WAN 22 SANITARY DEPARTMENT. REPO R T on the SANITARY CONDITION OF thE several parishes comprised in the WANDSWORTH DISTRICT, DURING THE YEAR 1870. By the Medical Officers of Herald. LONDON: PRINTED BY JOHN SMITH AND CO., 52, LONG ACRE, W.C. 1871 CONTENTS. Page 1. Health and Sanitary Condition of the entire District ... 2. Report on the Sub-district of Wandsworth, by Dr. Nicholas ... ... ... ... 3. „ on the Sub-district of Clapham, by Mr. MacDonogh ... ... ... .... 4. „ on the Sub-dirtrict of Battersea, by Dr. Connor ... ... ... ... 5. „ on the Sub-district of Streatham, by Dr. Noel ... ... ... ... ... 6. „ on the Sub-district of Putney, by Dr. Whiteman, ... ... ... ... 7. Appendix of Statistical Tables, &c. ... ... ... REPORT, 1870, To the Board of Works for the Wandsworth District. Gentlemen, We respectfully beg leave to submit the Fifteenth Annual Report on the health and sanitary condition of our respective sub-districts, and of the entire District. Although the statistics embodied in the tables applying to the entire District, shew the past year to have been one of extraordinary fatality in respect to Zymotic diseases, there will, we trust, be found but little in this Report to unduly excite the apprehensions of the inhabitants as to the future, or to cause the Board to view such fatality otherwise than as exceptional throughout the country. Looking forward to the speedy abatement of the present very formidable epidemic of Small-Pox, and to the speedy return to their normal condition of this and all other districts where both Small-Pox and Scarlatina have of late been unusually prevalent and fatal, We have the honour to be, Gentlemen, Your very obedient Servants, The Medical Officers of Health of the Wandsworth District. 5 HEALTH AND SANITARY CONDITION OF THE ENTIRE DISTRICT. But for the available facts and statistics furnished by the Census of April, 1871, the difficulties of deducing a correct death-rate for this extensive District for the past year would have been very great. The population of the District has, in the ten years interval, 1861-71, increased beyond all anticipation, and has given to the following observations of the Registrar-General an importance that will be very generally recognised. "The population of London is now overflowing its borders, and is thus thrown in increasing proportions on the outer ring of surrounding land. Hence, the estimated population and the dependant rates can only be considered approximations to be revised so soon as the Census has been taken." Since the above was written the Census spoken of has been taken, and seeing that the Wandsworth District embraces a very large portion of this "outer ring," it has been thought that it would not be without interest to shew in a tabular form the extent of increase in the five Subdistricts, as well as the actual number of inhabitants of the entire District at three decennial periods, 1851-61-71. SUB-DISTRICTS. 1851. 1861. 1871. Increase in the first decennial interval, 1851-61. Increase in the last decennial interval. 1861-71. Total Increase in the 20 years' interval, 1851-71. Battersea 10,560 19,600 53,988 9,040 34,388 43,428 Clapham 16,290 20,894 27,348 4,604 6,454 11,058 Wandsworth 9,613 13,346 19,797 3,735 6,451 10,186 Streatham, Tooting, and Balham 9,023 10,802 14,479 1,059 4,397 5,456 Putney & Roehampton 5,280 6,481 9,438 1,201 2,957 4,158 Totals 50,764 70,403 125,050 19,639 54,647 74,266 6 By this table it will be seen that in April, 1851, the population was ascertained to be 55,764 only. Between four and five years after the taking of this Census, viz., on the 14th of August, 1855, the Metropolis Local Management Act came into operation, and the sanitary control of the District was then undertaken by the newly constituted Board of Works. Assuming the population at this latter period had reached over 60,000, it is clear that, as the number of inhabitants is now (April, 1871) upwards of 125,000, the District Board has to exercise its powers over considerably more than double the number of people it did when it was first inaugurated, and that consequently the responsiblities of the Board and the duties of its officers must have become, since such inauguration, proportionately greater every year. Death-rate, Birth-rate, and Rate of Natural Increase, —It would be obviously incorrect to take the figures respecting the number of deaths in a given year, and then proceed to calculate the proportion which those deaths bear to a population ascertained three months alter the close of such year. In order, therefore, to deduce a correct deathrate for 1870, it will be necessary to adopt the method employed by the Registrar-General, and to make such a correction of the population return of April, 1871, as will place the number of inhabitants of the entire District at its proper figure in the middle of the year under review. This being done it has been found that the rate of mortality in 1870 (the deaths in that year being 2,650) was as near as can be calculated 22.1 in every 1,000 persons living. This, it will be observed, is nearly 3 less than the rate for the whole of London in the same year, which was 24.12. Considering the rate of mortality that attended several of the diseases of the Zymotic class (Scarletina amongst the number, to which in the past year as many as 352 deaths were attributed), the above result cannot be considered altogether unsatisfactory. 7 The Birth-rate for the entire District for 1870, calculated upon the same basis as the above, was 35.5 per 1,000, and the rate of natural increase 13.7 per 1,000. Zymotic Diseases and, their resulting Deaths.—The excess of deaths registered in the past year over the number noted in 1869, is undoubtedly due to the unusual fatality that attended three of the seven principal Zymotic diseases, viz., Scarlatina, Diarrhœa (ordinary and Choloreic), and Fever, the deaths from which amounted together to the large number of 568, which is 75.6 per cent. of the total mortality from this class of maladies, and 21.3 per cent. of the total deaths from all causes. In 1869, the abovenamed three diseases were fatal in 433 instances, which is 134 less than in 1870, although the former year may be looked upon as one in which all three of the diseases here referred to prevailed to a somewhat alarming extent in portions of this District. Comparing the mortality table in the present Report (No. I. appendix) with that in the Report of 1869, in respect to the fatality of the other diseases of the Zymotic Class, it is found that there is a considerable diminution in the number of deaths in favour of the past year; thus, the deaths from Small-Pox, which were 21 in 1869, fell to 15 in the past year; Measles, from 52 to 46; Diphtheria, from 14 to 12; and Whooping Cough, from 96 to 56, giving a total diminution in the number of deaths from four of the seven principal epidemic diseases of no less than 50. A decrease of 6 deaths from Small Pox in the two years, 1869-70, is not strikingly great, and it is a matter for considerable regret that this disease is found in the present year (1871) to be assuming proportions, both as regards cases and deaths, that cannot fail to very sensibly increase the mortuary rate of the District that will have to be calculated and referred to in the next Annual Report. In Battersea alone, the deaths due to Small Pox, between the week that ended January, 1871, and that which terminated on the 27th of May of the same year, numbered as many as 113; and in some other portions of the District the mortality is known to have been somewhat heavy during the same period. 8 The great prevalence and fatality of Small Pox throughout the country has, of late, immensely increased the demand amongst a certain class for vaccination and re-vaccination. Notwithstanding this there has occurred, within the last few years in this District, a great many fatal cases of Small Pox, in connexion with which it could be shown that the sufferers had never been submitted to the protective influence of the operation in question; whilst, on the other hand, but very few deaths are found to have occurred after this prophylactic has been properly applied, and on the authority of a professional man been pronounced to have taken effect. The Parliamentary Committee on vaccination, which a short time since reported the result of its deliberations, appears to have been somewhat influenced by the evidence of a few anti-vaccinationists, for without such influence it can scarcely be imagined that such a suggestion would have been made as—that the parents or guardians of unvaccinated children should, after being adjudged to pay a mere nominal penalty, be thenceforth free to suffer such children to remain wholly unprotected! It is indeed hard to believe that in Jenner's own country such a proposition as this will ever receive the sanction of the Legislature, or go unchallenged by the sensible portion of the public. Rather let us hope that Parliament will not be tardy in passing a measure that shall not only discourage unreasoning obstinacy in respect to vaccination, but deal a decisive blow at that foolish crusade against it which has of late been productive of such serious mischief. Mortality from Ordinary Diseases, Accidents, Old Age, &c.—The Table No. I. Appendix, not only distinguishes the ordinary from the Epidemic class of diseases, but clearly points out those maladies of all classes which have proved most fatal during the year. Although there were registered 266 deaths from all causes above the number tabulated in 1865, the average mortality of the past ten years, allowance being made for increase of population, is not so much 9 affected as might be supposed by the excess referred to. The total deaths from all causes, as already stated, was in the past year 2,659. Of these, 1,908 were registered as being due to ordinary causes, the deaths from Tubercular diseases, diseases of the Lungs, of the Brain and Nerves, and of the Digestive Organs, being the most numerous. Of Phthisis, there died 213 persons, of Old Age, 133, from Violence, 50, and from diseases not specified, 40. And here it should be observed that the number of deaths registered, without the cause being defined by medical certificate, was in the past year very large (70). Why, under circumstances that tell so greatly against this practice, the local Registrars throughout the country should still be permitted to constitute themselves judges of the cause of death in doubtful and suspicious cases, is not to be very easily understood. That the Registration Act needs amendment in this respect, and in respect also to the compulsory registration of births, and of still-born children, there cannot be two opinions amongst medical men, or indeed amongst any class of persons who have had opportunities of judging of the many deplorable evils known to arise from the acknowledged deficiencies of the Act in question. Ages at Death, Infant Mortality, &c.—The circumstance of the deaths of infants and young children, annually amounting to such large numbers, has always been commented upon in these Reports with regret, but as it is everywhere the same, few who have considered the subject can doubt but that the educational deficiencies of the poorer classes (soon now, it is hoped, to be combated by the exertions of the newly-constituted School Boards) has hitherto had much to do with this deplorable waste of life. The deaths during the past year of infants under one year of age amounted to no less than 713; of children between one and five years, to 540; and of those between five and ten years, to 157, making a total of 1,410, which 10 is a number exceeding, by nearly 20, one-half of the total mortality at all ages. The amount of ignorance amongst the working classes, concerning these natural laws which influence the mental and bodily health of children, is most deplorable, and has needed as much of the correcting hand of the Legislature as any other social evil that has ever occupied its attention. The deaths of persons of advanced life, that is to say, of those between GO and 100 years of age, were 511. Of these, 130 were registered as resulting from Old Age or natural decay, and the remainder from certified disease or accident. The oldest of these persons was a, female, who succumbed at the advanced age of 99, and who was a resident in Battersea at the time of her death. Social position of the deceased persons—Sickness and Mortality amongst the Union Poor.—The difference in the amount of fatal disease amongst the various classes of society, as shown in Table No. 1. Appendix, is found to be slightly in favour of the labouring classes. The deaths amongst the three classes collectively, above that of the industrial or labouring class, were in the proportion of 1545 of the former to 1514 of the latter. It is submitted, there is no fact furnished by these statistics that points out more clearly than this, the direction which sanitation has lately been made to take. It is the generally received opinion that the localities of a district, in which the Union Poor for the most part take up their residences, are the abiding places of all the more severe and fatal forms of disease. This is certainly true in the abstract, but it is not a little gratifying to find (vide Table V. Appendix) that of 6,037 cases of sickness amongst the out-door Parochial Poor, treated by the Union Medical Officers of the five Sub-districts, there are only 227 resulting deaths to be found recorded in the Union medical relief books. 11 This number furnishes but a very small percentage of the total deaths amongst all classes, and affords an additional proof that sanitation has not been neglected in quarters where it is always most needed. Sanitation during the past year.—As the last table inserted in the Appendix (No. VI.) sufficiently shows the amount of accomplished sanitary work throughout the District during 1870, any further reference to such work in this place is scarcely needed. There are also several very important matters which the Medical Officers of Health have so frequently discussed in their former Reports, as to leave very little more to be advanced concerning them. Of these measures the principal ones are (1) the supply on the constant principle of pure and wholesome water to the inhabitants, (2) the means of overcoming the baneful effects of sewer emanations from gratings in the public thoroughfares, (3) such amendments of the Vaccination Acts as shall prevent the possibility in future of any evasion of the law, (4) an amendment of the Registration Act as already suggested, and (5) a Legislative measure capable of being easily applied to prevent excessive overcrowding of the dwellings of the poor. These matters specially commend themselves to the consideration of both Boards of Works and the Legislature to insure a full recognition of the sanitary requirements of the present critical period; fur it is undoubtedly one demanding the adoption of every possible safeguard against the spread of those epidemic diseases, Small Pox and Scarlatina especially, which are now devastating both the Metropolis and the Provinces. Of all the subjects presenting themselves to our notice, there is not one requiring more thoughtful consideration, or more thorough ventilation, than that relating to water supply. Upon this question, so far as it concerns this District, it may be observed that the evidence tendered by the Medical Officers of Health to Captain Tyler, of the Department of the Board of Trade, has been fully borne 12 out by the subsequent investigations made by that gentleman, and by Professor Frankland. In the report of Captain Tyler, May, 1871, it is intimated that he has abundant evidence before him of the Southwark and Vauxhall Company having long possessed the means of admitting tidal water direct from the Thames at Battersea into their reservoir: and further, that one of these reservoirs, when emptied for his (Captain Tyler's) examination, was found to be the very reverse of impervious (as it was alleged to have been) to soakage or precolation of impure tidal water at that point. Captain Tyler, after alluding to the evidence of the Officers of Health and others, which he took on the 20th of December, 1870, and on the 3rd and 17th of January, 1871, gives the result of his own inspections of the reservoirs, and also his views of the several analyses conducted by Professor Frankland. The conclusions which he came to are well summed up in the last paragraph of this full and very interesting report, wherein it is stated that the "positive evidence" he (Captain Tyler) had received could not but throw" grave suspicions on the Company's proceedings." Whether the promise will be fully carried out on the part of the Company, to take immediate steps to preclude all suspicion of what Captain Tyler very properly terms "the wrong doing" of the Company for the future, remains to be seen; but it is right it should be known that Professor Frankland, in his May report of the present year, speaks of the Water supplied by the Southwark Company as being not only slightly turbid but containing moving organisms visible to the naked eye. "The best sample," says the Professor (26th May, 1871), "was that drawn from the West Middlesex Company's Main, and the worst that delivered by the Southwark and Vauxhall Company." The substitution of a constant for the present intermittent supply of water to the inhabitants of this District, is being still looked forward to as a boon which, it is hoped, 13 will not be much longer delayed. The same may be said of the wished-for adoption, at no distant day, of Clark's softening process, by which hard water drawn even from deep artesian wells, it has been shown, could be made to supply the Metropolis and its suburbs with a most potable and wholesome fluid. A very interesting table, showing the value of Clark's process, will be found in one of Paofessor Frankland's recent reports to the Registrar General. In this table the extent of sold impurity, hardness, and other qualities of certain waters, are fully set forth, both before and after Clark's process had been applied. These experiments were made in the provinces, at Caterham, Tring, and Canterbury, and in London, at the Grand Junction Company's Works, and every one of them with the most satisfactory results. In hardness, the difference before and after the process was strikingly great in all the waters experimented upon. To give only one example— the hardness of the water at Canterbury before the process was found to be 26.3, but after the process 4.9. In this same water the total solid impurity was, before the process, 33.60; after it, 11.94. So also of all the other waters examined. If, as Dr. Frankland states, "the cost of this process is far more than covered by the saving of soap which it effects," there can be very few who will not join in the hope that this method of supplying London with good and wholesome water will be ultimately embodied in an Act of Parliament, and become very generally adopted. The generally received opinion amongst those who have given attention to the subject being that the germs of many of the maladies of the Zymtoic class reside in impure water, and are often propagated and diffused through its agency, it is hoped it will be considered by no means an unreasonable view for the Health Officers to take of this great question, that an immense saving of life might be effected, amongst the poor especially, by (1) the grant of the great boon of constant supply, and (2) by the adoption of some efficient means of purifying and of softening all water 14 tributed to the inhabitants, whether through the agency of the companies, or through any of the more reliable sources that may hereafter find favor with the Legislature and the public. In the summaries which follow will be found further comments and opinions on matters of local and general interest. LOCAL SUMMARIES. 16 WANDSWORTH. The following Report will be found to contain, as usual, a brief summary of the vital statistics and other facts necessary for elucidating the sanitary condition of this Sub-district during the year 1870. An analysis of the Registrar General's returns, and of the parochial records of sickness and mortality, shows that a less favourable state of the health of this Parish prevailed during that period than heretofore. This effect appears to have been caused, to a very considerable extent, by diseases of the respiratory organs, resulting from a very inclement winter; but was for the most part attributable to the severe epidemic of Scarlatina which prevailed here, as elsewhere, during the year 1869, and continued its progress with increased violence during the whole of the past year. Population.—The population of this Sub-district in 1841 numbered 7,614; in 1851 it numbered 9,611; in 1861, 13,346; and at the recently taken Census it amounted to 19,797: so that during the ten years, 1841-51, it increased at the rate of 26 per 1,000 annually; during the ten years, 1851-61, at the rate of over 38 per 1,000 annually; and during the past ten years, at the annual rate of 48 per 1,000, nearly three-fifths of which will appear to have been due to immigration. The lately enumerated inhabitants consisted of 9,384 males, and 10,413 females, the latter showing about the same 17 excess observable at the previous Census. They were dwelling in 2,964 houses, the number in each house averaging, therefore, 6.67, or about 20 persons to every 3 houses. There were 362 houses uninhabited, and 33 in course of construction. At the Census of 1861 the average number to each house was a little over 7 (7.05); so that notwithstanding the sanitary disadvantage of a more condensed population, we have not since that period increased the similar but greater disadvantages of overcrowding in houses. Birth-rate.—The births registered during the past year were 645 in number, 316 males, and 329 females. The average annual number for the past ten years was 528. The birth-rate of the past year was 35 per 1,000, and the rate of natural increase 15.45 per 1,000 of the entire population. Death-rate.—The total deaths which occurred during the past year numbered 450; 232 were of males, and 218 of females. No less than 105 took place in public institutions, viz.:—72 in the Surrey County Lunatic Asylum; 13 in the House of Correction; 15 in the Hospital for Incurables; 2 in St. Peter's Hospital; 2 in the Reformatory for Boys; and 1 in the Patriotic Asylum for Girls. The number of deaths in these institutions exceeded the average by 20. The death-rate calculated from the recently enumerated population and the total deaths registered, would have been during the past year upwards of 23 per 1,000; but, as has been explained in previous reports, a rate so determined cannot be accepted as the natural death-rate of this Parish, in consequence of the undue augmentation of the death-register by the mortality of those institutions, as the County Lunatic Asylum and the Hospital for Incurables, whose inmates are derived from without the Parish, undergo no natural increase, and are subject to a very high mortality. It is B 18 necessary, therefore, to make correction for such institutions by eliminating their mortality, together with their population, from the calculation. The death-rate for the past year, after due correction made in the manner indicated, is found to have been 20.21 per 1,000 persons living. This is unusually high, for by a similar calculation the mean annual death-rate during the preceding ten years was 17.84 per 1,000, and closely corresponds with a similar average of the ten years 1851-61. The mean annual average death-rate of this locality during the past 20 years has not exceeded 18 per 1,000 of the population. The following Table contains a summary of all the causes of death, arranged in accordance with the classification of the Registrar-General, showing the sex, social position and age at death at different periods, and particularizing the several diseases of the Zymotic class:— 19 STATISTICS OF MORTALITY. WANDSWORTH. Total Deaths from each Class of Disease, &c., in the Sub-District Sex Age Social Position Population in 1871—19,797. Population in 1861—13,346. Males Females 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 80, 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 Increase in 10 years-6,451. Area in Acres, 2,478. Diseases and other Causes of Death. Diseases Classified. Classes:— Small pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 2 1 1 ... 2 ... 2 ... ... ... ... ... ... ... 2 Scarlatina 48 19 29 7 29 7 44 3 ... 1 ... ... 1 9 38 Diphtheria 4 3 1 ... ... 4 4 ... ... ... ... ... 1 ... 3 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 7 3 4 1 4 2 7 ... ... ... ... ... 1 1 5 Whooping Cough 16 11 5 5 10 1 16 ... ... ... ... 1 ... ... 15 1. Zymotic Typhus & Infantile Fever 10 5 5 ... 1 1 5 2 1 2 ... ... ... 2 8 Erysipelas 4 1 3 1 ... ... 2 ... ... 1 1 1 ... ... 3 Metria, Childbirth 4 1 3 4 ... ... ... ... ... ... ... ... 1 ... 4 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Dysentery 33 15 18 23 5 1 29 1 3 ... ... 1 ... 4 28 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals of Zymotic Class 128 58 66 37 31 16 109 6 4 4 1 3 3 16 106 2. Tubercular 46 21 25 9 3 ... 17 21 8 ... ... ... 2 4 40 3. Of Brain, Nerves, &c. 91 55 36 10 12 3 27 15 31 14 4 2 4 15 70 4. Of the Heart, &c. 18 9 9 ... ... ... ... 3 7 7 1 ... 3 3 12 5. Of Respiratory gans 68 38 30 9 4 2 26 4 11 26 1 ... 2 8 58 6. Digestive Organs 23 11 12 5 4 ... 10 4 2 5 2 ... 1 4 18 7. Urinary Organs 10 8 2 ... 1 ... 1 3 3 3 ... 1 ... 4 5 8. Of Organs of Generation 4 ... 4 ... ... ... ... 3 ... 1 ... ... ... 1 3 9. Of Joints, Bones, &c. 2 ... 2 ... ... ... 1 ... 1 ... ... ... ... 1 1 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality, formation, &c. 23 13 10 23 ... ... 23 ... .... ... ... ... 1 2 21 12. Of Uncertain Seat 12 2 10 1 1 ... 4 ... 3 5 ... 1 ... 2 9 13. Age 18 10 8 ... ... ... ... ... ... 8 10 2 1 3 12 14. Violence 8 4 4 ... ... 1 2 2 2 1 1 1 ... ... 7 15. Not Specified 3 3 ... ... ... ... ... ... 3 ... ... ... ... 1 2 Totals 450 232 218 94 76 22 220 61 75 74 20 10 16 64 360 20 The largest and most important part of the causes of death was formed, as usual, by the Zymotic class (epidemic, contagious), which constituted upwards of one fourth of the, whole. Infant mortality was consequently high, the deaths of children under five years of age forming upwards of 37 per cent. This amount, however, is not so high as that of last year, apparently in consequence of the epidemic (Scarlatina) having extended its ravages amongst persons of higher age. Diseases of the Brain and Nervous System (class 3) were the next in order of fatality, forming 20 per cent. of all deaths; one fourth part only of these, however, having taken place in the Parish proper, the remainder in the County Lunatic Asylum. Diseases of the respiratory organs (exclusive of Consumption), caused 15 per cent. of all deaths, an amount very considerably above the average. The Tubercular class (including Consumption), formed 10 per cent.—an average amount. Consumption alone formed 7 per cent., an amount which is relatively small in comparison with that of the other Metropolitan Districts. Age at death.—Upwards of one fifth of all deaths occurred under 1 year of age; 37 per cent. under 5 years; 42 per cent. under 10; and nearly 49 per cent. under 20 years of age. The last amount is unusually high. Although 18 deaths only are recorded in the register as having resulted from age, 57 deaths, or over 12 per cent., took place between the ages of 70 and 90 years; viz., from 70-75 nineteen; 75-80 eighteen; 80-85 thirteen; and 85-90 seven. Deaths in relation to social position.—By a reference to the Table it is seen that exactly 80 per cent. of the deaths from the general disease, and upwards 85 per cent. of the deaths from epidemic disease occurred amongst the industrial and labouring classes; that all the deaths from the Tubercular class except 6, all the deaths from Consumption except 3, and all from class 11 (comprising premature birth, low vitality, &c.) except 2, took place 21 amongst them. These facts, which cannot be too carefully noted, constitute, as they have hitherto invariably done, a well defined indication of the direction in which all measures calculated for the saving of life and the maintenance of health should be first projected, namely, to the dwellings of the labouring classes. 26 inquests were held during the year. 8 deaths resulted from violence, of which 5 were accidental and 3 suicidal. In no less than 15 instances the cause of death was not certified by medical testimony, a condition of things which, as has been shown in previous reports, urgently requires legislative interference. Epidemic Diseases.—Their prevalence and fatality.— The following Table shows the deaths which have resulted from the 7 principal epidemic diseases during the past and ten preceding years, and the relation which they bore to the deaths from all causes. YEARS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Cholera. Diarrhœa. Fever— Typhus and Typhoid. Total Deaths from Epidemics. Total Deaths from all causes. Percentage of deaths from Epidemics to deaths from all causes. 1860 0 5 4 1 4 ... 4 4 22 308 71 1861 1 1 12 1 4 ... 8 3 30 246 12.1 1862 0 28 2 5 11 ... 5 11 62 273 22.7 1863 8 2 23 1 9 ... 6 13 62 300 20.6 1864 4 0 3 6 9 ... 8 13 43 311 13.8 1865 5 2 3 1 6 ... 19 18 54 338 15.9 1866 3 23 10 2 5 7 18 5 73 351 20.7 1867 3 1 7 1 6 1 7 7 33 332 9.9 1868 0 8 5 2 20 ... 22 7 64 394 16.2 1869 0 23 36 0 7 ... 23 5 94 429 21.9 1870 0 2 48 4 16 ... 33 10 113 450 25.1 The mortality resulting from epidemic diseases is seen from the foregoing Table to have been unusually high. 22 The number of deaths from these diseases amounted to 113, the average of the past ten years having been 53, and formed 25 per cent. of all deaths. This greater fatality was principally due to the severe epidemic of Scarlatina which prevailed throughout the whole year, as it had done, although to a less extent, during the year preceding. It was most extensively prevalent and most fatal during the autumn; Diarrhoea was also very prevalent in the autumn, but was attended with less fatality than usual. Hooping Cough prevailed during the first six months, and Measles during the last six months of the year; both, however, were attended with but few fatal results. Sickness and Mortality of the Parochial Poor.—The nature, amount, and fatality of the sickness which came under treatment amongst the parochial poor during the past year is contained in Table 5 Appendix. The amount was very high, and, although not so high as in the year preceding, the mortality was greater. The number of cases of sickness was 2,019, and the deaths 70 or 3.46 per cent., the average number of cases during the preceding ten years was 1,600, with a mortality of 43 or 2.7 per cent. Epidemic diseases also were less numerous than in the preceding year, but were attended with greater fatality; the number of cases was 385, with 23 deaths, the average of the preceding ten years being 351, with 12 deaths. Sanitary Proceedings.—A summary of these proceedings is, as usual, contained Table 6 Appendix. In addition to which all the slaughter-houses and cow-houses within the Parish were examined and reported on prior to a renewal of their owners' licenses. The disinfection and purification of houses and rooms was assiduously carried out in all cases requiring such proceeding in consequence of the presence of infectious diseases; and disinfecting chemicals were supplied to poor persons requiring their use during the presence of such diseases. 23 These and similar general proceedings, although verybeneficial if pursued systematically and not by fitful efforts only in the presence of the epidemic, cannot, even when supported by every care and cleanliness, be alone effectual against the transfer of infection; a greater and more special intervention becomes necessary. The most practical and direct means which the Board possesses for the prevention of the spread of epidemic diseases is isolation—the separation of the sick from the healthy members of families. These means, however, are at present incapable of any but very partial application. Large hospitals, intended for the reception of patients whose abodes extend over a very large area, are scarcely calculated for such purpose; the distance, in the great majority of cases, being far too great for immediate and therefore useful action. In consequence of the many difficulties involved in the removal of patients to hospital, relating to time and other circumstances well known to the Medical Officer of Health, it would appear that smaller hospitals in smaller areas would be far more useful on account of their greater facility of access. Hence (confining the question to the requirements of this District), it would seem desirable to consider whether the Infirmary at the Workhouse, which latter should have nothing in common with a hospital, should not be the District Hospital, and as such utilized and made available for the purpose indicated. Under any circumstances, a more complete system of isolation of patients suffering from infectious diseases requires development before the suppression of these diseases—which it has been customary to regard as the natural inheritance of children, and which, as is shown annually in these reports, cause about one fourth of all deaths—can be attempted with any probability of success. GEORGE EDWARD NICHOLAS, M.D., Medical Officer of Health for Wandsworth. June, 1871. 24 BATTERSEA. So far as the natural increase of the population is concerned, as indicated by the excess of births over deaths, there is, of course, no difficulty in giving in any year the exact numbers. Not so, however, as to the increase by immigration, since that is governed by so many contingencies as to render it all but impossible, in a locality like Battersea, to form even an approximate estimate without almost an annual census. The difficulty experienced in this respect for some years past have been, for the present, removed. The Census returns of 1871, so far as they have been made known, shows that this Sub-district has increased its inhabitants, since the former Census in 1861, by the very large number of 34,146; and that the population has now (within eleven) reached the very high point of 54,000. The number of deaths during 1870 appears excessive, being 1,371, against 1,121 in the previous year. According to the method of calculation adopted by the RegistrarGeneral, the rate of mortality in the Sub-district, for the past year, is found to be, in round numbers, 27 per 1,000 persons living. This is a very high death-rate, but it is unquestionably an exceptional one. Some correction has also to be made for the number of poor parishioners who died in the Workhouse situated in this parish. Of the 162 deaths registered as having taken place in this institution, 64 only had acquired a settlement in Battersea. The deduction then of nearly 100 deaths from the total number registered will very materially lessen the deathrate proper to the parish, and will reduce the same to about 23 per 1,000. The following Table exhibits the causes of death, and many other particulars necessary to be known by those desirous of estimating for themselves, from time to time, the health and sanitary condition of this densely populated and still increasing Sub-district:— 25 STATISTICS OF MORTALITY. BATTERSEA. Population in 1871—53,988. Population in 1861—19,852. Increase in 10 years—34,136. Area in Statute Acres—2,343 Total Deaths from each Class of Disease, &c., in the Sub-District. Sex. Age Social Position. Males. Females. 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 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. DISEASES, And other Causes of Death. Classes— Small Pox 9 8 1 ... 2 3 7 2 ... ... ... ... ... 3 6 Measles 25 12 13 4 18 2 24 1 ... ... ... ... ... 6 19 Scarlatina 239 122 117 13 145 58 237 2 ... ... ... ... 10 114 115 Diphtheria 5 3 2 ... 4 1 5 ... ... ... ... ... 1 3 1 Quinsy 1 ... 1 ... 1 ... 1 ... ... ... ... ... ... 1 ... Croup 6 5 1 3 3 ... 6 ... ... ... ... ... ... 4 2 Whooping Cough 21 11 10 13 8 ... 21 ... ... ... ... ... 2 6 13 1. Zymotic Typhus, Infantile and other Fevrs 39 12 27 1 10 9 25 10 3 1 ... ... ... 17 22 Erysipelas 6 2 4 4 ... ... 4 ... ... 2 ... ... ... 2 4 Metria, Childbirth 11 ... 11 ... ... ... ... 10 1 ... ... ... ... 6 5 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza 1 1 ... ... ... ... ... ... 1 ... ... ... ... ... 1 Diarrhœa & Dysentery 62 42 20 54 61 ... 61 ... 1 ... ... ... 2 30 30 Cholera 4 3 1 ... 2 ... 2 ... 1 ... 1 ... ... 1 3 Totals of Zymotic Class 429 221 208 92 113 73 333 25 7 3 1 ... 15 193 221 2. Tubercular 224 128 96 88 24 12 142 42 35 5 ... 2 7 98 117 3. Of Brain, Nerves, &c. 198 111 87 51 40 8 104 11 34 46 3 5 6 89 98 4. Of the Heart, &c. 51 22 29 4 1 ... 8 7 13 21 2 1 1 23 26 5. Of Respiratory Organs 218 125 93 80 55 3 135 7 30 43 3 ... 3 106 109 6. Of Digestive Organs 45 14 31 14 2 2 21 5 11 7 1 2 3 23 17 7. Of Urinary Organs 10 6 4 ... ... ... 1 2 4 2 1 ... 5 5 ... 8. Of Organs of Generation 4 ... 4 ... ... ... ... 1 2 1 ... ... ... 3 1 9. Of Joints, Bones, &c. 1 ... 1 ... ... ... 1 ... ... ... ... ... ... 1 ... 10. Of Skin 3 2 1 3 ... ... 3 ... ... ... ... ... 1 ... 2 11. Premature Birth, Low Vitality, Malformation, &c. 70 41 29 70 1 ... 70 ... ... ... ... 1 2 32 35 12. Of Uncertain Seat 23 11 12 3 1 1 4 2 9 8 ... 1 2 8 12 13. Age 56 23 33 ... ... ... ... ... 1 26 29 3 3 19 31 14. Violence 29 20 9 5 3 3 18 7 3 1 ... ... ... 9 20 15. Not Specified 14 6 8 5 1 1 6 1 4 3 ... ... ... 4 10 Totals 1375 730 645 415 333 103 906 110 153 166 40 15 48 613 699 26 Zymotic Diseases.—Of the 429 deaths registered as having resulted from Zymotic diseases, considerably more than one-half, viz., 239, were due to Scarlet Fever, being a larger number than was registered in 1869 by 187. The deaths from Measles and Fever were also in excess. The numbers placed opposite the other diseases of this class do not present any material difference, if we except Whooping Cough, to which malady 21 deaths were attributed, against 52 in the preceding year. The deaths due to Small Pox were 9, which is less by 2 than were registered in 1869. It should be here stated that the present year, 1871, promises to be one of great mortality from this deplorable disease. During the single month of May (the time at which the statistics for this Report were being collected) there had taken place as many as 50 deaths from Small Pox ; from January to April there had also been registered the large number of 80 deaths from the same disease, making, in five months of the present year, a total of 113. I very much regret to state that, of the 9 deaths from Small Pox registered in the past year, 5 had received no protection whatever from vaccination. Ordinary diseases and their resulting deaths.—Opposite Class 2 (Tubercular diseases) will be found a much larger number of deaths noted than in 1869, in the proportion of 224 to 183. Of these 224 deaths, Phthisis is found to have claimed 109 victims; diseases of the Respiratory Organs were fatal in 218 cases, which is only 2 more than in the previous year; the large number of 198 died of Affections of the Brain and Nerves, which is 43 more than in the previous year. The deaths from Premature Birth, Low Vitality, &c., slightly exceeded those of 1869, whilst to Old Age and to Violence, 56 and 29 deaths were respectively referred, the numbers being in the two past years nearly equal. Ages at death, Infant Mortality.—The fatal cases among infants and young children, I regret to say, have increased. 27 During the past year there were registered between birth and 10 years of age the large number of 851 deaths, which is 208 in excess of 1869. It is with still greater regret 1 have to state that 364 of these deaths were due to Zymotic diseases, which is within 65 of the total deaths from this class of maladies. The deaths of infants and young children, that were registered as due to ordinary diseases and to violence, numbered 487, which is 73 in excess of 1869. The deaths of persons over 60 and between that age and the most extensive period of existence, were 206. There were 55 persons registered as having succumbed to old age or natural decay; and, among the persons over 80 at the time of death, it may be mentioned that 2 were registered as having reached the age of 90, and 3 the still more advanced ages of 92, 97, and 99. Disease and Mortality among the out-door Union Poor. —I have very accurately noted the cases of sickness and the number of deaths as they appear in the Medical Relief Hooks for the year 1870, but it strikes me the 76 deaths that occurred in the 2,370 cases (vide Table V. Appendix) that were treated during the same period, is a very small proportion. It is doubtless difficult to keep a very accurate record of all the cases that come tinder the cognisance of the District Medical Officers, since very many persons in the course of the year, after remaining a short time as Union patients, obtain admission into the special and other hospitals of the Metropolis, and dying there, their deaths fail to be noticed by the local Registrar, or in the Medical Relief Books. In this way the small proportion of deaths to cases treated may possibly be accounted for. Inquests, Violent and Sudden Deaths. — Forty-five deaths were made the subjects of enquiry by the Coroner. They may be thus classified:— 28 Found dead, unknown, newly born, 3 Starved (both infants), verdict, wilful murder 2 Burns and scalds 4 Accidentally run over in the streets 2 Other accidents by falls, &c 4 Found drowned, with no marks of violence 4 Accidentally drowned 5 Misadventure—drinking poisons, boiling water, &c. 4 Natural deaths from diseases (sudden) 5 Suicides by drowning and poison, whilst under mental derangement 2 Total 45 Of these 45 Inquests, 11 were held upon the remains of infants and young children, who were shown by the evidence to have met with violent deaths, either by accident or design. In addition to this large number of Inquests, there were the deaths of as many as 39 infants and children registered without any medical certificate of the cause of death. There were also 9 adults similarly registered. Here there are nearly 50 deaths in one Sub-district tested by no enquiry whatever. That the registration of deaths without medical certificates is an evil of the greatest magnitude, few will deny; that the practice can be much longer permitted one can scarcely believe possible. Summary of Sanitary Proceedings, Removal of Nuisances, Seizure of Unwholesome Food, &c.—In the column of Table VI. Appendix, relating to Battersea, will be found the usual. summary of the year's sanitary proceedings. Although it is by no means satisfactory to contemplate so high a death-rate as this Sub-district unfortunately exhibits, there can be but little doubt we should have had to deplore a still higher one, but for the great attention that has been paid to the sanitary requirements of the locality, as exemplified in the unremitting inspection of 29 houses and premises, and the prompt abatement or removal of all nuisances which such inspections have from time to time disclosed. It will be seen, by a mere glance at the Table, that there has been a considerable amount of effective sanitation accomplished during the past year; but, notwithstanding the employment of these measures, it can hardly be expected that, in a district abounding as this does in manufactories, and being singularly liable to all the evils resulting from overcrowding, improvidence, and defective education, that the proportion of deaths to population will ever be very small. In addition to the inspection of all places used for the keeping of cows and the slaughtering of cattle, much diligence has been employed to prevent the sale of unwholesome food, &c., but it is not without regret that it has been found necessary to make a good many seizures of meat, fish, fruit, and vegetables, as being wholly unfit for human consumption. Of meat, 2¾ cwt.; of vegetables, 1½ cwt.; of fruit, 3½ cwt.; and of fish as much as 17½ cwt. were condemned. The large amount of 25 cwt. of unwholesome food having been offered for sale is a serious matter, and had such sale been effected it is impossible to say what amount of mischief might have ensued. It only remains for me to refer my readers to the general report applying to the entire district, for the opinions I hold, in common with my colleagues, upon the water question, as well as upon some other equally important matters, which bear alike upon the public health of this and the other Sub-districts. WM. CONNOR, M.B., Medical Officer of Health for the Sub-district of Battersea. 30 CLAPHAM. Availing myself of the statistics of the late Census, I here reproduce a form of Table made use of in my report of 1861, with the view of showing the several additions that have been made to the population of this Sub-district in the seven decennial intervals, from 1801 to 1871. This Table cannot prove otherwise than interesting to the inhabitants of this Parish, inasmuch as it marks the gradual rise of the locality from a mere village of some 4,000 inhabitants, to a large and important township having, at the present time, a population of 27,348! Population. 1801. 1811. 1821. 1831. 1841. 1851. 1861. 1871. Males 1,675 2,150 3,124 4,412 5,214 6,970 8,857 11,886 Females 2,189 2,933 4,027 5,546 6,892 9,320 12,033 15,462 Total 3,864 5,083 7,151 9,958 12,106 16,290 20,890 27,348 In assuming the population in some of my former reports, the estimates I made were not, I may observe, very wide of the mark. The increase in the last ten years of 6,458, judging from the large number of newdwellings that have lately sprung up within the Parish, is no more than what might have been reasonably anticipated. The following Table, which I have annually made use of, shows, as usual, the exact number of births, deaths, and marriages that have taken place in the past year, and in the ten preceding years. The most striking feature of this Table is that the marriages have been much fewer in the past year than in any year since 1860—a circumstance very difficult to account for, unless it is upon the supposition that the dearness of food of late, or bad seasons for trade, have deterred many from entering the marriage state who would otherwise have done so. 31 MARRIAGES, BIRTHS, AND DEATHS. Years 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 Marriages 183 182 175 181 227 221 310 244 272 234 158 Births 608 624 622 685 640 707 711 777 801 838 867 Deaths 429 390 343 355 408 393 425 451 450 508 480 Excess of Births over Deaths 179 234 279 330 232 314 286 326 351 330 387 By this Table it will also be seen that there were registered in this Sub-district during the past year 480 deaths, of which 231 were of males, and 249 of females. The total number of deaths registered in the preceding year was 508, so that the number recorded in the past year was less by 28 than in 1869, notwithstanding a greatly augmented population. There were also registered the births of 433 males, and 434 females,—total 867. The excess of births over deaths, marking the natural increase of the population for the year, was therefore 387. Having no longer to speculate upon the actual number of the inhabitants, but relying on the statistics of the late Census, as giving to Clapham 27,348 as its present population, and 26,903 as the population in the middle of the year 1870, I am enabled to state, with some confidence, that the death-rate of the year 1870 could not have very greatly exceeded 17 in every 1,000 persons living, and this I find very closely approaches the rate 1 have assumed in several of my former reports.* The comprehensive Table which follows conveys in the smallest possible space a fund of information, and is, in point of fact, almost an annual report in itself, since it leaves but little to comment upon, if due comparison be made, from year to year, of the figures of the several Tables already published. * The above calculation is made on the principle adopted by the Registrar General, the correct death-rate, according to the figures officially communicated to the Chairman of our Association, being 17.4 per 1,000. 32 STATISTICS OF MORTALITY. CLAPHAM. Population in 1871—27,348. Population in 1861—20,894. Increase in 10 years—6,458. Area in Acres—1,233. Total Deaths from each Class of Disease, &c., in the Sub-District. Sex Ace Social Position Males. Females. Under 1 year. From 1 to 5 years. From 5 to 10 years. Under 20 years, includingall under 10 years. At 20, and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, &c. Middle & Trading Class, Shopmen, Clerks, &c. I Industrial and Laboring Classes. DISEASES And other Causes of Death Classes :— Small Pox. 6 3 3 1 4 1 6 ... ... ... ... ... ... ... 6 Measles 14 8 6 4 7 2 14 ... ... ... ... ... 2 5 7 Scarlatina 45 22 23 ... 23 17 44 1 ... ... ... ... ... 13 32 Diphtheria 2 2 ... ... 1 ... 2 ... ... ... ... ... 1 1 ... Quinsy 3 1 2 1 2 ... 3 ... ... ... ... ... ... 1 2 Croup 10 4 6 1 7 2 10 ... ... ... ... ... ... 4 6 Whooping Cough 9 4 5 3 6 ... 9 ... ... ... ... ... ... 6 3 1. Zymotic Typhus, &c. 12 6 6 1 3 2 9 2 1 ... ... ... ..2 3 7 Erysipelas 2 ... 2 1 ... ... 1 1 ... ... ... ... 1 ... 1 Metria, Childbirth 4 ... 4 ... ... ... ... 3 1 ... ... ... 1 2 1 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Dysentery 31 16 15 23 5 ... 28 3 ... ... ... ... ... 6 25 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals of Zymotic Class . 138 66 72 35 58 24 126 10 2 ... ... ... 7 41 90 2. Tubercular* 60 34 26 4 3 3 20 26 14 ... ... 2 4 17 37 3. Of Brain, Nerves,&c. 35 9 26 3 6 1 12 3 10 8 2 5 2 9 19 4. Of the Heart, &c. 33 15 18 ... 1 1 6 4 8 13 2 4 2 9 8 5. Of Respiratory Organs 53 32 21 12 16 1 30 3 6 13 1 1 1 9 42 6. Of Digestive Organs 8 2 6 1 ... ... 3 ... 3 2 ... 1 ... 3 4 7. Of Urinary Organs . 5 3 2 ... ... 2 2 ... 1 2 ... 1 ... 3 1 8. Of Organs of Generation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Of Joints, Bones, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth. Low Vitality, Malformation, &c. 79 43 36 69 9 ... 79 ... ... ... ... 1 2 15 61 12. Of Uncertain Seat 6 7 5 1 1 1 3 1 2 1 ... ... 2 1 4 13. Age 37 13 24 ... ... ... ... ... ... 23 14 3 2 9 23 14. Violence 5 4 1 1 ... ... 1 1 2 1 ... ••• 1 1 3 15. Not Specified 20 8 12 1 ... ... 3 4 8 5 ... 2 4 5 9 Totals 480 231 249 127 94 33 285 52 56 68 19 20 27 122 311 * Of the 60 deaths from Tubercular disease 55 were due to Phthisis. 33 Zymotic Diseases, and their fatality.—Preferring the tabular form of conveying the necessary information respecting the mortality from the principal Zymotic maladies to any mere description of their fatality during the past, as compared with that of previous years, I employ the following arrangement to show how extremely varied has been the mortality from these maladies since 1860, and down to the present period. It is gratifying however to find that, with the large addition which must have been made to the population since my last Report was furnished, that two more deaths only than appeared in the Table of 1869, should have been registered in the past year as due to the seven principal Zymotic diseases. It will be observed that the fatal cases of Measles, which in the three previous years had been respectively 3, 9, and '2, increased in the past year to 14; and that Scarlatina, which had in the same three years been 5, 14, and 29 respectively, increased to 45; thus constituting the past year quite an exceptional one in respect to the mortality from these two maladies. The deaths from Whooping Cough and Fever, I am pleased to find, show a considerable decrease in the past year compared with 1869. Years. 1860 1861 1862 1863 1864 1865 1866 1867 1S68 1869 1870 Small-pox. 6 6 1 11 3 7 10 7 0 10 6 Measles 20 0 6 24 12 7 18 3 9 2 14 Scarlatina. 24 22 13 28 11 11 6 5 14 29 45 Diphtheria 9 13 3 1 2 4 5 3 7 0 2 Whooping- cough 21 14 14 9 10 15 14 7 25 29 9 Typhus ... 6 5 8 6 14 11 16 10 26 17 12 Diarrhœa & Cholera 5 16 7 16 11 20 17 21 28 30 31 Totals 91 76 52 95 63 75 86 56 109 117 119 34 Small Pox and Vaccination.—Although the deaths from Small Pox were 4 less in 1870 than in the previous year, I regret to say the present year (1871) has dawned most unfavourably in respect to this disease, indeed at the time of preparing this Report the epidemic had assumed so severe and fatal a form as to give rise to a very general remark, that the Sub-district had never before experienced so alarming a visitation. Why, under what would appear to be circumstances by no means favourable to the invasion of this parish by Small Pox, this malady should have become suddenly prevalent, I can scarcely determine; but. this I do know, the Registration Act is being continually evaded, and there is nothing more certain than that the neglect of birth registration has in this District led, in very many instances, to the utter neglect of vaccination at the proper period. As regards both the Registration and Vaccination Acts, I must repeat the observations 1 made in my last Report, that neither of them should any longer be called 'Compulsory Acts,' if the authorities continue to shut their eyes to the consequences of parental apathy, and I may now add, with truth, of wilful neglect on the part of numbers of the inhabitants. Ages at Death.—A rather pad feature of the Mortality Table has here to be noticed, viz., that of the 480 deaths from all causes, registered in the past year, as many as 254 children between birth and ten years of age succumbed to the diseases, &c., incident to childhood, a number which is father above one-half of the total mortality at all ages. Large as this number is, it was exceeded in 1869, when, of a total of 508 deaths from all causes, 260 were registered at the same youthful ages. Concerning the deaths of persons advanced in life, the several columns relating to "age" in the Table will afford all the information needed. It may be stated, however, that of 87 persons between 60 and the most extreme age, there Were 60 between 60 and 80, and 19 at 80 and upwards, the eldest having reached the advanced age of 94 years. 35 Disease and Mortality amongst the Union Poor.—In Table V. Appendix are tabulated the numerous cases of disease, &c., that came under treatment amongst the outdoor Union poor of this Sub-district, with their resulting deaths. Of 1,162 cases treated, 49 deaths may be looked upon as a by no means large percentage. Violent, Sudden and Uncertified Deaths, Inquests.—There were, it appears, 13 inquests held in this Sub-district during 18.70. Of these, 9 were ascertained, and pronounced to be natural deaths, though sudden; 1 suicide; and 1 from a railway accident. The remaining 2 enquiries were upon infants newly born. One of these was supposed to have been wilfully murdered, since it was given in evidence that a string was found tightly fastened about its neck. In the other case there was no evidence to show whether or not the infant had been born alive. The deaths of 3 infants were registered as not certified by any medical attendant. Sanitation of the year.—Table VI, in the Appendix will, with the usual clearness, show the amount of useful and necessary sanitary work accomplished during the year. The addition of 6,619 feet of new sewage to that carried out in former years cannot, at any rate, be regarded as a very slight effort to improve the sanitary condition of the neighbourhood. With as many as 4,521 houses within the area of this Sub-district (4,329 of which are inhabited), the supervision of the officers of the Board must necessarily be required to be unremittingly exercised, in order to sustain the efficiency of those operations which have been already carried out, and that this supervision is being exercised in the right direction, and with most praiseworthy earnestness, is well shown by the other figures in the Table referred to. By the usual order of the Board both the slaughter and cowhouses within the parish received the usual inspections; and, as I had nothing unfavourable to report of them, their licences were all renewed. c 36 I have little else to add to this report hut to strongly urge upon the Board the necessity of promoting, by all the means in its power, the measure about to be brought under the notice of the Legislature, with respect to the water supply of London and its suburbs. JOHN MAC DONOGH, Medical Officer of Health for Clapham, 37 STREATHAM, INCLUDING TOOTING AND BALHAM. The calculation having reference to the death-rate of this Sub district, will, in this report, be made with comparatively little difficulty. The Census of April, 1871, furnishes some valuable statistics available for this purpose, and discloses the fact of there having been in the ten years that have elapsed since the Census of 1861, an increase of the inhabitants of Streatham, Tooting, and Balham combined, of no less than 4,397 persons, giving, within a small fraction, an annual average of 440. The number of inhabitants in 1861 was 10,082, it is now 14,479. Correcting these last figures in order to bring them to apply specially to 1870 (the year under review), and taking the registered deaths to be 209 as stated in the Mortality Table, it has been calculated that the death-rate of the past year was 14.7 per 1,000 persons living. This is exceedingly satisfactory. The births during the year were 382,—males 196, females 186. The excess of births over deaths, giving the natural increase of the population for the year, was 173. Of the 209 registered deaths, 107 were of males, and 102 of females. The following Table will afford more detailed information of the number of deaths, the causes of the same under each class of -disease, with several other particulars which it is hoped will prove alike interesting to the sanitarian and to the inhabitants generally:— 38 STATISTICS OF MORTALITY. STREATHAM, including TOOTING & BALHAM. Population in 1861—10,082. Area in Statute Acres—3,465 Total Deaths from each Class of Disease, &c., in the Sub-District. Sex Age Social Position Males. Females. 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 50 and under 90 years of age. 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, &c. Middle & Trading Class, Shopmen, Clerks, &c. Industrial and Laboring Classes. DISEASES, And other Causes of Death Classes: — Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 1 ... 1 ... ... 1 ... ... ... ... ... ... 1 ... Scarlatina 17 10 7 1 10 2 14 3 ... ... ... 1 2 10 4 Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 2 1 1 ... 2 ... 2 ... ... ... ... ... 1 1 ... Whooping Cough 2 1 1 1 1 ... 2 ... ... ... ... ... ... ... 2 1. Zymotic Typhus and Infantile Fever 7 3 4 ... 3 1 5 1 ... 1 ... 1 1 3 2 Erysipelas 1 ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... Metria, Childbirth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Dysentery 10 6 4 7 ... ... 7 ... ... 3 ... ... 2 5 3 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals of Zymotic Class 40 22 18 10 16 3 31 4 ... 5 ... 2 6 20 12 2. Tubercular 26 15 11 5 3 1 14 11 ... 1 ... 1 1 13 11 3. Of Brain, Nerves, &c. 23 14 9 6 1 ... 7 2 3 10 1 4 1 1 3 5 4. Of the Heart, &c. 21 10 11 ... 2 1 3 4 3 11 ... ... 2 11 8 5. Of Respiratory Organs 41 17 24 10 4 ... 14 5 6 13 3 3 1 18 19 6. Of Digestive Organs 11 7 4 4 ... ... 4 2 5 ... ... 2 2 3 4 7. Of Urinary Organs 9 3 6 ... ... ... 1 ... ... 7 1 3 1 4 1 8. Of Organs of Generation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Of Joints, Bones, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality, Malformation, &c. 11 6 5 11 ... ... 11 ... ... ... ... 1 1 7 2 12. Of Uncertain Seat 7 1 6 ... ... ... ... ... 2 5 ... 1 ... 3 3 13. Age 14 10 4 ... ... ... ... ... ... 5 9 2 2 6 4 14. Violence 4 1 3 1 ... ... 1 1 ... 2 ... ... 2 1 1 15. Not Specified 2 1 1 1 ... ... 1 1 ... ... ... ... ... 2 ... Totals 209 107 102 48 26 5 87 30 10 59 14 19 19 101 70 39 Zymotic Dieases.—Four more deaths from the Zymotic class of diseases occurred in the past year than in the preceding one. Notwithstanding this the Sub-district, in respect of its epidemic tendencies, continues to compare favourably with that of the entire District, the rate of mortality from these diseases being 19 per cent. of the deaths from all cases. Amongst this class of diseases the deaths due to Scarlatina, Fever, and Diarrhoea, show a slight increase compared with the previous year, whilst Measles, Diphtheria, and Croup show, on a similar comparison, a considerable decrease. The difference in the aggregate of deaths from Zymotic maladies in the past year compared with 1869, will be seen to be 36 against 40. To Small Pox, as in the previous year, no deaths were registered as being due, the few cases that came under treatment appearing to have been. very successfully treated. The Vaccination Act too, seems to have been complied with more generally than in some former years; but there is still much to amend in this measure to insure perfect obedience to the requirements of its compulsory clauses. Other Diseases.—The registered deaths due to the several non-zymotic maladies enumerated in the Table, from class 2 to 15, were only 3 more than in 1869, the diseases of the respiratory organs showing by far the highest figures, but numbering one more only than was noted in the previous year. The deaths from diseases of the brain and nerves were slightly less than in the previous year. The same may be said of the deaths from maladies of the digestive organs, and from those due to premature birth, low vitality, malformation, &c. There were 14 persons registered as having died of old age, which is 4 more than appears in the Table of 1869; of these 14 deaths, 5 succumbed at various ages between 60 and 80, and 9 at upwards of 80, the oldest person had reached the age of 90 at the time of death, and 2 others of 89 years. 40 Mortality amongst Infants and Children,—Comparing the Tables of the two years 1869 and 1870, there is found to be a slight decrease in favour of the past year in the number of deaths of infants and young children, between birth and 10 years of age, the figures standing at 79 against 84. Scarlatina and Diarrhoea amongst the Zymotic group, and diseases of the tubercular class and of the respiratory organs, amongst ordinary maladies, proved the most fatal to infant life, whilst to premature birth, low vitality, malformation, &c., 11 deaths of infants under one year of age are attributed, being one less than in the previous year. Cases and Deaths amongst the Out-door Union Poor of the Sub-district.—The fatal cases of illness due to Zymotic diseases arising amongst the Union Poor, as shown in Table V. Appendix, were 2 only, and the deaths from all other diseases, including those from violence, privation, &c., were together but 9, making a total of 11 deaths in 150 cases treated, or 7 3 per cent. of such total. Social Position.—There is little to remark upon in the columns of the mortality Table, relating to the social positions of those who died during the past year; but it may be observed that fewer of the industrial or labouring classes succumbed, compared with the number recorded in the Table of the previous year. The 70 deaths amongst the working classes bear also a much less relative proportion to the deaths amongst the three classes above them collectively than they did in 1869. Inquests on Violent Deaths and on Deaths from Unknown Causes.—There were but few of these inquiries during the past year, and there was nothing remarkable in any one of them to require comment in this Report. Two deaths it appears were occasioned by falls out of vehicles, and one from off a ladder, but all three were found to have been purely accidental. There was also one death, the cause of which was asphyxia in bed, and two from natural causes from disease. 41 Two deaths are recorded as having been registered without medical certificates—a practice which the law permits, but which, for many reasons, is open to grave objection. Sanitation.—The sanitary proceedings of the year are duly set forth in Table VI. Appendix. There is, however, little in the columns of this Table relating to this Subdistrict requiring comment, except it be to direct attention to the addition that has been made to the existing sewerage during the past year to the extent of 6,415 feet, and to the fact of all the other sanitary works, removal of nuisances, &c., being carried out with but two appeals to the police magistrate. It is almost needless to say that the usual inspections of and reports on the condition of all slaughter and cowhouses within the Sub-district were made, and that these places were found to be in a condition to entitle their proprietors in every case to a renewal of license. For my views on some few other sanitary matters of general as well as local importance, I must refer to that section of the Report which is made to apply to the entire District, in which they will be fully discussed. D. C. NOËL, Medical Officer of Health for Streatham, Tooting, and Balham. 42 PUTNEY AND ROEHAMPTON. The criterion of a healthy community, on the authority of that eminent official statist Dr. Farre, is 17 deaths in every 1,000 persons living. If, then, the rate of mortality of this Sub-district can be maintained below even 16 per 1,000— and the actual rate of 1870 has been calculated to be 15.7 only—the parish may be looked upon to hold a position amongst the healthy localities of the Metropolis, upon which the inhabitants might be very fairly congratulated The population of Putney, including Roehampton, in 1861, was 6,481 ; by the Census taken on April 3rd, 1871, the number of inhabitants was ascertained to be 9,438 ; thus showing an increase in the 10 years interval of nearly 3,000, and giving an average annual increase of about 300, or, to speak more exactly, 295.4. It had been long anticipated that the new Census would present rather favourable results in respect to the death rate of this locality, and it is gratifying to find that this expectation has been more than realised. The number of deaths in the Sub-distriet registered in the past year was 145, nearly equally divided as to sex, viz., 71 males and 74 females. The number of registered births in the same period was 271—of males 133, and of females 138—thus showing an excess of births over deaths of 126. This natural increase of the population exceeds that of the preceding year by 9 births, and is larger by 35 than that of the average of the 10 preceding years. 43 The number of dwelling-houses in the Sub-district was ascertained at the Census of 1871 to be 1,738, or, with 38 in course of erection, 1,776. The number of inhabited houses was, at the time of the Census, 1,589 ; it follows, therefore, (the population in April, 1871, being 9,435,) that the average number of persons to each house is within a fraction of 6. Unfortunately dwellings fitted for the residences of the very poor are not built in anything like sufficient numbers to meet the yearly increase of that class, hence overcrowding of certain portions of the Sub-district has still to be deplored. Nevertheless, by efficient drainage, and other sanitary improvements carried out in these poor neighbourhoods, the fatality of Zymotic disease generally, and of Fever especially, has of late years been very considerably diminished. It is a circumstance exceedingly gratifying to find that not a single death from Idiopathic Fever, registered as such, occurred in the past year, either amongst the poor or any other class of the population. ( Vide Table of Mortality.) The following condensed Table will show the fluctuations of the mortality due to the 7 principal Zymotic diseases, as well as the percentage of deaths of this class of diseases, to deaths from all causes during the 10 years 1861-70 :— YEARS. Number of Deaths from all Causes. No. of Deaths from Seven of the principal Epidemic Diseases. Percentage of Deaths from seven principal Epidemics to Deaths from all causes. 1861 124 21 16.9 1862 107 13 12.1 1863 129 29 22.4 1864 121 11 9.0 1865 115 11 9.5 1866 121 16 13.2 1867 128 20 15.6 1868 118 14 11.8 1869 133 31 23.3 1870 145 19 12.4 44 By comparing the figures of the past year with those of the preceding one, it will he seen that the deaths due to the 7 principal Epidemics were in the proportion of 19 in 1870 to 31 in the previous year. It is submitted that a decrease of 22 deaths in the two years can be viewed in no other light than as an indication of the operation within the Subdistrict of some very beneficial sanitary influences. In the number of deaths under every disease of the Zymotic class (Diarrhœa excepted) it has been found that there is a greater or less diminution in the two years that have been compared in favour of 1870 ; thus, there were registered in the past year, from Measles 4 deaths against 5 in 1869, from Scarlatina 3 against 6, from Diphtheria 1 against 2, from Croup none against 1, from Whooping Cough 3 against 6, from Fever none against 5, and from Metria or Puerperal Fever 1 against 2. Under Diarrhoea alone does there appear any increase (8 against 6), whilst to Small Pox, and all the other Zymotic diseases mentioned in the Table, there were no deaths whatever attributed in 1870. The following is the usual detailed Table setting forth the causes of death, as well as the sex, age, and social positions of every person whose death was registered in the past year, and distinguishing the deaths from Zymotic diseases from those due to all other causes. 45 STATISTICS OF MORTALITY. PUTNEY and ROEHAMPTON. Population in 1871—9,438. Population in 1861—6,481. Increase in 10 years—2,957. Area in Statute Acres—2,176. DISEASES, and other causes of Death. Total Deaths from each Class of Disease, &c., in the Sub-District. Sex. Age. Social position. Males. Females. 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 60, and under 80 years of age. 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, &c. Middle & Trading Class, Shopmen, Clerks, &c. Industrial & Labouring Classes. Classes :- Zymotic Small Pox Measles 4 2 2 1 3 4 1 2 1 Scarlatina 3 3 3 3 1 2 Diphtheria 1 1 1 1 1 Quinsy Croup Whooping Cough 3 1 2 1 2 3 1 2 Typhus & In fantile Fever Erysipelas Metria, Childbirth 1 1 1 1 Carbuncle Influenza Diarrhoea & Dysentery 8 4 4 3 3 3 2 3 1 3 1 Choleraic Diarrhoea Total of Zymotic Class 20 10 10 5 9 14 1 3 2 4 1 9 6 Tubercular 18 11 7 4 1 7 6 5 7 11 3 Of Brain, Nerves, &c. 18 11 7 5 2 7 1 5 5 2 3 5 8 Of the Heart, &c. 9 3 6 8 3 6 5 4 Of Respiratory Organs 31 14 17 7 4 12 6 12 1 2 6 5 18 Digestive Organs 17 9 8 2 2 1 4 10 3 3 6 5 7 Urinary Organs 5 3 2 2 2 1 1 2 2 8 Of Organs of Generation Of Joints, Bones, &c. 1 1 1 1 Of Skin Premature Birth, Low Vitality, Malformation, &c. 8 3 5 8 8 2 6 Of Uncertain Seat 5 2 3 1 1 2 1 1 1 2 3 Age 8 2 6 1 7 2 2 4 Violence 4 1 3 1 3 1 4 Not Specified 1 1 1 1 Totals 145 71 74 33 17 56 13 25 40 11 13 15 45 72 46 The most noteworthy points of this Table are :— 1. A considerable reduction in the number of deaths from Zymotic diseases generally, compared with the total of the same maladies registered in 1869. 2. The total absence of all record of deaths from Small Pox 3. A slight increase in the mortality, due to several diseases of the non Zymotic class. 4. A decrease of deaths of infants-and young children, from 59 in 1869 to 50 in the past year. 5. A decrease of 8 deaths of persons under 60, but an increase of 18 of those registered between 60 and 80 years of age, and of 6 of those over 80 years at the time of death, the two oldest of the last named having reached the ripe age of 92. 6. The nearly equal proportions of the first three classes collectively, mentioned under the heading " Social Position," and those of the industrial of labouring classes, viz., 72 of the latter to 73 of the former. It has been already observed that Small Pox has no fatality assigned to it in the above Table, and it is a circumstance not a little gratifying to find that since 1864, and down to a very recent period (February, 1871) the same absence of all record of deaths from this malady has been noted. The last return of the Local Registrar will show that fewer children than usual born within the year have escaped the performance of the important operation of Vaccination. In a similar Return inserted in my last Report it was shown that of 248 children born within the year 1869, the large 47 number of 61 remained Unvaccinated. In the present Return it will be seen that of the 271 births in the past year (1870) the small number of 14 Unvaccinated children are noted.* With such an everchanging population as that of Putney, several of these Unvaccinated children it is reasonable to suppose may have been removed from the district, and a few others may have been too delicate or too ill to be submitted to Vaccination within the prescribed period ; so that it is not by any moans improbable that the majority of the survivors of these 14 unprotected infants may ultimately receive the desired protection in some other locality, and in due course be registered in this parish. In my own practice I am aware of some few cases of postponed Vaccination from causes I have had no hesitation in certifying as being just and reasonable and I have no doubt other practitioners must have noted the same. I have great pleasure, then, in reporting the above great diminution in the number of Unvaccinated children. † * The Return referred to is as follows :— Number of Births from January 1st to December 31st, 1870—271. Of this number there were Vaccinated— By the Public Vaccinator 122 By resident Private Practitioners 75 By other Practitioners 44 241 Children who have not been Vaccinated 14 Children who have died before Vaccination 16 Total 271 (Signed) ADAM WALKER, Registrar. † At the earlier part of the present year, 1871, I was permitted by the Managing Committee to examine the arms of the pupils of both sexes of the National Schools, with the result of finding that 11 only of 430 children, or 2.5 per cent., being found without some marks of Vaccination. All those that were discovered to be without visible cicatrices, and others in which such cicatrices were indistinct or slight, were recommended to receive the protection forthwith, and I believe my suggestions, in the majority of instances, was followed. 48 With regard to the violent, sudden and uncertified deaths, 6 appear to have occurred in which enquiry by a Coroner and Jury was considered necessary. Of these, 2 were suicides, 1 an accidental death by drowning, 1 (an infant newly born) found dead in the water, and supposed to have been wilfully murdered, and 2 others, who, from the evidence adduced, were found to have died "natural deaths'' from disease. Uncertified deaths are perhaps a greater evil than uncertified births. It is true that 2 deaths only (the causes of which were registered up"n the mere statements of unprofessional persons) took place in this Parish during the past year ; but as no inquiries whatever were instituted as to why medical aid had not I been resorted to, it cannot be considered otherwise than most unsatisfactory that the Local Registrars should be allowed by the Law to receive information of the causes of death from other than Medical sources. This practice not only defeats the purpose for which the Registration Act was passed, but offers a great premium for the commission of crime that is sad to reflect upon. The deaths amongst the Union poor during the past year were in the proportion of 21 to 335 cases treated, which is about 6 per cent. This, however, is a greater one than in the previous year, when the proportion of deaths to cases treated was 4 per cent. only. The absence of any record of fatal cases of Fever in the Union Medical Relief books throughout 1870, is a circumstance well worthy of being noted. The greatest number of deaths amongst the Union poor are found to have been due to Lung diseases (including Phthisis), to which diseases more than one half of those who died in the year are found to have succumbed ; the proportion being 12 from Lung diseases to 9 from all other causes. (Vide Table VI., Appendix.) 49 SANITATION. There is perhaps no town of the same size and population as that of Putney where greater exertions have been used to bring to bear upon the public health all the modern appliances of sanitation. Apart from the efficient maintenance of the new sewerage that has been completed in this Parish, and to which an addition was made, during 1870, of 6,563 feet, there has been no abatement of energy in taking action against nuisances, &c., and in carrying out such sanitary works as are calculated to improve and beautify the neighbourhood. The results, it is suggested, are to be found in the diminished death rate of the Parish, and in the very visible increase in the population returns of the immigrant element. The favourable rate of mortality which, as before stated, is under 16 in a thousand, is one which persons seeking a suburban residence will not, it is imagined, be slow to recognise, and hence a still greater influx of new residents may reasonably be looked for in future years. Whilst our surrounding Commons and Heaths are preserved to us, and can be effectually kept from the ruthless hands that would destroy them, or render them subservient to purposes of a most objectionable, not to say unwholesome, character, there can be but little doubt that this suburb will continue to hold a high place amongst the healthiest localities of the kingdom. Once, however, suffer manure manufactories or depots, and such like unmitigated nuisances to appear within its area, and the decadence of the town and adjoining hamlet of Roehampton may be pretty safely predicted. In making these remarks 1 of course allude to the late attempt, on the part of a company, to obtain the sanction of Parliament to the establishment of a large sewage farm on Wimbledon and Putney Commons, designed to occupy a great number of acres of the same in both Parishes, with all the necessary tanks, pumping 50 apparatus, and overflow drains, which must have had their termination again in the Beverley brook. This brook, it must be understood is a contributory stream of the Thames, which the inhabitants, of Putney had, in completing their part of the great intercepting system of sewerage, expended many thousands of pounds in rendering pure and free from the fœcal and other impurities that were formerly permitted to flow into it. No wonder then that the ratepayers and residents of the Parish were to be found amongst the foremost to oppose so monstrous a proposition as that of bringing again into the District the same kind of sewage matter, which had been got rid of at so great an outlay. The ratepayers of this Sub-district may assuredly take credit for having so promptly memorialised the Home Secretary as to cause an immediate stop being put to the progress of this objectionable Bill through Parliament. For my own part I can but rejoice, as the Medical Officer of Health, at the successful opposition to the scheme, since I had no hesitation in expressing my belief, at a, meeting held by the inhabitants to petition against the Bill, that should the measure unfortunately receive Legislative sanction, one of the worst conceivable nuisances would be introduced and maintained in the neighbourhood, to the utter disgust of every one living within its influence. I have said nothing here of the prospects of securing a better water supply for the locality, since this subject will be fully commented upon in the introductory portion of the Report; but 1 may be permitted to say that it will be in the highest degree impolitic for the inhabitants to relax in their exertions to obtain a speedy and complete recognition of the principle of a constant supply, because it is but too evident that a very strong opposition to the proposed Government measure is being organised, both in and out of Parliament, by the Companies and others interested in maintaining the present unsatisfactory system. 51 In concluding this Report I have only to add that due inspection was made of all factories and workshops in the Sub-district in which labour has to be legally regulated, and it was found that none of the proprietors of these places had committed any offence against the law by exceeding the prescribed hours of employment of young persons and children. The cow-houses in the Parish, as well as all premises used for the slaughtering of animals, received the usual supervision, and I am pleased to report that all licences were renewed at the proper period without any opposition being offered on the grounds of a non-compliance with the requirements of the Act regulating such places. R. HARLAND-WHITEMAN, Medical Officer of Health for Putney and Roehampton. Chairman of the Associated Health Officers of the Wandsworth District. APPENDIX OF STATISTICAL TABLES. TABLE I. Summary of Deaths and their Causes, registered in the entire District during 1870, classified according to Sex, Age, and Social Position, and showing also the relative Numbers in each Sub-District. POPULATION OF ENTIRE DISTRICT, In 1871, 125,050. In 1861, 70,403. Increase in 10 years interval 54,647 Assumed Population for middle of year, 1870,— 119,777. Area in Statute Acres, 11,695. DISEASES, And other Causes of Death. Total Deaths from each Class of Disease, &c., in the entire District. Sub-Districts. Sex. Age Social Position Clapham—Population in 1871, 27,348, area in acre, 1.233. Wandsworth—Population in 1871,19,797, are in acres, 2,478. Battersea—Population in 1871, 53.988, area in acres, 2,343. Putney—Population in 1871, 9,435, area in acres, 2,176. Streatliam, Tooting, and Balham—Population 1871, 14,479, area in acres. 3,465. Males. Females. Under 1 year. From 1 to 5 years. From 5 to 10 years. Under 20 years, including all under 10 yearn. At 20, and under 40 years of age. At 40, and under 60 years of age. At 60, and under 80 years of age. 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Hankers, &c. Middle and Trading Class, Shopmen. Clerks. &c Industrial and Labouring Classes. Classes:— 1. Zymotic Small Pox 15 6 9 11 4 1 6 4 13 2 3 12 Measles 46 14 2 25 4 1 24 22 6 30 4 45 1 1 2 14 29 Scarlatina 352 45 48 239 3 17 176 176 21 210 84 342 9 1 1 13 147 191 Diphtheria 12 2 4 5 1 8 4 12 5 4 Quinsy 4 3 1 1 3 1 3 4 2 2 Croup 25 10 7 6 2 13 12 5 16 4 25 2 10 13 Whooping Cough 51 9 16 21 3 2 23 23 23 27 1 51 1 2 13 35 . Typhus and Infantile Fever 68 12 10 39 7 26 42 2 17 13 44 15 5 4 1 3 25 39 Erysipelas 13 2 4 6 1 3 10 6 7 1 4 1 1 1 2 9 Metria, Childbirth 16 4 11 1 16 14 2 1 9 6 Carbuncle Influenza 1 1 1 ... 1 1 Diarrhoea & Dysentery 144 31 33 62 8 10 83 61 110 17 1 128 4 4 6 2 4 5 48 87 Cholera or Choleraic Diarrhoea 4 4 3 1 1 2 3 1 1 3 Totals of Zymotic Class. 751 138 128 429 20 40 377 374 175 327 111 673 46 13 15 4 9 32 279 431 2. Tubercular 374 60 46 224 18 26 209 165 110 42 16 200 106 6 5 14 139 216 3. Of Brain and Nerves 365 35 91 198 18 23 200 165 75 63 12 157 32 83 83 10 18 16 131 200 4. Of Heart 132 33 18 51 9 21 59 73 4 4 2 17 18 34 58 5 5 8 51 68 5. Of Respiratory Organs 411 53 68 218 31 41 226 185 118 74 6 217 19 59 107 9 6 13 146 246 6. Of Digestive Organs 104 8 23 45 17 11 43 61 26 8 2 40 12 25 24 3 8 9 39 48 7. Of Urinary Organs . 39 5 10 10 5 9 23 16 2 2 5 7 8 16 3 5 7 18 9 8. Of Organs of Generation 8 4 4 8 4 2 2 4 4 9. Of Joints, Bones, &c. 4 2 1 1 1 3 1 3 1 1 2 1 10. Of Skin 3 3 2 1 3 3 1 2 11. Premature Birth, Low Vitality, Malformation, &c. 191 79 23 70 8 11 106 85 181 9 191 3 5 58 125 12. Of Uncertain Seat . 154 7 12 23 5 7 18 36 6 3 2 13 4 17 20 3 2 16 33 13. Age 133 37 18 56 8 14 58 75 63 69 12 8 39 74 14. Violence 50 5 8 29 4 4 30 20 8 7 4 25 12 7 5 1 1 3 11 35 15. Not Specified 40 20 3 14 1 2 19 21 7 10 6 16 8 2 4 12 22 Totals 2659 480 450 1376 145 209 1371 1288 713 540 157 1554 266 328 407 104 77 123 945 1514 53 TABLE 11." Bfrths registered during the year 1870. SUB-DISTRICTS. Males. Females. Total. Clapham 433 434 867 Wandsworth 316 329 645 Battersea ... 1102 1068 2.170 Putnty »nd Ro. hampton 133 138 271 Streitham, including Tooting and Balliani... 196 186 382 Total 2,180 2,155 4,335 *.* Tue excess ut Births over Deaths in the entire district is 1,676. TABLE III. Meteorological Elements for 1870. from Observations taken at Greenwich. MKANS Jan. Feb., and March. April. M>). and J une. Ju y, Antt. and September. Oct., Nov., and Dece i.ber. The Year. Tonpera'.ura if the\ Air / 38-0° 54-4° 60-7° 41-6" 48-7° Evaporation ... 35-9° 49-0" 56'3° 40 0" 45-4° Dew Point 32-8° 45-0° 52-5° 37-9° 42-0° Weiirht ( f V.ipour ] in a Cubic Foot V o! Air J 2 2 grs. 3'4 grs. 4 4 grs. 2'7 grs. 3*2 grs. Decree of Ilniiiidity) (Sdtn. 100) .../ 82° 70" 75° O *>. oo O oo r^- Reading i f Barometer 29'793in. 29742 in. 29-843in. 29-647in. 29'806in. Weiglit of a Cubic) Foot of Air ...J 555 grs. 539 grs. 530 grs. 548 grs. 543 grs. Rain (injount of) 4'1 in. 1'2 in. 5'6 in. 7-6 in. 18-5 in. 54 TABLE IV. Showing the total Deaths from the principal Epidemic Diseases registered in each Sub-District, and in the entire District, and the relation which they bore to the total Mortality in the several years 1860-70. Deaths from the seven principal Epidemics in each Sub-District. Entire District. Years. Clapham. Battersea. Wandsworth. Putney. Streatham. Total Deaths from the Seven Epidemics. Total Deaths Registered from all causes. Per centage of Deaths from the Seven Epidemics to Total Deaths. 1860 90 62 22 2 11 187 1374 13.6 1861 76 112 30 21 18 257 1393 18.4 1862 52 106 62 13 16 233 1343 17.3 1863 95 86 62 29 32 304 1471 29.9 1864 63 129 43 11 22 268 1688 15.8 1865 75 177 54 11 26 343 1783 19.2 1866 86 244 73 16 34 453 2072 21.3 1867 56 122 33 21 10 242 1937 12.4 1868 99 194 64 14 28 399 2168 18.4 1869 117 247 94 31 27 516 2393 21.5 1870 119 404 113 19 37 692 2659 26.0 *** The Diseases included in the above Table constitute, as in the RegistrarGeneral's Returns, the principal maladies only of the Zymotic class—viz.: Small Pox, Measles, Scarlatina, Diphtheria, Whooping-cough, Diarrhoea and Cholera, and Fever. TABLE V. 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 year ended 31st December, 1870. Compiled from the District Medical Relief Books. SUB DISTRICTS. Total Cases of Sickness treated in each Sub-district. 1—Small Pox. 2—Measles. 3—Scarlatina and Malignant Sore Throat. 4—Whooping Cough. 5— D iarrha and Dysentery. 6—Cholera. 7—Fever. 8—Erysipelas. 9—Puerperal Fever. 10—Lung Diseases except Phthisis. 11—Phthisis. 12—Hydrocephalus, Atrophy, Scrofula, and Convulsions, of Children. 13—Other Diseases. 14—Violence, Privation, 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. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths 49 Clapham 1162 23 4 50 3 22 8 11 89 3 177 3 4 169 3 17 6 26 4 518 15 56 Wandsworth 2019 8 13 47 10 42 2 208 6 37 3 24 2 445 19 14 2 11 4 1060 21 104 1 70 Battersea 2370 58 6 78 3 73 3 18 180 4 239 7 4 420 28 35 3 18 1 1161 21 86 76 Putney and Roehampton 335 17 1 5 1 37 1 7 2 ...i 32 7 7 5 207 7 20 21 Streatham, including Tooting and Balham 151 1 7 2 6 2 22 1 3 3 2 105 5 3 11 Totals 6037 90 10 158 7 154 23 78 2 520 14 460 13 36 2 1078 58 76 19 67 9 3051 69 269 1 27 ***The ratio of deaths to cases treated was 3.7 per cent; during the preceding year it was 3.5 per cent. 56 TABLE VI. Summary of the Sanitary Operations in the entire District during the year 1870. Clapham. Battersea. Wandsworth. Putney and Roehampton. Streatham, including Tooting and Baiham. Totals. Number of Houses and Premises inspected 1,400 3.358 320 84 275 5,437 1st Notices served 82 78 65 7 27 259 2nd Notices served 17 22 2 3 1 45 Cesspools emptied and cleansed 54 23 20 97 Cesspools abolished 15 23 4 3 34 79 Waterclosets constructed 55 23 81 229 388 Houses supplied with water 38 124 81 229 452 Drains constructed or connected with Sewer 95 215 43 74 142 569 No. of feet of New Sewers, &c. 6,619 10,298 3,170 6,563 6,415 33,965 Drains repaired or trapped, or obstructions removed 20 51 12 7 39 129 Open Ditches,Ponds, &c., cleansed (in feet 95 1 1,850 2,500 4,446 Dust-bins provided 30 59 81 213 383 Pig Nuisances removed 7 23 10 3 7 50 Accumulations of Offal, Manure, &c., removed 8 75 3 5 13 104 Unwholesomeand dilapidated Houses cleansed or repaired 46 37 40 3 2 118 Cases investigated by Magistrates 3 11 1 3 18 Compulsory Orders obtained 1 8 1 3 13 Compulsory works executed 1 11 3 15 Works remaining in abeyance from various causes 10 3 13