year I reported on an order issued by the Secretary of State, under section 27 of the Factory and Workshops Act, 1891. The order required lists to be kept of out-workers in the following businesses:— The manufacture of articles of wearing apparel. Cabinet and furniture making, and upholstery work. The manufacture of electro-plate. The manufacture of files. The list was to be repaired and kept up to date by the occupier of every factory or workshop, and every contractor employed by such occupier, and was open to the inspection 7 of the sanitary authority. This Board took every means of making the order known, but the order did not require the lists of out-workers or copies of such lists to be sent to the sanitary authority, and consequently the order was of little practical good in this District. Few of the out-workers living in this District have their factories and workshops situated within it, and consequently it is impossible to follow up these cases. It would have been of great service if the occupier of factory or workshop was ordered to forward the list of his out-workers to the respective Medical Officers of Health of the various sanitary districts. VITAL STATISTICS, The vital statistics are calculated upon the population at all ages estimated to the middle of 1893. This estimate gives a population of 12,861. These figures are too small to give any true estimate of the health of the District and are liable to inaccuracies caused by slight errors which would be inappreciable in a District with a large population. To give one of the many examples, during this year, the bodies of 12 persons were found drowned in the Thames, not one of whom were parishioners, but on account of the bodies being washed ashore in this District, they are returned as belonging to St. Olave's District, this error alone, if not accounted for, would raise the death rate nearly 1 per 1000. Again the annual death-rate of the last few years has been compared with that of some years back, and it has been Stated that in spite of the progress in sanitation, we compare 8 unfavorably at the present time with the past. When it is pointed out that only during the last four years have returns been obtained from outlying institutions, it shows how impossible this comparison is. For instance, 60 deaths have been returned from these institutions during this year, which by omitting or adding to the deaths gives a death rate of either 16 or 21 per 1000, In other words, in past years the death-rate would have been returned at 16 per 1000 instead of 21. It is obvious that to compare returns in which in the one case these deaths have been included and in the other excluded is absurd. Statistical fallacies of this kind are well known to any one who has taken the trouble to consider the matter, but as deductions have been made from figures such as above mentioned, it may be well to quote from Dr. Parkes' work on Hvgiene and Public Health. "Death-rates structed from the mortality returns of short periods, are not reliable as tests of health. They are necesserily subject to accidental fluctuations, which must prevent any true conclusions being drawn from them. So too with the death-rate of small populations, even when they exhibit returns covering a period of a year. The number on which the figures are founded are not sufficiently large to exclude those accidental fluctuations from varying circumstances, which must be got rid of before any just reasoning can be founded on death-rates." After making the necessary corrections it is found that there were 273 deaths of parishioners of St. Olave's, and 9 these 273 deaths are equivalent to a death-rate for the year of 21.2 per 1000. The death-rate for London for the year was 21.3. The corrected death-rates of St. Olave's and of London for the past four years are as under— Yar. St. Olave's Death-Rate per 1000. London Death-Rate per 1000. 1890 20.2 21.5 1891 25.2 21.4 1892 23.7 20.4 1893 21.2 21.3 There is no doubt that the epidemics of influenza are mainly the cause of these comparatively high death-rates. The detailed causes of death will be found on turning to the various tables accompanying this Report. The death-rate in St. Olave's from the seven principal zymotic diseases was 15 per 1000, a remarkably low rate considering the large number of cases of scarlet fever which occurred during the year. The great value of compulsory notification has been especially shown this year; without notification the above low zymotic death-rate would have given a very inacurate idea of the true sanitary condition. Notification, this year, has proved that we have had an exceptionally heavy visitation of zymotic diseases. Two hundred and nineteen notifications have been received, and it has been found on enquiry that no less than 193 of these belonged to the District. 10 They were distributed among the following diseases: — Scarlet Fever 109 Diphtheria 32 Smallpox 11 Membranous Croup 1 Typhoid 4 Puerperal 3 Erysipelas 33 193 Of these cases 160 or 84 p.c. were treated in Hospitals and 31 or only 16 p.c. at their own homes, 2 cases of diphtheria died while waiting to be removed to Hospital. Of the above 219 cases the following occurred in connection with Guy's Hospital, either originating in the Hospital or brought to that institution. Scarlet Fever 35 Diphtheria 14 Smallpox 1 Typhoid Fever 1 Puerperal 1 Erysipelas 14 The measures taken in dealing with the cases arising in the District outside Guy's Hospital were as follows:— Bodies removed to the Mortuary 2 No. of rooms fumigated 157 „ stripped and disinfected by Board 6 „ „ etc., by owners, upon verbal request 112 11 No. of notices served requiring disinfection 39 „ „ „ bedding to be given up for disinfection 2 No. of cases where bedding was removed for disinfection 95 No. of cases where bedding was destroyed and compensation given 9 These precautionary measures cost the Board a considerable sum. The disinfection by steam, carried out by the contractor for the four quarters of the year, cost £204 19s. 3d., and the compensation for articles destroyed £4 10s. 6d. The premises where the infectious cases occurred were all inspected and examined, and notices served when necessary. Smallpox has not arisen before in this District while I have held the post of Medical Officer, and this year it was evidently introduced by tramps. The first case, and nearly all the others, occurred in the common lodging-house in Tooleystreet. Very active steps were taken to deal with the outbreak. Each case was removed to hospital, and the room where it occurred was thoroughly fumigated with sulphur, and afterwards washed with a solution of perchloride of mercury, and the clothes either destroyed or disinfected by steam. The great difficulty in the majority of cases was the diagnosis, most of the attacks being very mild owing to the patient having been vaccinated when a baby, but unfortunately not re-vaccinated. Although the most urgent pressure was put on persons liable to come in contact with these cases to be re-vaccinated, it was seldom that they would avail themselves of the opportunity. 12 As in the rest of London, there is a decided increase in the number of cases of diphtheria, and I fear that until there is a better knowledge of the cause and methods of spread of diphtheria, we shall be unable to prevent this increase. It is undoubtedly the problem of sanitation. I am glad again to be able to state the entire absence of typhus from the District. BIRTHS. The number of births registered for the whole District, which includes the three Sub-Districts (St. Olave, St. John, and St. Thomas) for the 52 weeks, were 412. Of this total, 207 were male children and 205 female children. This gives a birth-rate of 32, as compared with one of 36.2 last year. A detailed account of the sanitary work done will be found in Table C, prepared for me by Mr. Ashdown, but I should like to draw the attention of the Board to an important seizure made by us of 2,501 tins of meat unfit for human food. I received private information that a large quantity of tinned meat was stored at Fenning's Wharf, Tooley-street, which, I was informed, was in such a state as to be unfit for the food of man. I therefore visited the wharf with the inspector, and (receiving every assistance from the proprietors of the wharf found that there were 250 cases, each containing 12 tins of meat. Of this number 32 cases had been separated from the rest, and placed on one side as bad. I then caused 9 cases to be picked out from different parts of the mass, and 12 tins 13 opened indiscriminately. These 12 tins were all unfit for for food, most of them being in a stinking condition. Finding that in 108 tins 12 of them taken from different parts were all bad, I thought that this ought to be sufficient to condemn the remainder. I consequently caused these opened tins to be taken before a magistrate, who gave the necessary order for their destruction, but refused to give the order for the remaining 2,501 cases, but stated that every tin must be separately opened. These cases were accordingly conveyed to the Board's Wharf, at considerable expense, and all opened, to the great danger of the men employed, who were liable to be cut and contract blood poisoning. Out of the 2,501 tins only 17 were found fit for food ! It appears to me that the law relating to the seizure of tinned goods require modification, for considering the very great danger there is to the public health from damaged articles of this kind getting on the market, it would be reasonable to condemn the sample if a certain percentage were found unfit for human food. Several deaths have been recorded from people partaking of tinned meats in an unwholesome condition, and it cannot be too widely known that when the jelly is liquified the meat is in all probability in a most dangerous condition for food. In addition to the seizure of these tins, 112 pieces of about 9 cwt. of butcher's meat were destroyed, and proceedings were taken and the owner fined £10 and costs. Five lots of food stuffs were voluntarily given up and destroyed during the same period, viz:— 14 About 9½ tons of potatoes. „ 5 tons of cheese. „ 1½ cwt. of eggs. During the year 39 bodies were placed in the Mortuary, a magistrate's order having been obtained for the compulsory removal of one body. I am. Gentlemen, Your obedient Servant, FALLON PERCY WIGHTWICK, M.D., D.P.H. Medical Officer of Health. 15 SANITARY. TABLE C. Summary of Nuisances and other matters reported on, and work done during the year ending 31st December, 1893. Number of Inspections made 892 Number of Complaints entered in complaint book 16 Number of Intimations served 308 Number of Statutory Notices served 118 Summons taken out for non-compliance with Notices 7 Sanitary defects found and dealt with, as above. WATER SUPPLY— Services transferred from cistern to main 3 Houses found without water supply 9 Number of cases in which the drinking water and the supply to the w.c. were the same 54 Cisterns found dirty 42 Cisterns imperfectly covered 40 Overflow pipes connected to soil pipes or drains 6 Defective water fittings 20 WATER CLOSETS— New closets provided at dwelling houses 2 „ „ at work places 18 Water closets reconstructed 17 Closets" without water 21 Closets with defective water supply 63 Closets defective, stopped or dirty 138 Closets without proper light or ventilation 25 Defective soil pipes 34 Urinals without water 4 „ provided at factory 1 16 DRAINS— Premises provided with new drains 99 Drains stopped 34 Drains defective 117 Drains untrapped 71 Drains with defective traps 14 Waste pipes from sinks, &c., connected to drains 104 Stack pipes connected to drains 63 DUST BINS— New sanitary bins provided 37 Defective and repaired 19 YARDS— Defective paving 44 Dirty, etc. 6 HOUSES— Requiring general repairs 16 Requiring through and better ventilation 22 Requiring ventilation under floors 49 Rooms dirty 110 Passages and staircases dirty 45 Overcrowded rooms 31 Defective roofs 15 Defective eaves, gutters and down pipes 18 Smoke nuisances 3 ANIMALS— Kept so as to be a nuisance 5 Accumulation of offensive matter 36 UNCLASSIFIED NUISANCES 46 17 TABLE I. SUMMARY OF TABLE II. CAUSES OF DEATH. AGES. , at all Ages. Under 1 Year. 1 Year ;«nd under 5. 5, and under 15. 15, and under 25. 25, and under 65. 65, and upwards. I.—Specific Febrile, or Zymotic Diseases. 1 Miasmatic Diseases 2 11 5 1 6 1 26 2 Diarrhœal 6 3 ... ... ... ... 9 3 Malarial ... ... ... ... ... ... ... 4 Zoogenous ... ... ... ... ... ... ... 5 Venereal 2 ... ... ... 1 ... 3 6 Septic ... ... ... ... ... ... ... II.—Parasitic Diseases ... ... ... ... ... ... ... III.—Dietetic Diseases ... 1 ... ... ... ... 1 IV.—Constitutional Diseases 4 7 6 4 35 3 59 V.—Developmental Diseases 8 ... ... ... 1 16 25 VI.—Local Diseases 1 Diseases of Nervous System 3 3 ... ... 13 4 23 2 Diseases of Organs of Special Sense ... ... ... ... ... ... ... 3 Diseases of Circulatory System ... ... 3 ... 15 4 23 4 Diseases of Respiratory System 9 9 2 ... 23 13 56 5 Diseases of Digestive System 7 3 ... ... 4 2 16 6 Diseases of Lymphatic System ... ... ... ... ... ... ... 7 Diseases of Gland-like Organs of Uncertain Use ... ... ... ... ... ... ... 8 Diseases of Urinary System ... ... 1 ... 5 ... 6 9 Diseases of Reproductive System ... ... ... ... ... ... ... (a) Diseases of Organs of Generation ... ... ... ... 2 1 3 (b) Diseases of Parturition ... ... ... ... 1 ... 1 10 Diseases of Bones and Joints ... ... ... ... 1 ... 1 11 Diseases of Integumentary System 2 ... ... ... ... 1 3 VII.—Violence. 1 Accident or Negligence 2 2 1 2 7 1 15 2 Homicide ... ... ... ... ... ... ... 3 Suicide ... ... ... ... 3 ... 3 4 Execution ... ... ... ... ... ... ... VIII.—Ill-defined and not Specified Causes 10 ... 1 ... 1 ... 12 Total 55 39 19 8 118 46 285 18 TABLE II. Deaths Registered in the St- Olave District in the year ending Dec. 31,1893. CAUSES OF DEATH. AGES. Total at all ages. Under 1 Year. 1 Year and under 5. 5 and under 15. 15, and under 25. 25, and under 65. 65, and upwards. I.—SPECIFIC FEBRILE, OR ZYMOTIC DISEASES 10 14 5 1 7 1 38 II—PARASITIC DISEASES ... ... ... ... ... ... ... III.—DIETETIC DISEASES ... 1 ... ... ... ... 1 IV.—CONSTITUTIONAL DISEASES 4 7 6 4 35 3 59 V.—DEVELOPMENTAL DISEASES 8 ... ... ... 1 16 25 VI.—LOCAL DISEASES 21 15 6 1 G4 25 132 VII.—DEATHS FROM VIOLENCE 2 2 1 2 10 1 18 VIII.—DEATHS FROM ILL-DEFINED and NOT SPECIFIED CAUSES 10 ... 1 ... 1 ... 12 Totals 55 39 19 8 118 46 285 L—SPECIFIC, FEBRILE OR ZYMOTIC DISEASES. 1.—Miasmatic Diseases. Smallpox Vaccinated ... ... ... ... ... ... ... Unvaccinated ... ... ... ... 1 ... 1 No Statement ... ... ... ... ... ... ... Measles ... 1 ... ... ... ... 1 Scarlet Fever ... 3 3 ... ... ... 6 Typhus ... ... ... ... ... ... ... Whooping Cough 2 1 ... ... ... ... 3 Diphtheria ... 6 1 ... ... ... 7 Simple Continued and Ill-defined Fever ... ... ... ... ... ... ... Enteric or Typhoid Fever ... ... 1 1 ... ... 2 Influenza ... ... ... ... 5 1 6 Other Miasmatic Diseases ... ... ... ... ... ... ... 2.—Diarrhœl Diseases. Simple Cholera ... ... ... ... ... ... ... Diarrhoea, Dysentery 6 3 ... ... ... ... 9 3.—Malarial Diseases. Remittent Fever ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... 4.—Zoogenous Diseases. Cowpox and effects of Vaccination ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... 5.—Venereal Diseases. Syphilis 2 ... ... ... 1 ... 3 Gonorrhœa, Stricture of Urethra ... ... ... ... ... ... ... 6.—Septic Diseases. Erysipelas ... ... ... ... ... ... ... Pyæmia, Septicaemia ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... 19 TABLE II.— continued. CAUSES OF DEATH. AGES. Total at all Ages. Under 1 Year. 1 Year and under 5. 5, and under 15. 15, and l under 25. 25, and under 65. 65, and upwards. II.— PARASITIC DISEASES. Thrash, and other Vegetable Parasitic Diseases, Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... III.— DIETETIC DISEASES. Want of Breast Milk, Starvation ... 1 ... ... ... ... 1 Scurvy ... ... ... ... ... ... ... Chronic Alcoholism ... ... ... ... ... ... ... Delirium Tremens ... ... ... ... ... ... ... IV.— CONSTITUTIONAL DISEASES. Rheumatic Fever, Rheumatism of the Heart ... ... ... ... 2 ... 2 Rheumatism ... ... ... ... ... ... ... Gout ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... Cancer, Malignant Disease ... ... ... ... 5 3 8 Tabes Mesenterica 1 1 ... ... ... ... 2 Tubercular Meningitis, Hydrocephalus 2 6 3 ... 1 ... 12 Phthisis 1 ... 3 3 24 ... 31 Other Forms of Tuberculosis, Scrofula ... ... ... 1 3 ... 4 Purpma, Hæmorrhagic Diathesis ... ... ... ... ... ... ... Anæmia, Chlorosis, Leucocythæmia ... ... ... ... ... ... ... Glycosuria, Diabetes Mellitus ... ... ... ... ... ... ... Other Constitutional Diseases ... ... ... ... ... ... ... V.— DEVELOPMENTAL DISEASES. Premature Birth & Inanition 6 ... ... ... ... ... 6 Atelectasis ... ... ... ... ... ... ... Congenital Malformations 2 ... ... ... ... ... 2 Old Age ... ... ... ... 1 16 17 VI.— LOCAL DISEASES. 1.—Diseases of Nervous System Inflammation of Brain or Membranes ... ... ... ... ... ... ... Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... ... 11 4 15 Insanity, General Paralysis of the Insane ... ... ... ... 2 ... 2 Epilepsy ... ... ... ... ... ... ... Convulsions 3 3 ... ... ... ... 6 Laryngismus Stridulus (Spasm of Glottis) ... ... ... ... ... ... ... Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... ... ... ... Other Diseases of the Nervous System ... ... ... ... ... ... ... 2.—Diseases of Organs of Special Sense (e.g, of Ear, Eye, Nose) ... ... ... ... ... ... ... 3.—Diseases of Circulatory System. Pericarditis ... ... ... ... ... ... ... Acute Endocarditis ... ... ... ... ... ... ... Valvular Diseases of Heart ... ... 2 ... 9 4 15 Other Diseases of Heart ... ... 1 ... 5 ... 6 Aneurism ... ... ... ... 1 ... 1 Embolism, Thrombosis ... ... ... ... ... ... ... Other Diseases of Blood Vessels ... ... ... 1 ... ... 1 20 TABLE II. — continued. CAUSES OF DEATH. AGES. Total at all Ages. Under 1 Yrar. 1 Year and under 5. 5, and under 15. 15, and under 25. 25, and under 65. 65, and upwards. 4.—Diseases of Respiratory System. Laryngitis ... 2 ... ... ... ... 2 Croup 1 ... ... ... ... ... 1 Emphysema, Asthma ... ... ... ... ... ... ... Bronchitis 5 1 ... ... 7 10 23 Pneumonia 2 6 2 ... 14 3 27 Pleurisy 1 ... ... ... ... ... 1 Other Diseases of Respiratory System ... ... ... ... 2 ... 2 5.—Diseases of Digestive System. Dentition ... 2 ... ... ... ... 2 Sroe Throat, Quinsey ... ... ... ... ... ... ... Diseases of Stomach ... ... ... ... ... ... ... Enteritis 5 1 ... ... ... ... 6 Obstructive Diseases of Intestine 1 ... ... ... ... 1 2 Peritonitis ... ... ... ... 1 ... 1 Ascites ... ... ... ... ... ... ... Cirrhosis of Liver ... ... ... ... 2 ... 2 Jaundice and other Diseases of Liver 1 ... ... ... ... 1 2 Other Diseases of Digestive System ... ... ... ... 1 ... 1 6.—Diseases of Lymphatic System. (e.g., of Lymphatics and of Spleen) ... ... ... ... ... ... ... 7.—Diseases of Glandlike Organs of Uncertain Use. (e.g., Bronchocele, Addison's Disease) ... ... ... ... ... ... ... 8.—Diseases of Urinary System. Nephritis ... ... 1 ... ... ... 1 Bright's Disease, Albuminuria ... ... ... ... 4 ... 4 Disease of Bladder or of Prostate ... ... ... ... ... ... ... Other Diseases of the Urinary System ... ... ... ... 1 ... 1 9.—Diseases of Reproductive System. A. Of Organs of Generation. Male Organs ... ... ... ... ... 1 1 Female Organs ... ... ... ... 2 ... 2 B. Of Parturition. Abortion, Miscarriage ... ... ... ... 1 ... 1 Puerperal Convulsions ... ... ... ... ... ... ... Placenta prævia, Flooding ... ... ... ... ... ... ... Other Accidents of Child Birth ... ... ... ... ... ... ... 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... 1 ... 1 Arthritis, Ostitis, Periostitis ... ... ... ... ... ... ... Other Diseases of Bones and Joints ... ... ... ... ... ... ... 21 TABLE II.— continued. CAUSES OF DEATH. AGES. Total at all Ages. Under 1 Year. 1 Year and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. 11.—Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... ... ... ... ... Other Diseases of Integumentary System 2 ... ... ... ... 1 3 VII.— DEATHS FROM VIOLENCE. 1.—Accident or Negligence. Fractures and Contusions ... 1 ... ... 1 ... 2 Gunshot Wounds ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... Burn, Scald ... ... ... ... ... ... ... Poison ... ... ... ... ... ... ... Drowning ... ... 1 2 6 1 10 Suffocation 2 ... ... ... ... ... 2 Otherwise ... 1 ... ... ... ... 1 2.—Homicide. Manslaughter ... ... ... ... ... ... ... Murder ... ... ... ... ... ... ... 3.—Suicide. Gunshot Wounds ... ... ... ... ... ... ... Cut, Stab ... ... ... ... 1 ... 1 Poison ... ... ... ... ... ... ... Drowning ... ... ... ... 2 ... 2 Hanging ... ... ... ... ... ... ... Otherwise ... ... ... ... ... ... ... 4—Execution. Hanging VIII.— DEATHS FROM ILL-DEFINED AND NOT SPECIFIED CAUSES. Dropsy ... ... ... ... ... ... ... Debility, Atrophy, Inanition 10 ... ... ... ... ... 10 Mortification ... ... ... ... 1 ... 1 Tumour ... ... ... ... ... ... ... Abscess ... ... ... ... ... ... ... Hæmorrhage ... ... 1 ... ... ... 1 Sudden Death (cause not ascertained) ... ... ... ... ... ... ... Causes not Specified or Ill-defined ... ... ... ... ... ... ... Totals 55 39 19 8 118 46 285 (A) TABLE.— In accordance with the Requirements of the Local Government Board. TABLE OF DEATHS during the year 1893 in the Metropolitan Sanitary District of St. Olave's, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics, Public Institutions being shown as separate localities. Mortality from all causes at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all ayes. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1. 2 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17 18. 19. 20. 21. 22. Smallpox Scarlatina. Diphtheria. Membranous Croup. FEVERS Cholera. Erysipelas Measles. Whooping Cough. Diarrhœa and Dysentry. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus Enteric or Typhoid Continued Relapsing Puerperal (a). (b). (c). (d). (e). (f). (g). (h). (i). The District, exclusive of all Public Institutions 182 48 29 12 1 59 33 Under 5 ... ... 4 ... ... ... ... ... ... ... ... ... 2 9 ... ... 1 14 ... 4 14 48 5 upwds. ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 ... 15 28 21 1 66 134 Guy's Hospital (20 only being of Parishioners) 571 2 3 1 1 13 ... Under 5 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 3 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 4 1 1 9 17 Parish Street Workhouse (11 only being of Parishioners) 41 3 2 ... ... 4 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 2 4 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 7 Found in the River Thames (none being Parishioners) 12 ... ... 1 2 8 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 ... 12 Totals 809 63 34 14 4 81 36 Under 5 ... l 4 ... ... ... ... ... ... ... ... 1 3 9 ... ... 1 14 ... 4 18 55 5 upwds. ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 ... 17 32 23 14 81 170 The subjoined numbers have also to be taken into account in judging of the above records of mortality Deaths occurring outside the District among persons belonging thereto 60 2 5 5 4 34 10 Under 5 ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 6 5 upwds. 1 3 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... 13 6 6 ... 22 54 Deaths occurring within the District among persons not belonging thereto 596 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 596 TABLE.— In accordance with the Requirements of the Local Government Board. TABLE OP POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS coming to the knowledge of the Medical Officer of Health during the year 1893 in the Metropolitan Sanitary District of St. Olave's, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Population at all ages. Registered Births. Aged under 5 or over 5 New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Number of such Cases removed from their houses in the several localities, for treatment in Isolation Hospitals. Census 1891 Estimated to middle of 1893. 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 Small-pox Scarlatina Diphtheria Membranous Croup FEVERS. Cholera Erysipelas Small-pox Scarlatina Diphtheria Membranous | Croup FEVERS Cholera Erysipelas Typhus Enteric or Typhoid Continued Relapsing Puerperal Typhus Enteric or Typhoid Continued Relapsing Puerperal (a) (b) (c) (d) (e) District. 12,691 12,861 412 Under 5 ... 26 9 1 ... ... ... ... ... ... 2 ... ... 10 67 15 1 ... ... ... ... ... ... 4 ... ... 5 upwds. 10 47 11 0 3 2 19 Guy's Hospital Under 5 ... 2 3 ... ... ... ... ... ... ... 3 ... ... 1 37 15 ... ... 1 ... ... 1 ... 17 ... ... 5 upwds. 1 35 12 ... ... 1 ... ... 1 ... 14 ... ... Parish Street Workhouse (All imported cases.) Under 5 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 3 1 ... ... 1 ... ... ... ... ... ... ... 5 upwds. 1 2 1 ... ... 1 ... ... ... ... ... ... ... Totals Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... 24 TABLE OF SALE OF FOOD & DRUGS ACT & MARGARINE ACT. During the year the following Samples have been taken and submitted to the Public Analyst:— Articles purchased for Analysis. Result of Analysis. Observations. Milk (22) Of which 8 were genuine „ (4) Returned as of low quality „ (1) 5% of water beyond the normal No proceedings. „ (1) 3% „ „ „ „ „ „ (1) 2% „ „ „ „ „ „ (1) 3% „ „ „ „ „ „ (1) 6% „ „ „ and deficient in butter fat 50% Fined £20, and costs 12/6. „ (1) 9% of added water Withdrawn, warranty considered proved „ (1) Deficient in butter fat 45%, and minute quantity of boracic acid added Fined £5 and costs 12/6. „ (1) 65% deficient in butter fat, and minute quantity of boracic acid added „ £1, „ „ „ „ (1) Deficient in butter fat 80%, and minute quantity of brracic acid added „ £20, „ „ „ „ (1) Deficient in butter fat 80%, about 1 fourth of 1% of starch, 4% of added water, and a minute quantity of boracic acid added „ £20, „ „ 42/-. Butter (3) All genuine Coffee (3) „