STPAN 34 St. Pancras, Middlesex. TWENTY-SECOND ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, Being the Report for the Year 1877. TO THE VESTRYMEN OF ST. PANCRAS. Gentlemen, During the year 1877 (52 weeks), 8,126 births were registered in St. Pancras, and 5,101 deaths. After making the proper allowances for the deaths of non-parishioners in public institutions situated in this Parish, and for deaths of parishioners in hospitals outside St. Pancras, the corrected number of deaths is 4,927. I estimate the population in the middle of the year 1877 as 236,000. This calculation is based on the assumption that the increase of the decade 18G1-71, has been maintained since 1871. Probably, however, that rate of increase has not been sustained, and the above estimate of population is doubtless rather too high. The births in 1877 were fewer by 191 than in 1876. The deaths were also fewer by 92 than in the year 1876. The annual rate of mortality in 1877 was 20.88 per 1000 persons living; and that of the preceding ten years, 1867— 1876, was 22.92. The death-rate of 1877 was hence 2.04 per 1000 below the average of the preceding 10 years; and was 0.62 per 1000 below that of 1876. The accompanying tables, drawn up in the manner recommended by the Society of Medical Officers of Health, show clearly the mode in which the mortality from various diseases, and classes of disease, has affected the population of St. Pancras, and affords useful information respecting the distribution of disease in St. Pancras and in the Metropolis generally. 2 I regret the late period at which this Report is presented. It was not till within two days of my ceasing to be your Medical Officer of Health that the Registrar General's Annual Summary of Births, Death, and Causes of Death in London appeared, and I was enabled to draw up this Report. SMALL POX. The following table exhibits the number of cases of Small Pox reported month by month in St. Pancras:— January 81 February 85 March 90 April 54 May 87 June 54 July 27 August 11 September 11 October 12 November 5 December 9 The great falling off in the number of new cases in the autumn months led to the closing of the Vestry's Temporary Hospital, there being at that time adequate accommodation procurable at the Highgate Small Pox Hospital on payment of a fee. Small Pox caused 2,516 deaths in the Metropolis, 129 of which are credited to St. Pancras. The usual vaccination table and other tables appended. I have the honour to be, Gentlemen, Your obedient Servant THOMAS STEVENSON, Medical Officer of Health. Sanitary Department, Vestry Hall, Pancras Road, n.w. July 18 th, 1878. 3 Table I. St. PANCRAS SANITARY DISTRICT. Table showing the Population, Inhabited Houses, Births, Deaths, and Marriages, for the year 1877 and 3 Years preceding. Gross Numbers. Population estimated at the middle of the Year * No. of Inhabited Houses in Parish or District. (Estimated) Births. Deaths.** 1877 25,580 8,126 4,927 236,000 1876 25,360 8,317 5,019 234,000 1875 25,140 8,000 5,401 231,000 1874 24,920 8,010 4,982 229,000 1873 24,700 8,095 5,392 227,000 Average of 4 Years 1873-1876 25,140 8,141 5,199 Notes. 1. Population at Census 1871, 221,465. 2. Area in acres, 2,672. 3. Average No. of Persons in each house at Census 1871, 9.2. For statistical purposes the Registrar-General estimates the population to the middle of the year on the basis of the rate of increase ruling between the two preceding Census periods. The estimate of population may be checked by the known number of inhabited houses, and by the average number of inmates per house, as ascertained at the preceding Census. The deaths of non-parishioners in public institutions within the parish are deducted, but a proportion of the deaths occurring in General Hospitals, relative to the population of the parish is added to the total number of deaths in this column. 4 Table II. St. PANCRAS SANITARY DISTRICT. Table showing the Annual BirthRate, Rate of Mortality, Death Rates among Children, and Deaths in Public Institutions, for the Year 1877 and 10 Years preceding. Birth Rate per 1000 of the Population. Annual Rate of Mortality, per 1000 living. Deaths of Children under 1 year: percentage of total Deaths. Per cent age of Deaths of Children under 1 year to Registered Births. Deaths of Children under 5 years: per centage of total Deaths. Total Number of Deaths in Public Institutions 1877 34.4 20.88 23.0 14.5 433 1,159 1876 35.7 21.54 24.8 15.5 370 1,119 1875 34.5 23.38 23.4 15.8 397 1,091 1874. 35.0 21.75 24.4 15.5 374 1,013 1873 . 35.1 22.32 1872 35.1 21.28 1871. 33.8 25.19 1800. 34.6 24.14 1869. 33.7 22.81 1868. 35.2 22.50 1867. 34.1 2.25 Average of 10 yea rs 1867 to 1870. 34.7 22.92 SAINT PANCRAS SANITARY DISTRICT. Deaths Registered at several groups of Ages from different causes during the Year 1877. Note.—The Deaths in Public Institutions except the Workhouse are excluded. CAUSE OF DEATH. AGES. 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 CLASSES I Zymotic Diseases 238 130 139 54 37 32 30 24 20 14 5 — — 307 723 II. Constitutional Diseases 183 57 34 30 65 145 132 97 6O 32 8 2 — 264 835 III. Local Diseases 458 192 145 65 65 101 149 226 291 357 128 26 1 795 2204 IV. Developmental Diseases 273 43 10 5 2 15 4 4 8 77 148 43 1 326 633 V. Violent Deaths 44 4 4 5 5 4 6 9 13 5 2 — — 52 101 Not specified or ill defined 3 0 0 0 0 0 — — 1 — — — — 3 4 Totals 1169 426 352 159 174 297 321 360 393 485 291 71 2 1947 4500 Class I.—Zymotic Diseases. Order 1.—Miasmatic. 1 Smallpox 7 2 8 2 16 7 5 3 6 2 1 ... ... 17 59 2 Measles 21 42 44 5 ... ... ... ... ... ... ... ... ... 107 112 3 Scarlet Fever (Scarlatina) 5 15 34 21 ... 5 1 ... ... ... ... ... ... 54 81 4 Diphtheria 2 ... 8 6 1 ... 1 ... ... ... ... ... ... 10 18 5 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Croup 5 9 10 5 ... ... ... ... ... ... ... ... ... 24 29 7 Whooping Cough 42 37 24 2 ... ... ... ... ... ... ... ... ... 103 105 Typhus Fever ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 8 Enteric or Typhoid F. ... 1 7 8 7 5 5 3 l 1 ... ... ... 8 38 Simple Continued F. 1 1 1 2 ... 1 ... ... 1 l ... ... 2 8 9 Erysipelas 14 ... ... ... 1 ... 2 2 4 4 ... ... ... 14 27 10 Puerperal Fever (Metria) ... ... ... ... ... 4 1 ... ... ... ... ... ... ... 5 11 Carbuncle ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 12 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Dysentery 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 14 Diarrhœa 98 13 1 2 2 ... 2 1 1 2 2 ... ... 112 124 15 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 Ague ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... 17 Remittent Fever ... l l ... ... ... ... ... ... ... ... ... ... 2 2 18 Rheumatism 1 ... ... 1 7 2 3 6 3 2 1 ... ... 1 26 19 Other Zymotic Diseases 1 ... ... 1 ... ... 1 ... ... ... ... ... ... 1 3 Order 2.—Entlietic. 1 Syphilis 23 8 ... ... ... 3 1 ... ... ... .. ... ... 31 35 2 Stricturo of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Hydrophobia ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 4 Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 3.—Dietic. 1 Privation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Want of Breast Milk 7 1 ... ... ... ... ... ... ... ... ... ... ... 8 8 3 Purpura and Scurvy ... ... l ... l ... ... ... ... ... ... ... ... 1 2 4 Alchoholism (a Del. Tremens) ... ... ... ... ... l l 2 ... ... ... ... ... ... 4 ,, (b Intemperance) ... ... ... ... ... 5 4 7 3 ... .. ... ... ... 19 Order 4.—Parasitic. 1 Thrush 11 ... ... .. .. .. .. .. .. 1 .. .. ... 11 12 2 Worms, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Class II.—Constitutional Diseases. Order 1.—Diathetic 1 Gout .. .. .. ... .. 1 1 4 ... 3 .. .. ... .. 9 '2 Dropsy ... .. 1 ... .. ... .. 3 1 3 1 • • ... 1 9 3 Cancer 1 2 ... .. ... l 10 16 17 14 6 2 ... 3 69 4 Cancrum Oris (Noma) 1 ... l ... ... ... ... ... ... ... ... ... ... 2 2 5 Mortification .. .. •• •• •• • • •• .. ... .. ... •• ... •• ... Order 2.—Tubercular. 1 Scrofula 62 15 5 1 2 ... ... 1 ... 1 ... .. ... 82 87 2 Tabes Mesenterica 48 16 16 1 ... ... .. .. .. .. .. .. ... 80 81 3 Phthisis 10 10 10 15 63 141 120 72 42 11 1 ... ... 30 495 4 Hydrocephalus 31 14 21 13 ... 2 1 1 . ... .. .. ... 66 83 Class III.—Local Diseases. Order 1.—Nervous System. i Cephalitis ... .. ... ... .. ... • •• ... ... .. .. .. ... ... ... 2 Apoplexy 2 .. ... ... 2 2 6 12 22 30 8 5 ... 2 89 3 Paralysis 2 ... ... ... 2 1 .. 9 10 27 9 ... .. 2 60 4 Insanity ... ... ... ... ... .. ... ... ... 2 1 ... ... ... 3 5 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Epilepsy 1 ... 1 3 l 4 ... 2 4 2 2 ... ... 2 20 7 Convulsions 108 35 11 3 1 ... 2 2 4 1 ... ... ... 154 167 8 Brain Disease, &c 22 17 24 9 9 11 12 11 8 27 6 1 ... 63 167 CAUSE OF DEATH. AGES. 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 Local Diseases continued. Order 2.—Organs of Circulation. - 1 Pericarditis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Aneurism ... ... ... ... ... 2 l 1 l 2 1 ... ... ... 8 3 Heart Disease, &c 5 2 2 11 12 21 32 35 44 571 18 2 ... 9 241 Order 3—Respiratory Organs. 1 Laryngitis 6 3 4 1 ... ... 3 1 ... 1 ... ... ... 13 19 2 Bronchitis 179 78 54 5 5 10 21 48 88 111 53 14 1 311 667 3 Pleurisy ... ... ... ... ... 2 1 1 ... 3 ... ... ... ... 7 4 Pneumonia 59 35 17 9 11 14 16 12 16 16 3 ... ... 111 208 5 Asthma ... ... ... ... ... ... 1 1 4 12 ... ... ... 0 18 6 Lung Disease, &c. 28 19 24 8 3 7 14 10 10 15 6 2 ... 71 146 Order 4.—Digestive Organs. 1 Gastritis 1 ... ... ... 2 ... 1 2 ... 1 ... ... ... 1 7 2 Enteritis 10 ... 2 1 1 ... 2 2 1 ... ... ... ... 12 19 3 Peritonitis 3 ... .. 1 2 3 2 3 4 2 2 1 ... 3 23 4 Ascites ... ... 1 ... ... 1 ... 6 ... ... ... .. ... 1 8 5 Ulceration of Intestines l ... ... ... 1 2 ... ... ... 1 ... ... ... 1 5 6 Hernia 2 ... ... ... ... 1 ... 2 4 5 ... ... ... 2 14 7 Ileus ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... 8 Intussusception l ... 1 ... ... ... ... ... ... ... ... ... ... 2 2 9 Stricture of Intestines 2 ... .. 2 1 ... l ... 1 l ... ... ... 2 8 10 Fistula ... ... ... ... ... ......... ... ... ... ... ... ... ... ... ... 11 Stomach Disease, &c. 10 l 3 2 3 2 ... 10 4 2 ... ... ... 14 37 12 Pancreas Disease, &c. ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... 13 Hepatitis l ... ... ... ... ... 2 1 1 2 2 1 9 14 Jaundice 7 ... ... ... l ... ... 2 4 2 1 ... ... 7 17 15 Liver Disease, &c. 6 ... ... 1 2 5 15 18 22 14 4 1 6 88 16 Spleen Disease, &c. ... ... ... ... ... ... ... 1 •• 1 ... ... ... ... 2 Order 5.—Urinary Organs. 1 Nephritis ... ... ... 1 ... 3 ... 1 ... ... 1 ... ... ... 6 2 Ischuria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Bright's Disease (Nephria) ... ... l 1 5 2 3 6 8 4 2 ... ... 1 32 4 Diabetes ... ... ... ... ... 2 ... 3 2 3 1 ... ... ... 11 5 Calculus (Stone) ... ... ... ... .... ... ... ... 1 ... ... ... ... ... 1 6 Cystitis ... ... ... .. ... ... ... ... 1 l 3 ... ... ... 5 7 Kidney Disease, &c. 1 ... ... 3 ... 1 2 3 6 6 3 ... ... 1 25 Order 6.—Organs of Generation. 1 Ovarian Dropsy ... ... .. ... ... ... ... ... 1 ... ... ... ... ... 1 2 Uterus Disease, &c. ... ... ... ... ... 3 10 15 9 3 ... ... ... ... 40 Order 7.—Organs of Locomotion. 1 Synovitis (Arthritis) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Joint Disease, &c. ... ... ... 4 1 2 l 4 l l 2 ... ... ... 16 Order 8.—Integumentary System. 1 Phlegmon ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Ulcer ... ... ... ... ... ... ... 2 ... ... ... ... ... ... 2 3 Skin Disease, &c. l 2 ... ... ... ... l ... ... 2 ... ... ... 3 6 Class IV.—Developmental Diseases. Order 1.—Diseases of Children. 1 Premature Birth 97 ... ... ... ... ... ... ... ... ... ... ... ... 97 97 2 Cyanosis 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 3 Spina Bifida 3 ... l ... ... ... ... ... ... ... ... ... ... 4 4 4 Other Malformations 8 ... ... ... ... ... ... ... ... ... ... ... ... 8 8 5 Teething 38 36 3 1 ... ... ... ... ... ... ... ... ... 77 78 Order 2.—Adults. 1 Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...2 Childbirth (see Puerperal Fever) ... ... ... ... 2 8 2 1 ... ... ... ... ... ... 13 Order 3.—Old People. 1 Old Age ... ... ... ... ... ... ... ... 8 77 148 43 1 ... 277 1 Order 4.—Nutrition. Atrophy and Debility 126 7 6 4 1 6 2 3 ... ... ... ... ... 139 155 1 Class 4.—Violent Deaths. Order 1.—Accident or Negligence. Fractures and Contusions 1 ... ... 1 2 1 V 2 1 6 2 1 ... ... 1 17 2 Wounds Gunshot ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 3 Burns and Scalds 1 ... 2 ... ... ... ... ... ... 1 ... ... ... 3 4 4 Poison ... ... 1 1 l ... ... 2 1 ... l ... ... 1 7 5 Drowning ... 1 1 2 ... l 1 .... 2 ... ... ... ... 2 8 6 Suffocation 22 1 ... ... ... ... ... 1 2 ... ... ... ... 23 26 7 Otherwise 6 1 ... 1 ... 1 ... 1 ... l ... ... ... 8 12 Order 3.—Homicide 13 ... ... ... ... ... ... ... ... ... ... ... ... 13 13 Order 4.— Suicide ... 2 l 3 4 2 1 ... ... ... ... 13 Causes not specified or ill defined 3 ... ... ... ... ... ... ... 1 ... ... ... ... 3 4 9 Table IV. St. PANCRAS SANITARY DISTRICT. Table shewing the Mortality from certain olasses of Diseases, and proportions to Population, and to 1,000 Deaths in 1877. Total Deaths. Deaths per 1000 of Population. Proportion of Deaths to 1000 Deaths. 1. Seven Principal Zymotic Diseases 755 3.20 148.0 2 Pulmonary Diseases (other than Phthisis) 1065 4.95 266.7 3. Tubercular Diseases. 663 3.09 147.3 4. Wasting Diseases of Infants 260 1.21 57.8 5. Convulsive Diseases of Infants 391 1.82 86.9 Notes. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever, and Diarrhœa. 3. Includes Phthisis, Scrofula, Rickets, and Tabes. 4. Includes Marasmus, Atrophy, Debility, want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. Table ,V. St. PANCRAS SANITARY DISTRICT. Table shewing the Number of Deaths from the seven principal Zymotic Diseases, in the 10 Years 1867 to 1876, and in the Year 1877. Disease. 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 Annual Average of 10 years, 1967.70. Proportion of Deaths to 1000 Deaths in 3 years, 1874.76. 1877 Proportion of Deaths to 1000 Deaths in 1877. Small Pox 65 12 1 21 448 58 2 3 2 22 64 1.9 129 2.53 Measles 83 102 68 87 105 105 221 64 82 117 103 17.6 143 2.80 Scarlet Fever 101 237 239 477 95 70 17 95 220 137 169 30.3 89 17.1 Diphtheria 44 50 20 35 37 16 38 35 55 38 37 9.2 22 4.3 Whooping Cough 166 128 221 99 158 259 212 121 232 198 179 33.9 141 27.7 Fever 118 122 126 168 112 78 78 67 58 84 100 15.7 76 14.7 Diarrhœa 211 286 219 227 236 235 253 222 178 239 231 44.5 155 30.4 Total 788 937 894 1104 1191 821 824 607 827 835 S83 153.1 755 148.0 London 11352 13518 12380 160.8 11 Table VI. ST. PANCRAS SANITARY DISTRICT. Report of the Sanitary Work, &c., completed in the year ending December 31st, 1876. No. of Complaints received during year from the Sanitary Inspectors and the Public- 2166 No. of Houses, Premises, &c., inspected- 3000 Results of Inspection. Orders issued for Sanitary Amendments of Houses and Premises - 1900 Houses and Premises, &c., Cleansed, Repaired, and Whitewashed - 1305 Houses Disinfected after Infectious Diseases 247 House Drains. Repaired, Cleansed, &c.- 281 Trapped or Ventilated - 428 Privies and Water Closets. Repaired, Cleansed, &c.- 610 Supplied with Water- 355 New provided 3 Dust Bins New provided 48 Repaired, Covered, &c. 171 Water Supply. Cisterns (new) erected - 15 Cisterns Cleansed, Repaired, and Covered 196 Miscellaneous. Overcrowding 109 Removal of accumulations of Dung, Stagnant Water, and other Refuse 102 Removal of Animals improperly kept 17 Bakehouses Regularly inspected- 196 Licensed Cowhouses 66 Licensed Slaughterhouses 59 Other Proceedings, Legal Proceedings 10 Return for the Period—July to December, 1876. RETURN made by Mr. W. T. Jones, Vaccination Officer of the Sub-Districts of St. Pancras Parish, respecting the Vaccination of Children whose Births were Registered in his District, from 1st July, to 31st December, 1876. Registration Sub-Districts comprised in the Vaccination Officers' District. Number of Births roturned in the Birth List Sheets as Registered from 1st July, to 31st December, 1876. Number of these Births duly entered by 31st July, 1877, in Columns 10, 11, and 13 of the Vaccination Ecgister (Birth List Sheets, viz.: Number of these Births which on the 31st July, 1877, remained unentered in the Vaccination Register on Account (aa shown by Report Book.) Number of these Births remaining on 31st July, 1877, neither duly entered in the Vaccination Eegister (columns 3, 4,5 and 6 of this Return) nor temporarily accounted for in the Report Book, Cols. 8, 9, and 10 of thia Roturn. Col. 10. Col. 11. Col. 13. Postponement by Medical Certificate. Removal to Districts, the Vaccination Officer of which has been duly apprised. Removal to Places unknown, which cannot be reached, and Cases not having been found. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Dead Unvaccinated. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1 Kentish Town 1458 1271 ... ... 117 5 3 56 3 2 Regent's Park 521 534 1 ... 47 ... 1 35 3 3 Camden Town 410 374 1 ... 28 1 ... 6 ... 4 Somers Town 671 567 ... ... 59 2 3 39 1 5 Tottenham Court Road. 447 379 1 ... 30 1 3 31 2 6 Gray's Inn Road 426 348 3 ... 37 1 6 27 4 Total 4033 3476 6 ... 318 10 16 194 * 13 * These Cases have been entered in the Report Book, Certificates promised. Return for the Period—January to June, 1877. Return made by Mr. W. T. Jones, Vaccination Officer of the Six Sub-Districts of St. Pancrass Parish, respecting the Vaccination of Children whose Births were Registered in his District from 1st January, to June 30th, 1877, inclusive. Registration Sub-Districts comprised in the Vaccination Officer's District. Number of Births returned in the Birth List Sheets as registered from 1st January to 30th June, 1877. Number of these Births duly entered by Slat January, 1877, in Columns 10, 11 and 13 of the Vaccintion Register (Birth List Sheets) viz.: Number of these Births which on 31at January, 1878, remained unentered in the Vaccination Register on account (as shown by Report Boole) of Number of these Births remaining on 31st January, 1878, neither duly entered in the Vaccination Register "(Columns 3, 4,6 & 6 of this Ruturn, nor temporarily accounted for in the Report Book," (Columns 8, 9 & 10 of this Return). Col. 10. Column 11. Col. 13. Postponement by Medical Certificate. Removal to Districts, the Vaccination Officer of which has been duly apprisod. Removel to Places unknown, or which cannot bo reached; and Cases not having boon found. Successfully Vaccinated, Insusceptible of Vaccination. Had Small Pox. Dead Unvaccinated. 1. 2 3. 4. 5. 6. 7. 8 9 10. 11. 1 Kentish Town 1442 124.3 4 ... 87 13 7 82 6 2 Regent's Park 609 514 4 1 44 3 2 40 1 8 Camden Town 399 354 ... ... 24 2 1 18 ... 4 Somers Town 655 547 ... 2 53 3 4 42 4 5 Tottenham Court Read 415 319 2 ... 42 5 2 39 6 6 Gray's Inn Road 474 388 2 ... 27 3 2 48 4 Total 3994 3365 12 3 277 29 13 269 • 21 *These cases have been duly entered is the Report Book, certificate produced. J