WAN 27 SANITARY DEPARTMENT. REPORT on the SANITARY CONDITION of the several parishes comprised in the WANDSWORTH DISTRICT. During the Year 1875. by the MEDICAL OFFICERS OF HEALTH. London: JOHN SMITH and CO., 52, LONG ACRE, W.C. 1876. Gentlemen, We have the honour to present the twentieth Annual Report on the health and sanitary condition of the area over which the jurisdiction of your Board extends. There is nothing that can more adequately show the advance which the District is making in all that relates to sanitation than a reference to the series of Tables which have been employed for so long a period in these reports; and it is hoped that in the present publication they will be found of equal interest to any that have preceded them. We have the honour to remain, Gentlemen, Your obedient Servants, The Medical Officers of Health of * the Wandsworth District. REPORT. 1875. To the Board of Works of the Wandsworth District. . 5 HEALTH AND SANITARY CONDITION OF THE ENTIRE DISTRICT. The health of this District, during the year 1875, in common with that of the rest of the Metropolis suffered considerably from the presence of Epidemic Diseases. But the incidence of the latter was so partial (as will be found on reference to the several Local Summaries contained in this report) that while some of the Sub-districts suffered a heightened mortality, others enjoyed comparative immunity from those diseases. Hence the death-rate of the entire District is found to have been below the average and not very materially heightened by such unfavourable influences. Vital Statistics. The total deaths registered in the entire District during the year 1875 numbered 3096; 1571 were of males and 1525 of females. The births were 5529 in number; 2771 of males and 2758 of females. The excess of births over deaths gives the natural increase of 2433. The Death-rate.-The most important and generally accepted exponent of the sanitary status of any locality is presented by its death-rate; but its trustworthiness, it need scarcely be remarked, is entirely dependent on its accuracy. Unfortunately such accuracy, except at the periods of each census, has been very difficult of attainment, in consequence of the absence of a reliable datum for determining the exact number of the population, upon which alone a correct estimate of the death-rate neces- 6 sarily depends. This difficulty is especially noticeable in the suburbs of the Metropolis, where the population is liable to great fluctuations, under the disturbing influences of emigration and immigration. The operation of the latter has, of late years, prevailed in this District,* in common with all the southern districts, to such an extent as to prevent the requisite degree of accuracy in deducing the death-rate by the ordinary method of calculation, such as is employed by the Registrar-General, and which consists in dividing the number of deaths by the population, the estimate of the population being based on the assumption that it has increased since the period of the last census in the same proportion as it had done during the ten preceding years. So calculated, the rate of mortality in this District during the year 1875 was 20.87 per 1000 persons living on an average during the year. The ratio of deaths to estimated population in each of the Sub-districts is shown in the following Table :— SUB-DISTRICTS. Estimated Population in the middle of 1875. Deaths. Ratio of Deaths to Population. Excluding Non- Parishioners who have Died in Public Institutions. Battersea 68,648 1,724 1 in 40 1 in 42 Wandsworth 22,524 420 1 in 53 1 in 64 Clapham 30,088 548 1 in 55 No appreciable dif- ference Streatham, Tooting, & Balham 16,340 237 1 in 69 Putney & Rehampton 10,693 167 1 in 64 * An illustration of this was furnished in East Battersea during the year 1874, when an influx of some 3000 persons took place to inhabit the Shaftesbury Park Estate, a reference to which will be found in the summary for that Sub-district, This correction is necessary, in consequence of the undue exaltation of the Death-rates of Battersea and Wandsworth by the mortality of the Union Infirmary in the former, and of the Surrey County Lunatic Asylum, St. Peter's Hospital, and the Hospital for Incurables in the latter, Sub-district. 7 The average death-rate during the years 1861-71 was 21.52; in the years 1861 and 1871 (census years, when the population was accurately known) it was 19.64 and 22.60 respectively. The mean of these rates is 21.55; so that the death-rate of the past year may be fairly assumed to have been considerably below the average. It is 2.83 per 1000 less than that for all London, and, for the reasons above indicated, is doubtless considerably in excess of the true one. Under these circumstances, therefore, it is thought desirable to test its accuracy by the adoption of another, and, it is believed, more trustworthy method of calculation, consisting in the employment of the ratio which the births are found, on an average, to bear to the population, for ascertaining the amount of the latter at any given period. By an examination of the Registrar General's Annual Reports for all England, extending over a period of 20 years, it is found that a certain nearly constant number of births occur on an average in a given population during a certain period of time, and that although this ratio of births to population is subject in different localities to variations from the ages, proportion of the sexes, and social condition of the people, yet such variation is exceedingly small and confined within certain definite limits, and that it moreover becomes, as it were, adjusted in a calculation derived from an average of several years. Thus, the above ratio in 1851 was 34.25 per 1000, or a little under 1 in 29; in 1871 it was 34.50 per 1000, or a little over 1 in 29. In this District during the years 1861-71, the mean annual number of births registered was 3,249 in a mean annual population of 97,715 (as ascertained by the census), giving a ratio of 33.25 births to the 1000, or 1 in every 30.07 persons living. In 1871 the ratio was 1 in 28.55, and in all London 1 in 28.98. In the years 1874 and 1875 in all London it was 1 in 28, the increase having been probably due to improved registration. From an examination of these figures it would seem that, allowing for the slight variations before referred to, the law of natural increase is fixed and constant, and that a given population will, in a given time, under 8 similarly prevailing conditions, produce a constant ratio of increase. If this proposition be correct, it must be apparent that the determination of the population from its ratio of births will embrace, amongst the lesser causes of variation referred to, all the fluctuations due to emigration and immigration, the latter of which can be arrived at only by the assumption of an estimate of increase which may or may not have any foundation on fact. These data being premised, the population of this District, calculated from its previously ascertained ratio of births on an average of 10 years, amounted during the year 1875 to 157,576 persons, giving a death-rate of 19.64 per 1000 living on an average during that year. Causes of Death.—The nature of the causes of death, and the classes of disease from which the mortality of the past year resulted, are recorded in Table 1 Appendix. These, with the relative positions which they occupied in their order of fatality, and their numerical comparison with those of former years, will be found fully commented on in the several local Summaries. It will therefore be necessary here only to indicate those classes which claim attention in consequence of their unusual activity or variation from their ordinary position in contributing to the rate of death. Diseases of the Respiratory Organs (excluding Consumption), which formed upwards of 20 per cent. of all deaths, assumed the first place in the causation of the mortality, thus occupying the position almost invariably held by diseases of the Zymotic class. The next most fatal class of diseases was the Tubercular, which includes Scrofula and Consumption, forming upwards of 18 per cent.; and the third in order of fatality was the Zymotic Class, constituting upwards of 17 per cent. The other classes present no variations which would appear to have affected the Death-rate in any appreciable degree; but it should be observed that Class 3 (Diseases of the Brain and Nerves) is, as usual, in excess, by reason of its containing the mortality of the Surrey 9 County Asylum, which receives its inmates from the whole County of Surrey, and, in consequence, unduly exalts the death-rate of this District, The most noteworthy circumstance in the Table is the numerical preponderance of Diseases of the Respiratory Organs, which, as in the year 1874, were so numerous, and attended with such great fatality, as to have created a suspicion of their derivation from some Zymotic cause. Epidemic Diseases.—Next to the death-rate, the most important means for elucidating the health of the District is presented by an examination of the amount of fatality which lias resulted from Epidemic disease, and of the relative proportion which it has borne to the total deaths; for the fluctuations in the death-rate are found to be very constantly dependent on the variations in the amount of fatality resulting from these diseases. On a reference to the Table, (No. 4 Appendix,) it will be seen that the total number of deaths which resulted from the seven principal Epidemic diseases in the entire District was 472, being 32 more than occurred in the previous year, and closely corresponding with the average of the preceding ten years ; but the ratio per cent. (15.2) which these diseases bore to the deaths from all causes was much less than a similar average (19.5). The diseases of this class, which caused by far the greatest mortality, are seen to have been Scarlet Fever, Diarrhoea, and Whooping-Cough, the two former having been equally fatal. The prevalence and fatality of these diseases varied very considerably in the several Sub-districts. Whooping Cough and Diarrhoea prevailed generally, while ScarletFever principally affected Battersea, Clapham partially, Wandsworth and Streatham slightly, and Putney not at all, —at least, fatally. Thus, of the 134 deaths which occurred from that disease, 103 took place in Battersea, 22 in the contiguous parish of Clapham, and 5 only in the adjoining parish of Wandsworth. The difference in incidence of fatality from these diseases in the several Sub-Districts is more concisely given in the following Table, which shows 10 the proportion which the deaths from (the 7 principal) Epidemic diseases bore both to the estimated population and to the deaths from all causes. With reference to the first determination it should be observed that, although the number of the population might be an uncertain factor in the calculation, still, the rates of the several Sub-districts being determined in the same manner, the proportion which they bear to each other is relatively correct; the second is absolutely so. SUB-DISTRICTS No. of Deaths from Epidemics per 1000 of the Estimated population. Ratio of Deaths from Epidemics to every 100 of the total deaths. Battersea 4.61 17.2 Clapham 2.46 13.5 Wandsworth 2.04 10.0 Putney 1.87 12.0 Streatbam 1.53 10.5 Infant Mortality.—Another indication of the health of the District is furnished by the proportion which the mortality of infants bears to the total mortality; on the greater or less amount of the former of which any important fluctuations of the general death-rate are found to be essentially dependent. 43.6 percent, of all deaths during the past year occurred to infants under 5 years of age. This rate is high, the corresponding rate for all London being under 40 per cent.; but it is found to be very considerably less than the mean annual rate which prevailed in this District during the preceding ten years, and which was 49.6 per cent. Sickness and Mortality amongst the Parochial Poor.— Table 5 in the Appendix shows the nature, amount, and fatality of the sickness which came under the treatment of the Union Medical Officers during the year, and serves to corroborate in a marked manner the deductions offered by a consideration of the table of total mortality. Of the 3,068 11 different cases of sickness which came under treatment, the large proportion (618) of pulmonary diseases, and the relative proportions of the three most fatal epidemic diseases referred to are at once apparent. The ratio of deaths to the total cases treated was 3.1 per cent., which closely corresponds with the average. Sanitation. —The amount of sanitary work which has been accomplished during the year is recorded in Table 6 in the Appendix. It is seen to have been of large and varied extent, and will be found to favourably bear comparison with similar records of former years, especially in reference to the inspection of houses and the construction of new sewers. It should be observed, in reference to this Table, that its figures very inadequately represent the amount of work actually performed; for there are a variety of proceedings known to the Medical Officers of Health and the Surveyors which cannot be tabulated; that is, the figures show the results obtained, but fail to indicate the means by which those results were secured. Although a vast amount of sanitary work has been beneficially accomplished during the now lengthened period of the Board's existence, there yet remain in this District very numerous sanitary requirements awaiting fulfilment. Some of the most important of these the Medical Officers of Health venture to bring to the notice of the Board, as having been either indicated in former reports, or which will be found commented on in the Local Summaries contained herein. These requirements may be thus briefly summarized :— 1. A constant service of pure water.* According to Dr. Frankland's Tables of Analysis of the waters supplied to the Metropolis during the year 1875, the two waters which contained on an average * According to the Registrar General's calculations contained in his Report for 1875, the Metropolis might be supplied with water at half the present cost. It would, therefore, seem desirable to consider whether this District could not procure for itself an abundant and economical supply of the greatest purity by artesian borings from the chalk strata. 12 the largest amount of organic matter were those of the Southwark and Lambeth Companies, and which are supplied to this District. 2. A continuous service of water (which need not be filtered) through the sewers, for the more rapid removal of their contents and the consequent prevention of decomposition and its gaseous products which at present form such a constant and serious nuisance in the public thoroughfares, and which will, if unremedied, most probably eventuate in some great and calamitous epidemic. 3. The establishment of Baths and Washhouses. 4. A more frequent and systematic removal of House refuse. 5. A more efficient scavengering and cleansing of the streets, especially in the bye-ways and in the precincts of the dwellings of the poor. 6. A law to suppress the nuisances arising from the keeping of swine. 7. An improvement in the law relating to noxious trades. 8. Well provided mortuaries in the Sub-districts not already so supplied. 9. A hot-air apparatus for the purification of infected clothing. 10. The prohibition of the return to school of children absent on account of sickness without a certificate from their medical attendant that they may do so without injury to themselves or others. A printed certificate to this effect, requiring only the signature of the Medical Attendant, is all that is needed to prevent a very fruitful source of the propagation of contagious diseases. 11. A preliminary medical investigation into the cause of every death which has not been certified by medical 13 testimony. During the past year no less than 34 deaths were recorded, the causes of which were not specified. 12. The necessity for every street to be permanently named and every house numbered; not only for the sake of public and private convenience, but to admit of greater facility for the investigation of the local causes of disease, and for the more complete employment of sanitary measures in their removal. All these requirements, many of which can be practically and immediately dealt with, present great claims upon the attention of the Board. LOCAL SUMMARIES. 16 WANDSWORTH. The health of this Sub-district during the year 1875, considered both in relation to the prevalence and the fatality of disease, was in a highly favourable condition. Satisfactory evidence of this is furnished by the following statistics, derived from an analysis of the mortality returns of the Registrar General, and is corroborated by similar data presented by the parochial records of sickness and mortality; and it is gratifying to find, from an examination of those trustworthy sources of information, that the high standard of health which so obtained, was essentially dependent on a diminution of the Zymotic class of diseases. vital statistics. • Population.—Assuming that the population has increased since the period of the last census in the same proportion as it had done during the preceding 10 years, the mean number of inhabitants during the past year is estimated to have been 22,524. Mortality.—The total deaths which were registered during the year were 420, in equal number of the two sexes. No less than 127 of them took place in public institutions, viz.:—In the Surrey County Lunatic Asylum 99; in the Hospital for Incurables 2; in St. Peter's Hospital 2; in the House of Correction 8; in the Reformatory for Boys 3. 34 deaths of Wandsworth parishioners occurred in the Union Infirmary, which do not appear on the register of this parish, but on that of Battersea, 17 in consequence of the Infirmary being situated in the latter parish, but which require to be taken into consideration in the estimation of the death-rate. The Death-rate deduced from the deaths registered, and the population estimated in the foregoing manner, was 18.64 per 1000 persons living. But, as has been explained in previous Reports, a rate so determined cannot be accepted as the natural one, in consequence of the undue exaltation of the death-register by the mortality of the Surrey County Lunatic Asylum, St. Peter's Hospital, and the Hospital for Incurables, the inmates of which institutions are with a fractional exception, derived from without the parish, undergo no natural increase, and are subject to a high mortality, and which, as is seen above, collectively contributed last year 30 percent, of all deaths. The natural death-rate for the past year, after correction for institutions in the manner explained in previous Reports, was 15.65 per 1000 persons living on an average during the year. This rate is very considerably less than that which obtains in rural districts (17 per 1000), and with the exception of the years 1857 and 1872 (in which it was 15.40 and 15.52 respectively) is the lowest rate attained since the existence of the Board. Birth-rate.—The births were 673 in number, 332 of males and 341 of females. The birth rate was 31.17, and the rate of natural increase 15.52 per 1000 persons living of all ages, both being calculated on the foregoing estimate of the population. causes of death. The following Table contains a summary of all the causes of death arranged in accordance with the classification of the Registrar-General, shewing the sex, social position of the deceased, and age at death at different periods, and particularizing the several diseases of the Zymotic class :— b 18 STATISTICS OF MORTALITY. WANDSWORTH. Population in 1871—19,783. Estimated population in middle of 1875—22,524. Area in Acres—2,478. 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. Diseases Classified. Classes :— Small Pox 1 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... Measles 2 2 ... 2 ... ... 2 ... ... ... ... ... 2 ... ... Scarlatina 5 3 2 1 4 ... 5 ... ... ... ... ... ... 2 3 Diphtheria 2 1 1 ... 2 ... 2 ... ... ... ... ... ... 1 1 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 4 2 2 1 3 ... 4 ... ... ... ... ... ... ... 4 Whooping Cough 14 8 6 5 9 ... 14 ... ... ... ... ... ... ... 12 1.Zymotic Typhus & In fantile Fever 5 2 3 ... 1 2 4 ... 1 ... ... ... ... 1 4 Erysipelas 3 1 2 1 ... ... 1 ... 1 1 ... ... ... 1 2 Metria, Childbirth 3 ... 3 ... ... ... ... 2 1 ... ... ... ... 1 2 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhæa & Dysentery 17 6 11 11 4 ... 15 1 ... 1 ... 2 2 1 12 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals of Zymotic Class 56 26 30 21 23 2 47 4 3 2 ... 2 4 10 40 2. Tubercular 76 43 33 11 8 2 27 29 14 5 1 ... 5 17 54 3. Of Brain, Nerves, &c. 98 57 41 9 4 3 18 17 33 26 4 3 6 20 69 4. Of the Heart, &c. 29 12 17 ... ... 1 2 5 12 9 1 1 ... 3 25 5. Of Respiratory Organs 57 23 34 14 7 ... 22 5 11 16 3 1 6 10 40 6. Digestive Organs 19 7 12 3 1 ... 4 4 7 4 ... 1 ... 4 14 7. Urinary Organs 10 8 2 ... ... ... ... 2 2 5 1 2 2 4 2 8. Of Organs of Generation 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 9. Of Joints Bones, &c. 2 1 1 ... ... ... ... 1 ... 1 ... ... ... ... 2 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality, Malformation, &c. 30 18 12 30 ... ... 30 ... ... ... ... 1 2 4 23 12. Of Uncertain Seat 19 7 12 1 1 ... 2 4 4 9 ... 2 2 7 8 13. Age 12 2 10 ... ... ... ... ... ... 4 8 1 2 1 8 14. Violence 9 6 3 1 2 ... 6 ... 2 1 ... ... ... 1 8 15. Not Specified 2 ... 2 2 ... ... 2 ... ... ... ... ... ... ... 2 Totals 420 210 210 92 46 8 160 71 89 82 18 14 29 81 296 19 In determining the relative proportions borne by the several classes of disease in the causation of the mortality, it is necessary to exclude class 3 (Diseases of the Brain and Nerves) in consequence of the disturbing influence of the County Asylum under the circumstances already explained in reference to the death-rate. Excluding class 3, the first in order of fatality was the Tubercular class, occupying the position usually held by class 1, the Zymotic (Epidemic—Contagious) and constituting about 18 per cent, of all deaths, and upwards of twice the average amount. Belonging to this class is Consumption, which, as is usually the case, was the most fatal single disease and formed 13|½ percent., and the next class was the Zymotic, of a little under the same amount. Class 4 (Heart Diseases) was unusually large, contributing double its usual amount of fatality. Class 11 was also great, exceeding, as in the previous year, the average by nearly one third. Age at Death.—A little under 22 per cent, of all deaths occurred to infants under one year of age; upwards of 32 per cent, to children under 5 years of age; and upwards of 38 per cent, under 20 years of age; thus almost exactly corresponding with similar figures of the preceding year. Collectively the infant mortality was considerably below the average, as might be anticipated from the less prevalence of the Zymotic diseases incidental to childhood. 12 deaths only are recorded as the result of old age unassociated with any particular disease, but 49 occurred between the ages of 70 and 89; viz.:—from 70—75, twenty-one ; 75—80, thirteen ; 80—85, thirteen; one at 87, and one at 89. Social Position. —70 per cent, of all the deaths from general disease, and 71 per cent, of the deaths from Zymotic diseasestookplaceamongthe labouringclasses. This amount, although excessive according to their relative numerical proportion, is very much less than the average of the past ten years, which is found to have been 78 per cent, (nearly) ; and the statistics of these reports shew that since the existence of the Board, the proportion of fatality borne by the working classes to that of the other classes of the B 2 20 inhabitants has become very materially lessened. This result, it need scarcely be observed, is indicative of the achievement of considerable success by the extensive sanitary measures which have been carried out during the period referred to. Inquests, Violent Deaths, t&c.— 31 Inquests were held during the year, with the following results : Natural Deaths from Disease - - 21 Deaths from Violence Accidental 8 9 Homicidal 1 Not specified 1 The verdicts in the cases of violence, &c., were the following, copied literatim; "Found drowned ; no marks of violence; no proof how she came to her death," " Drowned by falling out of a boat." " Mortal injuries by falling off a scaffold accidentally, 2½ hours." " Drowned ; fell into the river Thames accidentally, about a ¼ of an hour." " Fracture of cervical vertebra by falling down stairs when drunk, accidental." " Drowned, accidentally falling off a barge." " Accidentally drowned bathing, 4 days." " Scalded glottis, upon drinking boiling water from a kettle, accidental, 27 hours.'' " Wilful murder against some person or persons unknown, by some compression of the ribs." " Found dead in a nude state." There were 4 deaths only registered which were uncertified by Medical testimony. Of the 31 deaths on which inquests were held, in 8 only were post-mortem examinations made to determine the causes of death; and the latter, it would seem from an examination of the register, have been in some instances assumed on mere conjecture, or in error, or not arrived at at all; as in the case of the last verdict recorded above, wherein the nearest approach to an elucidation of the cause of death was found in the somewhat remote but self-evident fact of the nudity of the deceased 21 person. As a change in the law regarding the present unsatisfactory mode in which inquests are held appears to be in contemplation, it may be not out of place to refer to observations made on this subject in many previous reports, and especially in that of last year, wherein it was urged that, as the essential object for the coroner's inquest was the determination of the cause of death, such enquiry should be primarily of a medical nature, and that the prevention of the possibility of the perpetration of secret crime would be best ensured by the employment of a preliminary skilled enquiry in the place of the unskilled enquiry of the coroner's beadle, in every case in which the cause of death shall have not been certified by a registered Medical Practitioner. For the reasons for these conclusions the reader is referred to my Report for 1874, page 25. Epidemic diseases—their prevalence and fatality.— The following Table shews 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 Diarrhæa Fever—Typhus and Typhoid Total Deaths From Epidemics Total Deaths from all causes Percentage of deaths from Epidemics to deaths from all causes 1865 5 2 8 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 ... 8 6 2 20 ... 22 7 64 394 16.2 1869 ... 23 36 ... 7 ... 23 6 94 429 21.9 1870 ... 2 48 4 16 ... 33 10 113 450 25.1 1871 14 31 23 ... 11 ... 21 3 103 453 22.7 1872 1 5 1 3 13 ... 20 4 47 365 12.8 1873 ... 4 ... 3 8 ... 22 7 44 433 10.1 1874 ... 14 2 ... 19 ... 12 6 52 453 11.5 1875 1 2 5 2 14 ... 17 5 46 420 10.9 22 From an examination of the foregoing Table it will be seen with satisfaction that the amount of mortality resulting from these diseases, and the relation which it bore to the total mortality, was about one third less than the average of the past ten years. The most fatal of these diseases was Diarrhœa, which, as usual, was prevalent during the whole year. Hooping-cough was the next most fatal, and somewhat exceeded the decennial average; with this exception all the other diseases of this class were below the average, some very considerably so, and can scarcely be said to have prevailed epidemically. By far the larger proportion of fatality from these diseases occurred in the winter quarter, as seen in the following Table which shews the months in which the deaths from the seven principal Epidemic diseases took place. DISEASE. January February March April May June July August September October November December Small Pox ... ... ... 1 ... ... ... ... ... ... ... ... Measles 1 ... ... ... ... ... 1 ... ... ... Scarlatina ... ... ... 1 ... ... ... ... 1 2 ... 1 Diphtheria ... ... ... ... 1 ... ... ... ... 1 ... Hooping Cough 2 ... ... 3 1 1 1 3 1 2 Diarrhœa ... ... ... 2 ... 1 3 1 3 4 2 1 Fever 1 2 1 ... ... ... ... ... ... ... ... Sickness and Mortality among the parochial poor.— The amount of disease, with its nature and attendant fatality, which came under treatment amongst the parochial poor, is exhibited in Table 5, Appendix, from which it is seen that the mortality is found to have been nearly one third less than the average of the past ten years, and thus fully confirms the lowness of the mortality indicated by the returns of the Registrar-General. It is valuable also as furnishing the only available means of estimating the total amount of 23 sickness which has prevailed generally throughout the parish. This estimate, although approximate only, cannot err by exaggeration, and is made by accepting the proportion which the deaths bear to cases of sickness that prevailed amongst the parochial poor (and which is accurately recorded) as the proportion borne by the deaths to the cases of sickness amongst all classes of the inhabitants. So calculated, the total amount of sickness which prevailed generally may be assumed to have affected not less than 40 per cent, of the population, or about 5 per cent, less than the decennial average. Sanitary Proceedings.—Removal of Nuisances, &c.— In Table 6, Appendix, will be found the usual summary of the general sanitary operations which have been conducted during the year. In the removal and prevention of the recurrence of 4 nuisances it became necessary to obtain a prohibitory order from the presiding magistrate. Two of these were of considerable magnitude, arising in the carrying on of noxious trades. One was the huge piggery of Mr. Butterfield, situated in the Merton Road fields, and having a plant and appliances for 200 pigs under one roof. There was no proper drainage, and, on account of the level of the ground in relation to the river, no means of making any; eventually, the owner abandoned the undertaking. The other was the fat-boiling business of Mr. Harvey, at Groton Road, Dunsford Hill, in which fat was extracted, by boiling in an open copper, from animal refuse—principally Australian preserved meats which had become putrid and unfit for food. In addition to the proceedings enumerated in the Table, all the Cow-houses, 18 in number, and the Slaughterhouses, 10 in number, were examined and reported on prior to a renewal of their owners' licenses. No need arose for opposing the granting of the latter in any instance. In order to obtain more practical results from the information derivable from the returns of the RegistrarGeneral in regard to the localization of disease and the consequent projection of sanitary measures for its prevention, I 24 have prepared a list of the localities in which deaths from contagious diseases occurred during the past year, for the guidance of your Surveyor. But in consequence of the incompleteness in the numbering of the houses, especially in localities where for such purpose it is most needed, it is impossible in many instances to derive that practical value which the death register would otherwise convey. It is most desirable that every house should have its distinguishing number, for obvious reasons of private convenience; and this simple and inexpensive procedure, it is submitted, requires to be uniformly carried out, not only for the sake of the convenience of the inhabitants,but also for facilitating the performance of the sanitary duties of the Board. GEORGE EDWARD NICHOLAS, M.D. Medical Officer of Health for Wandsworth. f 25 BATTERSEA EAST. The population of this division of the parish is difficult to estimate by the ordinary methods of adding a certain number, equal to one tenth of the numerical increase in the years 1862-71, to the census population of 1871; as the number of additional inhabitants in the Shaftesbury Park Estate alone exceeds the official increase of population sanctioned by the Registrar-General. In these circumstances it is necessary to have recourse to other data, of which the birth-rate is the most trustworthy, corrected by taking into consideration the natural increase of population, i.e., the excess of births over deaths, and the ascertained addition to the number of inhabitants in the Shaftesbury Park Estate. Population.—The official meanpopulation of the Eastern division of the parish for the year 1875 is 34,826. This is manifestly inadequate, for the reasons already stated, as by the adoption of these numbers we should arrive at a death-rate of 24.8 per thousand per annum, and a birth-rate of 49 per thousand, both of which are clearly too high, as, taking the birth-rate as a test, in the year 1875 the birth-rate for London was 35.7 per thousand only. The 26 birth-rate of Battersea, as has beta shewn in former Reports, has generally reached the high rate of 42 per thousand, upon which basis a population of 42,058 is deducible. It is not possible to state positively that this large number of persons actually were resident in this division of the parish, but the probabilities are that the real numbers are rather above than below those thus estimated. The so-called natural increase of population, which is arrived at by deducting the deaths (867) which were registered in the Eastern division of Battersea during the year 1875, from the births (1709) similarly recorded, were 842. This natural increase is, however, not sufficient as a datum for calculating the increase of population in a district where immigration is so active as in that under consideration. Mortality.—The total number of deaths registered during the year 1875 in the Eastern division of the parish of Battersea was 867. The number registered in the previous year was 701, the increase being 166, which the large addition to the population accounts for. Of this number 430 were males and 437 females. If the real population has increased in the manner and to the extent indicated, its number may be estimated at 42,058 for the middle of the year 1875; and the deathrate will have been 20.6 per thousand per annum, or 3.1 lower than the death-rate for London during 1875, which was 23.7. The accompanying statistical Table gives, as heretofore, the cause of death, the age and social position of the persons whose deaths were included in the mortality returns during the year. 27 STATISTICS OF MORTALITY. BATTERSEA EAST. Population June, 1874— 33,085. Estimated mean *population, 1875 —34,826. Area in Acres 1235. Total Deaths from each Class of Disease, Ac., in the Sub-District. Sex. Age. Social Position. Males. Females. Under 1 year. From 1 to 5 years. From 5 to 10 years. From 10 to 20 years. All under 20 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 and Laboring Classes. Classes:— 1. Zymotic Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 9 7 2 3 6 ... ... 9 ... ... ... ... ... ... ... 9 Scarlatina 55 27 28 2 29 19 3 53 1 1 ... ... ... ... 4 51 Diphtheria. 6 1 5 ... 4 2 ... 6 ... ... ... ... ... 2 ... 4 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 13 8 5 2 9 2 ... 13 ... ... ... ... ... ... ... 13 Whooping Cough 42 23 19 19 22 1 ... 42 ... ... ... ... ... 5 3 34 Typhus, &c. 16 11 5 1 ... 6 1 8 5 2 1 ... ... ... 2 14 Erysipelas. 7 5 2 6 ... ... ... 6 ... ... 1 ... ... ... ... 7 Metria, Childbirth 4 ... 4 ... ... ... 1 1 3 ... ... ... ... ... 1 3 Carbuncle. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Cholera 44 22 22 31 10 2 ... 43 ... 1 ... ... ... 1 3 40 Totals of Zymotic Class 196 104 92 64 80 32 5 181 9 4 2 ... ... 8 13 175 2. Tubercular 197 94 103 76 47 6 5 134 45 7 1 ... 2 7 13 175 3. Of Brain, Nerves, &c. 100 51 49 46 28 1 2 77 4 9 9 1 2 6 6 86 4. Of the Heart, &c. 40 17 23 ... ... 1 3 4 8 14 11 3 2 2 14 22 5. Of Respiratory Organs 196 94 102 59 63 6 2 130 14 24 25 3 3 10 17 166 6. Of Digestive Organs 20 7 13 8 1 ... ... 9 4 4 3 ... ... 1 2 17 7. Of Urinary Organs. 8 5 3 ... 1 2 ... 3 3 ... 2 ... ... 1 2 5 8. Of Organs of Generation 2 ... 2 ... ... ... ... ... 1 1 ... ... ... ... ... 2 9. Of Joints, Bones, &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality, Malformation, &c 32 19 13 32 ... ... ... 32 ... ... ... ... ... 1 5 26 12. Of Uncertain Seat 21 11 10 3 2 ... 1 6 2 7 6 ... 1 ... 4 16 13. Age 19 5 14 ... ... ... ... ... ... 1 10 8 2 2 4 11 14. Violence 23 16 7 5 3 2 '4 14 6 2 1 ... ... 1 2 20 15. Not Specified 13 7 6 1 2 ... 1 4 4 4 1 ... ... 1 2 10 Totals 867 430 437 294 227 50 23 594 100 77 71 15 12 40 84 731 28 It will be observed that 294 deaths were registered as occurring under one year of age, which is equal to 34 per cent. of the gross mortality; in the two preceding years the proportion was 37 per cent. Between 1 and 5 years the number of deaths registered was 227; in all, under 5 years of age, 521, or 60 per cent. of the total number, which is precisely identical with the results similarly obtained last year. Fifteen persons are recorded as having died above 80 years of age, the age of the males was respectively 80, 81, 83, 84; and of the females 80, 81, 82, 82, 84, 85, 85, 86, 87, 88, 88. The females invariably present the most numerous instances of longevity, the laborious nature of most masculine occupations, added to the risks inherent to exposure during inclement weather, and the liability to accident, apparently being more inimical to prolonged life than the continuous anxieties of family cares and domestic duties. Social Position.—The following Table gives the rank or position in life of the persons whose deaths were registered as occurring during 1875, together with the relative proportions per cent. of the whole number of deaths. per cent. Nobility and Gentry 12 1.7 Professional Class 40 4.5 Middle and Trading Class 84 9.5 Industrial and Labouring Class 731 84.3 Total 867 100.0 Zymotic or Epidemic Diseases.-The mortality from this class of diseases amounted in the aggregate to 196, as detailed in the following Table, to which is appended the corresponding numbers for the preceding year, 1874. 29 1875 1874 Scarlatina 55 50 Diarrhœa 44 37 Whooping Cough 42 23 Fevers 16 17 Croup 13 9 Measles 9 12 Erysipelas 7 3 Diphtheria 6 3 Diseases of Childbirth 4 14 Small Pox 0 3 196 171 Twenty-three per cent. of the total number of deaths were registered as occurring from Zymotic Disease, and the Zymotic death-rate was 4.6 per thousand, which is about the same as that for London generally, and lower than last year, when the Zymotic mortality was above 24 per cent. of the gross number registered in this division of the parish. Scarlatina is again the prime factor of Zymotic deaths, 55 fatal cases were recorded in 1875 against 50 in 1874. Diarrhoea contributed 44 in 1875, against 37 in 1874; Whooping cough, 42 against 23 (this latter disease having been unsually fatal over the whole country); Fevers, 16 to 17; Croup, 13 to 9; Measles, 9 to 12; Erysipelas, 7 to 3; Diphtheria, 6 to 3; and Diseases of Childbirth, 4 as against 14 in the former year. The increase in the total of these diseases is not more than is equivalent to the increased population. No case of death from Small-Pox has occurred in the sub-district during the year, as against 3 last year. This is doubtless due to the stringency with which the vaccination laws are enforced by the Vaccination Officer, Mr. Payne, who is very energetic in carrying out the provisions of the Compulsory Vaccination Act. 30 Other Diseases.—Tubercular diseases, which include Pulmonary Phthisis, Water on the Brain, and Infantile Wasting, caused 197 deaths in 1875, against 172 in 1874. Diseases of the Respiratory Organs caused 196 deaths, contrasted with 156 last year. The earlier and latter portions of the year were characterised by low temperature and an excessive mortality from diseases of this class. From diseases of the Brain and Nerves exactly 100 deaths were recorded, the precise number as in the previous year. From Heart Disease 40 deaths in contrast with 25. Premature Birth 32, the number being in this instance increased by the fact that all children which have once respired must be registered; the practice formerly being to bury as still-born most of the children that survived birth but a few minutes or hours. There is nothing of moment to record of the other diseases contributing to the Mortality of the Sub-district during the year, except to remark that 23 deaths were attributable to Violence against 10 in 1874. An inquest was held in each case, the particulars will be found in a succeeding paragraph. Births.—The births of 866 males and 843 females, in all 17 09, were registered in this division of the parish of Battersea during 1875. During the year 1874, 1556 births were registered, and the increase was 253 in favour of the year under report, and at the rate of 42 per thousand, which is here the normal rate. An increase of population to the extent of 6000 persons, must have taken place by immigration and natural increase within 12 months in Eastern Battersea. Vaccination. — The public register of Vaccination shews that the public officer entrusted with the performance 31 of Vaccination in the district, operated successfully in 873 primary cases, and 2 re-vaccinations; in all 875. Inquests.—During 1875 the Coroner held enquiry as to the cause of death in 30 cases in this Sub-district. The following were the verdicts :— Natural Deaths (3,Heart disease) 7 Accidental do.: — Asphyxia in bed (Infants) 5 Scald 1, Burn 2 3 Killed on railway 5 Drowned 8 Do. (Suicide) 2 10 30 Uncertified Deaths. — The number of cases in which death is registered without a medical certificate of the cause of death, or an enquiry held into its cause by the Coroner, were 16 in the year 1875. It is satisfactory to find that the numbers are steadily diminishing, but every such case is a reproach to our boasted high state of civilization. A formal Coroner's inquest might probably not he absolutely essential in each instance where no medical certificate is forthcoming, but some skilled Medical Officer should have the power to make preliminary enquiry into every such case, after which it should be his duty either to supply the registrar with a certificate, or other information, stating what was, in his opinion, the cause of death, or if there were legitimate suspicion of wrong, to call upon the coroner to hold an inquest on the body. If such a preliminary enquiry took place in every case of death where no medical attendance had been previously received, a very large proportion of the present number of inquests would be dispensed with, leaving the Coroner sufficient leisure to thoroughly investigate those more important cases in which there were great difficulties 32 in the way of arriving at a decision as to the real cause of death, which latter is legally the true function of the Coroner's Court. Sanitary Operations.—During the year 1875 the following sanitary proceedings were carried out in this Sub-district by the Inspector of Nuisances. No. of Houses inspected 1320 ,, 1st Notices served 112 2nd ,, ,, 15 Houses or Closets supplied with water 113 Drains repaired 32 Dust bins provided 98 Pig nuisances removed 3 Accumulations of Offal, Manure, &c. 14 These proceedings are recorded in the Report books as the result of his ordinary house to house inspection, but there were numerous other inspections made by the same officer which are not recorded. In a large number of cases disinfection by sulphurous acid, after the existence of Zymotic disease, was carried out, and with this satisfactory result—that no recurrence of disease is known to have occurred in any house or apartment after such disinfection has been properly applied. I must here thank the Surveyor, Mr. Pilditch, for the readiness with which he has at all times rendered me every assistance in carrying out the necessary Sanitary work of the district, and express my satisfaction at the manner in which Mr. Richards has performed his duties as Inspector of Nuisances. The owners of factories in the sub-district have conducted their respective businesses with great care during the past year, and but few complaints have been received on the subject; in the very few instances in which those complaints have had any real foundation, the proprietors of the works complained of have with great promptitude adopted such measures as were necessary without regard to expense, and in no instance has it been necessary to resort to legal measures of compulsion. 33 The more important inspections, made by order of the Board or of the Battersea Local Committee during the year, were:— 1. A complaint from a resident in Haines Street, that a great escape of coal gas occurred opposite his house from some newly erected purifiers of the London Gas Company. Several inspections were made by me, assisted by my colleague for Western Battersea; the allegation not being eventually substantiated, as it was found that the purifiers in question had never been used. 2. Investigations and Reports with the Medical Officer for West Battersea as to the outbreak of Scarlet Fever, Diphtheria, &c., on St. John's Hill, Battersea Rise, and Wandsworth Common, comprising a very elaborate series of investigations, fully detailed by that gentleman in his Report. 3. Several visits to and Reports on the mode of manufacture adopted at a factory in the New Road for the production of Sulphate of Ammonia, in which some defects were discovered in the system adopted. The proprietor promised that these should be remedied without delay. The Slaughter-houses and Cow-houses in this Subdistrict have been, through the vigilance of the Inspector of Nuisances, kept in a cleanly and proper manner, and no complaints have been made. It has been proposed to construct an immense slaughter-house on a vacant plot of ground between Culvert Road and the Shaftesbury Park Estate. The Railway Companies, whose lines surround this ground, refuse to permit a siding into the proposed buildings, which will necessitate driving all the cattle and sheep there to be slaughtered through the open streets from the Goods Station at the foot of Chelsea Bridge, to the above site, a distance of about a mile, through what will shortly be one of the c 34 principal parts of the parish. This is in itself, from the danger and annoyance found elsewhere to attend the passage of large numbers of animals through the main thoroughfares, a sufficient reason for the most determined opposition to this establishment on the part of the inhabitants; but above and beyond, there are the dangers so cogently urged by Dr. Carpenter, of Croydon, against the admission of blood and other animal refuse into the sewers, more especially in such enormous quantities as would undoubtedly occur in the instance of so large an establishment as this is intended to be. It has been well shewn by the gentleman just mentioned, that many diseases are caused by the presence of decomposing animal matters in the sewers, such as Erysipelas, Pyaemia, and probably Scarlet Fever, It is at all events certain that this proposed gigantic abattoir can in no way advantage the district or its inhabitants, and may be the source of considerable annoyance and possibly of danger. W. H. KEMPSTEK, Medical Officer of Health for Battersea East. 35 BATTERSEA WEST. In presenting my annual report on the health of this Sub-district, I have to observe that, whereas the Death-rate during the past three years remained steadily at a fraction over 17 per 1000, it has this year increased considerably. This increase is due to two causes—1st, an Epidemic of Scarlet Fever, prevalent during the last six months of the year ; a reference to the mortality table will show that 49 persons succumbed to this disease, as against 5 in the previous year. Secondly, to a large amount of Lung disease, which prevailed during the first quarter, and which was especially fatal amongst young children and aged persons. Nearly double the number of Males than Females were registered from these diseases, no doubt owing to their exposure during their occupations to the ever varying climatic changes we so much experience in England. Phthisis also may be especially mentioned as having caused a large increase of deaths. With these latter diseases, as sanitarians, we have comparatively little to do, though there is no doubt that properly ventilated rooms, well drained houses, and cleanliness, tend very materially to the recovery of a person so afflicted. But it is very different when a disease of an Epidemic or preventible nature is raging; here the sanitarian steps in, and his means, if efficiently used, are of untold benefit; he succeeds not only in limiting the disease, but in a great measure checking its progress. But we must look forward, and c 2 36 remove those conditions which we know are favorable to their production, in fact, stamp out, as far as we know the cause, then, when disease makes its appearance, we shall be in the best possible condition to receive it. And I look forward to the time when the records of such disease will no longer appear on our registers, but be a matter to talk about as of the past, just as Small Pox has been in this district for the past two years, not a single death having been recorded, an immunity which to my knowledge it has never before enjoyed, and in my opinion is the result of the large amount of vaccination and revaccination which took place in 1872. It is to be regretted that the privileges offered to the public are not taken advantage of when Small Pox is not present. With respect to the epidemic of Scarlet Fever which commenced in June and continued to the end of the year, it is curious to observe the part of the district first visited, namely, St. John's Hill and its neighbourhood, where the best houses in the parish exist, the streets are wide and well cleansed, there is no overcrowding, and the inhabitants all of the better class. Whatever may have been the cause, this supposed healthier and much higher portion of the district suffered first and most. One medical gentleman, in reply to an application, stated "during the last month, July, I have on my books 116 patients who have suffered or are suffering from Scarlet Fever; of this number only 6 are below the railway; all the others, 110, in the neighbourhood of St. John's Hill." Another gentleman also informed me to the same effect, and I must here publicly thank them for the readiness with which the information was given, for it at once enabled your Officers to place the infected district under strict observation. A house to house visitation was made, and 168 cases were discovered in 500 houses, containing 2572 persons, giving an average of 1 in every 15 who were, or had been, suffering from Scarlet Fever. Special notices and printed regulations were drawn out by myself and colleague and sent to every house in which the Fever was known to be present, the streets were watered 37 with carbolic acid, the Sewers were examined and cleansed, well washed with disinfectants, charcoal placed in the ventilators, and the stump ends of many sewers were opened and ventilators inserted, so as to prevent as far as possible any gases accumulating, by allowing them immediate escape and so prevent their finding their way into the houses by the drains, very few of which are quite perfect. This matter of the immediate escape of sewer gas from the sewers is of great importance, for there cannot be a doubt that the sewers do possess a ready means of conveying infection, as they communicate with all parts of the parish, and should do with every house, and if the germs of infection can be carried off with gases, it will be readily understood how disease may be rapidly spread over a whole sewer district, for the sewers are the only channels by which all discharges from patients are got rid of. Gases will ascend to the highest point and it may be in this way that St. John's Hill and its neighbourhood was so generally visited before the lower portion of the district. I myself descended the Sewer on St. John's Hill and in High Street; the former was perfectly clean, but I was affected with very disagreeable nausea, evidently the effect of Sewer gas ; whilst in the latter, which contained some six inches of matter, I experienced no effect whatever. The pace of the flowing water in High street sewer was very slow indeed. What then is the remedy in reference to these same gases? plainly, to cause the soilandurine to be removed before they have time to decompose and so give out their foetid substances ; and this can be done only by periodical and frequent efficient flushings especially in hot weather. If no means exist in the inland portion of the District for such purpose, I would recommend that the 'main' be utilized. These remarks apply with great force to the drains in back streets, which are so frequently found stopped, and which there is no means of examining except by opening the ground directly upon them, so that it is almost impossible for the surveyor to be acquainted with their state. I fully agree with the opinion expressed by a member of the Board, that no sewer should exist which a man cannot pass through. 38 Fresh healthy fœces will do no mischief, it is only after decomposition. "The Pneumatic or Liernur sewerage system claims "as one of its first principles, that prevention is "better than cure, All human fœcal matter which, "according to Dr. Richardson, is directly or indi"rectly the origin of no less than 15 of the diseases "that scourge the human race, should be isolated "and removed every 24 hours, before it can do any "harm, this is effected by the Pneumatic system." If this system accomplishes all that it professes, and I see no reason why it should not, it will, indeed, solve the problem of sewage disposal, and of freeing our rivers from pollution—questions of the first importance. Before leaving the subject of Epidemic diseases, I must mention one particular fact which was constantly being reported to me by Spencer, the Inspector, viz., the removal of persons recovering from Scarlet Fever to the sea-side before the process of skinning, (the most infectious period) was completed. Mortality.—The total number of deaths registered as having occurred in this District during the year was 857, 474 being males, and 383 females, (the males exceeding the females by 91.) This is a considerable increase on those of the previous year, when 686 were registered. Of the above number 183 took place in public Institutions, viz., 4 in the Patriotic, 1 in the Industrial, 1 in the Freemasons' Schools, and 177 in the Infirmary at the Workhouse, 75 of which belonged to Battersea, and the remainder, 102, to the other parishes in the Union. These 177 deaths are an increase on the previous year by 44, when 133 were returned. Deducting, then, the 177 Infirmary deaths, which, as the inmates are derived from the whole of the Union, it is only fair to do, it will leave 680 as the correct number of deaths for this out-door District, *—the 75 which belonged to Battersea will be taken into account in the Death-rate for the whole Parish. *Out-door with reference to Infirmary. 39 Death-rate.—Calculating the death-rate on the assumption that the population has increased at the same rate as it did during the ten years ending 1871—which would give a population of 33,856 souls—and deducting the Infirmary population and its deaths, the death-rate is 20.2 per 1000, which is 3 per 1000 below that of London. It is, however, an increase of 3 per 1000 on the previous year, the causes of which will be noticed when treating of the various diseases. Birth-rate.—The births registered were 1371-700 males and 671 females—the birth-rate, calculated in the same manner as the deaths, was 40.4 per 1000, and the natural increase to population would be 514, after including all deaths in the Infirmary, This birth-rate of 40.4 per 1000 is very high, being 5 per 1000 above that of London— and points to one fact, namely, that our population must be greater than the foregoing calculation, for I do not suppose that more infants are born to a given number' of West Battersea people than those of London and England generally. It is a melancholy fact to relate that 75 of these births, 5.4 per cent., were illegitimate, and that the number of children dying without fathers during the same period were 52, so that we may infer that out of 75 illegitimate children born in the year, no less than 52 perished, a most alarming death-rate; various are the causes at work which produce this fearful mortality, but having in former Reports brought the matter of infant mortality before your notice, it will not be necessary for me to repeat it here. The following Table shows the causes of all deaths, classified at different ages, sex, and social position, which have taken place in this Sub-district during the year 1875.— 40 STATISTICS OF MORTALITY. BATTERSEA WEST. Population June, 1874— 32,135. Estimated mean population June, 1875— (52 weeks) 33,856, Area 1108 acres. Total Deaths fron each Class of Disease, &c., in the Sub-District Sex Age So 1a Position Males Females Under 1 year From 1 to 5 years From 5 to 10 years From 10 to 20 years All under 20 years At 20, and under 40 years At 40, and under 60 years At 60, and under 80 years 80 years and upwards Nobility and Gentry Professional Class, Merchants, Bankers, <fec. Middle and Trading Class, Shopmen, Clerks, &c. Industrial and Labouring Classes. Classes:— 1. Zymotic /Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 11 6 5 4 7 ... ... 11 n Scarlatina 48 19 29 1 25 15 3 44 3 1 ... ... ... ... 1 35 Diphtheria 7 2 5 ... 3 4 ... 7 ... ... ... ... ... ... 3 4 Quinsy ... ... ... ... ... ... ... ... ... ... ... ••• ... ... ... ... Croup 5 4 1 2 3 ... ... 5 ... ... ... ... ... ... 1 4 Whooping Cough 20 9 11 8 11 1 ... 20 ... ... ... ... ... ... 4 16 Typhus & other Fevers 14 9 5 1 2 ... 6 4 3 1 ... ... ... 8 12 Erysipelas 9 3 6 2 • •• ... ... 2 ... 3 3 1 ... ... 1 8 Metria, Childbirth 6 ... 6 ... ... ... ... ... 6 ... ... ... ... ... 2 4 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea Choleraic Disease 35 18 17 21 7 ... ... 28 ... 1 6 ... ... ... 7 28 Totals of Zymotic Class 155 70 85 39 59 22 3 123 13 8 10 1 ... 2 31 122 2. Tubercular 148 68 46 21 4 9 80 45 23 ... ... 2 1 14 131 3. Of Brain, Nerves, &c. 130 50 41 29 4 3 77 7 13 30 3 2 2 16 110 4. Of the Heart, &c. 37 15 1 ... 1 3 5 11 12 9 ... 2 1 6 28 5. Of Respiratory Organs 197 125 72 54 44 4 3 105 14 31 43 3 4 20 170 6. Digestive Organs 27 21 6 6 2 ... ... 8 3 9 7 ... 6 1 3 17 7. Urinary Organs 10 3 7 ... ... 2 ... 2 3 5 ... ... 2 ... 2 6 8. Of Organs of Generation 7 1 6 1 ... ... ... 1 2 2 2 ... ... ... 1 6 9. Of Cancer, &c. 8 3 5 ... ... ... ... ... ... 4 4 ... ... ... 1 7 10. Syphilis 2 2 ... 1 1 ... ... 2 ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality, Malformation, &c. 37 21 16 37 ... ... ... 37 ... ... ... ... ... ... 6 31 12. Of Uncertain Seat 39 21 18 6 3 ... ... 9 ... 11 18 1 2, 1 3 .13 13. Age 39 16 23 ... ... ... ... ... ... ... 18 21 4 2 6 27 14. Violence 15 8 7 ... ... 1 3 4 4 4 3 ... ... ... ... 15 15. Joints and Bones 6 1 5 ... ... ... ... ... 2 1 2 1 ... ... ... 6 Total 857 474 383 232 159 38 24 453 104 123 146 31 23 14 109 711 * This table includes all deaths in the Infirmary of the Union. 41 Zymotic mortality.—The deaths from this class of diseases collectively give an increase on the previous year of 18, and this increase is entirely due to Scarlet Fever, which raged with great severity during the latter six months of the year ; from this disease no less than 48 deaths were registered, as against 5 in 1874. There is a decrease in Whooping Cough, the deaths being less than in any of the three previous years ; also, in Fevers, Metria, Croup, and Diarrhoea, and an increase in Measles by 3, Diphtheria by 2, and Erysipelas by 5. Of the 155 persons who succumbed to this class of disease, 70 were males and 85 females, 98 were under 5 years of age, and 123, inclusive, were under 20. The death rate from this class of disease was 4.5 per 1000. The following Table contrasts all deaths in West Battersea from Zymotic causes from the past four years. 1872. 1873. 1874. 1875. Small Pox 4 1 0 0 Measles 24 11 8 11 Scarlatina 3 3 5 48 Diphtheria 15 3 5 7 Quinsy 0 0 0 0 Croup 7 6 16 5 Whooping Cough 31 24 30 20 Typhus, &c. 13 22 15 14 Erysipelas 5 4 4 9 Metria, Childbirth 2 4 11 6 Carbuncle 1 0 0 0 Influenza 0 0 0 0 Diarrhoea and Cholera. 32 37 43 35 Totals 137 115 137 155 Other Causes of Death.—Diseases of the Respiratory Organs, excluding Phthisis, again take the first place with 197, viz.:—Bronchitis 98, Pnuemonia 59, Disease of Lungs 23, Asthma 8, and Laryngitis 9, being, collectively, 46 in 42 excess of the previous year. The Tubercular class resulted in 148 deaths, of which 87 were from Phthisis, all taking place between the ages of 20 and 50, exactly the same ages at which this disease is always most fatal. Tabes Mesenterica was fatal in 52 cases, Scrofula in 6, and Hydrocephalus in 3. Diseases of the Nervous System were also in excess of the previous year, 130 being registered against 115. These then, are the principal causes which have swollen our death-rate of 1875 so much above the three previous years, —causes over which we have comparatively no control. The other causes of death were, Heart disease 37, Premature Birth and Low Vitality 37, Digestive Organs 27, Urinary Organs 10, Organs of Generation7, Cancer 8, Syphilis 2, Violence 15, Joints and Bones 6, Age 39, and Uncertain Seat 39. 404 were those of males and 378 of females. 193 were under 1 year of age, 100 under 5, and 453, inclusive, under 20. 156 were over 60; and 30 were 80 years and upwards, one, a female, having reached 95. The following Table contrasts all deaths from non-Zymotic causes during the past four years. 1872 1873 1874 1875 Tubercular including Phthisis 106 106 113 148 Of Brain, Nerves, &c. 76 100 115 130 Of the Heart, &c. 24 34 31 37 Of Respiratory Organs, cluding Phthisis 105 156 151 197 Of Digestive Organs 18 11 23 27 Of Urinary Organs 4 4 6 10 Of Organs of Generation 2 6 3 7 Of Joints, Bones, &c. 0 0 4 8 Of Cancer 15 . 14 ... 10 2 Premature Birth, Low Vitality, Malformation, &c. 22 23 26 37 Of Uncertain Seat 61 . 50 97 39 Age 46 51 22 39 Violence 28 4 15 15 Syphilis 0 0 6 9 Totals 507 559 552 702 43 Total Deaths from all causes, including all deaths in the Injirmary : 1872 1873 1874 1875 644 674 686 857 The Death-rates per 1000, excluding Infirmary deaths and its population:— 1872 1873 1874 1875 17.0 17.6 17.2 20.2 Inquests.—During the year 42 Coroner's Inquests were held, viz.:—on 27 males and 15 females, this being an increase on the previous year of 16, and is owing to the large number of sudden deaths which took place in the earlier months of the year, The verdicts returned were as under:— From Natural Causes 26 Accidental Causes 8 Suicide 7 Fractured Skull 1 The natural causes of death were principally from Heart Disease, sudden Syncope, Fits and Spasm of the Glottis, Of the accidental causes 5 were on the railways, 2 by burning, and 1 concussion of the brain. Of the suicides 1 cut throat, 1 by hanging, 1 on the railway, and 4 by drowning; these suicides were all mentally deranged. Social Position.—The proportion of deaths in relation to Social Position was as follows :— Nobility and Gentry 2-68 Professional 1.62 Middle and Trading 12.70 Industrial 83. 100.00 44 There is an increase in the Nobility and Gentry and Industrial Classes and a decrease in the Professional and Labouring as compared with last year. In the Professional class, no less than three of the fourteen were Surgeons. Deaths not Certified.—Of the 857 deaths, 28 were registered as not certified, that is had no medical attendance. It is clear that the time has not yet arrived in the minds of the present government that every death should be legally certified, for, in reply to a question it was stated, that it was not necessary in all cases that legal certificates for deaths should be forthcoming. The matter of non-certified deaths has lately received the attention of the Registrar General, who usually comments on them in his weekly return, from which I gather that South London is considerably in excess of all other Metropolitan Districts. Vaccination.—The number of infants vaccinated at the appointed station in West Battersea during the year was 618. Disease and Mortality amongst the Union Poor.— The number of cases which came under treatment was 381, viz., Males 186, Females 195, 40 of which were sent to the Infirmary, 19 to Lunatic Asylums, and 6 to Hospitals. On reference to Table V., Appendix, the nature of the different diseases will be found. There was 1 of Small Pox, 8 Scarlet Fever, 2 Measles, 17 Diarrhoea, 9 Fever, 103 Lung Diseases, excluding 5 of Phthisis, 10 Violence, and 222 various other diseases, principally Rheumatism, Old Age, and Disease of the Nervous System. Although Scarlet Fever was extensively prevalent, only 8 cases came under the District Medical Officer's notice, a number which bears no comparison to the cases existing ; we must, therefore, conclude that the people are in such a position as not to require the assistance of the Parish, though, in many instances, it would be far better for the people themselves, 45 and materially prevent the spreading of infectious diseases, if they would apply to the Officials, and be removed to Hospital. The number of deaths which took place was 27, being at the rate of a fraction over 7 per cent. Sanitary Inspections and Proceedings.—The Inspector of Nuisances has been very active during the past year. A house to-house visitation has been made, and in several localities, as cases of Zymotic disease have occurred, or complaints been made, the same ground has been gone over and over again. By this means, many nuisances have been discovered and removed. A large amount of disinfection and fumigation has been carried out in houses where disease of a contagious or infectious nature has taken place, and I believe that this has been very effectual, no second case having come under my notice in the same house after disinfection. The house-to-house visitation, though generally going on, was more particularly carried out, owing to the severe outbreak of Scarlet Fever, which I have already referred to in the earlier part of this report, and in regard to which it is only necessary to remark that few cases were sent to the Special Hospital provided for that purpose, and to point out how soon an outbreak may be checked if efficiently dealt with, as instanced at the Patriotic School for Boys on Wandsworth Common. In October an outbreak occurred ; in a few days there were 28 boys affected. Immediate isolation took place; the whole of the children thoroughly inspected ; the clothes, bedding and rooms were disinfected and not another case appeared. Without these precautions I have not the least doubt but that the disease would have spread through the whole school, I have to hank Mr. Hawken, the Medical Officer, for his kindness in so readily and unhesitatingly supplying me with the infornation asked for. I should mention that application was made to me to have some clothes, bedding and carpets disinfected by heat; having no chamber, it was impossible to iarry out the request, all I could do was to direct them to jo suspended and fumigated. It would be an advantage to construct such a chamber in connection with the proposed nortuary. 46 The Piggeries in Lachmere Grove were inspected and the reports duly placed before the Board. The Police Court was attended in reference to them. The owners pleaded that they had not sufficient time to carry out the improvements which they had promised to do, so the magistrate adjourned the cases for a month, at the end of which time the styes had all been bottomed with impervious material, drains properly constructed, &c., so the summonses were abandoned. No complaint has since been made, Whilst inspecting these piggeries I found many pigs suffering from foot and mouth disease; the Cattle Inspector (Metropolitan Board) was communicated with and took the necessary steps. The Alum and Ammonia Works have been the subject of considerable attention and reports; various suggestions have been made and carried out by the proprietors to endeavour to suppress the disagreeable vapours emanating from these works, but, from some cause, either the inattention of the men, or, the breaking of the machinery, the nuisance after an interval of freedom has recurred. These intervals of freedom show clearly that the manufacture can be carried on without annoyance, and the Board are perfectly right in insisting, for the comfort of the neighbourhood that it should be so. On seven different occasions, I telegraphed, by Order of the Board, for the attendance of Mr. Keats, but was unable to obtain his services. A matter of great importance and one which claims our utmost attention, is the water we drink. In the month of July, not feeling at all satisfied with the water supplied to my house, the Inspector took a sample from the cistern, and also the same water, after filtration, to Dr. Muter, the Board's analyst. The cistern water was found to be one of the worst of 15 samples analysed, taken from various parts of the district, whilst the same water, when filtered, was rendered actually the purest of the whole 15 samples analysed. The cistern stands by itself, has no connection with any water closet, is cleaned out every week, and the waste pipe is not connected with the sewers; therefore, the 47 organic impurities must be delivered in the water itself. The filter used was the Silicated Carbon, and, as Dr. Muter remarked at the foot of his Report, "No.3. Filtered water from the Priory is an example of the good effected by an efficient filter when properly looked after." No analyst or any other person can tell us whether water contains the specific poison of any particular disease, but we know that certain impurities are present in waters which by their use may cause serious epidemic diseases, and if we can by simple filtering get rid of such impurities, it is our duty to do so. JOSEPH OAKMAN, Medical Officer of Health for West Battersea. 48 CLAPHAM. I again make use of the introductory Table I have employed for many years, because I can find no better basis upon which to rest the descriptive portion of my annual report, and at the same time to save my readers the trouble of reading through lengthened remarks on matters that can be much better understood and appreciated by a mere glance at a simply constructed form such as the one which follows. This Table shows the number of marriages, births and deaths, that took place in this Sub-district during the past and ten preceding years, and it will, it is hoped, serve to facilitate the clear understanding of the other statistical facts which I shall subsequently have to remark upon. Years 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 Marriages 221 310 244 272 234 158 249 236 257 284 243 Births 707 711 777 801 838 867 864 858 929 937 965* Deaths 393 425 451 450 508 480 604 482 475 528 548 Excess of Births over Deaths 314 286 326 351 330 387 260 376 454 409 417 *Of this number I successfully vaccinated in 308 cases. — J. M. D. Although the marriages were not quite so numerous during the past year as during the previous one, they still present a goodly number, and, when viewed with the fact of there having been much the largest number of births of any year since 1864, and a much larger excess of births over deaths than in the preceding year, it gives very good evidence of the improving social condition of this locality. Zymotic Diseases.—This class of diseases, as regards both intensity and fatality, is well set forth in the next Table. There were as many as 125 deaths in the year preceding the one in review, but in the past year they 49 amounted to 81 only. This is a great reduction, and when we take into consideration that but two deaths occurred from Small-pox during the past year, and none whatever during the two preceding ones, we must consider it as most satisfactory. Scarlatina and Diarrhoea were also less fatal, and the deaths from both Fever and Measles were considerably less, having fallen in number from 33 to 22, as to the first named of these diseases, and as to the last from 6 to 3. The deaths from Whooping Cough and Diphtheria were slightly in excess of those recorded in 1875. The following Table gives the comparative number of deaths from the seven principal diseases of the Epidemic class in the several years from 1364 to 1875, affording at one view the means of judging of the advance of scientific sanitation as affecting the reduction in the number of these maladies. Years. 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 Small-pox 7 10 7 0 10 6 94 14 0 0 2 Measles 7 18 3 9 2 14 2 30 11 20 3 Scarlatina 11 6 5 14 29 45 20 6 2 33 22 Diphtheria 4 5 3 7 0 2 3 3 3 4 6 Whooping- cough 15 14 7 25 29 9 18 25 14 15 17 Typhus 11 16 10 26 17 12 10 11 10 6 2 Diarrhoea & Cholera 20 17 21 28 30 31 31 39 25 27 22 Totals 75 86 | 56 109 117 119 178 128 65 105 74 The following detailed Table, the one employed for many years by the entire medical staff, gives the number of deaths, together with all the necessary particulars as to sex, age, and social position, of the deceased persons, and forms, as I have frequently remarked in previous reports, almost a clear and concise report in itself; at all events requiring but very few comments to be made upon it, and those only in reference to one or two points of comparison with the statistics of former reports. D 50 STATISTICS OF MORTALITY. CLAPHAM. Total Deaths from each Class of Disease, &c., in the Sub-District. Sex Age Social Position Population in 1871—27,347. Estimated Population in middle of year 1875— 31,541. Area in Acres—1,233. Males. Females. Under 1 year. From 1 to 6 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 and Laboring Classes. DISEASES And other Causes of Death Classes :— 1. Zymotic ''Small Pox 2 1 1 1 ... ... 1 ... 1 ... ... ... ... ... 2 Measles 3 1 2 ... 2 1 3 ... .... ... ... ... ... 1 2 Scarlatina 22 9 13 2 15 5 22 ... .... ... ... ... 1 4 17 Diphtheria 6 2 4 ... 5 1 6 ... ... ... ... ... ... 2 4 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 3 2 1 3 ... .... 3 ... ... ... ... ... ... ... 3 Whooping Cough 17 12 5 12 5 ... 17 ... ... ... ... ... ... 2 15 Typhus, &c. 2 ... 2 ... 1 ... 1 1 ... ... ... ... ... ... 2 Erysipelas 2 ... 2 1 ... ... 1 ... 1 ... ... ... 1 ... 1 Metria, Childbirth 2 ... 2 ... ... ... ... 2 ... ... ... ... ... 1 1 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea, etc. 21 13 8 14 3 1 15 ... 2 1 ... ... ... 4 17 Cholera 1 ... 1 1 ... ... 1 ... ... ... ... ... ... ... 1 Totals of Zymotic Class. 81 40 41 34 31 8 73 3 4 1 ... ... 2 14 65 2. Tubercular* 84 43 41 8 11 4 32 32 18 2 ... ... 5 23 56 3. Of Brain, Nerves, &c. 63 33 30 28 9 5 43 1 9 8 2 ... 4 17 42 4. Of the Heart, &c. 37 19 18 2 2 1 5 6 7 19 ... ... 4 13 20 5. Of Respiratory Organs. 110 54 56 30 19 5 54 5 14 35 2 ... 8 26 76 6. Of Digestive Organs 42 24 18 4 9 1 15 4 15 8 ... ... 5 12 25 7. Of Urinary Organs 13 5 8 ... . . . ... 2 2 1 8 ... ... 3 4 6 8. Of Organs of Generation 2 ... 2 ... ... ... ... 2 ... ... ... ... ... 2 ... 9. Of Joints, Bones, &c. 1 ...... 1 ... ... ... ... ... ... ... 1 ... 1 ... ... 10. Of Skin 3 3 ... • •• ... ... 2 ... ...... 1 ... ... ... 1 2 11. Premature Birth, Low Vitality, Malformation, &c. 48 22 26 48 ... ... 48 ... ... ... ... ... 1 8 39 12. Of Uncertain Seat 7 3 4 2 ...... 1 3 ... 2 2 ... ... ... 3 4 13. Age 29 11 18 ... ... .... ... ... ... 9 20 ... 5 11 13 14. Violence 11 7 4 3 ... ... 5 2 2 1 1 ... ... 2 9 15. Not Specified 17 9 8 1 1 ... 3 4 5 4 1 ... 1 2 14 Totals 548 273 275 162 82 25 285 61 77 98 27 ... 39 138 371 * Of the 84 deaths from Tubercular disease 61 were due to Phthisis. 51 Infant Mortality.—The mortality of infants and young children, from birth up to the age of ten years, shews a much higher rate than prevailed in the preceding year, presenting a difference of 30, the numbers being 239 in 1874, and 269 in 1875. This infant mortality is much to be regretted. An explanation of many of its causes, I have frequently attempted in former reports, and to these I must refer the reader. Senile Mortality is also high, which is more satisfactory, yet not so high as in some former years. In the past year there were as many as 125 deaths of elderly persons whose ages ranged from GO to 89 years. Of persons dying exclusively of old age, there were 29, three of whom had reached the advanced age of 92 years. General Mortality.—The death·rate for the past year, determined by the same calculation as that which has been hitherto adopted, was 18·21 per 1000 persons living on an average during the year. The estimated population at the middle of the year having been 30,088. The Mortality amongst the Industrial Poor of this parish continues high, there having been 371 deaths amongst this class, all other classes of the community yielding but 177 deaths. Of the 371 deaths above named, there were 75 persons whose ages ranged from 60 to 89 years, whilst among all those who lived in better circumstances there were only 50 deaths at the same ages. In order to ascertain the amount of sickness, as well as that of the mortality amongst the Union Poor, Table V. of the Appendix may be consulted. It is here shown that during the past year 835 cases of sickness, accident, &c., were treated and that there were 45 resulting deaths. D 2 52 The number of deaths to cases treated presents by no means a high percentage. The diseases, however, are found to include a good many cases of fever in its various forms, and also Diarrhoea, Scarlatina, Diphtheria, Whooping Cough, and Zymotic cases generally. There were also treated 5 cases of non·fatal Small Pox, and 8 cases of Puerperal Fever. No cases of Measles are to be found in the medical relief book, aud consequently there were no deaths from this disease during the year among the class of persons of which I have been speaking. Of non·Zymotic, or ordinary diseases, the greatest fatality resulted from lung affections, tubercular maladies, affections of the brain and nervous system, and diseases of the digestive organs. Inquests.—Violent, Sudden, and, Uncertified Deaths.— Under this heading there were 16 deaths registered as having been subject to the enquiries of the Coroner: the verdicts were as follows:— Suicides 3 Death by burning 1 Overlaid or found dead 7 Accidentally run over 1 Accidental death in other ways 2 Death from natural causes 2 Total · 16 The Deaths of five persons were also registered, who unfortunately were allowed to go out of existence without any medical attendance and without the necessary care and attention due to the exigencies of civilised life. In my former reports I commented on this state of things as a great evil, and latterly, as one greatly on the increase all over the Metropolis. 53 SANITATION OF THE YEAR. A reference to Table VI. in the Appendix, will show the amount of sanitaiy work accomplished during the year. As many as 2000 houses and premises were taken cognisance of, and duly inspected by the Surveyor, Inspector of Nuisances and myself. It has been thought by some to be incredible that so large an amount of work was actually performed, but the proofs of its having been so could be given if necessary. As many as 3,554 feet of new sewers, in addition to 20 miles or more of the same work previously executed, has given to this Sub·district a character of making many judicious sanitary efforts, and causes it to hold a high position amongst neighbouring districts. To me, the most agreeable feature in this table is the absence of all record of litigation. This has been the case during the past year, as well as during several previous years, and appears to me to indicate a very good feeling on the part of all concerned to do what is right and just in improving the sanitary condition of the locality. Slaughter Houses and Cow Houses.—The new regulations that the Legislature has made to apply to these places, are, beyond all doubt, calculated to lead to good results. At first sight these regulations appeared to many to be severe and uncalled for, but it is now pretty generally acknowledged that, although proprietors were made to incur heavy expenses in the alterations and reconstruction of their premises, a permanent improvement has resulted throughout the Metropolis, and is calculated to give still greater satisfaction. The Water Supply·Though, it is not yet given, as has been so long promised, on the constant principle, has, nevertheless, undergone some improvement in quality, though it occasionally shows some impurities that it would be desirable to get rid of. I would advise that all potable water should undergo filtration through charcoal, or at all events be boiled, decanted, and kept cool for use. A very 54 great evil connected with this subject, I pointed out in my last report, and in some previous ones, viz.: the connection which is permitted to exist in so many houses between water·closets and cisterns. This is a great evil, which a little engineering skill, I am convinced, might easily overcome. I regret to find so little consideration given to this subject, seeing that we have had so many warnings from districts stricken by disease and death, traceable to the cause I have named. On some other subjects of sanitation I would refer my readers to the general report applying to the entire District, where will be found many observations in which I fully coincide. JOHN MAC DONOGH, Medical Officer of Health for Clapham. 55 STREATHAM INCLUDING TOOTING AND BALHAM. During the year 1875 there was an increase in the number of deaths in this Sub·district to the extent of seven only, which, it is hardly necessary to say, is by no means commensurate with the increase of population in the interval of the appearance of the previous and present Reports. The deaths in the past year (52 weeks ended January 1st, 1876) numbered 237 against 230 in the previous year, and included 110 males and 127 females. The births during the year were 519, males 245, females 274, which is 54 in excess of those registered in 1874. The excess of births over deaths was 282, representing, of course, the natural increase of the population. The number of inhabitants, which was estimated for 1874 to be 15,905, is now, upon the usual calculation adopted by the Registrar·General, 16,340, and will be found to yield a death rate of 14·50 per 1000 living. 66 STATISTICS OF MORTALITY. STREATHAM, including TOOTING & BALHAM. Population in 1871—14,475. Estimated Population middle of 1875—17,335 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 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 and Laboring Classes. DISEASES, And other Causes of Death Class.: Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 2 2 ... 1 1 ... 2 ... ... ... ... ... ... 1 1 Scarlatina 4 1 3 ... 3 ... 4 ... ... ... ... ... ... 2 ... Diphtheria 3 2 1 ... 1 1 3 ... ... ... ... ... ... 1 2 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 1 ... 1 ... 1 ... 1 ... ... ... ... ... ... 1 ... Whooping Cough 5 3 2 3 2 ... 5 ... ... ... ... ... ... 2 3 1. Zymotic Typhus and other Fevers 2 2 ... 1 ... 1 2 ... ... ... ... ... ... 1 1 Erysipelas 3 3 ... 1 ... ... 1 ... ... 2 ... ... ... 3 ... Metria, Childbirth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea Choleraic Disease J 9 4 5 7 ... ... 8 ... 1 ... ... ... 1 6 2 Totals of Zymotic Class 29 17 12 13 8 2 26 ... 1 2 ... ... 3 17 9 2. Tubercular* 84 15 19 4 2 2 12 15 4 3 ... 5 2 14 13 3. Of Brain, Nerves, &c. 41 17 24 11 3 2 18 3 5 14 1 8 3 21 9 4. Of the Heart, &c. 20 7 13 1 ... 1 3 2 3 12 ... 6 6 7 1 5. Of Respiratory Organs 34 21 13 7 2 ... 10 5 6 12 1 5 2 12 15 6. Of Digestive Organs 21 11 10 5 1 ... 6 1 7 7 ... 4 ... 9 8 7. Of Urinary Organs 6 2 4 ... ... ... ... 4 1 1 ... 1 3 1 1 8. Of Organs of Gene ration ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Of Joints, Bones, &c. 1 ... 1 1 ... ... 1 ... ... ... ... ... ... ... 1 10. Of Skin 1 ... l ... ... ... ... ... 1 ... ... ... ... 1 ••• 11. Premature Birth, Low Vitality, Malformation, &c. 14 7 7 14 ... ... 4 ... ... ... ... ... 2 6 6 12. Of Uncertain Seat 8 1 7 ... ... ... ... 1 4 3 ... ... 1 5 2 13. Age 20 8 12 ... ... ... ... ... ... 11 9 4 ... 7 9 14. Violence 6 4 2 1 ... 1 2 3 ... 1 ... ... ... 4 2 15. Not Specified 2 ... 2 ... ... ... ... ... ... 2 ... 1 ... 1 ... Totals 237 110 127 57 16 8 92 34 32 68 11 34 22 105 76 * Of the Tubercular class of Diseases, 25 deaths appear to have resulted from Phthisis. 57 The above Table discloses the usual facts, upon which it will be necessary to briefly comment. Zymotic Diseases.—The deaths from this class of diseases will be seen to have been less than in the preceding year, Small Pox having no entry in the Table, though in the previous year they amounted to 2. The mortality from Measles was 7 less than in the preceding year, while, from Scarlatina and Diphtheria it was respectively one and two more than in that year. Whooping Cough proved fatal in two more instances than was recorded in the former Table, while of Diarrhoea and Choleraic disease there were 9 deaths in the past year against 6 as the registered number in 1874. Almost all the deaths from Zymotic disease proved fatal to children and young persons, 3 only occurring to persons of advanced life, viz., between 40 and 80 years of age. The proportion of the mortality of the seven principal epidemics to deaths from all causes was during the year 10·4 per cent. The following Table may be referred to as giving the relative increase or decrease, as the case may be, of the seven principal Zymotic diseases in the two past years. DISEASES. 1874 1875 Seven principal Epidemics. Small Pox 2 ... Measles 9 2 Scarlatina 3 4 Diphtheria 1 3 Whooping Cough 3 5 Typhus, &c 2 2 Diarrhoea and Choleraic Disease 6 9 Totals:·31 25 58 Other Diseases.—The deaths from ordinary diseases (Non·Zymotic) were 208, which is more by 11 than in the preceding year. The deaths from this class of diseases, when viewed individually, give about the average numbers under each of the headings, the moat striking difference being found under Old Age, viz.: from 8 to 20 in the two past years. • Sickness and Mortality amongst the Union Poor.— Table V. in the Appendix gives the number of deaths and their causes amongst the out·door Union Poor of this Sub·district during 1875, The ratio of deaths to cases treated was 8·6 per cent., which is somewhat higher than in some of the neighbouring Sub·districts. Seven of the eight deaths recorded in this Table were the result of Lung diseases, including one from Phthisis. Ages at death.—The infant mortality was in excess of that of 1874 by eight. Twenty·three of these 81 deaths were due to Zymotic diseases, the highest number (7) being the result of Diarrhoea. The number dying between 60 and 80, and 80 and upwards were 79, the oldest person being 92. There were 32 who died between 40 and 60, and 34 between 20 and 40. The very aged persons who died during the year were far more numerous than in the preceding year, the relative proportion being 79 to 58. Sudden, Accidental, and other deaths necessitating Inquests·, Uncertified deaths, &c.—Two uncertified deaths appear to have been placed on the Register during the year. "Epileptic fits" was stated by the friends of the deceased to be the cause of death in one of these cases, and in the other it was thus entered: "Disease not known." No inquest was held on the latter, and it is to be presumed that the deceased woman, 69 years of age, had no medical attendant. I can only say, in respect to this death, that the registration was a perfectly useless one, and no dependence can be placed upon such a record for the means of rendering the vital statistics of the locality so perfect as they ought to be made. 59 There were twelve inquests held during the year, and the following verdicts returned:— Suicides. By Strangulation 1 3 „ By Poison 1 „ Cut Throat 1 Accidental deaths:— By Asphyxia in bed (overlaid) 1 3 By inadvertently taking a poisonous liniment · 1 By drowning 1 Natural deaths. Heart diseases 4 6 „ Apoplexy 2 Total 12 There was nothing particular to complain of in these verdicts, the evidence being too plain to admit of any doubts. This, it is feared, has not always been the case, and the dispensing with medical evidence cannot be too strongly objected to. A very recent instance in one part of this Sub·district, in which the verdict was deemed unsatisfactory, will, it is hoped, ultimately lead to considerable reforms in the Coroner's Courts. Sanitary work of the year.—A reference to Table VI. in the Appendix will give a concise view of what has been accomplished in the three parishes which constitute this Sub·district in the way of Sanitation during the year under review. It is hardly necessary to offer any comments upon this Table, but it may be observed that 5,450 feet of new sewers were constructed during the year, forming a very desirable addition to the same kind of Sanitary work noticed in former Reports. It might be stated that no cases having reference to the Sanitation carried out under the auspices of the Board had to be submitted to magisterial judgment. This speaks well for the locality, as it evinces, as a rule, theS 60 cordial co·operation of the inhabitants in all that is designed for the benefit of the Sub·district. Slaughter and Cow·houses, I need scarcely add, underwent the usual inspections prior to the renewal of licenses, and were found in possession of all the requisites entitling them to the same. D. C. NOËL, Medical Officer of Health for Streatham, Tooting, and Balham, 61 PUTNEY AND ROEHAMPTON. In order to arrive at even an approximate estimate of the death·rate of a locality for any given year, it is first essential to find the mean of the population of that year after the manner adopted by the statistical department of the Registrar·General's Office. The population of this parish and the adjoining hamlet of Roehampton was ascertained, in 1874, to have been in the middle of that year 13,396, but at the same period of the year under review, the number of inhabitants amounted to 10,891. The registered deaths for the past year having been 167, (74 males and 93 females) it follows that the rate of mortality was 15·7 per 1000 persons living, or 1 death in 64, Considering the past year was one of the most marked character in respect to the operation of many of those climatic influences which have a tendency to weaken the resistance which both old and young are enabled to make against the inroads of disease, it would not have been surprising had the rate been found considerably higher than the above estimate. The excess of deaths in the past year over the number registered in the previous one was 11, chiefly due, it would seem, to the fatality of Diseases of the Heart and of the Respiratory Organs, the one being in excess of 5, and the other of 6, over the numbers registered in 1874. During the year the births numbered 292, (143 males and 149 females) which is only 2 in excess of the previous year, and was therefore by no means proportionate to the increase of population. The excess of births over deaths was 149 against 135 in the previous year. The birth rate was 27'3 per 1000, and the rate of natural increase J l·6 per 1000, neither of them, it will be seen, very greatly differing from the rates estimated in the former report. Nothing, it is submitted can be, in a rapidly increasing suburb like Putney, more satisfactory than a death rate of 15·7 per 1000, seeing that the rate of the entire of London was 23·7 per 1000, and that the average of 21 of the principal towns and boroughs of the United Kingdom was 25·4 per 1000. Zymotic Diseases.—The 167 registered deaths in· 62 cluded (see mortality table) 20 as due to the above·named maladies, viz., to Diphtheria 4, Whooping Cough 9, and Diarrhoea 7. It should be stated, however, that the 7 deaths due to Diarrhoea, occurred to infants under 5 years of age, and were the result, it has been ascertained, of irritation of the bowels consequent on either difficult dentition or improper feeding. Some of these Diarrhoea cases occurred to the infants of wet·nurses; thus, many women are found who, whilst succouring the offspring of others, are deplorably neglectful of their own. It is satisfactory to find that under the twelve headings relating to Zymotic maladies, many were without any record of deaths whatever during the year. Of 135 registration districts into which the Registrar· General has divided London for statistical purposes, there are but two or three presenting so satisfactory a state of things. Dulwich and Eltham are amongst the favoured districts referred to, but these, it should be observed, do not contain one half the population of Putney. The following Table will show the per·centage of deaths from the seven principal diseases of the Zymotic class to deaths from all causes during the past aud ten preceding years. 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. 1865 115 11 9·5 1866 121 16 13·2 1867 128 20 156 1868 118 14 11·8 1869 133 31 23·3 1870 145 19 12 4 1871 151 32 21·4 1872 144 20 14·0 1873 125 6 4·8 1874 156 10 6·4 1875 167 20 11·9 As in all former years, the detailed mortality table annexed will give every necessary particular concerning the deaths from all causes, and distinguishing the sex, age, and social positions of the deceased persons. 63 STATISTICS OF MORTALITY. PUTNEY and ROEHAMPTON. Population (Census) 1871— 9,439. Estimated population in middle of the year 1875— 10.691. Area in Statute Acres—2,176. DISEASES, And other causes of Death. Total Deaths from cach 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:— 1. Zymotic' Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlatina ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 4 2 2 1 1 ... 2 1 1 ... ... ... 2 1 1 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 9 3 6 7 2 ... 9 ... ... ... ... ... ... 4 5 Typhus and other Fevers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Metria, Childbirth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Choleraic Disease. 7 4 3 5 2 ... 7 ... ... ... ... ... ... 1 6 Totals of Zymotic Class 20 9 11 13 5 ... 18 1 1 ... ... ... 2 6 12 *2. Tubercular 26 14 12 6 5 ... 12 9 5 ... ... ... 4 10 12 3. Of Brain, Nerves, &c. 23 10 13 9 2 1 12 1 6 4 ... 1 1 13 8 4. Of the Heart, &c 13 3 10 ... ... ... ... 1 I 9 2 1 1 4 7 5. Of Respiratory Organ 36 17 19 7 5 ... 15 3 5 12 1 ... 4 20 12 6. Digestive Organs 7 2 5 ... ... ... ... ... 3 4 ... ... 1 5 1 * 7. Urinary Organs 8 5 3 ... ... ... ... 1 2 4 1 3 1 3 1 8. Of Organs of Generation 1 ... 1 ... ... ... ... 1 ... ... ... ... ... 1 ... 9. Of Joints, Bones, &c. 1 ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality, Mai· formation, &c. 16 9 7 16 ... ... 16 ... ... ... ... ... 1 5 10 12. Of Uncertain Seat 1 ... 1 ... ... ... 1 ... ... ... ... ... 1 ... 13. Age 11 2 9 ... ... ... ... ... ... 4 7 2 2 3 4 14. Violence 4 3 1 ... ... ... 2 1 1 ... ... ... ... 1 3 15. Not Specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 167 74 93 51 17 3 77 18 24 37 11 8 18 71 70 * Of the Tubercular class of diseases there were 15 deaths registered as being due to Pulmonary Phthisis. 64 A brief analysis has already been given of the Zymotic portion of the Table, Of the several headings under ordinary diseases (Non·Zymotic), those of the "Brain and Nerves," "the Heart," and the "Eespiratory Organs," give greater numbers in the present report than in the previous one, but in all the others there appears but little difference, if we except the heading of "Premature Birth, Low Vitality, Malformation, &c.," which presents 16 deaths in the past year, against only 7 in 1874. The next point to be observed upon is the number of deaths amongst the infant and youthful portion of the population, or amongst those between birth and ten years of age. These deaths have rather increased during the past year, the relative proportions in the two years 1874·1875 being 57 against 71. Seventy· one is rather a large fatality to record amongst children out of 176 at all ages, but it is not so large as has prevailed in some of the past ten years. The persons dying of old age numbered 11, 4 of whom were between 60 and 80 years of age, and 7 between 80 and 91, the last·named age being that of the oldest person who succumbed during the year. Social Position of the Deceased.—There are four columns in the Table devoted to the record of the social position of the deceased, and it is interesting to observe the comparative numbers in these several columns. Of the three classes above that of the industrial, there appear to have died 97 persons, 71 of whom were of the middle or trading class, 8 of the nobility and gentry, and 18 of the professional and merchant class. In the aggregate the deaths amongst these three classes exceeded those amongst the industrial class by 27. It has been several times remarked in these reports that the disparity of numbers some years ago was very greatly against the industrial classes. This fact should never be lost sight of, as it indicates, in the clearest possible manner, the advantages which have accrued, and will ever accrue, from directing our sanitary efforts towards the amelioration of the condition of the poor. The 70 deaths in the fourth column of social position include the fatal cases that have occurred 65 amongst the out·door Union Poor. Amongst this latter class exclusively the proportion of deaths to cases treated during the year is a little over 6 per cent. As in the report of 1874, so in the present one, no deaths whatever are recorded in the Union Medical Officers, Relief Book as having been due to any of the 7 principal diseases of the Zymotic class, and of Small Pox, no cases appear to have even come under treatment. Inquests, &c.—Four Inquests were held during the year, the enquiries resulting in verdicts to the following effect:— Accidentally Drowned 1 Found dead in the river 1 Found dead on Putney Heath (no proof of cause of death) 1 Suicide by Drowning, body much 1 decomposed · Total · 4 There were two deaths placed on the register that were uncertified by any Medical Practitioner, both occurring in Roehampton, the information concerning which,it is to be presumed must have been received from the parents of the two children, for both of them were of tender years. Whether these children died of the diseases named, viz., "Chronic Inflammation of Lungs "and" Acute Laryngitis," it is impossible to say. There are, it appears, as many as 2194 local Registrars in England, and it is only to imagine that every one of these registers two deaths only in this unsatisfactory manner, and it will at once appear that the vital statistics of this country must be rendered in a manner the reverse of scientific, and calculated to cause the Registrar· General's published statistics to be of less value than they ought to be. E 66 The Sanitation of the Year. — Table VI. in the Appendix, will, as usual, afford every information upon the sanitary work, &c., executed during the year. There appear to have been about the same number of houses and premises inspected during the past year as in the preceding one. Rather more houses have been supplied with water than were noted in the previous report, and 1,840 more feet of new sewers appear to have been constructed over and above the number recorded in the table of 1874. As formerly, all the Slaughter and Cow·houses within the Sub·district were supervised and reported on under the new regulations, prior to the renewal of licences. It is with much satisfaction that I am enabled to state that all the proprietors of these places cheerfully obeyed the new regulations, and their condition has since been very satisfactory. A somewhat large number of nuisances of a more or less objectionable character were dealt with during the year, most of them being removed or abated without any great amount of trouble, by either persuasion or remonstrance, but some few requiring repeated notices and threatened legal proceedings to cause their entire abolition. It is satisfactory, however, to find that no case came under the notice of the Surveyor or myself necessitating a resort to the Police Court for compulsory orders. The long pending dispute concerning the drainage of the Priory Asylum, Roehampton, and the maintenance of a large open ditch to receive all the excremental matter of those extensive premises, was, in the latter part of the year taken cognisance of by a higher tribunal, the Court of Chancery, and by an injunction obtained, restraining the proprietor from continuing his objectionable proceedings, the matter was happily removed from the control of the local authorities who have not since interfered in any way. The danger to which the public is sometimes exposed by the transit of the sick from their homes to hospitals and infirmaries, when labouring under infectious diseases, is too well known to need but a passing notice. In one case strong remonstrance was required in respect to the use of 67 a public cab in this parish. I have every reason to believe that no further attempt was made to use any of the public vehicles for the purposes referred to after my interference. The cab itself, by my recomendation, was thoroughly ventilated, but I feel bound to mention that it was no fault of the cabman that the vehicle had been called off the rank without any intimation of the purpose for which it was required. In reference to this matter it is right it should be known that by the 29 and 30 Vic., cap. 90, section 25, it is enacted that " If any person suffering from any dan· "gerous infectious disorder shall enter any public conveyance "without previously notifying to the owner or driver "thereof that he is so suffering, he shall on conviction "thereof before any justice be liable to a penalty not "exceeding Five Pounds, and shall also be ordered by such "justice to pay to such owner and driver all the losses and " expenses they may suffer in carrying into effect the "provisions of this Act; and no owner or driver of any "public conveyance shall be required to convey any person "so suffering until they shall have been first paid a sum "sufficient to cover all such losses and expenses." R. HARLAND WHITEMAN, Medical Officer of Health for Putney and Roehampton. APPENDIX OF STATISTICAL TABLES. TABLE I. Summary of Deaths and their Causes, registered in the entire District during 1875, classified according to Sex, Age, and Social Position, and showing also the relative Numbers in each Sub·District. POPULATION of ENTIRE DISTRICT, As corrected by the Registrar General. Census 1871—125,060. Estimated Population for middle of year, 1875,— 148,297. Area in Statute Acres, 11,695. Total Deaths from each Class of Disease, &c., in the entire District. Sub·Districts. Sex. Age. Social Positios Chapnam—Population in 1671, 27,347, area in acres, 1,233. Wandsworth—Population in 1871, 19,783, area in acres, 2,478. Battersea—Population in 1871, 54,016, area in acres, 2,348. Putney—Population in 1871, 9,439, area in acres, 2,176. Streatham, Tooting, and Balham—Population 1871, 14,475, 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 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:— 1. Zymotic Small Pox 3 2 1 ... ... ... 2 1 ... ... ... 1 1 1 ... ... ... 1 2 Measles 27 3 2 20 ... 2 18 9 10 16 1 27 ... ... ... ... ... 2 2 23 Scarlatina 134 22 5 103 ... 4 59 75 6 76 39 128 4 2 ... ... ... 5 23 106 Diphtheria 28 6 2 13 ... 3 10 18 1 16 8 26 1 1 ... ... ... 4 8 16 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 26 3 4 18 ... 1 16 10 8 16 2 26 ... ... ... ... ... ... 2 24 Whooping Cough 107 17 14 62 9 5 58 49 54 51 2 107 ... ... ... ... ... 5 17 85 Typhus & other 39 2 5 30 ... 2 24 15 3 5 11 21 10 6 2 ... ... ... 6 33 Fevers Erysipelas 24 2 3 16 ... 3 12 12 11 ... ... 11 ... 5 7 1 ... 1 5 18 Metria, Childbirth 15 2 3 10 ... ... ... 15 ... ... ... 1 13 1 ... ... ... ... 5 10 Carbuncle.. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Choleraic \ Disease 134 22 17 79 7 9 67 67 90 26 3 120 1 5 8 ... 2 4 22 106 Totals of Zymotic Class 537 81 56 351 20 29 266 271 183 126 66 468 30 21 17 1 2 21 91 423 2. Tubercular 565 84 76 345 26 34 289 276 151 94 18 297 185 71 11 1 15 22 87 441 3. Of Brain and Nerves 455 63 98 230 23 41 248 207 143 75 16 245 33 75 91 11 16 22 93 324 4. Of Heart 176 37 29 77 13 20 80 96 4 2 5 19 33 49 69 6 12 14 47 103 5. Of Respiratory Organs 630 110 57 393 36 34 334 296 167 140 17 336 46 91 143 14 12 34 135 449 6. Of Digestive Organs 136 42 19 47 7 21 72 64 26 14 1 42 16 45 33 ... 11 8 35 82 7. Of Urinary Organs 55 13 10 18 8 6 28 27 1 4 7 15 11 20 2 8 10 16 21 8. Of Organs of Generation 13 2 1 9 1 ... 1 12 ... ... 1 6 4 2 ... ... ... 4 9 1 9. Of Joints, Bones, &c. 11 1 2 6 1 1 2 9 1 ... ... 1 4 1 3 2 1 1 ... 9 10. Of Skin 4 8 ... ... ... 1 3 1 ... ... ... 2 ... 1 1 ... ... ... 2 2 11. Premature Birth, Low Vitality, formation, &c. 177 48 30 69 16 14 96 81 177 ... ... 177 ... ... ... ... 1 7 34 135 12. Of Uncertain Seat . 105 7 19 70 1 8 48 57 19 7 "l 23 "V 32 42 1 5 5 23 72 13. Age 130 29 12 58 11 20 44 86 ... ... ... ... ... 1 56 73 13 13 32 72 14. Violence 68 11 9 38 4 6 44 24 10 5 4 33 16 11 7 1 ... 1 10 57 15. Not Specified 34 17 2 13 ... 2 16 18 4 3 9 8 9 7 1 "i 2 4 26 Totals 3096 548 420 1724 167 237 1571 1525 886 467 132 1660 399 422 502 113 97 160 613 2296 69 TABLE II. Births registered during the year 1875. SUB·DISTRICTS. Males. Females. Total. Clapham 485 480 965 Wandsworth 832 341 673 Battersea East—Males, 866; Females, 843 west·Males, 700; Females, 671 1,566 1,514 3,080 Putney and Roehampton 143 149 292 Streatham, including Tooting and Balharn 245 274 519 Total 2,771 2,758 5,529 *** The excess of Births over Deaths in the entire district is 2,433. TABLE III. METEOROLOGICAL TABLE for LONDON, 1875. (.Deduced from Observations, at Greenwich, under the Superintendence o f the Astronomer Royal, and compiled from Quarterly Tables, furnished to the Registrar General by James Glashier, Esq., F.R.S.) Winter . . Jan., Feb., March. Spring . . April, May, June. Summer . . July, Aug., Sept. Autumn . . Oct., Nov., Dec. Temperature of Elastic Force of Vapour. Weight of Vapour in a Cubic Foot of Air. Degree of Humidity. Reading of Barometer. Weight of a Cubic Foot of Air. Rain. Reading of Thermometer on Grass. Air. Evaporation. Dew point. Air· Daily Range. Number of Nights it wa6 Lowest Reading at Night. Highest Reading at Night. Mean. Diff. from Average of 104 Years. Diff. from Average of 34 Years. Mean. Diff. from Average of 34 Years. Mean. Diff. from Average of 34 Years· Mean. Diff. from Average of 34 Y ears. Mean. Diff. from Average of 34 Y ears. Mean. Diff. from Average of 34 Years. Mean(Satn= 100). Diff. from Average of 34 Years. Mean. Diff. from Average of 34 Years. Mean. Diff. from Average of 34 Years. Amount. Diff. from Average of 60 Years. At or below 30°. Between 30® and 40p. Above 40°. 1875. o o o o o o o o o in. in. grs. gr. in. in. grs. grs. in. in. Sums. o o YEAR 49·2 +0·6 —0·3 46·6 00 43·2 — 0·5 15·2 — 0·8 0·292 + 0·002 3·3 — 0·1 80 —1 29·811 +3 036 543 1 28·2 + 2.9 89 119 157 13·5 58·9 First Quarter 39·5 1+0·8 —0·3 38*6 +0·6 341 — 0·4 10·4 — 1*4 0*197 + 0013 2'5 — 0·1 80 —2 29·858 +0 096 554 2 4·4 — 0·6 46 31 13 13·5 46·3 Second do 53·4 + 11 +0.4 49*0 —0·3 44·6 — 0·9 21·1 + 0·6 0·299 —o·o1o 3·4 —0·1 73 —4 29·823 +0032 539 0 5·4 ·0·4 15 36 40 20·8 55·9 Third do. 60·7 +11 +0·4 57·6 +1·2 54·8 +1·9 18·8 — 1·0 0·429 + 0·025 4·8 + 0.3 81 +4 29·842 +0· 042 530 0 10·3 + 2·9 0 6 86 36·2 58·9 Fourth do 431 — 0·6 —1·5 413 — 1·4 391 — 1·7 10·7 — 1·3 0·242 — 0·019 2·7 — 0·3 87 —1 29·725 —0·027 548 2 8·1 + 1·0 28 46 18 20·1 48·2 In this Table, + and — respectively signify that the numbers in the preceding column «re above or below the average to the extent of the quantities to whioh these signs are prefixed. 71 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 1865—75. 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. 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 1871 178 463 103 32 31 807 2867 28·8 1872 128 220 47 20 31 446 2421 18·4 1873 65 205 43 6 32 350 2570 13·6 1874 105 238 52 10 26 440 2796 15·7 1875 74 307 46 20 25 472 3096 15·2 *** The Diseases included in the above Table constitute, as in the Registrar General's Returns, the principal maladies only of the Zymotic class—viz.: Small Pox, Measles, Scarlatina, Diphtheria, Whooping·cough, Diarrhœa and Cholera, and Fever. TABLE Y. Cases of Sickness amongst the Poor under the treatment of the Union Medical Officers, with the Deaths from each class of Disease, during the year ended 31st December, 1875. Compiled from the District Medical Belief 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—Diarrhoea and Dysentery. 6—Cholera. 7—Fever. 8—Erysipelas. 9—Puerperal Fever. 10—Lung Diseases except Phthisis. 11—Phthisis. 12—Hydrocephalic, AtroDhy, 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 Clapham 829 5 ... ... ... 17 18 1 42 2 ... ... 120 3 6 1 8 ... 83 9 30 8 46 5 418 16 36 ... 45 Wandsworth 706 1 ... ... ... 8 15 2 44 1 ... ... 4 ... 7 ... ... ... 186 18 8 6 3 ... 402 11 28 ... 38 East 901 8 ... 6 ... 32 2 10 ... 5 2 ... ... 30 1 4 ... 5 ... 207 12 38 3 6 1 550 9 ... ... 30 Battersea [West 383 ... ... 4 ... 8 . . . ... ... 17 1 ... ... 9 1 4 ... ... ... 103 5 5 4 ... ... 222 16 10 ... 27 Putney and Roehampton... 146 ... ... ... ... 7 ... 4 ... 7 ... ... ... ... ... 5 ... ... ... 18 3 6 ... 3 2 79 3 17 1 9 Streatham, including Tooting and Balham 103 ... ... 1 ... ... ... 1 ... 3 ... ... ... 3 ... ... ... ... ... 21 6 1 1 1 ... 69 ... 3 ... 8 Totals 3068 14 ... 11 ... 72 2 48 3 118 6 ... ... 166 5 26 1 13 ... 618 53 88 22 59 8 1741 56 94 1 157 ***The ratio of deaths to cases treated is 5·3 per cent. 73 TABLE VI. Summary of the Sanitary Operations in the entire District during the year 1875. Clapham. Battersea. Wandsworth. Putney and Roehampton. Streathara, including Tooting and Balham. Totals. Number of Houses and Premises inspected 2000 2,930 37 183 208 5,358 1st Notices served 290 272 ... 20 34 616 2nd Notices served 38 15 ... 2 55 Cesspools emptied and cleansed ... ... ... ... 1 1 Cesspools abolished 4 5 1 ... ... 10 Waterclosets constructed ... 5 3 58 172 238 Houses supplied with water 18 112 ... 58 176 364 Drains constructed or connected with Sewer 139 284 36 78 78 615 No. of feet of New Sewers and Branch Drains 3,554 8,928 3,324 2,950 5,450 24,208 Drains repaired or trapped, or obstructions removed 104 See Branch Drains. 9 37 36 186 Open Ditches, Ponds, &c., cleansed ... ... 5 1,400 ft. 1,500 ft. ... Dust-bins provided 155 98 2 58 171 484 Pig Nuisances removed 13 6 14 3 6 42 Accumulations of Offal, Manure, &c., removed 12 29 5 16 1 63 Unwholesome and dilapidated Houses cleansed or repaired 14 ... 8 6 1 28 Cases investigated by Magistrates ... 28 4 ... ... 32 Compulsory Orders obtained ... 28 4 ... ... 32 Compulsory works executed ... 28 4 ... ... 32 Works remaining in abeyance from various causes ... ... ... ... ... ...