WAN 9 SANITARY DEPARTMENT. REPORT on the SANITARY CONDITION OF THE SEVERAL PARISHES COMPRISED IN THE WANDSWORTH DISTRICT, for the quarter that ended SATURDAY, MARCH 28th, 1857. London; printed by w.br. brickhill, steam printing works. 1857. REPORT on the sanitary condition of the several parishes included in the wands worth district, for the quarter ending march 28th, 1857. To the Board of Works for the Wandsworth District. Gentlemen, In presenting this, the first Quarterly Report for 1857, the primary duty I have to perform on behalf of my colleagues is a very pleasurable one—that of congratulating the Board upon a greatly decreased rate of mortality in the district, during the past 13 weeks, compared with that of corresponding seasons. By a reference to the new and comprehensive series of tables furnished in the appendix to this report, it will be seen, that in the Quarter which ended on Saturday 28th March of the present year, the deaths of 284 persons were registered in the district. The average number of deaths of the corresponding quarters of the ten previous years, viz: from 1847 to 1856 inclusive, was 320, and if this number is raised in the usual manner in proportion to the increase of population, it becomes 352. The number of deaths therefore, recorded in the quarter just expired was less by 68 than would have been registered had the average rate of mortality still prevailed. Gratifying as it is to be enabled to place before the Board results such as the above, it would be nevertheless presumption to contend that the whole of this great saving of life was exclusively attributable to the recommendations that have emanated from my colleagues and myself; but seeing that a very manifest improvement in the sanitary aspect of those portions of the District, hitherto considered the worst conducted, and the most unhealthy, has been accomplished, it may, I think, be very fairly assumed that some few of these 68 lives have been in reality saved through improved and judiciously enforced sanitary regulations 4 To favourable atmospheric conditions, to thermal and other influences consequent upon a genial season, and may he a season of local prosperity, it would be but just, perhaps, to attribute some of the saving of life referred to, but I apprehend the influences I have named, were neither bo great nor so obvious during the past three months, as to warrant a belief that they had of themselves operated to effect a difference in the rate of mortality, to the extent of 68 lives saved beyond the average. Be this however as it may, there is not, nor can there be, any fallacy in the figures I have used. The calculation it should be observed, is made to rest entirely on the Registrar General's returns, and it will be at once conceded that the comparison I have instituted, is founded on no meagre or narrow average. It is true it may be urged as an objection to the correctness of my calculation, that in portions of two years of the ten from which the quarterly averages have been deduced, there prevailed in the district a very fearful and fatal epidemic, which must have greatly increased the number of registered deaths during those periods; but it should be borne in mind, that the winter quarters of both the Cholera years, (1849and 1854) were entirely free from the epidemic, or more properly speaking, the epidemic had altogether ceased in both those years before the winter quarter of either of them had fairly set in. The circumstance then, of Cholera having prevailed in the district in the summer and autumn quarters of the two years referred to, cannot in any way vitiate the favourable result of my calculation; on the contrary, its evident tendency is to improve the point upon which I have ventured to base that calculation, since the cholera which prevailed in portions of the September and December quarters of 1849 and 1854, must have considerably diminished the mortality of the March quarters following those periods, by reason of the disease having removed many of the weak and unhealthy who would, in all probability, had they survived the epidemic of the one quarter, have somewhat largely contributed to swell the death rate of the next. I mention this because I have no desire to force the fact of which I have been speaking, into an importance which it might not be thought to deserve. If then, less deaths by 68 can be shewn to have taken place in the quarter, than the average number which occurred in ten other corresponding periods, it cannot be a very unreasonable conclusion to arrive at, that some good has been effected, some valuable lives saved to the community, by the measures recommended by your Officers of Health, and carrie'l out under the 5 authority of your board. If this were not so, I fear we should be constrained to fall back upon that no very flattering alternative of considering that all the legislation of the Board, and all the labour of its Officers, had been exercised in vain. Mortality from Zymotic Diseases. The diseases classed under the head " Zymotic," (a word derived from the Greek, and signifying to ferment) include all epidemic, endemic, contagious and infectious maladies, and they are such as are generally considered to a great extent preventible, or, I should rather say, their causes are deemed much more within our power to remove, or to mitigate, than are the causes of many of the ordinary diseases which afflict mankind. This being the case, it is clear that a due consideration of the death rates from these peculiar maladies must be of the utmost importance in any attempted estimate of the healthiness or unhealthiness of particular localities. In the March quarter of last year (1856), it appears that as many as 3 7 deaths were registered from six of the most frequent, and the most fatal diseases of the Zymotic Class, viz:—Smallpox, Measles, Scarlet Fever, Hooping Cough, Diarrhoea, and Typhus Fever; whilst in the quarter just expired, 30 deaths only took place in the entire district from these maladies. When it is considered that the deaths in the last quarter, occasioned by the above named diseases, occurred in an increased population, and that the three months through which we have just passed, have not been marked by any very favourable conditions tending to prevent the occurrence, or the spread of Zymotic Disease, the saving of seven lives under this head will appear no slight one to record as the result of a stricter observance of the laws of health. In the March quarter of 1856, as many as six deaths occurred in the district from small-pox alone. A reference to the tables in the appendix will show that happily, out of an estimated population of near 60,000 souls, not a single individual died of this fearful disease, during the quarter just expired. Fully assured of the prophylactic value of vaccination when properly and carefully performed, your Medical Staff have neglected no opportunities since they have been in office, of furthering this most important branch of preventive medicine ; and perhaps to increased exertions in 6 this direction, and to increased care in the performance of the operation, is to be attributed the present comparative freedom from a pestilence, which for some years past appears to have claimed a somewhat large number of victims in the more populous parts of the district. The Zymotic Diseases to which the greatest number of persons have succumbed during the quarter, appears to have been Whooping Cough, which proved fatal in 10 instances; Scarlatina which resulted in death in 8 cases; and Typhus Fever which found 7 victims amongst the scattered population of the district. Of the total number of Zymotic cases, it is worthy of remark, that the majority of deaths occurred amongst the families of those who are constrained to dwell in places notoriously unhealthy, from absent or defective drainage, bad water, and deficient ventilation. From the above table we gather, that when the number of deaths amongst the industrial classes is deducted from the general total of 284, there will remain 83 deaths only to be distributed amongst the three other classes, gentry, professions and trades. The above may be termed the black side of the picture, and to look at it almost destroys the gratification experienced in recording the fact of a greatly decreased general rate of mortality. But may That this is unhappily the case under every form of disease that has resulted in death during the quarter, and (with one exception), in every Bub-district in which a register of mortality is kept, will be best shown, by a reference to the subjoined table:— Sul-districts. Number of Deaths during the Quarter amongst all Classes. Number of Deaths exclusively amongst the Industrial or Labouring Classes. CLAPHAM 74 50 WANDSWORTH 71 48 BATTERSEA 95 78 PUTNEY 23 15 STREATHAM. including TOOTING & BALHA.M 21 10 Total 284 201 7 not this be left as an evil to our time, that it may hereafter become a monument and trophy to the good we may be able to effect ? The blackness of the picture ought not to be a ground for despair, but a call to greater effort. If we once determine to make that effort, who shall say how soon we shall be enabled to reverse the picture ? Prevailing Sickness. At first sight it might strike a casual observer that the register of mortality of a district furnished a good index to the amount and intensity of the sickness of that district, and that the one was a fair measure of the other; but it is not so in reality. Particular diseases may and often do prevail at a time when the deaths from those diseases are but very few ; and the reverse may be the case. I believe the only way in the absence of returns from private practitioners, to arrive at even an approximate estimate of the amount of disease prevailing in a district, is to analyse the weekly records of sickness kept by the Union Medical Officers, and to obtain if possible, a similar analysis of returns which could be furnished by the Medical Officers of Local Public Institutions. The first of these analyses your Medical Staff (being all Medical Officers under the Poor law), can of course, (as they have already done) accomplish without difficulty. The other analysis it is thought, can only be accomplished successfully through the mediation of the Board, and hence my colleagues have requested me to appeal to the Board, in this Report, for its assistance in carrying into effect the suggestion of the Association of the Medical Officers of Health of the Metropolis, that " Application should be made through the medium of the Vestry or District Boaid, to the Managing Committee or Board of each Institution, for permission to obtain the information required." The importance of collecting these valuable statistics, and of embodying them as it is proposed to do, in a weekly publication under the authority of the General Board of Health, cannot be over estimated; and I shall have great pleasure in more fully explaining the proposed scheme and its requirements, whenever it is convenient to this Board or its Sanitary Committee to afford me an opportunity of doing so. A reference to Table IV. in the appendix will show, that 1140 cases of sickness &c., were treated by the Union Medical Officers during the past quarter, and that 36 only of those cases terminated fatally. The same table will also exhibit the gratifying fact, that both the sickness and mortality amongst the pauper population of the District was 8 usually slight, compared with that of corresponding seasons. A verification of this statement will be found in the return from my own subdistrict (Putney), in which it is recorded, that out 150 cases of sickness of greater or less severity, attended by me in my capacity of District Medical Officer, the death of but one person (a female 87 years of age) was registered during the quarter just expired. Sanitary Improvements—Removal of Nuisances, &c. As the Medical Officers of Health will shortly present their report for the past year (1856), and will therein have an opportunity of offering their suggestions, and of pointing out to the Board what has been done, what they propose should be done, and what they conceive has been left undone in their respective sub-districts, there will be but little need for me to attempt any very detailed analysis of such local sanitary operations as are intended to be dealt with by the individual Officers under whose cognisance they have especially fallen. But it will be as well to give in this section of the report, a brief summary of the most important of the suggestions contained in the fortnightly returns of my colleagues, as they apply to investigations and inspections made during the quarter, the sanitary operations of which it is part of my duty to review. Local Returns. CLAPHAM. The fortnightly returns from this sub-district, speak generally of the favourable state of the public health throughout the quarter. (The prevailing zymotic and other diseases in each of the seven sub-districts, can be best ascertained from the tables in the appendix, consequently there will no need to repeat them in this summary.) Mr. Mc. Donogh in several of his reports, repeats a recommendation to take advantage of favourable weather to complete certain sanitary operations which had previously been reported on, and he especially alludes to the condition of certain ponds in his sub-district, and to the want of drainage in many of the poor localities. WANDSWORTH. Mr. Nicholas makes many allusions to the unsatisfactory condition of the poorer class of houses in his sub-district. The inspections have been many and the evils disclosed such as appeared to require immediate attention. The main requirements of the houses examined, were a supply of good water, better ventilation, the more general adoption of covered dust-bins, the construction of decent wate r 9 closets, in the place of the disgusting open cesspools which abound throughout the parish, and above all improved drainage, which is a necessity in almost every locality in which the poor dwell. Speaking in one of his returns of the examination of 35 houses in South Street, Garratt Lane, Mr. Nicholas observes, " On the west side of this street, five houses are supplied by means of three pumps, the water being good, all the rest use the "Wandle water. Some of the privies of these last houses are made to overhang the river, an arrangement which, while furnishing an excellent illustration of the simple mechanical principles which should be adopted for the fulfilment of efficient drainage, must be admitted to be ill calculated to ensure a supply of wholesome water for drinking purposes, the water being dipped, within a yard or so, of the entrance of foecal matter." BATTERSEA. Particular attention is called by Dr. Connor to the unsanitary condition of the houses in Francis Street, in one of which seven cases of Scarlet Fever had occurred, and which he conceived had been very greatly aggravated by the filthy state and defective drainage of this locality. In one of the returns there is also mentioned an inspection of Ford's Buildings, which disclosed similar deficiencies as those found in Francis Street, the keeping of pigs (77 in number, in the rear of the buildings), contributing in no small degree to the unhealthiness of the neighbourhood. Other inspections are alluded to, and the houses said to be greatly deficient in drainage, dust-bins, and traps to the gullies. The health of this sub-district is spoken of as having been, tolerably good throughout the quarter, but that several of the diseases of the zymotic class had been prevalent. PUTNEY. In the returns from my own sub-district, the existence of a nuisance arising from defective drainagc, is pointed out in the Upper Richmond Eoad, where fever of a low type prevailed, the effect, it was supposed, of miasma from an open ditch in a filthy condition, situate in the parish of Barnes. Works are, I believe now in progress to remedy this evil. Nuisances existing on the lower common, and the very defective drainage of that locality are also alluded to. Here again, improvements are in progress; but the neighbourhood is I consider in anything but a sound sanitary condition. It is my opinion that many beneficial results will spring from the construction of the new sewerage of this town, and it affords me much satisfaction to be able to state that the works connected with this long desired undertaking are being carried out in a very efficient manner by the Contractor. The inspection of houses in this 10 locality should be resumed; those that were examined during the quarter, disclosed precisely the same deficiencies as are mentioned in the returns from many of the other sub-districts. STREATHAM. Cases of Fever having occurred in the Manor Park, Brick Fields, Mr. Brown in one of his returns calls attention to the necessity of some stringent measures to improve the state of this locality. He states, that " in front of the houses the people deposit all their refuse animal and vegetable matter, around which is a perfect swamp of putrid water, fully accounting for the cases of fever that have arisen there." The health of this sub-district appears by the return to have been very good throughout the quarter. TOOTING AND BALHAM. Both Mr. Chapman and Mr. Ward have furnished returns during the quarter, that are highly satisfactory as regards the health of their respective sub-districts. The former gentleman calls attention to the defective drainage of a court in his subdistrict, in which seven cases of common continued fever had come under his notice; and the latter to some sewers in Balham New Road, and in Devonshire Road which require examination and improvement. Several houses in the vicinity of these sewers were found flooded at their basements in consequence of the defects referred to. This nuisance, has, it appears, been several times reported on by Mr. Ward. The moral and physical deterioration of the industrial classes produced by unclean dwellings, ill ventilation, bad or absent drainage, and imperfect water supply, is a theme upon which volumes might be written; but the simple question I would now put, is—Is all being done that can be done, to secure the blessings of more healthy homes to those in this district who, it has been shown, are by reason of their helplessness and inability to secure these blessings for themselves, so much more liable than any other class to fall victims to sickness and its long train of attendant evils ? There can be no doubt that much activity is being displayed, and always has been displayed, by the Board end its executive officers, to fully accomplish the objects and design of the Act which authorises their efforts; but it may not be without its advantages to show, in as concise a form as possible, to what extent those efforts have been successful during the past quarter, as well as the results of the Board's interference where such was needed, and the want of success that has attended some few first efforts to effect certain improvements for the general 11 benefit of the community. The following table which has been prepared from information obtained through my colleagues, from the several inspectors acting under the authority of the Board, will I trust, exhibit with sufficient clearness the points I have alluded to. For the Quarter ending March 28th. 1857. SUB-DISTRICTS. Inspections and Notices served Results. Number of Houses, &c. inspected. Number of Notices served for various sanitary purposes by order of the Board. Notices complied with, and work completed. Improvements.&c. in progress of completion. Notices partially or imperfectly complied with. Notices wholly neglected, or work not commenced. Notices that have required magisterialinterferance to enforce. Convictions obtained. Cases dismissed. Clapham 2 105 50 29 26 5 5 Wandsworth 125 22 8 2 ... 12 Battersea 13 7 4 ... 1 2 Putney 69 25 6 19 Streatham 30 1 I ... Tooting 79 17 3 11 3 Balham 26 6 S ... 1 Total 344 183 71 48 1 63 5 5 It should be observed that the notices served on owners, occupiers, and others by the Inspectors, in compliance with the orders of the Board, were chiefly for the construction, cleansing, and trapping of drains, the laying on of water, the conversion of open cesspools into water closets, the construction of dust bins, the removal of swine, and the general abatement of nuisances injurious to health or interfering with the public convenience. Besides the above, several works of great and lasting utility have been begun in various parts of the district since the commencement of the quarter, some of which are evidently designed to remove many of the evils affecting the health of the public that have been reviewed in this report. Whilst your Inspectors have been active in their respective sub-districts in attending to the suggestions of the Medical Staff, and in the general superintendence of work?, the Officers of Health have availed themselves of every opportunity to discuss and mature plans for future action, and to engage themselves in making important investigations and statistical enquiries, with a view to establish on as scientific a basis as possible, their practice of preventive medicine—a practice which, to realize all the advantages to be obtained from it, they feel they must 12 not only exercise with diligence themselves, but teach others to exercise, in order that they may be the better able to obey its laws, to grapple with its difficulties, to understand its advantages, and to make it subservient to their best and highest interests. I am, Gentlemen, Most obediently yours, R. HARLAND WHITEMAN. Chairman of the Associated Medical Officers of Health of the Wandsworth District. Putney, 15th, April. 1857. APPENDIX. TABLE I. Deaths from ALL Causes Registered in the entire Wandsworth District during the Quarter, ending 28th March, 1857. Under 5 Years of Age. CAUSES or DEATH. Under 20 Years of Age At 20 and under 40 Years of Age. At 40 and under 80 Yearn of Age. At 60 and under 80 Yean of Age. At 80 Years of Age and upwards. TOTAL. Under 5 years of Age. CAUSES or DEATH. Under20Years of Age, At 20 and under 40 Years of Age At 40 and under 60 Years of Age, At 60 and under 80 Years of Age. At 80 Years of Age and upwards. TOTAL. 1.—Zymotic Class Gastritis ... ... ... ... ... ... Small Pox Enteritis ... ... 1 ... ... 1 1 Measles 1 1 ... ... ... 2 Peritonitis ... 1 ... ... 1 7 Scarlatina 8 ... ... ... ... 8 Ascites ... ... 1 ... ... 1 9 Hooping Cough 10 ... ... ... ... 10 Ulceratn. of intestines ... ... ... 1 ... 1 1 Croup 1 ... ... ... ... 1 Hernia ... ... ... 1 ... 1 Thrush ... ... ... ... ... ... ... Ileus ... ... ... ... ... ... 2 Diarrhoea ... ... ... 1 ... 3 1 Intussusception 1 ... ... ... ... 1 Dysentry ... Stricture of intestines ... ... ... ... ... ... Cholera ... Disease of Stomach ... ... 1 2 ... 3 Influenza ... ... ... ... ... ... ... Disease of Pancreas ... ... ... ... ... ... Purpura, Scurvy ... ... ... ... ... ... ... Hepatitis ... ... ... ... ... ... Ague ... ... ... ... ... ... ... Jaundice ... ... ... ... ... ... Remittent Fever ... ... ... ... ... ... Disease of Liver ... 1 ... ... ... ... Infantile Fever ... ... ... ... ... ... Disease of Spleen ... ... ... ... ... ... Typhus 3 l 3 ... ... 7 8.—Of Kidneys, &c. ... ... ... ... ... ... Metria ... 1 1 ... ... 2 Nephritis ... ... ... ... ... ... Rheumatic Fever ... ... ... ... ... ... Nephria ... ... ... ... ... ... Erysipelas ... ... ... 1 ... 1 Ischuria ... ... ... ... ... ... Syphilis ... ... ... ... ... ... Diabetes ... ... ... ... ... ... 1 Noma l ... ... ... ... 1 Stone ... ... ... ... ... ... Hydrophobia 2.—Dropsy, Cancer, & ... ... ... ... ... ... Cystitis Stricture of Uretha ... ... ... ... ... ... others of uncertain scat ... ... ... ... ... ... Disease of Kidneys &c ... 1 ... 1 ... 2 1 Haemorrhage 1 ... 1 ... ... 2 9.—Of Uterus, viz:— ... ... ... ... ... ... Dropsy ... ... ... ... ... ... Puerperal Disease, &c ... ... ... ... ... ... Abscess ... 1 ... ... ... ... Paramenia ... 1 Ulcer 1 ... ... ... ... 1 Ovarian Dropsy ... ... ... ... ... Fistula ... ... ... ... ... ... Childbirth(seeMetria) ... 1 1 ... ... 2 Mortification ... ... ... ... ... ... Disease of Uterus, &c. 1 1 ... 1 ... 3 Cancer ... ... ... ... ... 1 10.—Of Joints, Bonos, ... ... ... ... ... ... Gout ... ... ... ... ... ... viz.:—ltheumatism, &e. ... ... ... ... ... ... 3.—Tubercular Class. ... ... ... ... ... ... Arthritis ... ... ... ... ... ... 1 Scrofula 2 ... ... ... ... 2 Rheumatism ... ... ... ... ... ... 1 Tabes Mesenterica 1 ... ... ... ... 1 Disease of Joints, &c. ... ... ... ... ... ... 0 Phthisis 9 10 ... 3 31 11.—Of Skin, &c-; ... ... ... ... ... ... 9 Hydrocephalus ... 10 ... ... ... ... 10 Carbuncle ... ... ... ... ... ... 4.—of Brain, Nerves, &c. ... ... ... ... ... ... Phlegmon ... ... ... ... ... ... Cephalitis ... ... ... ... ... ... Disease of Skin, &c. ... ... ... ... ... ... Apoplexy ... 2 5 1 *8 5 12,—Malformation . 5 ... ... ... ... 5 Paralysis ... 1 8 8 3 20 8 13.—Debility from ... ... ... ... ... ... Delirium Tremens ... ... ... ... ... ... mature Birth, &c 8 1 2 ... ... 11 Chorea* ... ... ... ... ... ... 5 14.—Atrophy 5 ... ... ... ... 5 Epilepsy 2 3 ... ... ... 9 15.—Age ... ... 1 10 10 21 Tetanus ... ... ... ... ... 1 16.- Sudden ... ... ... ... ... ... Insanity ... ... ... 1 ... 2 17 Violence Priva ... ... ... ... ... ... 3 Convulsions 1 ... ... ... ... 4 tion. &c ... ... ... ... ... ... 1 Disease of Brain, &c. 2 ... ... ... ... 4 Intemperance ... ... ... ... ... ... 5.—Of Heart, &c ... ... ... ... ... ... ... Privation of Food ... ... 1 ... ... ... Pericarditis ... 1 ... ... ... J 1 j Want of Breast Milk 1 ... ... ... ... 1 Aneurism ... ... ... ... ... ... Neglect ... ... ... ... ... ... 1 Disease of Heart, &c 2 2 5 6 ... 15 Cold ... ... ... ... ... ... 6—Of RespirstoryOrgans Laryngitis ... ... ... ... 1 3 1 4 Poison Burns and Scalds 4 ... 1 1 ... 6 14 Bronchitis 14 2 3 g 1 28 11 an ging ... ... ... ... ... ... Pleurisy ... ... 1 ... ... ... 1 Suffocation 1 ... ... ... ... 1 13 Pneumonia 13 ... 1 2 ... 16 Drowning ... ... ... ... ... Asthma ... ... ... 5 ... 5 Fractures ... ... ... ... ... ... 1 Disease of Lungs. &c. 1 ... 1 ... ... 0 Wounds 1 1 1 ... ... 3 7 —Of digestive Organs \ 1 Other Violence 1 ... ... ... ... 1 4 Teething 4 ... ... ... ... 4 Total of eight last heads 7 1 2 1 ... 11 Quinsey 1 ... 1 ... ... 2 Causes not specified ... ... ... 2 ... 3 TABLE II SUMMARY of Deaths in each Sub-District during the Quarter, ending 28th March, 1857. Classified according to Age, Sex, and Social Position. DISEASES. Sub-Districts. Sex. Age Social Position. Clapham—Population 16,290 Area in Acres 1233 Wands worth— Population V611 Area in Acres 2478. .Battersea— Population 10,560 Area in Acres 2343. Putney—Population 5280 Area in Acres 2176. Streatham, including Tooting and balham—Population 9,023. Area in Acres, 3465. Male3. Females. Total. Under 1 year. From 1 to 5 years. From 5 to 10 years. Under 20 Years, including all under 10 years. At 20, and under 40 years of age. At 40 and under CO years of ape. At 50 and under 80 years of age 80 years and upward". Nobility and Gentry. Professional Class, Merchants Bankers, &c. Middle and Trading Class, Shopmen, Clerks, &c. Industrial and labouring Classes. 1. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles 1 1 ... ... ... 1 1 2 ... 1 ... 1 1 ... ... ... ... ... ... 2 3. Scarlatina and Malignant Sore Throat 4 1 2 ... 1 4 4 8 ... 4 4 8 ... ... ... ... ... ... 4 4 4. Hooping Cough ... ... 9 1 ... 5 5 10 4 5 ... 10 ... ... ... ... ... ... 3 7 5. Diarrhoea & Dysentry 1 ... 1 ... 1 '1 1 3 1 1 ... 2 ... ... 1 ... 1 ... 1 1 6.Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7. Fever 1 ... 3 1 ... 3 4 7 ... ... ... 3 1 3 ... ... ... ... 2 4 8 Erysipelas ... 1 ... ... .. ... 1 i ... ... ... ... ... ... 1 ... ... 1 ... 9. Puerperal Fever 1 ... ... ... 1 ... 2 2 .. ... ... ... 1 1 ... ... ... ... 1 1 10. Lung Diseases, ex- 17 8 20 5 5 22 33 55 26 6 ... 28 4 9 12 2 3 2 4 46 11. Phthisis 8 8 S 3 4 18 13 31 1 1 2 9 10 9 3 ... 1 1 8 21 12. Hydrocephalus, Atrophy, Scorfula, and the Convulsions of Children 5 8 9 1 ... 17 6 23 14 6 2 22 1 ... ... ... 1 ... 3 19 13. Other Diseases 27 40 38 12 6 61 62 123 14 4 1 23 18 34 34 14 5 5 31 82 14. Violence, Privation, & Premature Birth 9 2 5 ... 8 11 8 19 9 5 ... 14 1 3 1 ... 1 2 2 14 Totals. 74 71 95 23 21 144 140 284 64 33 9 120 37 59 52 16 12 11 60 201 15 TABLE III. Births during the Quarter ending 28th March, 1857. SUB-DISTRICTS. Males. Females. Total. CLArnAM 71 79 150 WANDSWORTH 42 43 85 BATTERSEA 79 55 134 PUTNEY 31 20 51 STREATHAM including TOOTING and BALHAM 34 28 62 Total •157 2 25 482 Meteorological Means. For the Quarter ending 28th March, 1857. Barometer corrected mean 29.920 Mjan temperature of the air 33.3 Moan degree of humidity 8.48 Mean amount of Ozone 1.933 Amount of Rain collected 4.06 TABLE IV. Cases of Sickness under the Treatment of the Union Medical Officers, with the Deaths from each Class of Disease, during the Quarter, ending 28th March. 1857. Compiled from the District Medical Relief Books. Sud-Districts. Total Cases of Sickness treated in each SubDistrict. 1. Small Pox. 2. Measles. 3. Scarlatina and Malignant Sore Throat. 4. Hooping Cough. 5. Diarrhoea and Dysentery. 6. Cholera. 7. Fever. 8. Erysipelas. 9. Puerperal Fever. 10. Lung Diseases except Phthisis 11. Phthisis. 12. Hydrocephalus Atrophy, Scorfula,& Convulsions of children. 13. Other Diseases 14. Violence, Privation, & Pre. mature Birth Total Deaths in each Sub-District. Cases. Deaths Cases. Deaths Cases Deaths | Cases. Deaths | Cases. 1 Deaths Cases. Deaths Cases. | Deaths Cases. Deaths j Cases. Deaths Cases. Deaths Cases. Deaths Cases Deaths Cases. Deaths Cases. Deaths CLAP HAM 280 32 1 8 2 6 4 2 52 2 6 3 1 147 6 20 12 11 WANDSWORTH 315 2 2 1 8 20 8 9 54 3 4 2 2 1 206 4 BATTER SEA 303 7 25 1 8 1 5 65 2 4 1 6 2 167 4 15 10 PUTNEY 150 7 8 2 1 10 4 104 1 14 1 STREATHAM... 43 1 3 1 5 1 2 8 3 25 2 TOOTING 32 1 4 16 3 1 1 BALAAM 17 2 15 1 1 TOTALS 1140 34 1 18 1 38 1 43 26 19 1 193 7 21 6 13 3 680 16 54 1 36 SANITARY DEPARTMENT. REPORT ON THE SANITARY CONDITION OF THE SEVERAL PARISHES COMPRISED IN THE WANDSWORTH DISTRICT, FOB THE QUARTER THAT ENDED SATURDAY, JUNE 27th, 1857. London; printed by w. brickhill, steam printing works. 1857. REPORT ON THE SANITARY CONDITION OF THE SEVERAL PARISHES INCLUDED IN THE WANDSWORTH DISTRICT. FOR THE QUARTER THAT ENDED JUNE 27th, 1857. To the Board of Works for the Wandsworth. District. Gentlemen, The statistical tables inserted in the appendix to this report have well repaid the trouble of compilation, shewing as they do results of a very satisfactory character. Mortality. In the quarter that ended 27th June, the number of deaths from all causes, registered in the entire Wandsworth District, was 257. The number registered in the June quarter of 1856 was 296. It follows therefore that the mortality of the past quarter was less by 39 than that of the corresponding one of last year, though no correction be made for the increase of population in the interval. Comparing the average mortality of the June quarters of the ten previous years with that of the quarter just expired, and allowing for increase of population, it will be found that the difference in favor of the latter is as near as possible the same as the above, viz, 39. A reference to the tables themselves, will furnish the enquirer not only with the relative rate of mortality of the several sub-districts, but with the ages at death iu all cases 4 the social position of the deceased persons, and it is believed with other information of equal interest to the statician and philanthropist. Prevalence of Epidemic Diseases. From five of the principal Epidemic or Zymotic diseases, viz:— measles, scarlatina, whooping-cough, diarrhaea and continued fever, there resulted 25 deaths, which is five less than took place from the same maladies during the previous or March quarter of the present year, and thirteen less than were registered in the corresponding quarter of last year. It is also a very gratifying circumstance to record that during both the March and June quarters of the present year, not a single death has been registered as the result of small pox. Whooping Cough it appears has been the most fatal amongst zymotic maladies, numbering ten victims in the entire district. Next to this, Scarlatina has resulted in the greatest number of deaths during the quarter, eight persons having succumbed to that disease. From fever of a typhoid character seven fatal cases have been recorded in the Registrars returns. Sickness and Mortality amongst the Union Poor. Of 1334 cases of sickness amongst the recipients of parochial relief, both in the Workhouse, and in the several sub-districts under the care of the Union Medical Officers, forty-eight only have resulted in death during the three months, a very small proportion considering the many disadvantages and drawbacks under which the treatment of disease amongst this class is frequently undertaken. The highest mortality amongst the pauper population of the district, (vide table 4), appears under the head phthisis, sixteen persons having died of that fatal and distressing malady out of twenty-eight who came under treatment. From lung diseases, exclusive of phthisis,, the ratio of deaths amongst the same class to the cases treated, was 9 to 160, from measles it was 1 to 16, whooping-cough 2 to 37, whilst of 18 cases of scarlatina, 65 of diarhoea and dysentery, 36 of fever, and 12 of erysipelas no deaths appear to have been registered. Of 962 cases of other diseases, injuries, accidents, &c., not included in any of the classes above-named, there were registered in the Medical Relief Books of the Union 19 deaths only. Upon the whole, it is believed a more satisfac- 5 tory state of the public health, so far as relates to the poor of the district, has been but seldom recorded. Meteorological Phenomena. In the table of meteorological observations for the past quarter, kindly furnished by the Principal of the Training College, Battersea, the mean temperature is registered as 39°3. which is above the average of corresponding quarters for some years past. The highest temperature as registered in the shade, was on the last day of the quarter (27th of June), and reached 81°5. It has been further ascertained that the mean temperature of the quarter was nearly half a degree higher than the average of the corresponding periods of 48 years. In the five corresponding weeks ending June 6th, 1857, the mean temperature was 10°3. above the same average. During this latter period there were but three deaths from epidemic diseases registered, throughout the entire district. Local Returns and Observations. CLAPHAM. Mr. Mc. Donogh reports "The health of this sub-district has been remarkably good throughout the quarter. The number of deaths as returned at each of the fortnightly periods of reporting to the Board has varied considerably, but upon the whole the rate of mortality has been low, compared with that of corresponding quarters of former years. The greatest number of deaths (19) was registered during the fortnight that ended June 20th, the lowest (4) was during the two weeks which expired April 25th. The average mortality of the 13 weeks appears to have been rather under 7 per week. During the month or six weeks immediately preceding the termination of the past quarter, whooping-cough prevailed in the parish to some considerable extent, and proved fatal to four children. By the Inspectors report for the quarter, it appears that in Clapham 41 notices had been served upon owners or occupiers of premises, for various sanitary purposes, nearly the whole of which have been complied with, or the necessary works commenced, Drainage and the conversion of open cesspools into water-closets, have been amongst the principal improvements accomplished, or being accomplished in this sub-district. The cases requiring magisterial interference have been two (for obstruction of the footways) and in both convictions were obtained. 6 The number of complaints entered in the Inspectors books, all of which have been enquired into by the Board, was 81. WANDSWORTH. Mr. Nicholas writes, "The improvement in the general health of this parish which was manifest in the first quarter of the year, was still more notable in that just ended. The number of deaths registered during the past quarter was 50, which is 15 less than the lowest number of any corresponding quarter during the past six years, 25 less than the average of corresponding quarters of the same period, and 35 less than the corresponding quarter of last year. There was less mortality from epidemic disease during the two past quarters, by one half, than during the corresponding periods of last year (6-12). By a similar comparison there were less cases of sickness by nearly one-sixth, and less mortality by nearly one-half amongst the poor. The above comparison is too extensive and varied to fall short of the conviction that a great diminution of mortality and sickness has taken place from some unusual cause, an explanation of which does not present itself, except by a full entertainment of the probable effects of sanitary agency." The Inspectors return from this sub-district, gives the number of sanitary notices served upon owners and occupiers as 16, nine of which appear to have been second notices. The number of houses inspected during the quarter was 79. The sanitary improvements perfected during the same period, comprise the construction of water-closets 11, the emptying of cesspools 10, the filling-up of the same 3, the completion of effectual house drainage 18, the erection of dust-bins 17, besides several other minor operations, all tending to the improvement of the public health of the locality. BATTERSEA. Dr. Connor accompanies his quarterly return with the following summary of sanitary operations, as furnished by the Inspector of his sub-district. NotIce served during the quarter. To cleanse drains, cesspools, ponds, &c. 3 To construct and repair drains where common sewers exist 3 To remove accumulations of manure and offal 2 To remove swine kept in improper situations 10 To cleanse unwholesome dwellings 2 To remove or abate other nuisances injurious to health 4 Total 24 7 Of these 24 notices it is stated that 10 were complied with, and the necessary works completed, and that 14 have not been commenced or remain to be enforced. Dr. Connor intimates that the general health of the sub-district has been good throughout the quarter, the deaths from epidemic diseases being few. Whooping-cough appears to have resulted in the greatest number of deaths (5) from that class of diseases. STREATHAM. Mr. Brown writes, "I have nothing particular to add to my returns for the past quarter." In one of this gentleman's previous reports, the following passage occurs—"I must beg leave to draw the attention of the Board to the necessity of having all open cesspools converted into water-closets with traps and pans and proper water supply. I have been lately attending a poor woman in Factory Square who has been suffering from an obstinate attack of Diarrhoea, attributable, I believe, to the miasma arising from the open cesspools at the back of the houses." In a still later return (June 20th), Mr. Brown writes, " Several cases of diarrhæa have occurred in private practice, and one case amongst the Union poor. Some cases of scarlatina are under treatment also in private practice; and a few fresh cases of measles have occurred amongst the pauper population." TOOTING. Mr. Chapman remarks,—" The sanitary improvements of Tooting are still being carried out, more particularly in the very important matter of thorough drainage. During the quarter 16 cases of scarlatina amongst the better class of poor, not in receipt of parish relief, came under my notice, all however recovered, the disease having been of a mild type." In all previous returns of the quarter, Mr. Chapman has spoken of the general health of this sub-district as being good; but in one report (25th April) he states that whooping-cough was then very prevalent. BALHAM. Of this sub-district, Mr. Ward reports—"The quarter ending 27th June has been a particularly healthy one, and the number of deaths from all causes very few. There has been no particular epidemic disease noticed during the three months." The following return has been received from the Inspector of the combined localites of Streatham, Tooting and Balham. 8 Inspectors Return for the Quarter ending June 17th, 1857. Inspections and Works accomplished, &c. Streatham Tooting. Balham. Number of house Inspected 15 69 5 Cesspools emptied 4 2 1 Cesspools filled up 11 46 Waterclosets constructed 13 64 Houses in which drainage has been perfected 3 8 1 Removal of Swine 1 Houses in which works are in progress 10 45 Do. in which works have not been mened 2 16 Urinals abolished 1 Houses cleansed 1 Contaminated Wells filled up 4 Construction of impermeable cesspools 2 1 To effect the above improvements there have been served 1st. Notices 6 20 3 2nd Notices 1 6 1 PUTNEY. In my own sub-district but few quarters have been, in respect to both sickness and mortality, more satisfactory than the one just expired. With the exception of two fatal cases of Fever occuring at long intervals, no death from epidemic disease has been registered during the thirteen weeks. The decreasing proportion of deaths amongst the industrial class is also remarkably apparent. In the Registrar General's returns for the past quarter, eleven deaths only are recorded as having taken place amongst the labouring population of this parish, which is just one half of the usual number. This is a somewhat unusual circumstance to place on record, since in most of my former calculations I have found the proportion of deaths amongst that class to be at least two thirds greater, and. sometimes more, compared with those registered among the gentry, professional and trading classes combined. The number of deaths amongst all classes and from all causes registered in this sub-district was 22 during the quarter, which is one less 9 than occurred in the previous March quarter of the present year, and considerably below the general average of corresponding quarters of former years. Amongst the Union poor of this parish, but 3 deaths have been registered during the same period out of 152 cases treated. The new sewerage and the drainage of houses, hitherto without these sanitary advantages, is unquestionably beginning to tell upon the rate of mortality in this sub-district, especially amongst the poor. Nothing that has been accomplished under the authority of your Board appears to have given more general satisfaction to the tenants of small houses in this locality, than the improvements I have referred to. The sanitary measures perfected, or in progress of completion in Putney and Roehampton, have been thus reported to me by the active Inspector of the sub-district. Number of houses inspected 179, cesspools emptied 155, cesspools filled up 138, water-closets substituted for open cesspools 131, dust-bins supplied 122, removal of swine 1, houses in which drainage has been perfected 136, houses in which the above improvements have been but partially accomplished, or in which the works are in progress 20, works not commenced 4. In order to accomplish this large amount of improvement, there have been served upon owners or their agents 45 first, and 30 second notices, nearly all of which have been attended to. Conclusion. Reviewing the satisfactory information conveyed in the several local returns in connexion with the very visible diminution in the amount of sickness and the rate of mortality throughout the district, as indicated by the statistical tables in the appendix, nothing can be more gratifying to your Officers of Health, than the contemplation of what may be further accomplished by a continuation in the same direction of their individual and combined exertions. The importance of the matters to which I have been called upon to refer in this report in behalf of my colleagues, is very generally admitted, and at the present period when there are unmistakeable threatenings of the re-appearance of a disease from which the metropolis so seriously suffered in former years, these measures justly occupy a large 10 share of the public attention. It is the earnest hope of your Medical Staff, that prompt action will always be taken upon recommendations having for their object the amelioration of the sanitary condition of the poor, »ince they are convinced that in proportion as sickness and mortality is diminished amongst that class of the community, will prosperity accrue to the district, and the best and highest interest of every individual resident be promoted. I am, Gentlemen, Most obediently yours, R. HARLAND WHITEMAN. Chairman of the Associated Medical Officers of Health of the Wandsworth District. Putney, June, 1857. APPENDIX. TABLE I. Deaths from All Causes Registered in the entire Wandsworth District during the Quarter, ending 27th June, 1857. Under 5 Years of Age. CAUSES or DEATH. Under 20 Years of Age. At 20 and under 40 Years of Age. At 40 and under 60 Years of Age. At 60 and under 80 Years of Age. At 80 Years of Age and upwards. Total. Under 5 years of Age. CAUSES of DEATH. Under 20Years of Age, At 20 and under 40 Years of Age. At 40 and under 60 Years of Age, At 60 and under 80 Years of Age. At 80 Years of Age and upwards. Total. 1.—Zymotic Class: Gastritis ... ... ... ... ... ... Small Pox ... ... ... ... ... ... Enteritis ... ... ... ... ... ... 1 Measles I ... ... ... ... 1 Peritonitis ... ... ... ... ... ... 2 Scarlatina 3 ... ... ... ... 3 Ascites ... ... ... ... ... ... 10 Hooping Cough. 11 ... ... ... ... 11 Ulceratn. of intestines ... ... ... ... ... ... 3 Croup 4 ... ... ... ... 4 Hernia ... ... ... ... ... ... 1 Thrush 1 ... ... ... ... 1 Ileus ... ... ... ... ... ... 2 Diarrhoea 4 ... ... ... 1 5 1 Intussusception 1 1 ... ... ... 2 Dysentry ... ... ... ... ... ... Stricture of intestines ... ... ... 1 ... 1 Cholera 1 ... ... ... ... 1 Disease of Stomach ... 2 1 3 ... 6 Influenza ... ... ... ... ... ... Disease of Pancreas ... 2 1 3 ... 6 Purpura, Scurvy ... ... ... ... ... ... Hepatitis ... ... ... 1 ... ... Ague ... ... ... ... ... ... Jaundice ... ... ... ... ... ... Remittent Fever ... ... ... ... ... ... Disease of Liver ... 1 1 2 2 6 Infantile Fever. ... ... ... ... ... ... Disease of Spleen ... ... ... ... ... ... Typhus 1 1 2 1 ... 5 8.—Of Kidneys, &c. Metria ... 1 ... ... ... 1 Nephritis ... ... ... ... ... Rheumatic Fever ... ... ... ... ... ... Nephria ... ... ... ... ... ... Erysipelas ... ... ... 1 ... 1 Ischuria ... ... ... ... ... ... 2 Syphilis 2 ... ... ... ... 2 Diabetes ... ... ... ... ... ... Noma ... ... ... ... ... ... Stone ... ... ... ... ... ... Hydrophobia ... ... ... ... ... Cystitis ... ... ... ... ... ... 2.—Dropsy, Cancer, & others of uncertain seat Stricture of Uretha ... ... ... ... ... ... Disease of Kidneys &c ••• 2 ... ... ... 2 Hæmorrhage ... .. ... ... ... ... 9.—Of Uterus, vis:— Puerperal Disease, &c ... 2 ... ... ... 2 Dropsy ••• ... 1 ... ... 1 Abscess ... ... ... ... ... ... Paramenia ... ... 1 ... ... 1 Uleer ... ... 1 ... ... 1 Ovarian Dropsy ... ... ... ... ... ... Fistula ... ... ... ... ... ... Childbirth (seeMetria) ... 1 ... ... ... 1 Mortification ... ... ... ... ... ... Disease of Uterus, &c. ... 2 ... 1 ... 3 Cancer ... ... ... ... ... ... 10.—Of Joints, Bones, viz.:—Rheumatism, &c. Gout ... ... ... ... ... ... 3.—Tubercular Class. Scrofula ... ... ... ... ... ... Arthritis ... ... ... ... ... ... Rheumatism ... ... ... ... ... ... 12 Tabes Mesenterica 13 ... ... ... ... 13 Disease of Joints, &c. ... ... ... ... ... ... 5 Phthisis 8 23 12 5 ... 48 11.—Of Skin, &c.; Carbuncle ... ... ... ... ... ... 2 Hydrocephalus ... 2 ... ... ... ... 2 4.—Of Brain,Nerves, &c. Phlegmon ... ... ... ... ... ... Cephalitis ... ... ... ... ... ... Disease of Skin, &c. ... ... ... ... ... ... Apoplexy ... ... 1 2 3 2 12,—Malformation 2 ... ... ... ... 2 Paralysis ... 1 3 ... 4 13.—Debility from Premature Birth, &c 5 ... ... ... ... 5 Delirium Tremens ... ... ... ... ... ... Chorea* ... ... ... ... ... 1 14.—Atrophy ... ... ... ... 2 ... 2 Epilepsy 2 4 1 1 ... 8 15.—Age ... ... ... 11 8 19 Tetanus ... ... ... ... ... ... 16.—Sudden 1 ... 3 1 ... 5 Insanity ... ... 3 1 ... 4 17.—Violence, tion.&c. 6 Convulsions 6 ... ... ... ... 6 2 Disease of Brain, &c. 2 ... ... ... ... 2 Intemperance ... ... ... ... ... ... 5.—Of Heart, &c . Privation of Food ... ... ... ... ... ... Pericarditis 1 ... ... ... ... 1 2 Want of Breast Milk 2 ... ... ... 2 Aneurism ... ... ... ... ... ... ... Neglect 1 ... ... ... ... 1 Disease of Heart, &c 2 3 2 5 1 13 Cold ... ... ... ... ... ... 6— Of Respiratory Organs Poison ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... 1 Burns and Scalds 1 ... ... ... ... 1 10 Bronchitis 11 ... 3 4 .. 18 Hanging 1 ... ... ... ... 1 Pleurisy ... ... ... ... ... ... ... Suffocation ... ... ... ... ... ... 12 Pneumonia 13 1 ... ... ... 14 Drowning ... 1 ... ... ... 1 Asthma ... ... ... ... ... ... Fractures ... 1 ... ... ... 1 4 Disease of Lungs, &c. 4 2 5 ... ... 11i Wounds ... ... ... ... ... ... 7.—of digestive Organs Other Violence ... ... 1 ... ... ... 4 Teething 4 ... ... ... 4 Total of eight last heads ... ... ... ... ... 6 Quinsey 1 ... ... ... ... 1 Causes not specified ... 1 1 1 ... 3 TABLE II. Summary of Deaths in each Sub-District during the Quarter, ending 27th June, 1857. Classified according to Age, Sex, and Social Position. DISEASES. Sub-Districts. Sex. Age. Social Position. Ulapham—Population I6,290 Area in Acres 1233. Wandsworth—Population 9611 Area in Acres 2478. Battersea—Population 10,560 Area in Acres 2343. Putney—Population 5280 Area in Acres 2176. Stmitham, including Tooting and Balhara—Population 9,023. Area in Acres, 3465. Males. Females. Total. Under I year. From 1 to 5 years. From 5 to 10 years. Under 20 Years, including all under 10 years. At 20, and under 40 years of age. At 40 and under 60 years of ape. At 60 and under 80 years of age 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, &c. | Middle and Trading Class, Shopmen, Clerks, &c. Industrial and labouring Classes. 1. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles 1 ... ... ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... .. ... 1 3. Scarlatina and lignent Sone Throat 1 1 ... ... 1 1 2 3 ... 2 1 3 ... ... ... ... ... 1 2 4. Hooping Cough 1 1 5 ... 1 5 6 11 6 4 1 11 ... ... ... ... ... ... 5 6 5. Diarrhoea & Dysentry 2 3 ... ... ... ... 5 5 ... 2 1 4 ... ... ... ... ... ... ... 4 6. Cholera, (English) ... ... 1 ... ... ... 1 1 ... ... 1 1 ... ... ... ... ... ... ... 1 7. Fever 1 i 1 2 1 4 5 ... ... 1 1 1 2 1 ... ... ... 5 8. Erysiplsa ... 1 ... 1 ... 1 ... ... ... ... ... ... 1 ... ... 1 ... ... 9. Puerperal Fever ... ... 1 ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... 1 10. Lung Diseases, cept Phthistis 14 5 15 5 4 18 25 43 18 8 ... 27 3 6 7 ... 4 15 24 11. Phthisis 16 9 15 2 6 26 22 48 3 2 1 8 23 12 5 ... 1 1 16 30 12. Hydrocephalus, Atrophy, Scrofula, and the sions of Children 10 5 5 5 1 16 10 26 17 8 1 26 ... ... ... ... ... ... 8 18 13. Other Diseases 28 24 32 6 9 50 49 99 9 4 4 20 19 19 32 9 2 9 28 60 14. Violence, Privation, & Premature Birth 4 1 3 2 3 12 1 13 6 2 ... 10 2 1 ... ... ... 1 ... 12 Totals. 81 50 79 22 25 130 127 257 59 33 11 113 48 40 46 10 4 16 73 164 13 TABLE III. Births during the Quarter ending 27th June, 1857. SUB-DISTRICTS. Males. Females. Total. CLAPHAM 69 58 127 WANDSWORTH 37 50 87 BATTERSEA 75 59 134 PUTNEY 25 30 55 STREATHAM including TOOTING and BALHAM 34 22 56 Total 240 219 459 Meteorological Means. Eor the Quarter ending 27th, June 1857. Barometer corrected mean 29-920 Mean temperature of the air 39º3 Mean degree of humidity 0898 Mean amount of Ozone 2.0 Amount of Rain collected 4.06 Wind (general direction of ) Westerly. TABLE IV. Cases of Sickness under the Treatment of the Union Medical Officers, with the Deaths from each Class of Disease, during the Quarter, ending 27th June. 1857. Compiled from the District Medical Relief Books. Sub-districts. Total Cases of Sickness treated in each SubDistrict. 1. Small Pox. 2. Measles. 3. Scarlatina and Malignant Sore Throat. 4. Hooping Cough. 5. Diarrhoea and Dysentry. 6. Cholera. 7. Fever. 8. Erysipelas. 9. Puerperal Fever. 10. Lung Diseases except Phthisis 11. Phthisis. 12. Hydrocephalus Atrophy, Scrofula^ Convulsions of children. 13. Other Diseases 14. Violence, Privation, & Pre. mature Birth Total Deaths in each Sub-District. Cases. Deaths Cases. | Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths J Cases Deaths Cases. Deaths Cases. Deaths CLAPHAM 365 12 1 9 9 20 11 70 3 10 5 3 2 204 1 17 12 WANDSWORTH 269 3 2 30 10 5 20 1 3 1 6 1 190 3 6 BATTERSEA 446* 2 25 1 8 3 1 57 3 7 7 338 9 6 21 PUTNEY 152 — — 4 7 1 7 1 1 1 5 116 1 11 3 STREATHAM 50 1 1 1 2 2 2 3 1 1 33 5 2 TOOTING 31 7 1 1 2 5 1 13 2 1 B ALH AM 21 6 1 1 1 13 2 3 TOTALS 1334 16 1 18 37 2 65 36 12 1 160 9 28 10 14 3 907 16 41 46 * The Workhouse of the Union is included in the Battersea Sub-District. REPORT ON THE SANITARY CONDITION OF THE SEVERAL PARISHES COMPRISED IN THE WANDSWORTH DISTRICT, FOR THE QUARTER THAT ENDED SATURDAY, SEPTEMBER 26, 1857. London: PRINTED BY W.. BRICKHILL, STEAM PRINTING WORKS, NEWINGTON BUTTS. 1858. REPORT ON THE SANITARY CONDITION OF THE SEVERAL PARISHES COMPRISED IN THE WANDSWORTH DISTRICT, FOR THE QUARTER THAT ENDED SATURDAY, 26th SEPTEMBER, 1857. To the Board of Works for the Wandsworth District. Gentlemen, The number of deaths from all causes registered in the entire district, in the quarter that ended 26th September of the present year was 280; in the corresponding quarters of three preceding years (excludiag for obvious reasons the cholera year of 1854,) the average number of deaths was 244; but as the deaths in the quarter just expired occurred in an increased population, this average has to bo raised proportionally to such increase, in which case it becomes 268. The returns of deaths, therefore, in the September quarter of the present year exhibit an excess of 12 over the corrected average. At first sight this calculation appears to place the health of the district in a somewhat unfavourable light, but when it is considered that the death-rate of the quarter just expired was greatly augmented by an unusual mortality from diarrhoea and summer cholera (in all 62 fatal cases), the small increase noted above will not excite so much surprise, especially if it be borne iu mind that the excess is exactly balanced by the register during the quarter of the unusual number of 12 deaths from violence, suicide, &c., viz.: 5 from drowning, 1 from hanging, and 5 from wounds, fractures, and other injuries of the person. It should also be recollected that the excessive death rate from diarrhoea during the quarter was by no means confined to the Wandsworth District. Much as we have to deplore this unusual mortality from one particular disease, wc have the gratifying fact to place in the opposite scale, that the number of deaths in the district during the same period, from most of the other severe forms of zymotic disease, though occurring in an 4 increased population, was only one in excess over that recorded in the corresponding quarter of 1856, as will be clearly exhibited in the following table:— Zymotic diseases Deaths in quarter ending 27th Sept. 1856 Deaths in quarter ending 27th Sept. 1857. Small Pox 1 0 Measles 1 0 Scarlatina 3 3 Hooping Cough 8 7 Fever 6 10 Total 19 20 Of these five diseases of the zymotic class the excess is shown to have arisen entirely from the increased fatality from fever, which is accounted for in some measure by the unusually high temperature of the months of July and August, and even of tbe latter part of September, and by the many and sudden atmospheric changes throughout the quarter. In one year only (1818) out of 86 years, as ascertained by Mr. Glaisher, did the temperature exceed that of the three summer months now under review; the month of September was also more humid than usual, but those of July and August were less so than has been observed for many years. In three of the diseases enumerated in the above table a decrease in the number of deaths in the September quarter, 1857, is exhibited, and in scarlatina the numbers at both periods are equal. It is worthy of remark that all the deaths from fever in the past quarter, as well as the majority of those from other epidemic and endemic diseases, occurred amongst the industrial classes residing for the most part in unculverted localties, or in courts, lanes, and alleys known to be badly paved, inefficiently drained, or having open ditches, or other nuisances in their vicinity. At Wandsworth, five cases of fever appear to have terminated fatally; two in Garratt Lane, one at the Waterside, one in Edwards' Place, and one in North Street. At Clapham, three deaths from fever were registered in the quarter, their localities being, Crescent Place, Park Road; James's Place, Larkhall Lane; and Park Hill. At Battersea, but one death from fever has been recorded, and that took place in York Street, where it appears there is an open ditch. Streatham also returns one death from the same malady, and as having taken place in a locality (Bridge Green, Lower Streatham,) not yet possessing the advantages of good drainage and other sanitary improvements. Putney has, fortunately, no registered death from fever 5 to place on the present quarterly record,—a circumstance that may be very fairly attributed to the improved state of the drainage throughout the town during the last year. This sub-district, doubtless from the same cause, has also escaped in a remarkable manner the fatality usually attendant upon the other diseases of the zymotic class, prevalent in the summer and autumn months, as is shown in the weekly returns of the Registrar General, from which the following table has been compiled. Deaths from six of the principal Zymotic Diseases registered in each sub-district during the thirteen weeks of the September quarter, 1857. SUB-DISTRICTS. Small Pox. Measles Scarlet Fever. Hoopng Cough, Diarrhæa. Fever Typhus & Typhoid. Total Clapham ... ... 2 6 21 3 32 Battersea ... ... ... ... 16 1 17 Wandsworth 10 6 15 Putney ... .. ... ... 1 ... 1 Streatham, (including Balham and Tooting ... ... 1 1 4 1 7 Totals ... ... 3 7 52 10 72 The above table will also point out not only the sub-districts in which preventible disease has been most rife during the quarter, but those to which the attention of the Board and of its executive officers is most needed. Sickness and Mobtalitx amongst the Union Poor. Table IV., appendix, exhibits a most favourable rate of mortality amongst the indigent receiving parochial relief out of the workhouse. Out of 1474 cases of sickness attended, and administered to, by the Union Medical Officers during the quarter, only 52 deaths resulted, although a severe and very fatal epidemic prevailed nearly the whole time. By excluding from this table all the cases of diarrhoea and English cholera, that came under treatment, and comparing the number of other diseases treated, with the number recorded in table IV., appended to the Report of the previous or June quarter, a great improvement in the health of the pauper population of this Union will be made manifest. For example in the one class of maladies connected with the lungs, including phthisis, as many as 188 cases were treated during the quarter that ended 27th June last, of which number 25 resulted in death ; whereas in the quarter that expired on the 26th September, 56 cases and 14 deaths are all that are found recorded in the Medical Relief Books. 6 Local Summaries. Clapham.—Mr. McDonogh appends to his return the following' remarks : "Diarrhoea, fever, hooping cough, and scarlatina, the latter "in a mild form, prevailed in the month of July; during August "diarrhoea became still more prevalent and severe, and hooping cough "increased at the latter end of the month. At the early part of September "diarrhoea became less prevalent, and towards the close of the month "but few cases comparatively speaking presented themselves. The "numbers of registered deaths from all causes varied considerably during "the quarter, the lowest number (10) having been recorded in the fort' "nightly return of July 4th, and the highest (16) in the return of "September 12th." Mr. McDonogh adds, that " 209 inspections of "houses, &c., took place during the quarter, 43 cesspools were filled "up, 44 closets supplied with water, and 2 new closets constructed." Further, that "there wore 174 complaints received, 74 notices served, "and 11 nuisances removed or abated." With reference to the mortality from fever, the locality of Crescent Place and James's Place, in cach of which a death took place, the drainage is described as "defective," whilst the sanitary condition of Park Hill, where the third death from fever occurred, is stated to be "tolerably good." Wandsworth.—Mr. Nicholas writes, "The improved state of the "health of this sub-district, which obtained during the previous "quarter of this year still continues, the total number of deaths "registered during the past quarter was 62, occurring equally in the "two sexes; this number is less by 11 than the average of the corres'ponding quarters of the last 7 years, and 1 less Jhan the corres"ponding quarter of last year. There were 15 deaths from epidemic "diseases, being 4 more than occurred in the corresponding quarter of "last year. This increase was chiefly due to diarrhoea, which was with "one exception confined to infants. There was (see Table IV., "appendix,) a corresponding increase of diarrhoea this quarter amongst "the poor; but as there is an absence of other contagious diseases, the "total amount of epidemic disease is nearly the same. There was "upwards of Jth more general disease and twice the number of "resulting deaths amongst the poor than occurred in the same quarter "of last year; but still this statement is not above the average, for "the autumn quarter of last year was an unusually healthy one, and "inasmuch as the mean temperature of this quarter was 31/2º above the "average, is very satisfactory." 7 Battebsea.—Dr. Connor furnishes the following summary of sanitary Work suggested, and improvements accomplished, during the past quarter. "Houses inspected, 13; notices served to cleanse drains, cesspools "&c., 6; to construct drains where main sewers exist, 5; to convert "open cesspools into water-closets, 1; to remove swine, 2; to cleanse "unwholesome dwellings, 1; to remove other nuisances, 2; of the "above notices 11 have been complied with, and 6 remain to be enforced." In reference to the death from fever which is registered as having occurred in York Street, Dr. Connor writes, " I know nothing of this death myself, "but I can state that the street has good facilities for drainage, and that "there is an open ditch at one end which might influence a case of this "kind, if it occurred at that end." The number of deaths from all causcs in this Parish, during the quarter was 85, which is only six more than took place in the previous or June quarter, the excess being occasioned by the increased mortality from choleraic disease and diarrhoea. In the previous quarter the number of deaths from this latter cause was 5 only; in the present table (vide appendix) as many as 21 deaths are recorded as the result of these same maladies. Steeatham.—From this sub-district no return of house inspections, &c., has been received for the quarter that ended 26th September, owing, it is apprehended, to the office of Inspector having lately become vacant. To the return of sickness and mortality amongst the out-door poor of this sub-district, Mr. Brown, appends the following note:—" But one "death has occurred amongst the Union Poor during the quarter, "to an infant, only one day old, from atrophy. Diarrhfea has "been very prevalent, but not imich amongst the Union Poor; fever also "has been very prevalent, but only one death at the termination of the "quarter had occurred from it, and it has been confined exclusively to "that portion of the district callcd Lower Streatham, the drainage and 'sewerage in that locality not being in so good a state as in the other "parts of the district." Tooting and Balham.—Owing, it is supposed, to the same cause as stated under Streatham, the usual return from the Inspector has not been forwarded. Mr. Ward remarks in reference to Balham, that " during "the quarter just ended, the prevailing sickness was almost exclusively "confined to diarrhoea, which, however, was of a mild character and "readily yielding to treatment. Of sanitary improvements many have "been accomplished, but several yet remain to be carried out, more "particularly in the way of drainage." 8 Putney. The most gratifying feature in the mortality return of this sub-district, (vide Table II, appendix) is almost the total absence of all record of fatal cases of the ordinary zymotic diseases. With the exception of English cholera, to which one child—as certified by the medical attendant—is registered as having succumbed, and of diarrhoea, which in my own practice, resulted in death in one instance (the deceased woman having reached her 99th year,) there have been no deaths from ordinary epidemic disease during the entire quarter. The total number of deaths from all causes—although the present return presents an excess of three over the June quarter—is below the average of corresponding seasons, after making the usual correction for increase of population. The table referring to the sickness and mortality of the out-door union poor is, as far as it relates to Putney, of an equally gratifying character; the nnmber of deaths recorded as having occurred amongst this class of persons in the Parish, amounting to only three during the entire quarter, out of 206 cases treated. This rate of mortality, considering how extensively diarrhoea prevailed amongst the class referred to, is extremely low, and has scarcely a parallel in the Union records for years past. In the corresponding quarter of 1856, the number of deaths amongst the same class of patients, was four, out of only 129 cases treated. The principal sanitary event of the quarter is the completion of the drainage and sewerage in the bye-ways and poorer localities of this town, to the inhabitants of which it has proved one of the greatest possible boons. In conclusion it may be observed that considerable advance has been made during the quarter towards improving the sanitary condition of the entile district, a fact which will be rendered still more apparent by a reference to the following report from the Inspector of the Wandsworth and Putney sub-districts, which I regret to say, came to hand too late to be inserted in its proper place amongst the local summaries. Inspector's Report for the Parish of Putney, for the Quarter ending September 29th, 1857. Number of Houses inspected 54 First notices served 14 Second do. do 3 Cesspools emptied 26 Do. filled up 24 Water supplied 15 Drained into Sewer 49 9 Dust Bin provided 20 Removal of Pig nuisances 4 Unwholesome dwellings lime-whited 1 Nuisance from foul ditch removed 1 Magisterial interference 0 , For the Parish of Wandsworth. Number of Houses inspected 65 First notices served 13 Second do. do 1 Cesspools emptied 19 Ditto filled up 19 Drained into Sewer 18 Closets constructed 18 Dust Bins provided 13 Removal of vegetable, dung, and other offensive matters 5 Removal of Swine 1 Unwholesome dwelling cleansed 1 Magisterial interference 0 (Signed,,) J. NIBLETT, Inspector. In respectfully urging upon the Board a continuance of efforts in the same direction, the excellent precautionary advice lately issued by the President of the Board of Health, and subsequently endorsed by the Registrar General, may be very appropriately referred to: the former authority thus concludes his able manifesto—" Local Boards may be "well assured that if any precautions adopted by them against Cholera, "should hereafter seem to have been superfluous in relation to that "epidemic,—if the suggested possibility of a fourth visitation should, "happily not now be realized—the pains and cost which may have "been given to sanitary improvement will in no degree have beeii wasted, "since undoubtedly such exertions will have borne fruit in preventing "other disease, and in lessening both the misery and the expense, the "waste of life and the waste of money, which is now the consequence "of defective sanitary arrangements." It need scarcely be remarked that your Officers of Health entirely concur in every principle enunciated, and in every recommendation contained in the valuable document from which the above is an extract—more especially as regards the 10 water supply of a district, and the necessity of preserving and publishing for the convenience of comparison, correct local records of the fluctuations of sickness and mortality - and they confidently appeal to the Board to revoke its decision with respect to the publication of the quarterly statistical tables and summaries relating to this district, by which publication they hope not only to carry out more effectually the recommendations above referred to, but to secure for themselves a more efficient co-operation with the Board of Health, the Registrar General, and their fellow labourers in the other districts of the Metropolis. I have the honor to be, Gentlemen, Your very obedient servant, R. HARLAND WHITEMAN, Chairman of the Associated Ilealth Officers of the Wandsworth District. Putney October, 1857. APPENDIX. TABLE I. Deaths from All Causes Begistered in the entire Wandsworth District during the Quarter ending 26th September, 1857. Under 5 Years of Age. CAUSES or DEATH. Under 20 Years of Age. At 20 and under 40 Years of Age. At 40 and ander 60 Years of Age. At 60 and under 80Years of Age. At 80 years of Age and upwards. Total. Under 5 Years of Age. CAUSE8 of DEATH. j Under20 Years af Age. I At 20 and under 40 Y'ears of Age I At 40 and under 60 | YcaraofAge At 60 and under 60 Years of Ape, At 80 Years of Age and upwards. Total. 1—Zymotic Class: Gastritis ... ... ... ... ... ... Small pox ... ... ... ... ... ... Enteritis 1 ... ... 1 ... 2 .Measles ... ... ... ... ... ... Peritonitis 2 ... ... ... ... 2 2 Scarlatina 3 ... ... 3 Ascites ... ... ... ... ... ... 5 Hooping Cough 7 ... ... ... ... 7 Ulceratn. of intestines ... ... ... ... ... ... 2 Croup 3 ... ... ... ... 3 Hernia ... ... ... 1 ... 1 1 Thrush 1 ... ... ... ... 1 1 Heus ... ... ... 1 ... 1 12 Diarrhoea 44 2 2 5 2 55 Intussusception 1 ... 1 ... 2 1 Dvsentry 1 ... ... 2 1 4 Stricture of intestines- ... ... ... ... ... ... 3 Cholera 3 ... ... ... ... 3 Disease of Stomach ... ... ... 1 ... 2 Influenza ... ... ... ... ... ... Disease of Pancreas ... ... ... ... ... ... Purpura, Scurvy ... ... ... ... ... ... 1 Hepatitis ... ... ... ... ... ... Ague ... ... ... ... ... ... Jaundice 1 ... ... ... ... ... Remittent Fever ... ... ... ... ... ... Disease of Liver 1 ... ... ... ... 1 Infantile Fever ... ... ... ... ... ... Disease of Spleen 1 ... ... ... ... ... 2 Typhus 4 3 2 ... ... 10 8.—01 Kidneys, &c. Metria ... ... ... ... ... Nephritis ... ... ... ... ... ... Rheumatic Fever ... ... ... ... ... ... Nephria ... ... ... ... ... ... 1 Erysipelas 2 ... ... ... 3 Ischuria ... ... ... ... ... ... Syphilis ... ... ... ... ... ... Diabetes ... ... ... ... ... ... 1 Noma 1 ... ... ... ... Stone ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... Cystiti ... ... ... ... ... ... 2.—Dropsy, Cancer, & others of uncertain 6eat Stricture of Uretha.. ... ... ... ... ... ... Disease of Kidneys &e ... 1 ... ... ... 1 Haemorrhage ... 1 ... ... ... 1 9.—Of Uterus, viz:— Puerperal Disease, Slc... Dropsv ... ... ... 2 2 Abscess ... ... ... ... ... 1 Paramenia ... ... ... ... ... ... Ulcer ... ... ... 1 ... 1 Ovarian Dropsy ... ... ... ... ... ... Fistula ... ... ... ... ... ... Childbirth (see Metria) ... ... 1 ... ... 7 Mortification 1 ... ... ... ... 2 Disease of Uterus, &c. ... ... ... ... ... 1 Cancer ... 1 ... ... ... 1 10.—Of Joints, Bonce, viz.:—Rheumatism, &c. Gout ... ... ... ... 1 3.—Tubercular Class: Arthritis ... ... ... ... ... ... scrofula ... ... ... ... ... ... Rheumatism ... ... 1 1 ... 2 20 Tabes Mesenterica ... 20 ... ... ... ... 20 Disease of Joints, &c. ... ... ... 1 ... 1 1 Phthisis 6 15 9 4 ... 34 11.—Of Skin, &c-; ... ... ... ... ... ... 3 Hydrocephalus 3 ... ... ... ... 3 Carbuncle ... ... 1 1 ... 2 4.—Of Brain, Nerves. Phlegmon ... ... ... ... ... ... 1 Cephalitis 1 ... ... ... ... 1 1 Disease of Skin, &c. ... 1 ... ... ... 1 Apoplexy ... 2 6 ... ... 9 3 12,—Malformation., 1 1 ... ... ... 2 Paralysis ... 1 2 3 ... 7 13.—Debility from Delirium Tremens ... 1 ... ... ... 1 mature Birth, &c 3 ... ... ... ... 3 Chorea ... ... ... ... ... ... 14.—Atrophy ... ... 3 3 ... 6 Epilepsy ... ... 1 1 ... 2 15.—Age ... ... ... 8 8 16 Tetanus ... ... ... ... ... ... 16.- Sudden ... ... ... ... ... ... Insanity ... ... ... ... ... ... 17.—Violence. 1 Convulsion 1 ... ... ... ... ... tion, &C ... ... ... ... ... ... 2 Disease of Brain, &c. 2 2 2 3 ... 9 Intemperance ... ... ... ... ... ... 5.—Of Heart, &c 4 Privation of Food .. ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... Want of Breast Milk 4 ... ... ... ... 4 Aneurism ... ... ... ... ... Neglect ... ... ... ... ... ... Disease of Heart, &c ... 2 2 1 ... 5 Cold ... ... ... ... ... ... 6—of Respiratory Organs Poison ... ... ... ... ... ... 2 Laryngitis 2 ... ... ... ... 2 Burns and Scalds ... ... ... ... ... ... 2 Bronchitis 2 1 2 2 7 Hanging ... 1 ... ... ... 1 Pleurisy ... ... ... ... ... ... ... Suffocation ... ... ... ... ... ... 4 Pneumonia 4 ... ... ... 1 5 Drowning 4 ... 2 ... ... ... Asthma 1 Fractures 1 ... ... 1 ... 6 Disease of Lunirs. &c 1 2 1 ... ... 4 Wounds 1 ... 1 ... ... 2 7—Of Digestive Organs Other Violence ... ... ... ... ... ... 3 Teething 3 ... ... ... ... 3 Total of eight last heads 6 1 3 2 ... 12 Quinsey ... ... ... ... ... ... 1 Causes not specified 2 ... 1 ... ... 3 >—* to TABLE II. Summary of Deaths in each Sub-Di»trict during the Quarter ending 26th September, 1857. Classified according to Age, Sex, and Social Position. DISEASES. SUB-districts Sex. Age. Social Position Clapham—Population 16,290 Area in Acres 1233. Wands worth—Population 9,611 Area in Acres 2478. Battersea—Population 10,560 Area in Acres 2343, Putney—Population 5,280 Area in Acres 2175. Streatham, including Tooting and Balham—Population 9,023 Area in Acres 3,466. Males Females Total Under 1 Year. From 1 to 6 Year». From 5 to 10 Years. Under 20 Years, including all under 10 Years. At 20, and under 40 Years of Age. At 40, and under 60 Years of Ago. At 60, and under 80 Years of Age. 80 Years and upwards. Nobility and Gentry. Professional Class, Merchants Bankers, &c Middle and Trading Class, Shopmen, Clerks, &c. Industrial and Labouring Classes. 1. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... 3. Scarlatina and Ma-) lignant Sole Throat J 2 ... ... ... 1 2 1 3 1 1 1 3 ... ... ... ... ... ... 2 1 4. Hooping Cough 6 ... ... ... 1 1 6 7 1 5 1 7 ... ... ... ... ... 1 2 4 5. Diarrhoea & Dysentery 23 10 19 2 5 24 35 59 34 10 ... 45 2 2 7 3 1 3 8 47 6 Cholera ... ... 2 1 ... 2 1 3 1 2 3 ... ... ... ... ... ... 1 2 7. Fever 3 5 1 1 4 6 10 2 1 4 3 2 1 ... ... ... 2 8 8. Erysipelas ... 1 1 1 ... 2 1 3 1 ... 1 2 ... ... 1 ... ... ... ... 3 9. Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10. Lung Diseases, ex-1 5 2 5 5 1 11 7 18 4 4 ... 9 4 2 2 1 1 ... 3 14 11. Phthisis 9 6 11 5 3 17 17 34 ... 1 6 15 9 4 1 7 9 17 (1). Hydrocephalus, Artrophy Scrofula and the Convul 8 3 13 3 1 18 10 28 23 5 28 ... ... ... ... ... ... 7 21 3. Other diseases 25 32 24 1 11 49 47 96 8 2 3 18 13 24 32 9 2 5 26 63 14. Violence, Privation,) & Premature Birth J 1 3 9 4 2 13 6 19 7 1 2 13 1 3 2 ... ... 2 1 16 Totals, 82 62 85 25 26 143 137 280 80 33 9 138 38 42 49 13 5 18 61 196 13 TABLE III. Births during the Quarter ending 26th of September, 1857. SUB-DISTRICTS. Males. Females. Total. CLAPHAM 54 74 128 WANDSWORTH 41 35 76 BATTERSEA 73 73 146 PUTNEY 21 21 42 STREATHAM, including TOOTING and BALHAM 29 33 62 Total 218 226 444 Meteoeological Means, For the Quarter ending 26th of September, 1857. Barometer corrected mean 29.953 inch. Mean temperature of the air 62o. 3 Mean degree of humidity 0.914 Mean amount of Ozone 1.8 Amount of Rain collected 8.101 inch. Wind, (general direction of) W. & S. W. * This Return does not include the Sickness and Mortality in the Workhouse. TABLE IV. Cases or Sickness amongst the Poor under the Treatment of the Union Medical Officers, with the Deaths from each Class of Disease, during the Quarter, ending 26th September, 1857, compiled from the District Medical Belief Books. Sub-Districts. Total Cases of Sickness treated in each Subdistrict 1. Small Pox. 2. Measles. 3. Scarlatina and Malignant Sore Throat. 4, Hooping Cough. 4. Diarrhoea and Dysentery. 6. Cholera. 7. Fever. 8. Erysipelas. 9. Puerperal Fever. 10. Lung Diseases exceptPhthisis 11. Phthisis. 12. Hydrocephalus, Atrophy, Scrofulu,&Convulsions of Children. 13. Other Disease. 14. Violence, Priva tlon and Premature Birth Total Deaths in each Sub-district. Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases, Deaths Cases. Deaths Cases. Deaths Cases. Deaths | Cases. 1 Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. Deaths. CLAPHAM 462 10 6 1 252 4 28 1 16 9 3 1 118 4 21 12 WANDSWORTH 357 1 147 4 2 3 9 1 2 193 6 10 'BATTERSEA 270 98 6 6 2 2 5 7 5 159 2 22 PUTNEY 206 101 1 5 5 10 3 80 2 2 3 STREATHAM 76 1 4 1 13 2 41 1 6 1 TOOTING 81 2 11 3 1 3 1 1 60 2 3 BALHAM 22 13 1 1 8 1 TOTALS 1474 1 16 7 1 630 11 11 2 53 2 7 42 14 14 5 5 659 15 29 2 52 WAN 9 SANITARY DEPARTMENT. REPORT ON THE SANITARY CONDITION OF THE SEVERAL PARISHES COMPRISED IN THE WANDSWORTH DISTRICT, FOE THE QUARTER THAT ENDED SATURDAY, DECEMBER 26th, 1857. London; PRINTED BY W. BRTCKITILL, STEAM PRINTING WORKS. 1858. REPORT ON THE SANITARY CONDITION OF THE SEVERAL PARISHES COMPRISED IN THE WANDSWORTH DISTRICT. FOR THE QUARTER THAT ENDED DECEMBER 26th, 1857. To the Board of Works for the Wandsworth District. Gentlemen, The Medical Officers of Health desire, in this their general report for the quarter that ended December 1857, to bring under the consideration of the Board, in as concise a form as possible consistent with the requirements of the subject, the localized statistics of disease and mortality, together with a summary of the principal sanitary events of the period. Believing, that in order to furnish the means of properly comparing the state of the public health of one period with that of another, it would be inexpedient to depart materially from their original plan of proceeding, it has been deemed advisable to adopt the same tables, and to follow the same arrangement in this as in former reports; and it is hoped, that whilst furnishing reliable data, which may serve to test the sanitary value of the measures executed from time to time under the authority of the Board, your Medical Officers of Health will be considered to have contributed something towards the realization of the 4 objects contemplated by recent sanitary legislation, and to have rendered some, not unimportant, assistance, towards the promotion of the Science of Preventive Medicine. Local Summaries. Viewed as retrospects of the principal sanitary events of given periods, the quarterly reports are rendered valuable in proportion to the information they are made to afford by which to judge of the effects of the measures of the Board, in diminishing within the District the amount of sickness and the rate of mortality. The amount and importance of the sanitary work actually accomplished during the past quarter will be best shown by arranging the information obtained from the Inspectors of the several sub-districts, and presenting the same in a tabular form. This done, the test furnished by the statistical data embodied in the tables appended to this and former reports, may with greater facility be brought to bear upon the subject, and conclusions drawn from the suggested analysis that cannot fail to convince the most sceptical, that the Wandsworth District is making considerable advancement in the direction of improvement and healthfulness. It should be observed, with reference to the following tabular summary, that the returns from the sub-districts of Streatham, Tooting, and Balham embrace the works, executed during the months of November and December only, these parishes having been without an inspector during the first month of the quarter. The Inspections enumerated in the table are exclusive of those of slaughterhouses, which every year form the subject of a distinct report from each of the Health Officers. 5 Summary of Sanitary Inspections, Notices served, and Improvements effected in the several sub-districts during the quarter that ended December 1857. Claphain. Buitersea Wandsworth. Putney. Streatham. Tooting. Balham. Totals. No. of houses and premises inspected 78 30 37 36 35 32 11 259 1st Notiees served 15 14 10 4 4 2 1 50 2nd Notices served - - 9 4 - 1 - 14 Cesspools emptied or cleansed 8 12 21 - 5 2 1 49 Cesspools abolished 25 28 12 6 3 8 3 85 Water-closets constructed 33 13 12 5 8 9 4 84 Water-closets supplied with water 38 13 12 5 8 9 4 89 Drains constructed, or coninected with sewer 40 50 12 5 8 11 5 131 Drains repaired, or trapped, or obstructions removed 33 8 1 2 6 3 - 48 Open ditches, ponds, &c., cleansed 1 1 1 1 9 3 7 23 Dust-bins provided 13 10 - 2 3 - - 28 Pig nuisances removed 20 3 1 2 - - - 26 Accumulations of oflal, manure, &c., removed 30 - 1 2 1 - 2 36 Unwholesome & dilapidated dwellings cleansed or repaired 1 - 1 1 1 - - 4 Cases investigated by Magistrate 1 1 1 - - - - 3 Compulsory orders obtained 1 4 - 5 - - - 10 Compulsory works executed 1 4 - 2 - - - 7 Works remaining in abeyancc from various causes - 2 - 3 - 7 2 14 Apart from the Sanitary work set forth in this table, (amounting it will be found, to upwards of 900 accomplished improvements of greater or less importance) many minor nuisances have been removed or abated throughout the District. In almost every instance where water has been laid on for closet purposes, a supply for culinary uses has been secured. A little more care, however, seems desirable in some parts of the District in the arrangements with regard to the supply of water to the 6 poor. In Wandsworth for example, there are instances* of water cisterns being placed within the closets, where the water remains exposed to all the contaminating influences usually found in such places, and where it is necessary for the tenants to go to obtain every drop of fluid for drinking and other domestic purposes. Additional Remarks relating to the several Sub-Districts. CLAPHAM.—In reference to this sub-district, Mr. Mc.Donogh states, in his return, that the health of the inhabitants continued good throughout the whole of October, with little or no epidemic disease coming under treatment. Throughout November and December, although the health of the locality was on the whole satisfactory, and particularly so amongst the poor, bronchial, catarrhal, and other affections of the respiratory organs prevailed to a considerable extent, and contributed somewhat largely to the registered mortality of those months. Mr. Mc. Donogh further states, that 55 complaints were entered in the complaint book and were attended to; and that 135 dwellings were carefully inspected by himself, finding however, in the majority of the examinations made, but little to complain of. In the early part of October 23 slaughter-houses were duly inspected ana reported on, and recommendations were tendered to the proprietors to adopt certain sanitary improvements, which were, with scarcely an exception, at once cheerfully carried out. In the return of November 7th, a recommendation was inserted that all persons keeping pigs should be registered by the Inspector, and cleanliness strictly enforced in every case. In subsequent returns attention was directed to numerous dwellings in the parish needing sanitary appliances to render them healthy residences for the poor. Especial attention was also called to the bad sanitary condition of Howard Street and of Waterloo Place, and to the state of several dung heaps and accumulations of offal. The deaths from all causes, during the Quarter, in Clapham were 84, the births 145—thus giving an excess of births over deaths of 61. Neither the amount of sickness, nor the rate of mortality amongst the pauper population was unusually high during the Quarter. Lung * In Martin's Buildings, Frogmore. 7 diseases, including phthisis, resulted in death amongst this class of persons in the greatest number of instances; for of 15 deaths, from all causes, (vide Table IV, Appendix,) it will be seen that 11 occurred from pulmonary affections alone. BATTETRSEA.—From this sub district a by no means unfavourable quarterly return has been received. As respects the poor of this parish, a very satisfactory state of things is indicated by the return of Dr. Connor, (vide Table IV, Appendix) by which it appears that, of 252 cases of sickness amongst the out-door recipients of Union relief, 5 deaths only have been registered during the past quarter, and that of these 5 deaths not one has been recorded as the result of epidemic disease. In the preceding quarter, the number of deaths amongst the same class was 22 out of 270 cases that came under treatment. The total number of deaths from all causes, and amongst all classes, in this sub-district, during the quarter just past, is 84, of which 26 are registered as the result of diseases of the organs of respiration, including phthisis. In the three preceding quarters, or those that ended in March, June, and September, the deaths from all causes were respectively 95, 79, and 85. The 84 deaths therefore, of the December quarter, occurring as they did in an increased population, may be considered to indicate an improving state of the public health of this locality, and very fairly leads to the inference that the sanitary measures already executed in the parish have not been altogether unproductive of beneficial results. With reference to the fatality attending epidemic maladies in this sub-district, and the localities of their occurrence, Dr. Connor writes, "There is nothing remarkable in the sanitary condition of the houses in which deaths have taken place from zymotic diseases during the quarter, except in Ford's Folly, which is in a very unwholesome and unhealthy state." WANDSWORTH.—Mr. Nicholas, in a Quarterly Appendix to his returns, makes the following remarks:—"A comparison of the mortality of the December quarters of previous years, together with a similar comparion of the sickness which has prevailed amongst the poor, with its attendant mortality, demonstrates by a very great diminution of disease both in amount and intensity, a very notable improvement in the health of this parish. During the 7 years, 1850-6, The average num- 8 ber of deaths in the quarter corresponding with the last was 69; this average being raised in proportion to increase of population, in order to admit of a just comparison, becomes 76. The total number of deaths registered during the past quarter was 68, and therefore 8 below the average. The comparison spoken of also shows that one-third fewer deaths from epidemic disease occurred in the past quarter than in the corresponding quarter of 1856. By a similar comparison of the tables of disease and mortality amongst the Union poor, it has been found that there was upwards of one-fifth less disease, and upwards of one-third fewer resulting deaths during the December quarter of 1857 than during the same quarter of 1856. The past quarter has been characterized by the prevalence of influenza, and much fatality from diseases of the respiratory organs; nearly one fourth of the total number of deaths being attributable to the latter diseases. The quarter has also been remarkable for an almost entire absence of the eruptive fevers. An unusually high state of the barometer prevailed, especially during December." STREATHAM, TOOTING, and BALHAM.—The sub-district which comprises the above three localities, under the respective sanitary superintendence of Mr. Brown, Mr. Chapman, and Mr Ward, furnishes returns for a very satisfactory quarterly summary, though it appears there has been a slight increase in the number of deaths during the past quarter over the number registered during the three preceding quarters. The total number of deaths from all the causes specified in Tables I and II, appended to this Report, is 28. In the three preceding quarters, the numbers of fatal cases were respectively 21 25, and 26. The excess of the past quarter is more marked in the register of lung diseases than in that of any other malady; but it is gratifying to find that, in respect to the diseases of the zymotic class, a considerable fall in the rate of mortality is observable in the present return when compared with that which immediately preceded it. In the quarter just past, but 3 deaths were recorded as the result of epidemic disease; whilst there appears in the register of the September quarter as many as 8 deaths from this class of maladies. The number of deaths during the quarter, compared with the number of eases treated amongst the out-door poor of the three parishes comprising the sub-district of Streatham, is also small. Of 108 cases of sickness, attended .by the Union, 9 Medical Officers, 7 only appear to have proved fatal, viz.:—1 at Streatham, 3 at Tooting, and 3 at Balham. PUTNEY.—In my own sub-district, I find the number of registered deaths, from all causes, during the three months constituting the December quarter of 1857, to be 18 only, and to be distributed amongst the different classes of society in the following proportions:—Nobility and Gentry, 1; Professional class, including Merchants, Bankers, &c., 1; Middle or Trading class, 6; Industrial or Labouring class, 10. Of the latter deaths, 6 were of persons receiving at the time Union relief. Deducting from these 6 deaths, one as the result of accident, and two from infirmity of age (80 and 88 years) the mortality from actual disease, although scarlatina and influenza prevailed extensively throughout nearly the whole of the quarter, will have been unusually slight. The 18 deaths, from all causes and amongst all classes, is also a rate of mortality greatly below the average. Amongst children under five years three deaths only have occurred, which is a much smaller proportion than usual at a season when lung diseases are so prevalent, and generally so fatal amongst the very young. Of persons whose ages exceeded 80 there died as many as 4; but as these latter may be justly said to have succumbed to old age and infirmity, the actual deaths from disease, during the quarter, may be set down as 14 only. Of the zymotic class of diseases, diarrhæa proved fatal to one person and fever to another. I carefully inspected the house in which the latter death took place and, although I found its sanitary condition to admit of some improvement, I discovered nothing which could be viewed as a cause of the affection. Mortality of the Quarter. The manuscript weekly returns of deaths occurring in the several parishes comprising the Wandsworth District, now so obligingly and regularly furnished by the Registrar-General, have been carefully collated and localized for the quarter under notice, and the results given in Tables I and II in the Appendix. A reference to these tables, and a comparison of them with those appended to the Report of the previous or September quarter, will furnish the gratifying fact of there 10 having occurred, during the past quarter, but 2 deaths only in excess of the number recorded in the three months immediately preceding— the difference being that between 280 and 282—thus shewing but a very slight increase considering the number of deaths (92) registered in the past quarter as the result of lung diseases exclusively. In order, however, to show that 282 deaths, occurring in a quarter comprising three of the most uncongenial months in the year, is not an excessive mortality, it is only necessary to compare the number of deaths in the three months we are now reviewing with the number registered in the corresponding quarter of the previous year, 1856. If this be done, a difference in favour of the quarter just past of as many as 30 deaths will be exhibited—the number, in the December quarter of 1856, being as high as 312. "With this fact, then, before us, we are fully justified in saying that the public health of the district is improving. Zymotic Diseases. But there is another fact to which reference may be very fairly made, as affording proof of the value of sanitary improvements in diminishing the rate of mortality. Taking six of the principal zymotic diseases that have proved fatal during the Christmas quarters of the two years of 1856 and 1857, and placing the numbers of deaths of each period in opposite columns, there will be exhibited a clear gain of 17 lives in favour of the latter. Zymotic Diseases. Deaths in December Quarter, 1856. Deaths in December Quarter, 1857. Small Pox 1 0 Measles 5 0 Scarlet Fever 8 3 Hooping Cough 12 5 Diarrhoea 5 9 Fever, Typhus & Typhoid 10 7 Totals 41 24 It cannot, certainly, be denied that the favourable temperature and other genial atmospheric influences of the last quarter may have 11 had much to do with the reduction in the number of fatal cases of epidemic diseases so greatly below the rate of the previous year; but something, it is considered, may be very fairly placed to the credit of sanitary improvements when it can be shown that, in all but one of the parishes of which the Wandsworth District is composed, a somewhat considerable decrease in the number of deaths resulting from the principal zymotic diseases has followed the execution of the measures emanating from the Board in the interval between the periods referred to. This fact will, perhaps, be more clearly shown in the following table. Table showing the Number of Fatal Cases resulting from Six of the Principal Zymotic Diseases in each sub-district during the corresponding December Quarters of 1856 and 1857. Zymotic Diseases. Clapham. Battersea. Wandsworth Putney. Streatham, including Tooting and Balham. Totals. Dec. Quarter 1856. Dec. Quarter 1857. Dec. Quarter 1856. Dec. Quarter 1857. 1 Dec. Quarter 1856. Dec. Quaitcr 1857. Dec. Quarter 1850. Dec. Quarter 1 1857. | Dec. Quarter 1856. Dec. Quarter 1857. 1856. 1857. Small Pox — — — — — — — — 1 — 1 — Measles 4 — 1 — — — — — — — 5 — Scarlet Fever 5 1 1 1 2 — -— — — 1 8 3 Hooping Cough 1 3 3 2 6 — 1 — 1 — 12 5 Diarrhæa 1 1 — 4 1 1 1 1 2 1 5 9 Fever 1 2 2 1 3 1 3 1 1 2 10 7 Totals 12 7 7 8 12 2 5 2 5 4 41 24 It is worthy of remark, that in most of the sub-districts where zymotic diseases have manifested themselves, they have proved more severe and more fatal in just those localities which seem destined to remain unhealthy by reason of the legal difficulties experienced in enforcing the execution of efficient sanitary measures in respect to property considered not to come within the jurisdiction, or sanitary supervision; of the Board, and where, consequently, suggested works of improvement stand but a slight chance of being carried out at present in a way to prevent the recurrencc of such preventible diseases 12 A consideration of the known causes of the severer forms of epidemic disease will show that few of them can be removed by measures of a trifling nature or of a mere temporary application. Extended works of a permanent character in the way of drainage, improved habitations for the poor, a better water supply, and, above all, powers to compel the abolition of cesspools, and the cleansing and ventilation of streets and other places inhabited by the indigent, in a way to secure for them more of the requisites of healthfulness and decency, are still desiderata. When even these are obtained, and obtained to the fullest extent (as at no distant day they doubtless will be) there will still remain the unceasing social duty on the part of those whose avocations bring them in daily contact with the poor of instructing the ignorant and the careless amongst this class how to use and not to abuse these benefits. To this end, apart from their more regular duties, your Officers of Health have, from the first, perseveringly devoted themselves; and they hold that there are but few things appertaining to their office of more importance than these practical teachings, seeing that without them the advantages to be derived from sanitary improvements have been seldom properly appreciated, or held in such estimation as to render them of permanent benefit to the localities to which they have been applied. I am, Gentlemen, Most obediently yours, R. HARLAND WHITEMAN. Chairman of the Associated Medical Officers of Health of the Wandsworth District. Putney, January, 1858. APPENDIX. TABLE I. Deaths from All Causes Registered in the entire Wandsworth Disteict during the Quarter, ending 26th December, 1857. ft Years of Age. CAUSES or DEATH. Under 20 Years of Age. At 20 and under 40 Years of Age. At 40 and under 60 Years of Age. At 60 and under 80 Years of Age. At 80 Years of Age and upwards. Total. Under 5 years of Age. CAUSES or DEATH. Under20Year8 af Age, At 20 and under 40 Years of Age. At 40 and under 60 Years of Age, At 60 and under 80 Years of Age. At 80 Years of Age and upwards. Total. 1.—Zymotic Class: Gastritis ... ... ... ... ... ... Small Pox ... ... ... ... ... ... Enteritis ... ... ... 1 ... 1 Measles ... ... ... ... ... ... Peritonitis ... ... 1 1 ... 2 1 Scarlatina 3 ... ... ... ... 3 Ascites ... ... ... ... ... ... 5 Hooping Cough 5 ... ... ... ... 5 Ulccratn. of intestines ... ... ... 1 ... 1 4 Croup 4 ... ... ... ... 4 Hernia ... ... ... ... ... ... 1 c Thrush 1 ... ... ... ... 1 Ileus ... ... ... ... ... ... 0 Diarrhoea 6 ... ... 1 2 9 1 Intussusception 1 ... ... ... ... 1 Dy sentry ... ... ... ... ... ... Stricture of intestines ... ... ... ... ... ... Cholera ... ... ... ... ... ... Disease of Stomach ... ... 1 ... ... 1 Influenza ... ... ... ... 2 2 Disease of Pancreas ... ... ... ... ... ... Purpura, Scurvy ... ... ... ... ... ... Hepatitis ... 1 ... ... ... 1 Ague ... ... ... ... ... ... Jaundicc ... ... ... 1 ... 1 Remittent Fever ... ... ... ... ... ... Disease of Liver ... 1 3 3 ... 7 Infantife Fever ... ... ... ... ... ... Disease of Spleen ... ... ... ... ... ... Typhus 4 2 1 7 8.—Of Kidneys, &c. Metria ... 1 ... ... ... 1 Nephritis ... ... ... ... ... ... Rheumatic Fever ... ... ... ... ... ... Nephria ... ... ... ... ... ... o Erysipelas ... ... ... ... ... ... Ischuria ... ... ... ... ... ... I Syphilis 2 ... ... ... ... 2 Diabetes ... ... ... ... ... ... Noma (fromGlanders) ... 1 ... ... ... 1 Stone ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... Cystitis ... ... ... 2 ... 2 2.—Dropsy, Cancer, & others of uncertain seat Haemorrhage ... ... ... 1 ... 1 Stricture of Uretha ... ... ... ... ... ... Disease of Kidneys &c ... 1 ... ... ... 1 9.-Of Uterus, viz:— Dropsy ... 2 ... 1 ... 3 Puerperal Disease, &c 1 Abscess 1 1 ... ... ... 2 Paramenia ... ... ... ... ... ... Ulcer ... ... ... ... ... ... Ovarian Dropsy ... ... 1 ... ... ... Fistula ... ... ... ... ... ... Childbirth (seeMetria) 1 ... ... ... ... 1 Mortification ... ... ... ... ... ... Disease of Uterus, &c. ... ... ... 1 ... 1 Cancer ... 1 1 1 ... 3 10.—Of Joints, Bones, viz.:—Rheumatism, &c. 1 Gout ... ... ... 1 ... 1 3.—Tubercular Class. Arthritis ... ... ... ... ... ... Scrofula l ... ... ... ... 1 Rheumatism ... ... ... ... ... ... 16 Tabes Mesenterica 17 ... ... ... ... 17 Disease of Joints, &c. ... ... 1 ... ... 1 2 Phthisis 7 21 8 2 ... 38 11.—Of Skin, &c.; Carbuncle ... ... ... ... ... ... 3 Hydrocephalus 3 ... ... ... ... 3 4.—Of Brain, Nerves, &c. Phlegmon ... ... ... ... ... ... 1 Cephalitis 3 ... ... ... ... 3 Disease of Skin, &c. ... ... ... ... ... ... Apoplexy ... 1 3 ... 1 5 1 12.—Malformation.,. 1 ... ... ... ... ... Paralysis ... 3 9 4 1 18 1 13.—Debility from Premature Birth, &c 10 ... ... ... ... 1 Delirium Tiemens ... 1 ... ... ... 1 Chorea ... ... ... ... ... ... 14.—Atrophy ... ... 3 1 10 Epilepsy 1 2 1 1 ... 5 15.—Age ... ... ... 8 12 4 Tetanus ... ... ... ... ... ... 16.- Sudden ... ... ... ... ... 20 Insanity ... ... 1 1 ... 2 17.—Violence, Priva- ... ... ... ... ... ... 3 Convulsions 4 ... ... ... ... 4 Disease of Brain, &c. 2 ... 1 1 1 5 Intemperance ... ... ... 1 ... 5.—Of Heart, &c ... ... ... ... ... ... Privation of Food ... ... ... ... ... 1 Pericarditis ... 1 ... ... ... 1 1 Want of Breast Milk 1 ... ... ... ... ... Aneurism ... ... ... ... ... ... Neglect 1 Disease of Heart, &c 2 ... 4 2 ... 8 Cold ... ... ... ... ... ... 1 6— Of Respiratory Organs Poison ... ... ... 1 ... Laryngitis 1 ... 1 ... ... 2 Burns and Scalds 1 11 Bronchitis 11 ... 4 7 4 26 Hanging ... ... ... ... ... ... in Pleurisy ... ... ... ... 1 1 1 Suffocation 1 ... ... ... ... ... 1U Pneumonia 12 1 3 ... ... 16 Drowning 1 2 ... ... ... 1 Asthma ... ... 1 2 ... 3 Fractures ... ... ... ... ... 3 1 Disease of Lungs, &c. 1 ... 2 ... ... 3 Wounds ... ... 1 ... ... 1 7.—Of digestive Organs 1 Other Violence 3 ... ... 1 1 1 Teething 1 ... ... ... ... 1 1 Causes not specified 1 ... 2 ... ... 4 Quinsey ... ... ... ... 1 1 3 14 TABLE II. Summary of Deaths in each Sub-District during the Quarter, ending 26th December, 1857. Classified according to Age, Sex, and Social Position. DISEASES. Sub-Districts. Sex. Age. Social Position. (Clapham—Population 16,290 Area in Acres 1233. Wandsworth—Population 8611 Area in Acres 2478. .battersea—Population 10,560 Area in Acres 2343. Putney—Population 5280 Area in Acres 2176. Streatham, including Tooting and Balham—Population 9,023. Area in Acres, 3466. 'Males. Females. Total. Under 1 year. From 1 to 5 years. From 5 to 10 years. Under 20 Years, including all under 10 years. At 20, and under 40 years of age. At 40 and under 60 years of age. At bO and under 80 years of age 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, &c. 1 Alturtle and 1 rading Class, Shopmen, Clerks, &c. Industrial and labouring Classes. 1. Small Fox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3. Scarlatina and Malignant Sore Throat 1 ... 1 ... 1 2 1 3 ... 1 2 3 ... ... ... ... ... ... 2 1 4. Hooping Cough 3 ... 2 ... ... 1 1 5 1 4 ... 5 ... ... ... ... ... ... 2 3 5. Diarrhoea & Dysentry 1 3 4 1 ... 5 4 9 3 2 1 6 ... ... ... ... ... ... 4 5 6. Cholera, ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7. Fever 2 1 1 1 2 8 4 7 ... ... 1 4 ... 2 ... ... ... ... 3 4 8 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Puerperal Fever ... ... ... 1 ... ... 1 1 ... ... ... ... 1 ... ... ... ... ... ... 1 10. Lung Diseases, ex- 25 5 14 1 9 25 29 54 15 8 1 26 1 11 9 7 5 1 12 36 11. Phthisis 11 11 12 2 2 16 22 38 ... 2 1 7 21 8 2 ... ... 2 17 19 12. Hydrocephalus, Atrophy,) Scrofula, And the Convul- 9 7 7 1 2 19 26 13 9 2 26 ... ... ... ... ... ... 2 24 13. Other Diseases 24 38 39 8 11 64 56 120 9 5 3 23 16 33 33 15 8 10 23 79 14. Violence, Privation, & Premature Birth 8 3 4 3 1 15 4 19 11 1 1 13 3 1 2 ... ... 1 6 12 Totals. 84 68 84 18 28 153 129 282 52 32 12 113 42 55 48 24 13 14 71 184 15 TABLE III. Births during the Quarter ending 26th December, 1857. SUB-DISTRICTS. M ales. Females. Total. CLAPHAM 72 73 145 WANDSWORTH 41 35 76 BATTERSEA 85 83 168 PUTNEY 17 14 31 STREATHAM including TOOTING and BALHAM 37 31 68 Total 252 236 488 Meteorological Means. For the Quarter ending 26th, December, 1857. Barometer corrected mean 30.089 Mean temperature of the air 4881 Mean degree of humidity 0.917 Mean amount of Ozone 0.8 Amount of Rain collected 6.563 Wind (general direction of) Oct. W. Nov. N.E. (Dec. S.W. 16 TABLE IV. Cases of Sickness amongst the out-door Poor under the Treatment of the Union Medical Officers, with the Deaths from each Class of Disease, during the Quarter, ending 26th December, 1857. Compiled from the District Medical Relief Books Sud-DISTRICTS. Total Cases of Sickne,s treated in each SubDistrict. 1. Small Pox. 2. Measles. Scarlatina and ??? Sore .Throat 4. Hooping Cough. Diarrhoea and Dysentry. 6 Cholera. 7. Fever. 8. Erysipelas. 9. Puerperal Fever. 10. Lung Diseases except Phthisis 11. Phthisis. 12. Hydrocephalus Atrophy, Scrofula, & Con vulsions of children. 13. Other Diseases 14. Violence, Privation, & Pre. mature Birth. Total Deaths in each Sub-District Cases. Deaths Cases. Deaths Case .. Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases. i Deaths Casesj Deaths Cases. Deaths Cases. Deaths Cases. Deaths Cases Deaths Cases. Deaths Cases, Deaths CLAPHAM 294 1 1 2 11 14 1 5 117 5 9 6 11 114 3 10 15 WANDSWORTH 233 1 16 1 4 86 1 2 2 123 5 8 BATTERSEA .. 232* 5 1 10 1 5 42 2 169 2 1 5 PUTNEY 157 23 5 1 1 35 1 4 1 80 9 8 1 6 STREATHAM 56 1 2 1 2 13 7 1 27 1 3 1 TOOTING 33 4 1 3 1 3 22 2 3 BALHAM 19 1 1 3 3 12 2 3 TOTALS 1024 2 1 36 1 2 2 47 31 1 15 293 10 14 8 16 1 547 18 21 2 41 * This return does not include the sickness and mortality in the Workhouse, situated in the parish of Battersea.