STPAN 31 St. Paneuas, Middlesex. NINETEENTH ANNUAL REPORT OF the MEDICAL OFFICER OF HEALTH, Being the Report for the Year 1874. TO THE VESTRYMEN OF ST. PANCRAS. Gentlemen, The Census of 1871 showed a population of 221,594 in St. Pancras; and. allowing for the usual rato of increase there would bo a population of about 229,000 living in the parish in the middle of the year 1874. In the 52 weeks ending January 2, 1875, 5,029 deaths were registered in St. Pancras. The number of births registered during the year of 52 weeks was 8,010. The increment of births over deaths was hence 2,981. Of the 5,029 deaths, 1,013 occurred in public institutions. After making the necessary corrections for deaths of non-parishioners in public institutions, and of St. Pancras parishioners in institutions outside the parish, the corrected number of deaths in 1874 is 4,982. The annual rate of mortality was 21.75, a lower rate than any during the last 10 years, except that of 1872. The average death rate of the preceding 10 years was 23.78 per 1,000; and that of the Metropolis, in 1874, was 22.5, or 0.75 per 1,000 above the local rate in St. Pancras. In the annexed tables the details of the mortality of the parish are set out, and some instructive comparisons made. It will be observed that the deaths from Zymotic diseases were almost identical in proportion to the respective populations in the Metropolis and in St. Pancras, the parish having suffered severely from Hooping Cough and Scarlet Fever. Notwithstanding this, the deaths from the seven principal Zymotic diseases— viz.: Small Pox, Measles, Scarlet Fever, Diphthera, Hooping Cough, Fever and Diarrhcea formed only two-thirds of the numbers registered on the average, and were lower than in any of the preceding 10 years. This is a very satisfactory statement, and shows how much has 2 been achieved; but it must be supplemented by the further statement that the deaths on the aggregate from the seven principal Zymotic diseases enumerated above, from tubercular diseases, and from the wasting and convulsive diseases of infants, all for the most part preventible, gave a death-rate of 7.8 per 1,000, or more than onethird of the total death-rate. The low death-rate of St. Pancras has been shared by the Metropolis generally, the death-rate in which in 1874 was, as has been already said, 22.5, whilst the death-rate of the North districts, in which St. Pancras is situate, was 21.8, or exactly the same as in this parish. The lust three years show indeed a marked reduction in the mortality of London. SMALL POX. This disease has been almost non-existant. Only three deaths were recorded from it. MEASLES have been prevalent, though not in a virulent form; they caused 64 deaths. SCARLET FEVER has prevailed, to a greater extent, among the upper than among the lower classes. 95 deaths were registered from this disease, a greater number than has been recorded since the year 1871. HOOPING COUGH. There have been many ca9es of this Zymotio disease, which caused 121 deaths. TYPHUS AND TYPHOID FEVER caused only 67 deaths, about half the average number; a smaller mortality from these diseases than has been known for at least eleven years. DIARRHŒA resulted in 222 deaths, or rather fewer than the average. MORTALITY TABLES. I present these in an amended form, having adopted those recommended after much consideration by the Society of Medical Officers of Health. THE STATE OF THE REGENT'S CANAL has caused a good deal of acrimonious discussion. I have not, however, felt that I could advise you to take any action against the canal company in the matter. 3 SLAUGHTER-HOUSES. Owing to reccnt alterations in the law the number of these has been reduced from 82 to 65. The new regulations of the Metropolitan Board of Works Bill will doubtless necessitate the abolition of others. COW SHEDS. These have on the whole undergone much improvement, and will compare very favourably with those of other parishes in London. VACCINATION. The appended table kindly furnished by the Vaccination Officer gives very interesting details of Vaccination. Only 52 registered births out of 7,914 remain unaccounted for. It is usual to see at the Vaccination Stations arms exhibiting five good vesicles. GAS SUPPLY. The average illuminating power of the Gas supplied by the Imperial Company, at 10, Edward Street, was 14 Standard Sperm Candles, when tested according to the requirements of the Metropolis Gas Act, 1860. The maximum illuminating power was 16.1, and the minimum 12.9 candles. The Gas was at all times free from sulphuretted hydrogen. The average amount of sulphur was 21.3 grains per 100 cubic feet Ammonia (traces only) was invariably present. I have the honor to be, Gentlemen, Your obedient Servant, THOS. STEVENSON, M.D., Medical Officer of Health and Examiner of Gas. Sanitary Department, Vestry Hall, Pancras Road, n.w. June 5th, 1875. 4 Table I. St. PANCRAS SANITARY DISTRICT. Table showing tho Population, Inhabited Houses, Births, and Deaths, for the years 1873-74. Gross Numbers. Population estimated at the middle of the Year* No. of Inhabited Houses in Parish or District, (approximate) Births. Deaths.** 1874 229,000 24,920 8,010 4,982 1873 227,000 24,700 8,095 5,392 Notes. 1. Population at Census 1871, 221,465. 2. Area in acres, 2,672. 3. Ayerage No. of Persons in each house at Census 1871, 9.2. *For statistical purposes the Registrar-General estimates the population to the middlo of the year on the basis of the rate of increase ruling between the two preceding Census periods. The estimate of population may be checked by the known number of inhabited houses, and by the average number of inmates per house, as ascertained at the preceding Census. **The deaths of non-parishioners in public institutions within the parish is deducted, but a proportion of the deaths occuring in General Hospitals, relative to the population of the parish or district, is added to the total number of deaths in this column. 5 Table II. ST. PANCRAS SANITARY DISTRICT. Table showing the Annual Birth-Rato, Rate of Mortality, Death Rates among Children, and Deaths in Public Institutions, for the Year 1874 and 10 Years preceding. Birth Rate per 1000 of the Population. Annual Rate of Mortality, per 1000 living. Deaths of Children under 1 year: per centnge of total Deaths. Percent- age of Deaths of Children under 1 year to Registered Births. Deaths of Childron under 6 years: percentage of total Deaths. To tal Num ber of Deaths in Public Institutions 1874 35.0 21.75 24.4 15.5 37.4 1,013 1873 35.1 22.32 1872 35.1 21.28 1871 33.8 25.19 1870 34.6 24.15 1869 33.7 22.81 1868 35.2 22.50 1867 34.1 24.25 1866 33.4 24.45 1865 24.80 1864 26.03 Average of 10 years 1864 to 1873 23.78 6 Table IV. S T. PANCRAS SANITARY DISTRICT. Table showing the Mortality from certain classes of Diseases, and proportions to Population, and to 1,000 Deaths in 1874. Total Deaths. Deaths per 1000 of Population. Proportion of Deaths to 1000 Deaths. 1. Seven Principal Zymotic Diseases 584 2.0 145 2 P ulmonary Diseases (other than Phthisis) 920 4.0 229 3. Tubercular Diseases 615 2.3 128 4. Wasting Diseases of Infants 406 1.8 101 8. Convulsive Diseases of Infants 247 1.1 60 Notes. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever, and Diarrhœa, 3. Includes Phthisis, Scrofula, Rickets, and Tahes. 4. Includes Marasmus, Atrophy, Debility, want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. Table V. ST. PANCRAS SANITARY DISTRICT. Table showing the Number of Deaths from the seven principal Zymotic Diseases, in the 10 Years 1864 to 1873, and in the Year 1874. Disease. 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 Annual Average of 10 years, 1864-73. 1874 Proportion of Deaths to 1000 Deaths in 1874.. Small Pox 14 26 43 65 12 1 21 448 58 2 69 3 0.8 Measles 144 108 101 83 102 68 87 105 105 221 112 64 15.3 Scarlet Fever 230 133 121 101 237 239 477 95 70 17 172 95 22.8 Diphtheria 59 35 31 44 50 20 35 37 16 38 37 35 8.4 Whooping Cough 163 225 211 166 128 221 99 158 259 215 184 121 29.0 Fever 171 162 170 118 122 126 158 112 78 78 130 67 19.7 Diarrhœa 174 282 215 211 286 219 227 236 235 253 234 222 53.2 Total 955 971 892 788 937 894 1104 1191 821 824 938 622 149.2 London •• •• •• •• •• •• •• •• •• •• •• 11352 148.0 8 Table VI. St. PVNCRAS SANITARY DISTRICT. Inspector's Report of the Sanitary Work, &c., completed in the year ending December, 1874. Sanitary Authorities or Sub Disteicts. Total. No. of Complaints received during year 1113 No. of Houses, Premises, &c., inspected 1250 Results of Inspection. Orders issued for Sanitary Amendments of Houses and Premises 695 Houses and Premises, &c., Cleansed, Repaired, and Whitewashed 334 Houses Disinfected after Infectious Diseases 100 House Drains. Repaired, Cleansed, &c. 121 Cesspools abolished 16 Trapped or Ventilated 161 Privies and Water Closets. Repaired, Cleansed, &c. 221 Supplied with Water 164 New provided 5 Dust Bins. New provided 24 Repaired, Covered, &c. 54 Water Supply. Cisterns (new) erected 8 Cisterns Cleansed, Repaired, and Covered 72 Miscellaneous. No. of Lodging Houses registered under 35th Clause of Sanitary Aot, 1866 None Removal of accumulation of Dung, Stagnant Water, and other Refuse 25 Removal of Animals improperly kept 22 Bakehouses Regularly inspected 190 Licensed Cowhouses 73 Licensed Slaughterhouses 65 Legal Proceedings 20 Overcrowding abated 28 Smoke Nuisances abated 7 TABLE VII. RETURN respecting the Vaccination of Children whose births were reported in the Parish of St. Pancras, from 1st January to 30th June, 1874, inclusive. Registration Sub-Districts comprised in the Vaccination Officer's District. Number of Births registered in the liirth List Sheets as registered from 1st January to 30th June, 1873. Number of these Births duly entered by 31st January, 1874, in the Vaccination Register (Birth List Sheets), viz.: Number of these Births, which on the 31st January, 1874, remained unentered on the Vaccination Register on Account of Number of these Births remaining on 31st January, 1873, neither duly entered in tho Vaccination Register, nor temporarily accounted for in the Report Book Successfully Vaccinated Insusceptible of Vaccination Had Small Pox Bead Unvaeeinated Postponement by Medical Certificate Removal to Districts, the Vaccination Offieor of which has been duly apprised Removal to Places unknown, or which cannot be reached; and Cases not having been found Regent's Park 1201 1020 4 ... 90 25 8 49 4 Tottenham Court Road 848 661 2 ... 90 14 11 61 9 Gray's Inn Road 983 787 2 ... 86 15 13 71 9 Somers Town 1319 1061 7 ... 128 22 4 87 10 Camden Town 851 700 1 ... 64 6 4 09 7 Kentish Town 2712 2260 10 ... 214 41 13 161 13 Total 7914 6483 26 ... 672 123 54 498 62 Dated February 5th, 1875. Signed, W. T. Jones, Vaccination Officer. Table III.—Deaths Registered at several groups of Ages from different causes during the Year 1874. ages. Note.—The Deaths in Public Institutions of non-residents are excluded. CAUSE OF DEATH. 0 to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 to 95 95 and upwards Total under 5 years Total CAUSE OF DEATH. AGES. Order 2.—Organs of Circulation. 0 to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 to 95 95 and upwards Total under 5 years Total 1 Pericarditis ... 1 ... 1 ... 1 1 ... ... ... ... ... ... 1 4 2 Aneurism ... ... ... ... ... ... 4 2 4 3 ... ... ... ... 13 3 Heart Disease, &c. 2 3 3 8 10 27 36 37 49 33 20 ... ... 8 228 CLASSES. Order 3—Respiratory Organs. 1 Laryngitis 4 2 6 ... ... ... ... ... ... ... ... ... 12 12 2 Bronchitis 158 54 16 4 9 14 39 44 92 77 45 7 228 559 3 Pleurisy ... 1 ... 1 ... 4 4 ... 2 2 1 14 I. Zymotic Diseases 275 105 149 70 49 23 31 28 21 20 15 5 — 529 791 4 Pneumonia 51 31 24 8 7 15 20 17 15 16 ... 106 209 II. Constitutional Diseases 79 46 33 24 69 118 120 85 73 22 8 1 - 158 678 5 ... 2 20 Ill Local Diseases 382 120 100 56 55 103 172 187 289 227 120 10 — 602 1827 5 Asthma 2 ... ... ... ... ... ... 4 8 5 1 ... ... 48 106 IV. Developmental Diseases 355 36 5 2 3 12 3 1 6 37 62 41 2 390 565 6 Lung Disease, &c. 38 6 4 6 3 11 6 10 14 3 3 2 ... v.Violent Deaths 54 2 3 8 11 5 14 10 9 10 1 2 — 59 129 Order 4.—Digestive Organs. Not specified or ill defined 8 2 — 1 — — 5 2 5 1 2 — — 10 26 Totals 1153 311 290 101 187 261 345 313 403 317 208 08 2 1754 4016 1 Gastritis 1 ... 1 ... 1 1 1 ... ... 1 ... 1 ... 2 7 2 Enteritis 8 ... 3 ... ... ... ... 1 1 ... ... ... ... 11 13 3 Peritonitis 1 ... ... 2 8 5 2 1 ... 1 1 1 ... 1 22 Class I.—Zymotic Diseases. Order 1.—Miasmatic. 4 Ascites ... ... 1 ... ... 1 ... 1 1 2 ... ... ... 1 6 5 Ulceration of Intestines ... ... ... ... ... 1 1 2 1 1 ... ... ... ... 6 6 Hernia ... ... ... ... ... ... 1 1 1 1 ... ... ... ... 4 1 Smallpox 1 ... ... ... 1 1 ... ... ... ... ... ... ... 1 3 7 Ileus ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Measles 13 16 27 6 2 ... ... ... ... ... ... ... ... 56 64 8 Intussusception ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 3 Scarlet Fever (Scarlatina) 12 13 48 27 1 1 ... ... ... ... ... ... ... 73 102 9 Stricture of Intestines ... ... ... ... ... ... 1 1 1 1 2 ... ... ... 6 4 Diphtheria 2 7 15 7 3 1 ... ... ... ... ... ... ... 24 35 10 Fistula ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 5 Quinsy 1 ... 2 1 ... ... ... 1 1 ... ... ... ... 3 6 11 Stomach Disease, &c. ... ... ... ... ... ... 3 ... 1 ... ... ... ... ... 4 6 Croup 1 6 14 5 ... ... ... ... ... ... ... ... ... 21 26 12 Pancreas Disease, &c. ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... 7 Whooping Cough 40 45 30 10 ... ... ... ... ... ... ... ... ... 115 125 13 Hepatitis ... ... ... ... ... 1 2 4 4 1 ... ... ... ... 12 8 Typhus Fever 1 ... 1 2 4 ... 1 1 2 ... ... ... ... 2 12 14 Jaundice ... 1 ... ... ... ... ... 1 2 ... 3 ... ... 1 7 Enteric or Typhoid F. ... ... 3 7 10 ... 3 2 2 1 ... ... ...... 3 27 15 Liver Disease, &c. ... ... ... ... ... 8 9 8 15 7 1 ... ... ... 48 Simple Continued F. 1 1 4 2 2 1 ... 1 1 1 ... ... ... 6 14 16 Spleen Diseaso, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 Erysipelas 7 2 ... ... 1 2 2 5 6 1 3 3 ... 9 32 Order 5.—Urinary Organs. 10 Puerperal Fover (Metria) ... ... ... ... 6 7 5 1 ... ... ... ... ... ... 18 11 Carbuncle ... ... ... ... ... ... 2 1 2 1 ... ... ... ... 6 1 Nephritis ... ... 3 2 ... ... 1 2 1 1 ... ... ... 3 10 12 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... 2 Ischuria ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 13 Dysentery 1 .. 1 ... 1 1 ... ... ... 1 ... ... ... 2 5 3 Bright's Disease (Nephria) ... ... 3 ... 1 1 6 5 6 3 l ... ... 3 26 14 Diarrhoea 159 14 2 ... 1 ... 2 2 4 7 10 1 ... 175 202 4 Diabetes ... ... ... ... 3 ... ... 2 1 ... 1 ... ... ... 7 15 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Calculus (Stone) ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 2 16 Ague ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 2 6 Cystitis ... ... 1 ... ... ... ... 1 ... 2 2 ... ... 1 6 17 Remittent Fever 1 ... 1 ... 2 ... ... ... ... ... 1 ... ... 2 5 7 Kidney Disease, &c ... 1 ... 1 2 1 1 7 4 2 1 ... ... 1 20 18 Rheumatism 1 ... ... 2 9 6 10 10 ... 5 1 1 ... 1 45 Order 6.—Organs of Generation. 19 Other Zymotic Diseases 1 ... ... ... 3 1 1 ... ... ... ... ... ... 1 6 Order 2.—EnUietic. 1 Ovarian Dropsy ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 2 Uterus Disease, &c. ... ... ... ... ... ... 1 ... 2 1 ... ... ... ... 4 1 Syphilis 20 ... ... ... ... 1 1 ... ... ... ... ... ... 20 22 ... 2 Stricture of Urethra ... ... ... ... ... 1 ... ... 1 1 ... ... ... ... 3 Order 7.—Organs of Locomotion. 3 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Synovitis (Arthritis) ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 2 4 Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Joint Disease, &c. ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Order 3.—Dielic. Order 8.—Inteaumentary System. 1 Privation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Phlegmon ... ... ... 1 2 ... ... ... ... 1 ... ... ... ... 4 2 Want of Breast Milk 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 2 Ulcer 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 3 Purpura and Scurvy 1 ... 1 1 3 ... ... 1 ... 1 ... ... ... 1 8 3 Skin Disease, &c. 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 4 Alchoholism (a Del. Tremens) ... ... ... ... ... ... ... 1 1 ... ... ... ... ... 2 Class IV.—Developmental Diseases. Order 1.—Diseases of Children. ,, (b Intemperance) ... ... ... ... ... ... 4 2 1 ... ... ... ... ... 7 Order 4.—Parasitic. 1 Premature Birth 92 ... ... ... ... ... ... ... ... ... ... ... ... 92 92 1 Thrush 10 1 ... .. .. .. .. .. • • • • •• •• •• 11 11 2 Cyanosis 8 1 ... ... ... ... ... ... ... ... ... ... ... 9 9 2 Worms, &c. ... ... .... ... ... ... ... ... ... ... ... ... ... ... ... 3 Spina Bifida 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 Class II.—Constitutional Diseases. Order 1.—Diathetic 4 Other Malformations 9 ... ... ... ... ... ... ... ... ... ... ... ... 9 9 5 Teething 30 27 3 ... ... ... ... ... ... ... ... ... ... 60 60 Orgder2.—Adults 1 Gont .. .. .. .. .. .. 1 1 3 2 .. .. •• .. 7 1 Paramenia ... ... ... ... ... ... ... ... ... 2 Dropsy .. 1 .. .. .. .. 2 2 4 2 1 1 ... 1 13 2 Childbirth (see Puerperal Fever) ... ... ... ... 2 10 1 1 ... ... ... ... ... ... 14 3 Cancer .. .. .. .. .. 3 7 20 35 14 5 .. .. .. 84 ... ... ... ... ... ... 4 Cancrum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 3.—Old People 5 Mortification .. .. .. .. .. .. .. .. 2 .. 1 .. .. .. 3 1 Old Age ... ... ... ... ... ... ... ... 5 33 60 41 2 ... 141 Order 2.—Tubercular. Order 4.—Nutrition. 1 Scrofula 1 1 17 3 1 .. .. .. 1 .. 1 .. .. .. 5 8 1 Atrophy and Debility 214 8 2 2 1 2 2 ... 1 4 2 ... ... 224 238 2 Tabes Mesenterica 46 6 3 2 .. .. .. .. .. .. .. .. 69 74 3 Phthisis 14 8 9 16 67 115 110 61 29 3 1 ... .. 31 433 Class V.—Violent Deaths. Order 1.—Accident or Negligence. 4 Hydrocephalus 18 19 15 4 .. .. ... .. .. .. .. .. .. 51 56* Class III.—Local Diseases. Order 1.—Nervous System. 1 Fractures and Contusions 1 1 2 5 6 2 5 6 3 8 ... 2 ... 4 41 2 Wounds Gunshot ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 Cephalitis 2 .. 3 2 ... 1 1 ... 1 .. .. .. ... 5 10 3 Burns and Scalds 2 ... ... ... ... ... ... 1 ... ... ... ... ... 2 3 2 Apoplexy 1 .. 4 1 1 1 9 16 26 17 13 2 ... 5 91 4 Poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Paralysis ... ... ... 1 1 1 8 1 19 35 15 3 ... ... 84 5 Drowning ... 1 1 2 ... ... 2 ... ... ... ... ... ... 2 6 4 Insanity ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 2 6 Suffocation 41 ... ... ... ... ... ... ... ... ... ... ... ... 41 41 5 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Otherwise 1 ... ... ... ... ... 1 ... ... ... ... ... ... 1 2 6 Epilepsy 1 ... ... 1 2 2 1 3 1 ... 1 ... ... 1 12 Order 3.—Homicide 9 ... ... ... 1 ... ... ... 1 ... ... ... ... 9 11 7 Convulsions 87 12 15 2 ... 1 2 ... 2 ... ... ... ... 114 121 Order 4.—Suicide ... ... ... 1 4 3 5 3 5 2 1 ... ... ... 24 8 Brain Disease, &c. 23 8 13 15 3 2 9 15 14 10 5 ... ... 44 117 Causes not specified or ill defined 8 2 ... 1 ... ... 5 2 5 1 2 ... ... 10 26