ST. SAVIOUR'S DISTRICT BOARD OF WORKS. FOURTH ANNUAL REPORT OF THE MEDICAL OFFICER, ROBERT BIANCHI, Esq., Presented to the General Meeting, held on the 6th of June, 1860, AND ORDERED TO BE PRINTED AND CIRCULATED THROUGHOUT THE DISTRICT. London: PRINTED BY F. SHANLY, 57, BRIDGE STREET, SOUTHWARK. ST. SAVIOUR'S DISTRICT BOARD OF WORKS. FOURTH ANNUAL REPORT OF THE MEDICAL OFFICER, ROBERT BIANCHI, Esq., Presented to the General Meeting, held on the 6th of June, 1860, AND ORDERED TO BE PRINTED AND CIRCULATED THROUGHOUT THE DISTRICT London: PRINTED BY F. SHANLY, 57, BRIDGE STREET, SOUTHWARK. MEDICAL REPORT. "Mr. Chairman & Gentlemen, - It is a gratification to me to know that I have the honour to address a Board of which the members are not indifferent even to a cold and dull report of our proceedings in sanitary works —not uninterested in the short and slow, and often intercepted, steps by which we are advancing in the way oi what must be at last one of the most universal of all our national blessings. For, with all the drawbacks and checks which occur to ???s, we are yet achieving steady progress in the work of making life more durable and health more undisturbed ; and, though our gain is not great as we calculate it month by month, or year by year, yet we may enjoy the conviction that our course is a sure and safe one which will probably give to our descendants at some distant time a condition of enjoyment which it would be at present regarded only as a dream of fancy to describe. But we have, meanwhile, in the vast and complicated measures of our sanitary reform many obstacles which we are sure to meet with. Multitudes of persons and of things, mounds of prejudice and ???ignorance and neglect will be continually setting impediments in the way of our scientific arrangements. A very lamentable example of this antagonism forces itself before our notice in the Report which I have to make to you concerning the past year. If there is one great scourge of our physical nature which, more than another, we lave already learned the means of mitigating and defeating of its leadlieet results, it is undoubtedly the small-pox by means of vaccilation. "Well—in common with the other districts of this metropolis —we have had a visitation of the dire disease, and the Union has ost by it thirteen lives. But, the crying shame is, that, of these ???hirteen persons who were destroyed, nine had never had the degree of protection given to them which vaccination is admitted to afford. Their lives were exposed to the known and impending danger without the protection of a known, and not easily penetrated shield. 4 The proportion of these deaths to those of the far vaster number of vaccinated persons leaves a result not undeserving of the sad and deep remembrance of the individuals — be they professional advisers, parents or friends — by whose mismanagement or neglect a calamity so irremediable has been occasioned It should leave, also, a lasting and profound lesson for the preservation, at least from one perilous disease, of those who are now entering into life with all its glorious possibilities of usefulness and happiness at stake upon a multitude of circumstances individually small. Amongst these circumstances, a large number of deaths, chiefly amongst infants, has been occasioned during the year by diarrhoea. The losses from this cause have been as many as thirty-eight in the whole District, of which twenty-one were in the Parish of St. Saviour, and seventeen in that of Christchurch. More favourable than this is the report which I have to make to you concerning typhus — a fearful and destructive malady, about which I hope it is not too sanguine an anticipation that it will be swept for ever from the land by our sanitary measures as soon as they become operative in their highest ultimate perfection. In my last annual Report I had to announce to you a diminution of ten in the number of deaths from this disease, and I have at present to inform you of a further decrease of four on the mortality of that year. This result is, as you will allow me to observe, a very grateful and encouraging one, since it is in its hostility to this terrible disease that our measures have the fairest field afforded to them and the finest instruments of warfare placed within their reach. In the construction of my Tables you will perceive that I have made some considerable deviation from my usual plan. The object of this novelty in arrangement is, of course, to make a completer record of the numerous facts which have to be condensed within sosmall a space, and — I hope — to make at the same time a record that shall be both clearer and more effective in its communications to you. 5 Houses inspected and improved, and Nuisances removed, in the the Parish of Christchurch, South wark, from the 1st of January, 1859, to December 31st, inclusive Number of houses inspected. Number of notices issued. Cesspools emptied, filled up, and drained into sewer. Privies cleansed, panned, and trapped. Summonses heard by Magistrate. Sinks in yards trapped. Defective drainage inspected and made good. Offensive smell in houses. Dung and filth removed. No privy accommodation. Dirty houses lime-whited and properly cleansed. Dangerous houses taken down and re-built Offensive privy pans cleansed out. Stagnant water and filth removed.! Number of dust complaints and neg lects of the dustmen attended to. Number of visits paid, (approximate). Dilapidated houses cleansed and repaired. Houses drained into sewer. Urinals cleansed. 90 | 70 14 13 1 1 17 4 3 1 14 2 20 1 339 240 20 4 6 6 Houses inspected and improved and Nuisances removed in the Parish of Saint Saviour, Southwark, from the 1st of January, 1859, to December, 31st, inclusive. Number of houses inspected. Number of notices issued Cesspools emptied, filled up, and drained into sewer. Cesspools emptied drainage not available. Privies cleansed, panned, and trapped, Summonses heard by Magistrate. Sinks in yards trapped. Yards repaved. Dust bins erected. Unwholesome fruit. Dilapidated houses taken down. Dung and filth removed. Dirty houses lime-wliited and properly cleansed. Number of dust complaints andneglects of the dustmen attended to. Number of visits paid, (approximate). No privy accommodation. Ventilated houses Defective drainage inspected and made good. Open sewer under dwelling houses properly cohered over. 250 130 10 4 24 3 3 4 2 20 4 20 22 650 700 1 5 32 2 7 In examining these new Tables with a little attention you will observe that they afford a more precise exposition than wE have had hitherto, both of the exact mortality of the District and of the special mortality of each of the two Parishes of which is is composed. The casual deaths of persons coming amongst us only as it were to die, have been carefully separated from those of habitual residents, and excluded from the absolute amount of District mortality. Thus, the deaths which have occurred in the workhouse have been carefully apportioned between the two parishes from which the sufferers came; and, amongst the deaths in the Hospitals, an exact distinction has been made between those of persons living previously amongst us and those of persons merelv coming in from,other places. by strict adherence to this rule of computation it wall be observed that the number of deaths wIthin the year which precisely belong to the Parish of Christchurch have been 400, and those which are with equal precision to be referred to St. Saviour's, 470 ; —or, a gross District total of 870 deaths. It may, however, be objected to this exclusive manner of computation that the very favourable result which it sets before us is merely a factitious one, created really by the omission of what had formerly been put down as an integral part of my Report; to avoid this imputation, I have also prepared a Table in the old mode, and after including in it every death that would have found a place in Tables framed upon my former method, I have the gratification of announcing to you a decreaso in the General District mortality for 1859, which amounted to no less a number than 51. The comparison of births and deaths during the year gives to the former an excess of 520, — a fact which proves conclusively the prevailing healthiness of the District, and in some measure may be taken as indicative of its general prosperity. The result which is presented to us in the sixth table is also a faithful and a highly favourable one. It cannot fail to be a gratification to us to.know that we have a lighter per-centage of mortality to pay than that which falls upon the neighbouring districts, or, indeed, upon the vast metropolis of which they are a part. You will be pleased to know that our deaths are nearly 3 in 1000 less than in the group of districts South of the Thames, and nearly 2 in 1000 less than in the whole of London. And you will be, I trust, still further pleased, and strengthened in your zeal when you know that a lesser mortality has been in like manner dealt to us under the ravages of the fearful epidemic of the past year. We have had from small-pox less than the common average loss. For, whilst the deaths from that diseaso have been upon the whole mortality of London a 1/55 and upon ihe mortality of the Southern Districts as1/59 they have been in their relation to that of St. Saviour's only as 1/67 and for this considerable difference in our favour we are clearly 8 not indebted to any accidental or occasional excess of deaths elsewhere. For, in the Report of the Registrar-General, we are informed that the per-centage of deaths —both in the whole of London, and in its Southern Districts - was not only absolutely less last year than in the previous one, but less also than the mean mortality of the preceding seventeen years- In a Table set apart to that purpose, I have made a Report of that portion of our work which probably is the most onerous and ungracious to perform, as well as the most serviceable to the great business of sanitary improvements, as to its ultimate effect. You will understand that I am referring to those visits of inspection in which so many of the causes of unhealthiness are detected and destroyed before the opportunity has been allowed them to beget disease. It is a great pleasure to m e to have to acknowledge, in reference to this duty how much I have been indebted to the quick intelligence and watchful diligence of your Inspector of Nuisances, by whose aid much of the sanitary improvements have been carried out. 6 SAINT SAVIOUR'S DISTRICT. Population at Census, 1851, 35,731. Statement of Deaths registered from January 1st, to December 31st, 1859, and a comparison with the mortality for the Year 1858. Under 1 year. 1 year and under 20. 20 years and under 40. 40 years and under 60. 60 years and under 80. 80 years and upwards. Totals. Grand Total. In the District M F M F M F M F M F M F M F 140 92 114 118 46 39 57 66 36 42 6 9 399 366 765 In the Workhouse 7 6 4 5 9 11 9 10 12 17 1 10 42 59 101 In the Hospitals 0 1 6 32 3 50 2 25 0 10 0 1 11 119 *130 Totals 147 99 124 155 58 100 68 101 48 69 7 20 452 544 996 Increase 4 0 0 0 11 8 0 24 0 0 0 2 15 34 Total crease 51 Decrease 0 15 31 2l 0 0 2 0 10 14 7 0 50 50 * Of this number only 4 were admitted from St. Saviour's District. BIRTHS. DEATHS. Christchurch 698 400 Saint Saviour 692 470 1390 870 Excess of Births over Deaths 520 01 PARISH OF CIIRISTCHURCH. Population at Census, 1851, 16,022. Statement of Deaths registered from January 1st to December 31st., 1859, inclusive. Under 1 year. 1 year and under 20. 20 years and under 40. 40 years and under 60 60 years and under 80. 80 years and upwards. Totals. Grand Total. M F M F M F M F M F M F M F In the Parish 67 47 61 57 19 14 28 31 19 20 3 4 197 173 370 Workhouse cases previously resident 2 2 2 2 3 5 2 3 1 4 0 4 10 20 30 69 49 63 59 22 19 30 34 20 24 3 8 207 193 400 General Statement of the causes of Deaths registered in the Year 1859. EPIDEMICS. OTHER CAUSES. Total columns, A & B. Small-Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhoea. Typhus. Total A. Consumption, or Phthisis. Diseases of piratory Organs. Other Causes. Total B. In the Parish 8 5 7 11 17 5 63 38 53 216 307 370 Workhouse cases previously resident 0 0 0 1 0 0 1 5 6 18 29 30 Totals 8 5 17 12 17 5 64 43 59 234 336 400 11 PARISH OF SAINT SAVIOUR. Population at Census, 18.51. 19,701). Statement of Deaths registered from January 1st to December 31st, 18.59, inclusive. Under 1 year. 1 year and under 20. 1 20 years ami under 40. 40 years and under 60 60 years and under 80. 80 years and upwards. Totals Grand Total. M F M F M F M F M F M F M F In the Parish 73 45 53 61 27 25 29 35 17 22 3 5 202 193 395 Workhouse cases previously resident 5 4 2 3 6 6 7 7 11 13 1 6 32 39 71 Hospital cases previously resident 0 0 0 0 1 1 0 1 0 1 0 0 1 3 4 Parish totals 78 49 55 64 34 32 36 43 28 36 4 11 235 235 470 Hospital cases from other Parishes 0 1 6 32 2 49 2 24 0 9 0 1 10 116 126 Grand totals 78 50 61 96 36 81 38 67 28 45 4 12 245 351 596 12 General Statement of the causes of Deaths Registered in the year 1859 EPIDEMICS. OTHER CAUSES Total columns A & B. Small Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhœa. Typhus. Total A Consumption or Phthisis. Diseases of Respiratory Organs. Other causes. Total B In the Parish 5 1 15 16 21 2 60 51 102 182 335 395 Workhouse cases previously resident 0 2 0 0 0 0 2 20 9 40 69 71 Hospital cases previously resident 0 0 0 0 0 0 0 1 0 3 4 4 Parish totals 5 3 15 16 21 2 62 72 111 225 408 470 Hospital cases from other Parishes 0 0 0 0 0 0 0 14 3 109 126 126 Grand totals 5 6 15 16 21 2 62 86 114 334 534 596 13 Mortality of the Saint Saviour's District, compared with the Smith Districts & the whole of London. Population 1851. epidemics. OTHER Causes Grand Totals. • Mortality percent. Small Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhœa Typhus. Totals. St.Saviour's District 35,731 13 8 32 28 38 7 126 744 870 2.434 South Districts 616,635 279 244 1271 370 845 477 3,486 13,208 16,694 2•701 London 2,362,236 1156 1305 4197 1741 3335 1796 13,530 48,087 61,617 2.608 * The present population of London would reduce the mortality In each case about J per cent 14 And now, Mr. Chairman and Gentlemen, I have only to report that expression of my personal thanks to you for unvarying confidence and kindness to me, which, though I make it every year, is made, I assise you, from the impulse of a grateful heart. I know of no course of conduct which could have encouraged me more in my duties than that which you have uniformly held. To the Sanitary Committee, especially, I owe a debt of thankfulness which will remain amongst the pleasantest memories in my mind.