STPAN 36 St. Pancras, Middlesex. TWENTY-FOURTH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, Being the Report for the Year 1879. TO THE VESTRYMEN OF ST. PANCRAS. Gentlemen, A Statistical Report on the Health of St. Pancras must of necessity depend for accuracy upon an exact knowledge of the population of the district, but unfortunately this report refers to a period eight years after the Census was taken, and during this period many and important changes have taken place in the parish, the full effect of which, on the population, it is impossible with certainty to estimate. The growth of houses in the neighbourhood of Gospel Oak, and the demolition of houses in the sub-registration district of Somers Town, are disturbing elements in any estimate of the population. It may, however, be well to see in what direction an estimate leads, and for this purpose I will take the population of St. Pancras as found at the Census of 1871. It then amounted to 221,103. In the previous decade it had increased at the rate of 1.1 per cent. each year, and if this increase had been continued till 1879, the number would have amounted to 211,712. Bearing in mind the fact that this natural increase has been somewhat reduced by the destruction of houses in Somers Town, it will be more accurate to take 240,000 as the population of St. Pancras for 1879. Mr. Firth has, for the purpose of his Municipality Bill, estimated the population of our Parish, for the year 1880, at 249,000; but 240,000 will be the figures on which the calculations of the present Report are based. The Registrar General's year of 1879 begins on December 29th, 1878, and ends on January 3rd, 1880, thus including fifty-three weeks, and I have followed the example of my predecessor in including the births and deaths in this period, for the purpose of this Report. 2 During this year 8,226 births and 5,607 deaths were registered in St. Pancras; but in order to ascertain the exact number of deaths of St. Pancras parishioners during this period, it is necessary to deduct the deaths of non-parishioners which occurred in Public Institutions, and to add the number of our parishioners who died in Public Institutions in other parts of the Metropolis; the corrected number then amounts to 5,189. The birth-rate was 34.2 per 1000 of the population. This was .4 below the rate of the preceding year, and the same amount below the rate of the ten previous years, and 2.3 below the birth-rate of the whole of London for 1879. The death-rate was 21.62 per 1000 of the population, or .09 below the death-rate of the previous year, and .88 below the death-rate of the ten preceding years, and is also 1.68 below the death-rate of the whole of London for 1879. The excess of births over deaths has been less marked than in the Metropolis as a whole, whereas in 1878 the reverse was the case; but a comparison of the average of the five years preceding 1879, shows that the excess of births over deaths is slightly more marked in the Metropolis as a whole than in Saint Pancras. MORTALITY AT DIFFERENT AGES. 1231 children under one year died in St. Pancras, in 1879 or 23.7 per cent. of the total deaths. This is 2.8 per cent less than in the preceding year, but is .6 more than the per centage of children who died in the whole of London during 1879. 2100 children under 5 years of age died in St. Pancras in 1879. This is 40.4 per cent of the total deaths, and is slightly less than the proportion which deaths of children of this period of life bear to total deaths in London, where 41.7 per cent of the total deaths were of children under five years of age. 2030 persons between the ages of 5 and 65 years died in St. Pancras in 1879, and 1068 over 65 years of age. Of the total number of deaths among children in Saint Pancras, 92 were those of illegitimate children. 3 ZYMOTIC DISEASES. SMALL POX. 19 persons died of Small Pox during 1879, among 65 persons suffering from this disease who became known to the Sanitary Department. Of the 19 who died, 14 had before their death been removed to hospitals, leaving five who died in houses in the Parish. But for the immediate removal of persons suffering from this disease to hospital, and for the steps taken to secure the vaccination of others who had resided in the same house as the sufferer, Small Pox would have undoubtedly spread to a larger number of persons than has been the case. Very few cases occurred in the early part of the year. In January the existence of one case in Wakefield Mews was reported to me, and an investigation of this case led to two others coming to my knowledge, while one death from this disease was registered during that month. A little later an occasional case or two were reported, and in the month of May this number increased; but in the following months again diminished until the end of the year. A few of the cases are of special interest. A young man who had never been vaccinated was taken ill in May with Small Pox, while living in the South of London, and was brought to bis family in this Parish to be nursed, at a time when his disease was not sufficiently developed for it to be recognised. The other members of his family consisted of a father, mother, and his six brothers and sisters, none of whom, with the exception of the father, had been vaccinated, and they were all therefore exposed to the risk of contracting Small Pox. As soon as it was known that the invalid was suffering from Small Pox, he was removed to the hospital at Highgate. At the same time his brothers and sisters were vaccinated, and his father re-vaccinated; but the mother absolutely refused to permit herself to be vaccinated, although I pointed out to her, in the strongest manner, the risk to which she was exposed. Her son, having never been vaccinated, suffered from a confluent form of Small Pox and died, and his death was followed by that of his mother shortly afterwards from the same disease, while the rest of the family escaped. Thus, in this family of nine persons, the two unvaccinated died, while the seven vaccinated escaped even from contracting Small Pox. 4 A second death also occurred from importation of Small Pox into a family residing in this parish. In this instance the first case was a girl living in the West End, and she, as in the other instance, was brought home to her family to be nursed, before her disease was recognised. As soon as it was known she was suffering from Small Pox, her three brothers and a servant were re-vaccinated, but the same precaution was not taken by her father or mother, the former of whom appears never to have been vaccinated. Of this family the four who had been re-vaccinated escaped from any illness at all; the mother, who had been vaccinated in infancy, but who had not been re-vaccinated, suffered from a mild attack of Small Pox and recovered, and the father, who had never been vaccinated, suffered from a severe attack of Small Pox and died. I have thought it desirable to dwell especially on these cases as good instances of the behaviour of Small Pox among vaccinated and unvaccinated persons, as showing the absolute protection afforded by vaccination against Small Pox. This cannot be too clearly recognised, and it is particularly deserving of attention at the present time when the outcry against the innocent operation of vaccination, is increasing, and when the Government is showing a tendency to relax the penalties attaching to disobedience of the laws for enforcing it. During the year some cases of Small Pox having occurred in a post office, I brought this fact to the knowledge of the late Postmaster General, and he was good enough to give instructions, that in future all cases of infectious diseases occurring in post offices, should be reported to the Sanitary Department. Great care has been taken by the late vaccination officer, Mr. Jones, to inquire for unvaccinated persons in the houses or neighbourhood where Small Pox was known to exist, and I am convinced that this precaution has greatly aided in preventing the occurrence of fresh cases. To Mr. Jones I am indebted for the Vaccination Tables which accompany this report. In them will be found an account of the number of infants born, the number vaccinated in St. Pancras from July to December, 1878, and from January to June, 1879. It will be seen that 6.2 per cent. of the total number of children born escaped vaccination. 5 SCARLET FEVER. Scarlet Fever or Scarlatina caused 144 deaths in St. Pancras in 1879. This is at the rate of 27.7 in each 1000 deaths from all causes, and is 3.5 above the average of the three preceding years, but is 3-9 below the proportion in every 1000 deaths caused in the whole of the Metropolis in 1879 by Scarlet Fever, as shown by the Registrar-General. But the Registrar-General's tables show as large a number of deaths from this disease in St. Pancras as 177, this difference being due to the fact that in the tables accompanying this Report only those deaths which have resulted directly from Scarlet Fever have been classed under this heading. If the Registrar-General's tables be taken for the purpose of comparing the amount of Scarlet Fever in St. Pancras with that occurring in the Metropolis as a whole, it will be found that the number of deaths in St. Pancras bears the same proportion to deaths from all causes as in the Metropolis as a whole. It must, however, then be recollected that St. Pancras contains no Fever Hospital, and that many cases from our Parish died in the Fever Hospital in Liverpool Road, as well as in those of the Metropolitan Asylums Board, and if these cases were added to our other Scarlet Fever deaths, St. Pancras would show a larger death-rate from this disease than the Metropolis as a whole; 374 cases of Scarlet Fever became known to the Sanitary Department during 1879, and iu each case disinfection of the infected room was carried out, and, when possible, the sufferer was removed to the Hospital. Many of these cases, however, were not reported until it was too late to prevent a considerable amount of loss of life ensuing. Thus, in one house in the Tottenham Court Road district, to which my attention was drawn by the Registrar, eight children were attacked with Scarlet Fever of whom five subsequently died. If the first patient had been removed to the Hospital when first taken ill, I have no doubt but that this loss of life could have been prevented, and it is instructive to notice that although at the time of my visit a large number of young children remained in the house who had not had Scarlet Fever, and who were, therefore, doubtless susceptible to it, the removal of the sick to the hospital, of the dead to the mortuary, and the disinfection of the house, prevented any further extension of the disease. I cannot characterize too strongly the conduct of persons who retain in houses inhabited by young children a single case of infectious disease. The ignorance of the poor is often 6 a cause of calamities such as I have just described, but in many cases the character of the disease is known to those who might have acted as advisers to the inhabitants of the houses, or who might have reported the existence of the first case to the Sanitary Department. Gases such as these point most strongly to the necessity of a system of registration of cases of infectious disease, at any rate in houses let out in tenements. The utter carelessness of people with regard to this dangerous disease was well exemplified by the conduct of a man who removed his child while suffering from Scarlet Fever in University College Hospital from that institution by the Metropolitan Railway to his home. The course taken by the Vestry in prosecuting the offender led to a punishment being inflicted which will be useful in deterring others from committing similar offences. DIPHTHERIA. 44 cases of Diphtheria became known to the Sanitary Department in 187!); 25 persons died from this disease in St. Pancras during that year. In this disease also the Registrar General's returns show a larger number of deaths than the tables which accompany this report. This difference has perhaps resulted from the fact that some practitioners have returned a cause of death two diseases—Diphtheria and Scarlet Fever—in the same person. I have not regarded the diphtheritic sore throat, which often accompanies Scarlet Fever, as an indication of the existence of the two diseases, but have classified these cases as Scarlet Fever in the tables which accompany this Report. 25 deaths is in the proportion of 4.8 of every 1000 deaths from all causes. The Registrar-General's returns, however, show a slightly smaller proportion of Diphtheria to deaths from all causes in St, Pancras than iu London as a whole. One localized outbreak of this disease occurred in June, 1879 in which six persons were attacked. These cases were apparently due to infection from one person suffering from this disease. The removal of the sick to hospital prevented any lurther extension of the outbreak. WHOOPING COUGH. This disease caused directly 154 deaths in St. Pancras during 1879, but if we were to include cases which died at a long period afterwards from Bronchitis, doubtless due in the first instance to Whooping Cough, the number amounts to 175. 7 154 deaths is in the proportion of 29.6 of every 1000 deaths from all causes. If we take for the purpose of comparison of the deaths in St. Pancras with those of the whole of London, the Registrar-General's classification, we find a difference of 4 in every 1000 deaths from all causes in favour of St. Pancras. FEVER. It is worthy of remark that no deaths occurred in St. Pancras from Typhus Fever during 1879, and but four of our parishioners died in the Fever Hospitals to which they had been removed, whilst suffering from this disease. 57 died from Enteric or Typhoid Fever, and 102 cases were reported to the Sanitary Department. This disease caused an equal share of every 1000 deaths in St. Pancras, as in the Metropolis as a whole. Enteric Fever might, with a proper system of drainage and drain ventilation, be almost entirely eliminated from our death returns. The more carefully this disease is studied, the more evidence is iound to exist that the poison of Enteric Fever lies in the bowel discharge of persons suffering from it, and that this discharge by poisoning the air of defective drains is a common cause of disease. A small outbreak of Enteric Fever occurred in a family living in a large model lodging-house in St. Pancras. The history of these cases is especially interesting, as showing the manner in which Enteric Fever is communicated On December 5th, 1878, the father of the family died after a brief illness, and the cause of his death was registered as Pneumonia. On January 11th, his son, who lived in another part of the Parish, and who visited the father during his illness, was attacked by Enteric Fever. On February 22nd, a daughter also developed Enteric Fever. Her mother, who was ill about the same time, died on March 10th from a disease which was registered as Pericarditis. The sick persons were visited by a married daughter and her husband, the former of whom fell ill on March 3rd of Enteric Fever, and the latter on March 8th of the same disease. Another brother who did not live in the lodging-house, but who also visited there, fell ill on March 15th of Enteric Fever. 8 The Medical man who attended the parents, and who had taken great care to investigate their illness, subsequently believed that their symptoms were not satisfactorily explained by the disease stated in the death register, and read by the light of the other cases, he had but little doubt but that they suffered from the same disease as their children. Iu all, therefore, in this family seven persons were attacked with Enteric Fever. On April 3rd, a boy who lived in another tenement, was also attacked by Enteric Fever. This boy had had no communication with the family above-mentioned, nor with their rooms or water closet, but his water closet was iu connection with the soil pipe belonging to the tenement the occupants of which were suffering from Enteric Fever. An investigation into the outbreak showed at once that no suspicion could be cast on the water or milk supply to these people, and a careful inquiry failed to show that the last case had been anywhere exposed to infection outside the lodging house. Eventually it was found that at the bottom of the soil pipe in the basement was a deep dip trap which had led to the accumulation of excrement for some time past. There can be but little doubt that this was the cause of the illness of all these people, and it is satisfactory to be able to report that the dip traps in the whole of this lodging-house have been abolished, and this disease has not been known there since. While other towns are making progress in the construction and ventilation of their drains, the Metropolis is almost standing still, and we shall have enteric fever among us so long as house-drains are wrongly constructed and unventilated. By the 76th section of the Metropolis Local Management Act it is ordered that with regard to all new houses, every draiu shall be made in such "manner, form, and of such material and workmanship" as the Vestry shall order. This is, therefore, a subject much under the control of the Vestry and deserves their consideration. MEASLES. Measles caused directly 129 deaths in St. Pancras during 1879, while a larger number died from other causes some time after an attack of this disease. According to the RegistrarGeneral's calculations, measles caused in St. Pancras 1.2 in every thousand deaths less than in the Metropolis as a whole. 9 but the total number shows a decided increase upon the number of deaths from this disease in the previous year, and the average of the previous three years. DIARRIHŒA. Diarrhoea caused directly only 118 deaths in St. Pancras in 1879. The cold weather and the heavy rainfall are responsible for this small mortality, which is about half the average number of deaths from this disease during the past ten years. HOSPITAL PROVISION for INFECTIOUS DISEASES Unfortunately the hospital provision for infectious diseases still remains in a most unsatisfactory condition. The great provision made by the Metropolitan Asylums Board is still practically reserved only for those who are willing to become paupers, in order that they may be admitted into the hospitals of this Board. The Poor Law Act of 1879 gives power to the Vestries, as the Sanitary Authorities of the Metropolis, to contract with the Metropolitan Asylums Board for the admission into the hospitals of the latter of persons who are not paupers, but the arrangement with a Poor Law Authority for this purpose has not appeared to the Metropolitan Sanitary Authorities to be desirable. The arrangement existing with the London Fever Hospital is still in force, and in 1879,35 persons were sent to that institution on the order of your medical officer. LABOURERS' AND ARTIZANS DWELLING ACT (1878) AMENDMENT ACT, 1879. This Act was passed at the end of last session, and had in view the better compensation of persons whose houses were condemned by the Sanitary Authority. By the fifth section the owner of houses thus condemned is empowered to compel the Vestry to purchase such houses within three months after an order has been made, and in the event of the Vestry not putting the Act in force, the Metropolitan Board of Works is empowered to carry out the work, and charge the Vestry with the expenses. It is obvious that an Act which would compel the Vestry to 10 chase houses thus reported on, even when repairs only are perhaps wanted to make them habitable, is not likely to be of much service in improving the condition of dwellings. SLAUGHTERHOUSES. There are fifty licensed slaughterhouses in St. Pancras, No fresh applications for licenses were made in 1879. The slaughterhouses wore found on inspection to be, as a rule, in a satisfactory condition; and but two cases of infringement of the bye-laws were brought to the knowledge of ihe Saritary Committee. COWHOUSES. There are 51 Licensed Cowhouses in the Parish, and their condition was found to be satisfactory. It will be recollected that the Contagious Diseases (Animals) Act, 1878, gives power to the Metropolitan Asylums Board to draw up regulations having reference to the precautions to be taken to prevent the contamination of milk, and for prescribing and regulating the lighting, ventilation, cleansing, drainage, and water supply of dairies and cowsheds. Many of these regulations are exceedingly beneficial; on the other hand, the Metropolitan Board have recognised 600 cubic feet as sufficient air space for each cow in a wellventilated cow shed, while they insist upon 800 in those which are not well-ventilated. But the Vestry have wisely adhered to the standard of 800 cubic feet for each cow, and have preferred to guard against defective ventilation in other ways. SANITARY WORK. A Table is appended giving details of work carried out by the Sanitary Department during the year.— Vide Table VI. DUST. The necessity for an alteration in the present method of dealing with dust has been made obvious by the breakdown in the arrangements for procuring its removal. As this subject is now receiving the careful attention of the Vestry, and has been made the subject of a special report by your Medical Officer, it is not necessary to do more than refer to it in this report. 11 HOUSE TO HOUSE INSPECTION. This most important branch of all Sanitary work, has received as much attention as the number of the Sanitary Staff will admit. One hundred and thirty-four streets have thus been visited by the Inspectors, for the purpose of the discovery and abatement of nuisances. Every care has been taken to prevent the extension of infectious diseases, by the removal of the sick to hospitals, and the disinfection of rooms and clothing. The Regent's Canal was the subject of careful inspection. It was found that some amount of pollution of the water resulted from the percolation into it of fluid from the manure heaps on the wharves. Steps were successfully taken to obtain the paving of the wharves, and the construction of the necessary drains to enable the offensive fluid to pass into the sewer. The market places in the Parish are under the constant surveillance of the Sanitary Inspectors; as a rule the food offered for sale is of fair quality, but seizures have from time to time been made during the year. The following is a summarised list of them:— Plaice 3 barrels. ,, 2 trunks. Stocken Fish 1 trunk. Skate 1 kit. Soles 1 trunk. Mackerel 1 box. Beef 70 lbs. Pork 40 lbs. Mutton 2 legs. „ 1 shoulder. „ 1 fore-quarter. „ 3 scrags. „ 60 lbs. of pieces. I have the honour to be, Gentlemen, Your obedient Servant, SHIRLEY F. MURPHY, Medical Officer of Health. 12 Table I. PARISH OF ST. PANCRAS. Table showing the Population, Inhabited Houses, Births and Deaths for the year 1879 and 6 Years preceding. gross Numbers. Population estimated at the middle of the Year * No. of Inhabited Houses. ( Estimated) Births. Deaths.** 1879 26,020 8.226 5,189 1878 238,000 25,800 8,249 5,068 1877 236,000 25,580 8,126 4,927 1876 234,000 25,360 8,317 5,019 1875 231,000 25,140 8,000 5,401 1874 229,000 24,920 8,010 4,982 1873 227,000 24,700 8,095 5,392 Average of 6 Years 1873-1878 25,250 8,132.8 5,131.5 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 the deaths of St. Pancras Parishioners occurring in General Hospitals in other parts of the Metropolis are included. 13 Table II; PARISH OF ST. PANCRAS. Table showing the Annual Birth-Rate, Rate of Mortality, Death Rates among Children, and Deaths in Public Institutions, for the Year 1879 and 10 and 5 Years preceding. Birth Rate per 1000 of the Population. Annual Rate of Mortality, per 1000 living. Deaths of Children under 1 year: per centage of total Deaths. Per age of Deaths of Children under 1 year to Registered Births. Deaths of Children under 6 years: per centage of total Deaths. Total Num ber of Deaths in Public Institutions in the Parish. 1879 34.2 21.62 23.7 14.9 40.4 1,295 1878 34.6 21.71 26.5 16.2 45.6 1,095 1877 34.4 20.88 23.0 14.5 43.3 1,159 1876 35.7 21.54 24.8 15.5 37.9 1,119 1875 34.5 23.38 23.4 15.8 39.7 1,091 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 24.14 1869 33.7 22.81 Average of 10 years 1869 to 1879. 34.6 22.5 Average of 5 years, 1874 to 1878. 24.4. 15.5. 40.8. 1,095.4. . PARISH OF SAINT PANCRAS. Deaths Registered at several groups of Ages from different causes during the Year 1879. Note.—The Deaths of Non-Parishioners in Public Institutions are excluded, and deaths of St. Pancras Parishioners in Public Institutions in other parts of the Metropolis are included. 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 231 161 178 104 44 28 31 18 12 12 8 2 — 870 829 II. Constitutional Diseases 109 49 4 3 38 61 154 146 128 88 35 14 1 — 201 866 III. Local Diseases 460 220 140 78 65 124 169 250 364 405 180 27 3 820 2485 IV. Developmental Diseases 366 54 9 I 2 13 8 8 21 103 182 61 3 429 828 V. Violent Deaths 64 6 8 8 4 12 19 16 7 10 7 2 1 78 164 Mot specified or ill defined 1 — 1 1 — 8 2 — 2 2 — — — 2 17 Totals 1231 490 379 230 176 339 375 417 494 567 391 93 7 2100 5189 Class I—Zymotic Diseases. Order 1.—Miasmatic. 1 Smallpox 2 ... ... 5 5 4 1 2 ... ... ... ... ... 2 91 2 Measles 26 50 45 8 ... ... ... ... ... ... ... ... ... 121 129 3 Scarlet Fever (Scarlatina) 7 32 43 57 4 ... 1 ... ... ... ... ... ... 82 144 4 Diphtheria 3 3 9 10 ... ... ... ... ... ... ... ... ... 15 25 5 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (i Croup 16 11 15 2 1 ... ... ... ... ... ... ... ... 42 45 7 Whooping Cough 50 50 52 2 ... ... ... ... ... ... ... ... ... 152 154 Typhus Fever ... ... ... ... ... 4 ... ... ... ... ... ... ... 0 4 8 Enteric or Typhoid F. 1 3 5 12 21 1 6 3 3 1 1 ... ... 9 57 Simple Continued F. ... ... 2 2 ... 1 ... ... ... ... ... ... ... 2 5 9 Erysipe'as 6 ... ... ... ... 1 1 2 ... ... 2 1 ... 6 13 10 Puerperal Fever (Metria) ... ... ... ... 2 7 5 ... 1 ... ... 1 ... 0 16 11 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Influenza ... ... ... ... ... ... ... ... ... 1 ... ... ... 0 1 13 Dysentery 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 11 Diarrhœa 1 11 6 2 1 1 2 2 2 5 5 ... ... 98 118 15 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Remittent Fever ... ... ... ... ... ... ... 1 ... ... ... ... ... 0 1 18 Bheumatism ... ... 1 4 5 2 6 ... 3 4 ... ... ... 1 25 19 Other Zymotic Diseases 4 ... ... ... 3 ... ... 1 2 ... ... ... ... 4 10 Order 2.—Enthetic. 1 Syphilis 24 1 ... ... ... 1 4 ... ... ... ... ... ... 25 30 2 Stricture of Urethra ... ... ... ... ... ... ... 2 ... ... ... ... ... 0 2 3 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Order 3.—luetic. 1 Privation 1 ... ... ... ... ... ... 1 ... ... ... ... ... 1 2 2 Want of Breast Milk 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 4 3 Purpura and Scurvy ... ... ... ... l ... ... ... ... ... ... ... ... 0 1 4 Alchoholism (a Del. Tremens) ... ... ... ... ... 4 2 3 ... ... ... ... ... ... 9 „ (b Intemperance) ... ... ... ... 1 2 3 1 1 ... ... ... ... ... 8 Order 4.—Parasitic. 1 Thrush 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 5 2 Worms, Ac. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Class 11.—Constitutional Diseases. Order 1.—Diathetic 1 Gout ... ... ... ... ... ... 1 4 2 2 2 ... ... 1 11 2 Dropsy ... ... ... ... ... 1 ... 2 ... 1 ... 1 ... 0 5 3 Cancer 1 ... 1 1 1 10 22 37 36 19 3 ... ... 2 137 4 Cancrum Oris (Noma) ... ... ... 1 ... ... ... 1 ... ... ... ... ... 0 2 5 Mortification ... ... ... ... ... 1 ... 1 2 2 1 ... ... 0 7 Order 2.—Tubercular. 1 Scrofula 6 2 ... 1 1 ... 1 ... ... ... ... ... ... 8 11 2 Tabes Mesenterica 43 17 9 2 ... ... 1 ... ... ... 1 ... ... 69 73 3 Phthisis 25 11 10 20 58 42 121 83 48 11 1 ... ... 46 530 4 Hydrocephalus 34 19 23 13 1 ... ... ... ... ... ... ... ... 76 90 Class III.—Local Diseases. Order 1.—Nervous System. 1 Cephalitis 14 5 7 3 1 5 3 1 1 1 ... ... ... 26 41 2 Apoplexy 1 1 ... ... ... 4 6 16 41 34 17 5 ... 2 125 3 Paralysis ... ... 1 2 2 1 4 5 12 20 7 4 1 1 19 4 Insanity ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Chorea ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 6 Epilepsy 2 2 2 3 1 5 2 1 1 1 ... ... ... 6 20 7 Convulsions 95 23 9 1 2 ... 1 ... ... ... ... ... ... 127 131 8 Train Disease, &c. 17 12 13 11 ... 5 12 17 13 15 12 l ... 32 128 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 ... ... 1 ... ... 4 1 1 1 ... ... ... ... 1 8 2 Aneurism ... ... ... ... ... 1 2 5 2 2 ... ... ... 0 12 3 Heart Disease, &c. 2 2 1 9 81 21 31 41 52 42 27 ... ... 5 243 Order 3— Respiratory Organs. 1 Laryngitis 8 7 7 3 1 2 1 ... 1 1 ... ... ... 22 31 2 Bronchitis 224 113 00 8 8 15 27 77 152 191 83 13 1 397 972 3 Pleurisy 1 ... ... ... 3 3 2 2 2 5 ... ... ... 1 18 4 Pneumonia 52 38 26 8 11 16 22 20 20 24 12 1 ... 116 250 5 Asthma ... ... ... ... ... 1 1 5 4 2 1 ... ... 0 14 6 Lung Disease, &c. 14 6 7 1 1 2 6 4 10 5 1 ... ... 27 57 Order 4.—Digestive Organs. 1 Gastritis 1 ... ... 1 ... 3 1 2 1 4 ... ... ... 1 13 2 Enteritis 6 6 l 2 2 2 ... 2 2 1 1 ... ... 13 25 3 Peritonitis 2 ... ... 4 2 5 5 2 1 2 ... ... ... 2 23 4 Ascites 1 ... ... 2 1 ... 3 1 4 1 ... ... ... 1 13 5 Ulceration of Intestines ... ... ... ... ... ... 1 2 ... ... ... ... ... 0 3 6 Hernia ... ... ... ... 1 ... 3 1 1 2 2 ... ... 0 10 7 Ileus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 Intussusception 3 ... ... ... ... ... ... 1 1 ... ... ... 3 6 9 Stricture of Intestines ... 1 ... 1 ... ... 1 ... 2 5 2 1 ... 1 13 10 Fistula ... ... ... ... ... ... ... ... 2 1 1 ... ... 0 4 11 Stomach Disease, &c. 2 ... 1 1 ... 1 3 3 5 5 2 ... ... 3 23 12 Pancreas Disease, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Hepatitis 1 ... ... ... 1 ... ... 1 1 1 ... ... ... 1 5 14 Jaundice 5 ... ... ... ... ... ... 1 ... 2 ... ... ... 5 8 15 Liver Disease, &c. 1 ... ... 4 2 7 10 19 15 17 3 ... 1 1 79 16 Spleen Disease, &c. ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 2 Order 5.— Urinary Organs. 1 Nephritis ... ... 1 2 ... 3 2 1 ... ... ... ... ... 1 9 2 Ischuria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Blight's Disease (Nephria) 1 ... ... ... 2 6 4 7 3 8 3 ... ... 1 34 4 Diabetes ... ... ... 1 2 1 1 ... 3 3 ... 1 ... 0 12 5 Calculus (Stone) ... ... ... ... ... ... 1 ... ... 1 ... ... ... 0 2 6 Cystitis ... ... ... ... 1 2 1 1 1 3 2 1 ... 0 12 7 Kidney Disease, &c. 2 ... ... ... ... 4 1 5 4 1 ... ... ... 2 17 Order 6.— Organs of Generation. 1 Ovarian Dropsy ... ... ... ... ... ... 1 ... 1 1 ... ... ... 0 3 2 Uterus Disease, &c. ... ... ... 1 ... 3 6 3 1 1 1 ... ... 0 16 Order 1—Organs of Locomotion. 1 Synovitis (Arthritis) ... ... ... ... 1 ... ... 1 ... ... ... ... ... 0 2 2 Joint Disease, &c. ... 1 2 10 2 1 2 1 3 2 1 ... ... 3 25 Order 8.—Integumentary System. 1 Phlegmon ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Ulcer 2 ... ... ... ... ... 2 1 1 ... 2 ... ... 2 8 3 Skin Disease, &c. 3 2 ... ... ... ... ... ... ... ... ... ... ... 5 5 Class IV.—Developmental Diseases. Order 1— Diseases of Children. 1 Premature Birth 99 ... ... ... ... ... ... ... ... ... ... ... ... 99 99 2 Cyanosis 7 ... ... ... ... ... ... ... ... ... ... ... ... 7 7 3 Spina Eifda 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 5 4 Other Malformations 5 1 ... ... ... ... ... ... ... ... ... ... ... 6 6 5 Teething 39 38 1 ... ... ... ... ... ... ... ... ... ... 73 78 Order 2.—Adults. 1 Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Childbirth (sec Puerperal Fever) ... ... ... ... ... 9 3 ... ... ... ... ... ... 0 12 Order 3.— Old People. 1 Old Age ... ... ... ... ... ... ... 1 9 97 181 61 3 0 352 1 Orderr 4.— Nutrition. Atrophy and Debility 211 15 8 1 2 4 5 4 12 6 1 ... ... 234 262 Class 4.—Violent Deaths. Order 1.—Accident or Negligence. 1 Fractures and Contusions 2 ... 4 6 1 5 6 4 4 6 6 1 1 6 46 2 Wounds Gunshot ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab 2 ... ... ... ... ... 2 ... ... ... ... ... ... 2 4 3 Burns and Scalds 2 3 4 1 ... ... 1 3 ... ... ... 1 ... 9 15 4 Poison 1 ... ... 1 ... 1 2 ... ... ... ... ... ... 1 5 5 Drowning ... ... ... ... 2 ... 1 1 1 ... ... ... ... ... 5 6 Suffocation 49 3 ... ... 1 1 1 ... 1 1 ... ... ... 52 57 7 Otherwise 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 4 Ol der 3.—Homicide—Infanticide 3 ... ... ... ... ... ... ... ... 2 ... ... ... 3 5 Order 4.—Suicide 1 ... ... ... ... 5 6 8 1 1 1 ... ... 1 23 Causes not specified or ill defined 1 ... 1 1 ... 8 2 ... 2 2 ... ... ... 2 17 19 Table IV. PARISH OF ST. PANCRAS. Table shewing the Mortality from certain classes of Diseases, and proportions to Population, and to 1,000 Deaths in 1879. Total Deaths. Deaths per 1000 of Population. Proportion of Deaths to 1000 Deaths. 1. Seven Principal Zymotic Diseases 655 2.7 126.2 2. Pulmonary Diseases (other than Phthisis) 1342 5.5 218.6 3. Tubercular Diseases. 614 2.5 118.3 4. Wasting Diseases of Infants 372 1.5 71.6 5. Convulsive Diseases of Infants 381 1.5 73.4 Notes. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever, and Diarrhoea. 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. PARISH OF ST. PANCRAS. Table shewing the Number of Deaths from the seven principal Zymotic Diseases, in the 10 Years 1869 to 1878, and in the Year 1879. Disease. 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 Annual Average of 10 years, 1869-78. Proportion of Deaths to 1000 Deaths in 3 years, 1876-78. 1879 Propertion of Deaths to 1000 Deaths in 1879. Small Pox 1 21 448 58 2 3 2 22 129 94 78.0 16.2 19 3.6 Measles 63 87 105 105 221 64 82 117 143 48 108.0 20.5 129 24.8 Scarlet Fever 239 477 95 70 17 95 220 137 89 138 155.7 24.2 144 27.7 Diphtheria 20 35 37 16 38 35 55 38 22 23 31.9 5.5 25 4.8 Whooping Cough 221 99 158 259 212 121 232 19S 141 217 185.8 37.0 154 29.6 Fever 126 158 112 78 78 67 58 84 76 67 90.4 15.1 66 12.7 Diarrhœa 219 227 236 235 253 222 178 239 155 229 219.3 41.5 118 22.7 Total 891 1104 1191 821 824 607 827 835 755 816 867.4 16.0 655 126.2 London 17630 16891 19676 12874 11549 11352 1351S 12696 12380 14857 14342.3 167.7 12256 143.2 21 Table VI. PARISH OF ST. PANCRAS. Report of the Sanitary Work, &c., completed in the year ending December 31st, 1879. No. of Complaints received during year from the Sanitary Inspectors and the Public 1830 No. of Houses, Premises, &c., inspected 3046 Results of Inspection. Orders issued for Sanitary Amendments of Houses and Premises 1304 Houses and Premises, &c., Cleansed, Repaired, and Whitewashed 724 Houses Disinfected after Infectious Diseases 271 House Drains. Repaired, Cleansed, &c. 230 Trapped or Ventilated 256 Privies and Water Closets. Repaired, Cleansed, &c. 465 Supplied with Water 316 Now provided 3 Dust Bins. New provided 22 Repaired, Covered, &c. 116 Water Supply. Cisterns (new) erected 11 Cisterns Cleansed, Repaired, and Covered 168 Miscellaneous. Cesspools abolished 12 Overcrowding rooms for which notices were served 14 Removal of accumulations of Dung, Stagnant Water, and other Refuse 62 Removal of Animals improperly kept 17 Bakehouses Regularly inspected 225 Licensed Cowhouses 51 Licensed Slaughterhouses 51 Clay burning 3 Smoke Nuisances 5 Other Proceedings, e.g. Legal Proceedings 7 Return for the Period—July to December, 1878. 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, 1878. Registration Sub-Districts comprised in the Vaccination Officers' District. Number of Births returned in the Birth List Sheets as Registered from 1st July, to 31st December, 1878. Number of these Births duly entered by 31st July, 1877, in Columns 10, 11, and 13 of the Vaccination Register (Birth List Sheets, viz. : Number of these Births which on the 31st July, 1877, remained unentered in the Vaccination Register on Account (as shown by Report Book.) Number of these Births remaining on 31st July, 1877, neither duly entered in the Vaccination Register (columns 3, 4, 5 and 6 of this Return) nor temporarily accounted for in the Report Book, Cols. 8, 9, and 10 of this Return. 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 bo reached, and Cases not having been found. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Dead Unvaecinated. 1 Kentish Town 1703 1429 2 1 133 13 10 90 25 2 Regent's Park 591 498 1 ... 50 2 4 27 9 3 Camden Town 384 327 2 ... 34 3 2 13 3 4 Somers Town 672 521 2 ... 79 3 4 58 5 5 Tottenham Court Road 425 331 1 ... 41 1 2 43 6 6 Gray'a Inn Road 461 348 ... ... 52 1 1 47 12 Total 4236 3454 8 1 389 23 23 278 • 60 * These Cases have been entered in the Report Book, and the Certificates promised. Return for the Period—January to June, 1879. Return made by Mr. W. T. Jones, Vaccination Officer of the Six Sub-Districts of St. Pancras Parish, respecting the Vaccination of Children whose Births were Registered in his District from 1st January, to June 30th 1879, 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, 1879. Number of these Births duly entered by 31st January, 1877, in Columns 10, 11 and 13 of the Vaccination Register (Birth List Sheets) viz.: Number of theBe Births which on 31st January, 1878, remained unentered in the Vaccination Register on account (as shown by Report Book) of Number of these Births remaining on 31st January, 1879, neither duly entered in the Vaccination Register "(Columns 3, 4, 5 & 6 of this Return, 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 apprised. Removal to Places unknown, or which cannot be reached ; and Cases not having been found. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Dead Unvaccinated. 1 Kentish Town 14S8 1290 1 1 93 6 4 69 24 2 Regent's Park 628 525 4 ... S7 7 5 39 11 3 Camden Town 392 342 ... ... 32 1 1 12 4 4 Somers Town 628 522 ... ... 48 3 3 46 6 5 Tottenham Court Road 383 305 ... ... 29 1 1 40 7 6 Gray's Inn Road 478 390 1 ... 41 3 3 28 12 Total 3997 3374 6 1 280 21 17 234 * 64 * These cases have been duly entered in the Report Book, and the certificates produced.