The Board of Works for the Wandsworth District. SANITARY DEPARTMENT. REPORT ON THE SANITARY CONDITION OF THE SEVERAL PARISHES COMPRISED IN THE WANDSWORTH DISTRICT, DURING THE YEAR 1880. BY THE MEDICAL OFFICERS OF HEALTH. London: LOVE BROS., PRINTERS, 13, COLEMAN ST., BANK, E.C 1881. REPORT, 1880. To the Board of Works for the Wandsworth District. Gentlemen, We have the honour to present the twenty-fifth Annual Report on the health and sanitary condition of the Wandsworth District. The quarter of a century during which your Medical Officers have collated the sanitary statistics of this District, in the present form, has seen great improvements effected in the condition of the neighbourhood, both as regards its extraordinary growth in population, and the attainment of a higher standard of health; and the year 1880 may be pointed to as affording evidence of the strongest kind in favour of this opinion. The Census, taken at the end of the first quarter of 1881, gives us the means of accurately determining the proportion of the births and deaths to the population, and of presenting to you with confidence these figures and the deductions founded upon them. We have the honour to remain, Gentlemen, Your obedienr Servants, The Medical Officers of Health for the Wandsworth District. A* 5 HEALTH AND SANITARY CONDITION OF THE ENTIRE DISTRICT. The census of 1881 has put us in possession of the means of marking our progress, in sanitary matters, in a very much more satisfactory manner than we have been able to do for several years. Deducting from the figures announced to us by the Registrar General as our present population, the amount of increase supposed to have occurred in the interval, between the date of the Census and the middle of 1880, we find the population of the entire district at the latter date to have been 205,300. This greatly exceeds the estimated population upon which our death and birth-rates were calculated during the past few years, and renders the figures then produced of less value for purposes of comparison. The rates of increase, during the later years of the last decade, exceed even the estimate formed from the births, which we have shown to be more reliable than the official method of averages, and completely alters the relation of the figures then given. The year has been a warmer one and almost as moist as its predecessor. As might be expected Diarrhoea was very prevalent. Respiratory diseases decreased in severity. Scarlatina almost assumed epidemic proportions, 6 Births and Birth-rate.— The number of births registered during the year 1880 was 7,038: of these 3,590 were of males, and 3,448 of females. The birthrate for 1880 is 34.2 per 1,000, or 1 in every 29 persons. In the table below it will be seen that the birth-rate has steadily increased since 1871 to 1879, and now has fallen again to almost the identical figure at which it began. The births, as we have in former reports asserted, maintain a fixed proportion to the population, viz.: (in this district), 1 in 29 or 30 persons, or about 34.0 to 34.5 per 1,000. The figures of the year under review support this assertion. Year 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 Births 4380 4540 5053 5221 5529 5999 6159 6508 6833 7038 Birth-rate per 1000 34.5 34.4 36.4 36.5 37.3 39.5 38.6 39.4 39.7 34.2 Deaths 2867 2421 2580 2796 3096 3154 2991 3275 3526 3593 Death-rate per 1000 22.6 18.3 18.7 19.5 20.87 20.0 18.7 19.8 20.5 17.5 It has been, therefore, our practice to use this fact in estimating the population, when, as in the later years of the decade, we get further and further from the truth as to our population. The birth-rate of London was 36.2 per 1,000. Deaths and Death-rate.—During the year 1880 3,593 deaths were registered, of which 1,786 were of males, and 1,807 of females. This number is 3 fewer than the Registrar General has given in his Annual Summary (page xxxii.), and is due to the fact that 3 deaths were registered twice by the Local Registrar of the Putney sub-district, the mistake having passed unobserved at Somerset House. The death-rate, as may be 7 seen in the table above, is only 17.5 per 1,000. Although, for reasons already stated, it is hardly fair to contrast this rate with those of the years immediately preceding; the lowness of the mortality in the year 1880 was remarkable as contrasted with the average mortality of the past 10 years. It may fairly be taken as an evidence of success in the efforts of Sanitary Science to stem the tide of disease and death. The death-rate for London was 22.2 per 1,000, that of the 20 largest towns of the United Kingdom 22.7, and that of 50 other large towns 21.5. Only Dover and Newport among the latter, and none of the former, have so low a rate as prevails in this district. Neither of these towns have a population exceeding one-fifth of the population of the Wandsworth District. The table below gives the population and relative rates of mortality of the different sub-districts. SUB-DISTRICTS. Population in the middle of Deaths. Deathrate. Excluding Parishioners who have Died in Public Institution*. 1880 1879 1880 1880 1880 per 1000 per 1000 Battersea 103,266 1,980 2,040 19.7 18.8 Wandsworth 27,389 516 484 176 15.4 Clapham 35,678 561 544 14.9 Inappreciable Streatham, Tooting, and Balham 25,000 290 318 13.9 Putney and Roehampton 12,938 179 177 13.6 The excess of births over deaths was 3,445, or a rate of 16.8 per 1,000. This represents the natural increase of the population. 8 Table I. of the Appendix gives the entire mortality statistics of the year. For the sake of comparison, however, we have the total mortality from each cause set side by side in the Table now presented. DISEASES, And other causes of Death 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 Classes:— 1. Zymotic Small Pox 15 377 26 9 5 3 26 57 19 4 3 Measles 46 52 86 55 66 27 88 64 84 125 59 Scarlatina 352 126 26 9 94 134 86 58 39 134 173 Diphtheria 12 6 26 11 12 28 15 7 19 17 19 Quinsy 4 1 2 1 2 ... ... ... 1 ... 1 Croup 25 13 18 21 40 26 27 20 39 40 19 Whooping Cough 51 52 108 74 89 107 126 73 149 148 123 Typhus and other Fevers 68 54 52 65 48 39 47 64 39 62 44 Erysipelas 13 22 13 12 20 24 13 13 5 13 10 Metria, Childbirth 16 13 15 28 34 15 26 20 7 28 23 Carbuncle ... 2 1 ... 1 ... ... ... ... ... ... Influenza 1 ... ... ... ... ... ... 1 ... ... ... Diarrhoea & Choleraic Disease 148 140 140 126 117 134 159 114 182 94 213 Totals of Zymotic Class 751 858 513 411 528 537 613 491 583 665 687 2. Tubercular 374 423 419 426 469 565 555 514 501 513 625 3. Of Brain, Nerves, &c. 365 371 341 370 426 455 416 450 503 474 464 4. Of the Heart, &c. 132 152 127 139 146 176 170 204 212 203 193 5. Of Respiratory Organs 411 431 100 543 541 630 561 519 694 891 657 6. Digestive Organs 104 118 87 96 111 136 126 155 150 117 155 7. Urinary Organs 39 20 27 34 26 55 62 63 42 74 66 8. Of Organs of Gene ration 8 16 9 17 21 13 23 29 19 25 20 9. Of Joints, Bones, &c. 4 5 7 10 14 11 14 13 15 8 15 10. Of Skin 3 2 3 4 9 4 5 6 1 3 8 11. Premature Birth, Low Vitality, Malformation, &c. 191 145 143 143 168 177 226 212 177 170 266 12. Uncertain Seat 54 69 118 126 77 105 97 101 106 91 110 13. Age 133 125 105 144 106 130 150 126 141 141 136 14. Violence 50 56 87 70 75 68 90 82 75 83 96 16. Not Specified 40 76 35 47 79 34 3096 46 26 56 68 95 Totals 2659 2867 2421 2580 2796 3154 2991 3275 8526 3593 9 Zymotic Diseases.—Smallpox was only fatal in 3 cases in the District; as we must admit, however, the disease had began towards the end of 1880 to assume serious proportions, this only indicates the thoroughness with which isolation in Hospital was carried out. We have still to regret our want of opportunity in tracing the historv of the cases removed, without which no idea can be formed of the mortality from this cause among patients removed to Hospital from this District. Scarlatina was very prevalent and fatal during the year. The epidemic was especially severe in the Streatham sub-district. Diarrhœa was a feature of the epidemic mortality for which the heat and humidity of the year were greatly accountable. Whooping Cough prevailed somewhat largely. The total amount of Zymotic mortality in the several sub-districts is shown in the following table. SUB-DISTRICTS. No. of Deaths from Zymotic Diseases per 1000 of the Estimated population Ratio of Deaths from Zymotic Disease to every 100 of the total deaths. Battersea 3.6 18.7 Clapham 3.3 21.9 Wandsworth 3.3 19.0 Streatham 2.5 19.5 Putney 1.9 14.1 Non-Zymotic Diseases.—The only point of importance to be noted is the great decrease in the fatal cases of chest disease. The warmer temperature no doubt was favourable to this result. 10 The deaths from premature birth, &c., should perhaps demand some notice. The number steadily increases, and we cannot but look with some apprehension on the fact. Mortality According to Age.—The infantile mortality, as shown in the following table, was very high in 1880. Nearly 50.0 per cent. of the total deaths occurred under 5 years, and 31.6 under 1 year. YEARS. AGE. Under 1 year From 1 to 5 years From 5 to 10 years All under 20 years From 20 to 40 years From 40 to 60 years From 60 to 80 years 80 years & upwards 1870 713 540 157 1554 266 328 407 104 1871 753 538 142 1517 380 411 441 118 1872 705 452 61 1297 282 394 354 94 1873 636 387 75 1285 326 391 448 127 1874 777 452 107 1438 361 462 419 116 1875 886 467 132 1660 399 422 502 113 1876 910 524 99 1638 398 468 540 110 1877 840 466 109 1517 387 458 525 104 1878 983 600 100 1780 33S 483 532 142 1879 947 682 102 1878 368 487 658 135 1880 1,136 600 140 2021 374 500 560 138 The deaths of persons of advanced life have diminished. The proportion of deaths over 60 was 19.6 per 1,000. Social Position.—The proportion of deaths amongst the various classes is to be found in the table below, for 4 years, 1877-80. 1877. 1878. 1879. 1880. Nobility and Gentry 2.5 1.62 3.3 3.4 per cent. Professional Class 6.2 5.08 5.9 5.5 „ Middle Class 18.2 18.10 17.4 16.9 Industrial Class 73.1 75.20 73.4 74.2 „ 100.0 100.0 100.0 100.0 11 Sickness and Mortality among the Union Poor.— The important details in regard to this subject will be found in Table V., Appendix. The rate of mortality is nearly 5.0 per cent. Inquests.— The Inquests held during the year numbered 151, viz:— 81 in Battersea; 29 in Wandsworth; 17 in Clapham, and 12 each in Streatham and Putney. The Verdicts may be grouped as follows:— I. Accident 56 II. Natural 65 III. Suicide 21 IV. Unknown 6 V. Murder and Manslaughter 3 This constitutes 4.2 per cent. of the total deaths. Uncertified Deaths, &c.—This very unsatisfactory class of deaths numbered 78; viz.: 54 in Battersea,* 12 in Clapham, 7 in Streatham, 3 in Wandsworth, and 2 in Putney. In many cases the deaths are referred to the Coroner and certified by his direction, but in others the body is buried without any inquiry as to the cause of death (sec Summary for Battersea East, page 22). This is surely a serious evasion of the Registration Act, and a danger to life, especially of illegitimate children. Sanitation.—A Summary of the Sanitary operations of the District will be found in Table VI., Appendix. There is no comment necessary upon the information there given. *In Battersea 12 of these certificates, however, were given by a qualified medical practitioner, whose name was temporarily removed from the Medical Register, owing to a change of abode without notice to the Registrar of the Medical Council. 12 Cow and Slaughter Houses, &c.—These premises were inspected as usual by the Medical Officers of Health. Exception was found to the condition of some of the Cow-houses at Streatham (page 64). Elsewhere the Regulations now in force seem to have been fairly well carried out. Active operations against Piggeries have been carried on in some of the sub-districts, especially Battersea and Wandsworth, (see Summaries, pp. 37 and 54). Their presence is an offence to the inhabitants of this now thickly populated Suburb, and nothing will be left undone to banish them for ever from the Wandsworth District. The Water Supply.—Complaints are still made regarding the supply of water for Dietetic purposes. Remarks on this subject will be found at page 73. Press of work has no doubt deferred for a time the consideration of this subject on the part of the Government, but the question is one which admits of no shirking or neglect. The Water supply of London is a disgrace to the sanitary legislation of the present day. LOCAL SUMMARIES. 14 BATTERSEA. The mean population of the parish of Battersea for the year 1880, arrived at by computing the average rate of increase between the year 1871 and 1881, as shown by the census, was 103,266. As the increase in population during the ten years was 53,232, the average annual rate of increase has been 5,323. The births registered in the whole parish during 1880 were 4,095, giving on the mean population a birthrate of 39 per thousand. This rate is rather lower than at the last decennium, when the rate was nearly 42 per thousand. The total number of deaths registered in Battersea during the year was 2,040. This would, in a population of 103,266, indicate a death-rate of 19.7 per thousand per annum. As, however, 90 of the persons whose deaths were recorded were non-parishioners, dying in the Union Infirmary and other public institutions, the real number of deaths of parishioners within the parish was 1950; the consequent death-rate being 18.8 per thousand. It is proper to add, per contra, that no return can be obtained of inhabitants of this parish dying in the various public institutions in the metropolis or elsewhere. The annual rate of mortality for all London during 1880 was 22.2 per thousand. A detailed statement of the various causes of mortality will be found in the reports for the respective sub-districts of East and West Battersea. 15 BATTERSEA EAST. The official determination of the real number of persons residing in the sub-district of Eastern Battersea— the result of the recent census enumeration—conveys to us the fact that at that date, April 4th, 1881, therein existed 50,196 persons. This number exceeds, although but slightly, the estimated mean population used in the fortnightly returns, but is much in excess of the official mean population of the Registrar General, which would have credited the sub-district for the year 1880 with but 12,925 inhabitants, or thereabouts, and which was, as has frequently been stated in these reports, not at all a satisfactory mode of computation as far as the population of this rapidly increasing district is concerned. The mean population for the year 1880 will be the probable number of persons that resided in the subdistrict of Eastern Battersea on the middle day of that year, which is arrived at by deducting three-fourths of one year's ascertained increase of population in the decade 1871-81. The actual increase of population in the ten years was 29,188, and the subtraction of 3/40 will give a mean population for 1880 of 51,285. The estimated mean population derived from the ascertained number of births, and which has always been used in these calculations, and at which I had arrived some months before the census was taken, was 53,738, thus, after a period of ten years, being only 517 wide of the 16 actual number, a difference so small that it would have effected no appreciable alteration in the birth and death rates. Births.—The births of 1,153 males and 1,104 females were recorded by the registrar during the year 1880. The total number of births registered during the year was consequently 2,257, and the birth-rate in a population of 54,285 (which is shown elsewhere to have been the actual mean number of inhabitants in Eastern Battersea during the year) will be at the rate of 41.17 per thousand persons per annum. This agrees in a remarkable manner with the birth-rate of the past three census periods, when the birth-rate has also been approximately 42 per thousand, and this birth-rate has been employed as the basis upon which the population has been estimated between these periods. Natural increase of population.—During the year 1880, 2,257 persons were born in the sub-district, and 1,030 deaths were registered. The numerical difference between the births and deaths is called the natural increase, and amounted to 1,227 during the year. As the average annual increase of population during the decade has been 2,948, the difference in the numbers must have been the result of the immigration of 1,721 persons, or thereabouts. Prolific as the inhabitants of the subdistrict have been, a birth-rate scarcely varying from 42 per thousand having been shewn elsewhere to have prevailed throughout the decade 1871-81, this enormous increase is chiefly due to the influx of fresh inhabitants, and is the direct result of the great number of habitations constructed yearly. Mortality.—The annexed tabular statement of the cause of death, together with the age and social dition of the deceased, will be found to be of great statistical value:— 17 STATISTICS OF MORTALITY. BATTERSEA EAST. Official mean Population, Juno, 1880 54,285 Area in Acre*, 1,236. Total Deaths from each Class of Disease, Ac., in the Sab-District. Sex. Age. Social Position. males. Females. Under year. 1 1 From 1 to 5 year. From 6 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, Hankers, &c. Middle and Trading Class, Shopmen, Clerks, Ac. Industrial and Laboring Classes. Classic:— 1. Zymotic Smallpox 1 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 Measles 22 13 9 4 17 1 ... 22 ... ... ... ... ... 1 2 19 Scarlatina 63 32 31 4 36 19 8 62 1 ... ... ... ... 1 9 53 Diphtheria 2 2 0 1 1 • •• ... 2 ... ... ... ... ... ... ... 2 Cronp 4 2 2 ... 3 1 ... 4 ... ... ... ... ... ... 2 2 Whooping Cough 43 15 28 22 19 2 ... 43 ... ... ... ... ... ... 6 37 Typhus, Ac. 15 6 9 ... 2 3 5 10 3 9 ... ... ... ... 2 13 Erysipelas 4 ... 4 1 2 ... ... 3 ... ... ... 1 ... ... ... 4 Metria, Childbirth 5 ... 5 ... ... ... ... ... 4 1 ... ... ... ... ... 5 Carbuncle ... ... ... ... ... ... ... ... ... ... ... • •• ... ... ... ... influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa A Cholera 78 42 36 59 13 ... 1 73 1 1 2 1 ... 1 9 68 Totals of Zymotic Class 237 113 124 92 93 26 9 220 9 4 2 2 ... 3 30 204 2. Tubercular 218 125 123 117 44 5 13 179 43 25 1 ... 2 1 22 223 3. Of Brain, Nerves, &c. 110 60 50 34 26 2 6 68 7 14 21 ... ... 6 13 91 4 Of the Heart, &c. 28 13 15 1 ... ... 2 3 4 13 8 ... 1 ... 7 20 5. Of Respiratory Organs 190 98 92 74 57 4 2 137 12 18 21 2 1 2 21 166 6. Of Digestive Organs 41 20 21 11 4 3 3 21 3 10 7 ... ... 1 6 34 7. Of Urinary Organs 18 11 7 2 1 2 ... 5 5 7 1 ... ... ... 3 15 8. Of Organs of Generation 4 ... 4 ... ... ... ... ... 2 2 ... ... ... ... ... 4 9. Of Joints, Bones, &c. 1 ... 1 ... ... ... 1 1 ... ... ... ... ... ... ... 1 10. Of Skin 5 4 1 5 ... ... ... 5 ... ... ... ... ... ... ... 5 11. Premature Birth, Low Vitality, Malformation, &c. 69 39 30 69 ... ... ... 69 ... ... ... ... ... 4 7 58 2. Of Uncertain Seat 12 5 7 3 ... ... ... 3 2 3 4 ... ... ... 2 10 3. Age 22 9 13 ... ... 1 12 9 1 ... 4 17 4. violence 33 28 5 9 3 3 4 19 6 6 2 ... ... 1 6 26 5. Not Specified 12 6 6 2 1 ... 4 7 3 2 ... ... ... ... ... 12 Totals 1030 531 499 419 229 45 44 737 96 105 79 13 5 18 121 886 B 18 The deaths registered during the year 1880, in the Eastern division of the parish of Battersea, were 531 of males, and 499 of females. The total number was 1,030, and the death-rate for the year, in an actual population of 54,285, was 18.9 per thousand per annum. This is an increase on the number of deaths recorded during the two preceding years, and appears to indicate the truth of the law, that the mortality of a district increases directly with the density of its population. It is of course the aim of sanitary measures to neutralise this law and render its application limited, but it is not possible with a population of 44 to an acre, which existed in the sub-district during the year, to keep the mortality down to the rate of suburban or rural districts without the most untiring supervision and increasing attention to details, often seemingly unimportant in themselves, but in the aggregate determining the mortality of a district. Amongst these subjects may be included overcrowding, condition of water supply, whether with reference to quantity or storage, absence or presence of communication by means of overflow-pipe between cistern and drains, a fertile source of disease especially to be looked for in every sanitary inspection of houses, and as the result, many hundreds of overflows being diverted from the drains or closet pans to the open-air. Further remarks on cognate subjects will be found under the heading of sanitary operations. Ages at death.—The deaths under one year of age were 419, equal to about 40 per cent. of the total mortality. Under five years of age the total number was 648, and 62 per cent. of the whole number of deaths recorded. The infantile mortality is slightly higher than last year, but is in accord with the proportions which prevail over a series of years. 19 Above 80 years of age 13 persons died. Zymotic or Epidemic diseases,—A small increase in the number of deaths from Zymotic diseases took place during 1880—237 deaths having occurred in that year against 218 deaths in 1879. The following table gives the specific causes of deaths from this class of diseases for the last four years. 1880 1870 1878 1877 Diarrhœa and Infantile Cholera 78 43 71 47 Scarlatina 63 44 19 18 Whooping Cough 48 39 63 20 Measles 22 47 6 47 Fevers Typhus 2 15 13 12 17 Enteric 13 Metria (Childbirth) 5 12 2 8 Croup 4 9 12 10 Erysipelas 4 4 0 4 Diphtheria 2 6 4 1 Small Pox 1 1 5 28 Total 237 218 194 206 Zymotic death-rate per 1,000 per annum 4.3 8.9 3.7 4.3 It will be observed that the higher death-rate from Diarrhoea, and the allied diseases, accounts for most of the increased Zymotic mortality. This depends much upon the condition of the atmosphere as regards temperature, pressure, and humidity, and here can be no doubt that improper feeding in the very young is also an important factor in the production of this disease. The admission of sewage gases by the medium of untrapped and improperly laid drains is another fertile source of danger, and the condition of the water supplied to the locality has been shown to be, when the normal temperature is exceeded, directly productive of affections of the alimentary canal. 20 Scarlatina has been for the past two years very prevalent and correspondingly fatal. During the year 63 deaths occurred from this disease and its various complications and sequelae; in the year 1879, 44 deaths only having been registered. It is, however, satisfactory to be able to state that towards the latter part of the year the disease became much less prevalent, and there is reason to believe that the epidemic of the last two years has now come to an end. Whooping cough was fatal in 43 instances, chiefly during the colder months. Measles caused death in 22 cases, being in almost every instance complicated by some disease of the respiratory organs, such as pneumonia or bronchitis. The other diseases of this class do not call for special comment, their numbers being but small in so large a population. Other diseases.—From tubercular diseases, which include Pulmonary Consumption, Hydrocephalus and Atrophy, 248 deaths were registered. This exceeds the number for 1879 by 81; an increase due, it is to be feared, to the cold and wet weather which prevailed during the year, and to the general poverty which prevailed. Of these no less than 117 were under one year of age, the majority being only a few weeks or months of age, and fed by hand on more or less improper food. From diseases of the Respiratory Organs the large number of 190 person died, these however being exactly 81 less than during the preceding year. If the mortality from this class of disease and those from 21 tubercular disease he added together, it will be seen that during the last two years 433 deaths arose each year from these combined causes. From diseases of the Brain and nerves 110 deaths arose. From diseases of the Digestive Organs 41; while to Premature Births 09 deaths were ascribed ; and from Age 22 deaths. Inquests.—The Coroner held 43 judicial investigations into the cause of death during the year in the subdistrict, and in addition, 23 cases of death in which no medical certificate was forthcoming, were submitted for his consideration; he deciding in these latter that no inquest was necessary. The verdicts returned by the several juries were as follows:— From Natural causes 12 From Accidental causes— Asphyxia (overlaid 7) 8 Drowned 5 Killed on Railway 5 Concussion, Falls, &c. 4 Scald 1—23 Homicidal— Suicide—Cut Throat 2 „ Poison 2 „ on Railway 1 ,, Shot 1—6 Wilful Murder 2—8 43 The verdict of wilful murder was found in the very distressing case of the woman, Amy Pleasance, who cut her younger child into pieces, in all probability in the parish of Chelsea, and drowned the elder, when she found that she was suspected, in the lake in Battersea Park. 22 Uncertified deaths.—There occurred during the year 50 cases in which the cause of death was not certified in the ordinary manner by a qualified medical practitioner. Of these 23 were submitted to the Coroner, 12 were certified by a medical practitioner who is duly qualified, but not at the time of certifying registered, and in the other 15 cases, principally those of young children, burial took place without any investigation. It cannot be too strongly urged that no human being should be interred without an investigation into the cause of death being held by some competent authority—which if rendered compulsory by law, would remove any possible suspicion as to the manner in which these persons, generally young, and but too frequently illegitimate, came by their death. Social position.—The social position of the persons deceased in the sub-district, during the year, was as under:— per cent. Nobility and Gentry 5 = .50 Professional Class 18 = 1.75 Middle and Trading Class 121 == 11.75 Industrial and Labouring Class 886 = 86.00 1030 100.00 Disease and Mortality amongst the Union Poor.— The cases which have come under the care of the District Medical Officer, during the year 1880, numbered 1,001, and included an unusually large proportion of cases of acute disease. The severity of the cases is evidenced by the mortality, 33, more than double that of the preceding year, when it amounted to 16 only. The mortality of cases treated is nearly 33 per thousand, but many cases were removed to the Metropolitan Asylums, and other Hospitals, with the object of procuring proper lodging, diet, 23 and nursing, so essential in the treatment of acute disease amongst the poor. How many of these persons died whilst under such treatment elsewhere there is no means of ascertaining. An attempt was made recently to procure this most desirable information, hut difficulties were found to exist, mainly arising from defective registration at the respective Institutions, the officials of which declared themselves unable to give information of the death of each inmate to the parish from whence he came; and in one instance advised that the Medical Officers of Health of each District in the Metropolis should annually visit each Institution, and himself pick out the names of the several persons admitted from his District in the Hospital books. As the officials of these Institutions professed themselves unable to obtain the required information from this source, it would obviously be impossible for the several Medical Officers to be more successful. Sanitation in the Sub-District during 1880.—Subjoined will be found a return from the Inspector of Nuisances as to the recorded Sanitary operations, as entered in his books. It must, however, be understood that these do not include inspections of premises or food, or attendances at Police and other Courts, by myself. I may here add that the able manner in which Mr. Richards, the Inspector of Nuisances, and the Assistant Inspector, Mr. Barnes, have fulfilled the duties of their respective offices has given me much satisfaction. A brief resume shows that the work of the Inspectors increases year by year, in proport ion to the general increase of habitations and population, nearly 2,000 house to house inspections having been made, and when the fact is stated that 30 columns are tilled in the Inspectors' book at each inspection, many thousands of distinct inquiries or investigations will be seen to have been made. 24 One hundred and twelve houses and their contents were disinfected, in 16 instances after smallpox, and with such success that no second case of infectious disease occurred in the same room or bed after disinfection with the fumes of burning sulphur, with which method I am perfectly satisfied, as efficacious and inexpensive. The usual repairs to water fittings, &c., were made, and water laid on where necessary. Another subject of great importance is the removal of pig nuisances, which has been enforced most successfully, the Magistrates readily making orders for removal of pigs and against recurrence of the nuisance. With the dense population now located in the District there can be no doubt that all pigs should be removed, a matter which could now be carried out without difficulty, as the pig feeders seem to be aware that the time has come when they must migrate elsewhere, and there can be no doubt that a nuisance and a danger to health are constituted by the keeping of pigs, the boiling and preparation of their food, the accumulation of manure, and the surroundings generally. Abstract of Sanitary Work carried out in Eastern Battersea, During the Year ending December 31 st, 1880. No. of houses inspected 1957 No. of 1st Notices served 123 No. of 2nd Notices served 27 Houses disinfected and where necessary cleansed after smallpox 16 25 Houses disinfected and where necessary cleansed after various kinds of Fevers 96 Defective drains cleansed and repaired 136 Cesspools abolished 13 Accumulations of Manure removed 14 Dust Bins provided 92 Defective apparatus to water closets repaired 75 Water supply added to closets 17 Water supply added to houses 9 Pig nuisances removed 17 Covers to cisterns provided 42 Obstructions on footpaths removed (Building Material) 5 Dilapidated closets repaired 6 Dilapidated houses repaired 11 No. of houses where separate drainage has been enforced 36 New cisterns provided 12 Overcrowding abated 2 Orders of the Board obtained 24 Summonses 8 Unwholesome moat destroyed 971bs. W. H. KEMPSTER, Medical Officer of Health for Eastern Battersea. 26 BATTERSEA WEST. The decennial census having been completed, one is able to present this report with a satisfactory knowledge that the statistics referred to in it present an accuracy which it has been impossible to give during the past few years. It has revealed the fact that the official population has been for years far below that which actually existed, and that the numbers on which the death rate, &c., have been calculated have given two or three per 1,000 more than the district deserved. This has been referred to in the previous reports. The increase in the population has been extraordinarily large ; in 1871 it was 26,572; in 1881 it was 50,703; giving an increase of 24,131. This is due, not merely to natural increase, but in a much larger degree to immigration, as the following table, compiled from facts under my own observation for the past ten years, will show:— 27 Table showing Increase of Population by Natural Means and by Immigration. Population in April, 1871. Population in April, 1881. Actual Increase. 26,572. 50,703. 24,131. Total Deaths from 1871 to 1881. Total Births from 1871 to 1881. Excess of Births over Deaths. Natural Increase. 7,453. 13,179. 5,726. Deducting the Natural Increase, 5,726, from the Actual, 24,131, gives 18,405 as the approximate number of persons who have migrated into this district during the past 10 years. The 50,703 persons are made up of 24,612 males, and 20,091 females, giving an excess to the latter of 1,479, just the reverse of the sexes at birth, for some 500 more males were born than females during the decade; this arises from the greater risks the male portion are exposed to than the female, consequently greater numbers die. These 50,703 persons inhabited 7,668 houses, giving an average of 6.6 persons per house; at this rate, to afford accommodation' for immigrants alone, 2,782 houses would have to be erected. The past year on the whole has been as favorable as regards health as any of its predecessors, and still 28 more so in reference to diseases of a Zymotic character. In 1879 it will be seen that 174 deaths were registered from this class of disease, whereas in 1880 146 were returned, being a decrease of 28, and when we notice that in the latter year 61 deaths were due to diarrhœa €/ against 17 in 1879, the improvement in other diseases, such as Measles, Scarlet Fever, and Eevers generally, is most marked. This is very satisfactory, as it is against this class of disease the sanitarian is constantly at work, and bears evidence that the efforts put forth for years past by the Board and its Officers are bearing fruit, and that not under the most favourable circumstances, for the tendency is, with increasing density of population and consequent greater pollution of air, &c., to deteriorate health and not to improve it. Therefore, it is a matter for congratulation that, under these circumstances, one is able to report a great falling off in those diseases which are amenable to sanitary laws. The death-rate, calculated on a mean population in June, 1880, is 16.5 per 1,000, thus bearing out the assertions made in previous reports that our method, viz., that of the Registrar-General, of calculating the increase of population on which to form the basis of statistics was erroneous, and has given for years past 3 per 1,000 more than really existed. The above is a death-rate which will bear favourable comparison with any part of the Metropolitan District, and when we consider the nature of this district and its people, reflects great credit on those who have the direction and carrying out of our local affairs, and I doubt if a lower death-rate will ever be attained. Mortality.—The total number of deaths registered as having taken place in the district was 1,010; 498 being males, 512 females, the latter being 14 in excess of the former. In 1879, 1,002 were returned, there is, 29 therefore, an increase of 8 on that year. Of the total number 1,010, 188 occurred in the Union Infirmary, 98 of which belonged to Battersea as a whole, leaving 90 to be divided amongst the other parishes of the Union. These 188 deaths are 16 below those returned in the previous year, when 204 took place. The 98 belonging to Battersea as a whole will be taken into account when calculating the death-rate for the whole parish. Deducting the 188 Infirmary deaths, 822 will be the corrcct number for this *out-door district. Death-rate.—The death-rate, which one is now able to calculate with a degree of accuracy, which has been impossible for some years past, is 16.5 per 1,000. Birth-rate.—The number of births registered was 1838; 913 being males and 895 females, these give a rate of 37.5 per 1,000, or a decrease of 5 per 1,000 on the previous year, this is of course owing to the difference between the real and previously estimated population. Natural Increase.—The above number of births are 1,016 in excess of the deaths, and constitute the year's natural increase. The following table shows the causes of all deaths, classified at different ,ages, sex, and social position, which have taken place in the sub-district during the year. * Out-door with reference to Infirmary. 30 STATISTICS OF MORTALITY. BATTERSEA WEST. Total Deaths from each Class of Disease &c., in the Sub-District. Sex. Age. Social Position. Official mean population, June, 1880— 52 weeks) 48,981, 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, &c. Middle and Trading Class, Shopmen, Clerks, &c. Industrial and Labouring Classes. Area 1108 acre# Classes:— 1. Zymotic Small Pox 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 8 2 6 4 4 ... ... 8 ... ... ... ... ... ... 1 7 Scarlatina 30 11 19 2 13 11 3 29 1 ... ... ... ... ... 6 24 Diphtheria 3 2 1 ... 3 ... ... 3 ... ... ... ... ... ... ... 3 Quinsy 0 0 O ... ... ... ... ... ... ... ... ... ... ... ... ...... Croup 1 1 O 1 ... ... ... 1 ... ... ... ... ... ... ... 1 Whooping Cough 23 11 12 7 13 3 ... 23 ... ... ... ... ... ... 4 19 Typhus & other Fevers 10 6 4 ... 2 3 ... 5 3 2 ... ... ... ... ... 10 Erysipelas 3 1 2 ... ... ... ... ... ... I 1 1 ... ... ... 3 Metria, Childbirth 7 0 7 ... ... ... ... ... 6 1 ... ... ... ... 1 6 Carbuncle 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... Iufluenza 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa & Choleraic Disease 61 28 33 44 10 ... 1 55 1 ... 4 l ... ... 4 57 Totals of Zymotic Class 146 62 84 58 45 17 4 124 11 4 5 2 ...... ...... 16 130 2. Tubercular 196 109 87 66 20 6 16 108 51 33 4 ... 1 2 17 176 3. Of Brain, Nerves,&c. 117 63 54 42 24 4 3 73 2 12 25 5 3 3 14 97 4. Of the Heart, &c. 72 33 39 1 ... ... 3 4 14 19 35 0 5 2 6 59 5. O Respiratory Organs 215 103 112 69 43 2 5 119 10 35 39 12 4 3 16 192 6. Digestive Organs 47 21 26 9 3 2 6 20 5 13 9 ... ... ... 8 39 7. Urinary Organs 15 10 5 3 ... ... 1 4 3 3 5 ... ... ... ... 15 8. Of Organs of Generation 9 1 8 ... ... ... ... ... 4 1 4 ... ... ... 1 8 9. Of Cancer, &c. 22 6 16 1 1 ... ... 2 2 9 8 1 ... ... 6 16 10. Syphilis 4 2 2 3 1 ... ... 4 ... ... ... ... ... ... ... 4 11. Premature Birth, Low Vitality, Malformation, & c 70 44 26 70 ... ...... ... 70 ... ...... ... ... ... 1 7 62 12. Of Uncertain Seat 36 11 25 5 3 ... 1 9 6 4 15 2 1 1 1 33 13. Age 35 13 22 ... ... ... ... ... ... ... 13 22 4 ... 5 26 14. Violence 23 18 5 5 3 2 1 11 3 7 1 1 ... ... 4 19 15. Joints and Bones 3 2 1 ... ... ... ... ... ... 1 2 ... ... ... ... 3 Total 1010 498 512 332 143 33 40 548 111 141 165 45 18 12 101 879 * This table includes all deaths in the Infirmary of the Union, 31 Zymotic Mortality.—The deaths from this class of disease were 146, being 28 below those of the previous year. There was a considerable decrease in Measles, Scarlet Fever, and Fevers generally, with the exception of child-bed, 7 being returned as against 2. The most notable difference in this class of disease is Diarrhoea, 61 being returned against 17. Whooping Cough increased from 11 to 23. There is no fatal return of Small Pox. Of the 146 deaths, 62 were males and 84 females, 103 were under 5 years of age, 124 inclusive under 20, and 22 from 20 to 80 years and upwards. As usual by far the majority took place in young children, whose delicate organisations render them very susceptible to Zymotic poison. The deaths from Fevers were returned as follows : Typhus 4, Typhoid 6, the latter in some instances being registered as Typhoid Pneumonia. The death-rate from this class of disease was 2.9 per 1,000. The following table contrasts all deaths from Zymotic causes during the past 9 years. 32  1872 1873 1874 1875 1876 1877 1878 1879 1880 Small Pox 4 1 0 0 3 13 9 2 0 Measles 24 11 8 11 35 8 34 43 8 Scarlatina 3 3 5 48 20 8 4 55 30 Diphtheria 15 3 5 7 5 2 3 7 3 Quinsy 0 0 0 0 0 0 0 0 0 Croup 7 6 16 5 6 5 10 8 1 Whooping Cough 31 24 30 20 32 18 36 11 23 Typhus, &c. 13 22 15 14 19 25 15 27 10 Erysipelas 5 4 4 9 0 3 4 2 3 Metria, Childbirth 2 4 11 6 5 3 1 2 7 Carbuncle 1 0 0 0 0 0 0 0 0 Influenza 0 0 0 0 0 0 0 0 0 Diarrhœa and Cholera 32 37 43 35 43 22 41 17 61 Totals 137 115 137 155 168 107 157 174 146 Other Causes of Death.—These diseases collectively are 36 in excess of the previous year, 864 were returned, 436 being males and 428 females. Disease of the Respiratory Organs were 215, Bronchitis 119, Pneumonia 60, and other such diseases 60. Brain and Nerves 117, Digestive Organs 47, Heart 72, Cancer 22, Age 35, Premature Birth 70 ; the latter's existence being registered as minutes, hours, days, and weeks, tending materially to swell the death-rate, though dying of no actual disease. The Tubercular class realised 196 deaths; by Phthisis 109, Atrophy 57, Scrofula 23, and Hydrocephalus 23. 109 were males, and 87 females. Of the 864 deaths, 274 were under 1 year; 98 between 1 and 5 ; 424 under 20, inclusive; 20 to 40,101; 40 to 60, 139; 60 and upwards, 160 ; and 43 above 80, 3 being 90, 92, and 96; the two former females, and the latter male. 33 The following Table contrasts all deaths from nonZymotic causes during the past nine years:— 1872 1873 1874 1875 1876 1877 1878 1879 1880 Tubercular, including Phthisis 106 106 113 148 149 172 143 165 196 Of Brain, Nerves, &c 76 100 115 130 119 148 137 136 117 Of the Heart, &c. 21 31 31 37 19 55 53 56 72 Of the Respiratory Organs, excluding Phthisis 105 156 151 197 160 121 204 260 215 Of Digestive Organs 18 11 23 27 19 37 27 27 47 Of Urinary Organs 4 4 6 10 13 14 10 20 15 Of Organs of Generation 2 6 3 7 8 8 3 9 9 Of Joints, Bones, &c. 0 0 4 8 4 1 2 2 3 Of Cancer 15 14 10 2 23 22 23 14 22 Premature Birth, Low Vitality, Malformation, &c. 22 23 2G 37 30 30 31 36 70 Of Uncertain Seat 61 50 27 39 37 25 29 17 36 Age 46 51 22 39 53 47 58 57 35 Violence 28 4 15 15 18 23 20 13 23 Syphilis 0 0 6 6 4 7 11 16 4 Totals 507 559 552 702 686 713 751 828 864 Total deaths from all causes, including all deaths in the Infirmary, in the respective years were— 1872 1873 1871 1875 1876 1877 1878 1879 1880 644 674 689 856 854 820 908 1002 1010 The deaths in the Infirmary were 188. * 34 The death-rates per 1000, excluding Infirmary deaths and its population, were— 1872 1873 1874 1875 1876 1877 1878 1879 1880 17.0 17.6 17.2 20.2 19.5 17.1 18.5 20.0 16.8 The latter year was based on the recent Census, taking the mean in June. Inquests.—During the year 38 inquests were held on the bodies of 30 males and 8 females, being an increase on the previous year of 15—besides these, 9 other cases were submitted to the Coroner, who did not deem an enquiry necessary. The verdicts on those held were as follows:— From Natural Causes 16 „ Accidental Causes 15 Found Dead 2 Suicide 4 Manslaughter 1 Of the accidental causes 5 were of infants suffocated in bed, 2 from bathing (drowned), and 2scalded; of the found dead 1 was in a ditch, newly born, and 1 in the river. The suicides were, respectively— 3 Cut-Throats. 1 Poison by Prussic Acid. Social Position.—The per-centage of deaths in relation to social position was as follows:— Nobility and Gentry 1.79 Professional 1.19 Middle and Trading 9.91 labouring 87.11 100.00 35 Deaths not Certified.—I am glad to be able to report a marked decrease in the number of persons who die and are buried without a certificate of the cause of death. Such were but four—three of infants, who lived but a few hours, and one an adult male; this is satisfactory, as nothing can be more reprehensible than the consigning to the grave of persons simply on information given to the Registrars, as has been the case for years past. Disease and Mortality amongst the Union Poor.— The number of cases which came under treatment were 260—101 being males and 159 females. On reference to Table VI., Appendix, will be found the nature of the various diseases. Small Pox shows a decrease, the epidemic which has been raging this year not then having reached us. The cases of Diarrhoea were but 11, and those of Fevers 4, against 8 in 1879. Lung Diseases were 66 ; Violence, 4 ; other Diseases, consisting principally of Rheumatism, Brain, and Nerves, &c., were 150. There was one case of child-bed Fever, attended by a midwife, which proved fatal. Looking at the small amount of epidemic disease, and indeed the smallness of the entire number of cases, the poor of the district must have been very healthy daring the year. Of the 260 cases there were 11 deaths, which give a rate of 4.2 per cent. Vaccination.— Return made February 7th, 1881., by Mr. Payne, Vaccination Officer, respecting the vaccination of children whose births were registered in the c* 30 Battersea District, from 1st of January to December 31st, 1879, inclusive— Total Births returned 3050 Successfully Vaccinated 3374 Insusceptible of Vaccination 9 Had Small Pox 1 Dead Unvaccinated 338 Postponed by Medical Certificate 36 Removed to districts the Vaccination Officer of which has been duly apprised 2 Removed to places unknown or which cannot be reached 191 Mortuary.—The Mortuary continues of much usefulness, receiving corpses from the river, and of persons who die from Accident, &c. It would be well if it were more generally known by the Medical gentlemen of the Parish, that it is fitted with every convenience for the performing of Post-mortem operations, and that it is always at their service for such purposes. The Coroner is generally, when ordering post mortem examinations to be made, willing to defray the expense of moving the body, knowing how difficult it is in private houses to perform such duties, and cannot be nearly so hurtful to the feelings of the relatives. The keys can always be had by applying to Mrs. Ambrose, Church Lane, the keeper, or to my colleague or myself. Sanitary Matters.—A perusal of the Abstract, at the end of this Report, taken from the Inspector of Nuisances Daily Book, will show the large amount of Sanitary Work carried out in the District during the year. A systematic house-to-house inspection is made, and well repays the labour bestowed on it; no less than 114 37 defective drains were discovered and dealt with—in manv */ cases the sewage was found to occupy the whole space between the ground and floor boards. Out of 271 first notices served to remedy various defects, it was only necessary to serve a second in 31 cases, and in but 3 instances had the Court to be attended to obtain orders for the enforced carrying out of the necessary work. This I think speaks well for the people themselves, and shows a desire to do that which must be conducive to their health and comfort. Of the 1702 houses inspected but two cases of overcrowding were found—one of which gave considerable trouble, necessitating visits at all hours of the night, by the Inspector, before information could be obtained to bring them before the magistrate; evidence was given and an order made for its discontinuance. The removal of pigs under Magistrates' orders, which had commenced in 1879, was continued during the present year. The chief complaints being against Messrs. Newbey & Buttcrfield; Mr. Shiel, the Magistrate, after hearing the case, in conjunetion with myself, visited the former's premises, when food of the most offensive nature was found, and an immediate order for discontinuance was made—to the above can be added several other piggeries from which the pigs have been removed, making a total of 1154. The Dust depot of Messrs. Hudson is kept under periodical inspection and report—the result being that no undue accumulation takes place. During the house-to-house inspection the greatest neglect is often found in the condition of the water cisterns for months, and in some instances they have 38 never been known to be cleansed, and, as a consequence, are in a filthy state; they are frequently uncovered, thus becoming receptacles for contaminating matter. The water delivered by the Company in good condition is, by being received in such dirty cisterns, much deteriorated and possibly rendered totally unfit for dietetic purposes. The remedy for this state of things is the constant supply system—thus doing away with unfit receptacles, a large amount of waste, and probably being frozen out in the Winter. The following is a Summary of the Sanitary Work carried out in the District, supplied by Mr. Richards, the Inspector of Nuisances, of whom I have to express my continued satisfaction of the manner in which he performs his duties.. Abstract of Sanitary Work carried out in Western Battersea during the year ending December 31st, 1880:- No of house inspected 1702 No. of 1st Notices served 271 No. of 2nd Notices served 31 No. of Houses disinfected, and where necessary cleansed after Small Pox 7 No. of Houses disinfected and where necessary cleansed after various kinds of Fever 47 Defective drains cleansed and repaired 114 Cesspools abolished 1 Accumulations of manure removed 12 Dust-bins provided 84 39 Defective apparatus to water closets repaired 5i Water supply added to closets 18 Water supply added to houses 18 Pig nuisances removed 8 Covers to cisterns provided 42 Cisterns provided 9 Obstructions on footpaths removed (Builders' Materials) 14 No. of Houses where separate drainage has been enforced 9 Dilapidated closets repaired 9 Overcrowding abated 2 Diseased or unwholesome meat destroyed 2121b. Bad Fish destroyed 108 „ 2 Boxes of bloaters No. 72 Orders of the Board obtained 17 Summonses JOSEPH OAKMAX, Medical Officer of Health, Wcst Battersea. 40 CLAPHAM. As we are now in possession of the results of the late census, it may not be out of place to introduce here a table which I made use of in my report of 1871, showing the increase of population during the eight decennial periods from 1801 to 1881. This table cannot prove otherwise than interesting to the inhabitants of this sub-district, inasmuch as it shows the gradual rise of the locality from a mere village of some 4,000 inhabitants to a populous suburb of upwards of 36,000. POPULATION. 1801. 1811. 1821. 1831. 1841. 1851. 1861. 1871. 1881. Males 1,675 2,150 3,124 4,412 5,214 6,970 8,857 11,886 15,924 Females 2,189 2,933 4,027 5,546 6,892 9,320 12,033 15,462 20,454 Total 3,864 5,083 7,151 9,958 12,106 16,290 20,890 27,348 36,378 1 present also the following table as a means of comparing the births, deaths, and marriages for the 11 years 1870-80. 41 Yeas. 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 Marriages 158 249 236 257 284 243 313 319 282 303 329 Births 867 864 858 929 937 965 1029 1019 1095 1125 1082 Deaths 480 604 482 475 528 548 545 467 580 561 544 Excess of Births over Deaths 387 260 376 454 409 417 48-1 552 515 564 538 In the above table it will be seen that there were 43 fewer births in 1880 than in the preceding year, yet we know the population was increased by over 1,000 during the former year. This of course is due to immigration. Of the 30,378 inhabitants of this sub-district, 15,924 are males, and 20,454 females. This large preponderance of females is extraordinary, and no doubt due to the greater hardships and consequent mortality among the males, and perhaps also to emigration of males. The excess of births over deaths was also smaller in 1880 than in the previous year. The number of marriages was greater than has yet been solemnized in this parish. The mortality statistics of this parish are, as usual, tabulated according to cause of death, and sex, age, and condition of the deceased, and forms a brief annual report in itself. 42 STATISTICS OF MORTALITY. (52 WEEKS.) CLAPHAM. Total Deaths from each Class of Disease, Ac., in the Sub-District. Sex. Age. Social Position. Population in 1881, 30,378 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 yeurs of age. 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, Ac. Middle & Trading Class, Shopmen, Clerks, Ac. Industrial and Laboring Classes. Official Population in middle of year 1880 85,538 Area in Acres, 1,233. DISEASES And other Causes of Death. Classes:— 1. Zymotic Smallpox 2 • • • 2 1 1 • • • • • • 2 • • • • • • • • • • • • • • • • • • 1 1 Measles 19 9 10 4 14 1 • • • 19 • • • • • • • • • • • • • • • 1 8 10 Scarlatina 21 11 10 2 9 8 1 20 1 • • • • • • • • • 1 2 7 11 Diphtheria 3 1 2 • • • 3 • • • • • • 3 • • • • • • • • • • • • • • • • • • 1 2 Croup 3 1 2 • • • 3 • • • • • • 3 • • • • • • • • • • • • • • • • • • 1 2 Whooping Cough 25 11 14 7 16 2 • • • 25 • • • • • • • • • • • • • • • 1 6 18 Typhus, &c. 4 2 2 • • • • • • 2 • • • 2 1 • • • 1 • • • • • • • • • 1 3 Erysipelas 1 • • • 1 l • • • • • • • • • 1 • • • • • • • • • • • • • • • • • • • • • 1 Metria, Childbirth 3 • • • 3 • • • • • • • • • • • • • • • 3 • • • • • • • • • • • • • • • • • • 3 Carbuncle • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Influenza • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • •• • • • • • • • • • • • Diarrhœa 36 21 15 25 3 1 • • • 29 2 1 4 • • • 3 4 7 22 Cholera 2 ... 2 ... • • • • • • • • • • • • 2 • • • • • • • • • • • • • • • • • • 2 Totals of Zymotic Class 119 56 63 40 49 14 1 104 9 1 5 • • • 4 8 32 75 2 Tubercular 65 30 35 8 5 4 8 25 23 12 5 • • • 3 10 20 32 3. Of Brain, Nerves, &c. 41 17 27 4 2 1 2 q 2 q 21 3 4 11 15 14 4. Of the Heart, &c. 40 19 21 1 3 4 3 17 15 1 5 4 13 18 5. Of Respiratory Organs 84 41 43 13 14 • • • 2 29 4 19 25 7 5 15 22 42 6. Of Digestive Organs 9 7 2 2 1 • • • • • • 3 1 1 4 • • • 1 3 2 3 7. Of Urinary Organs 11 8 3 • • • 2 • • • • • • 2 1 5 3 ... 2 1 3 5 8. Of Organs of Generation 1 0 1 • • • • • • • • • • • • • • • • • • 1 • • • • • • • • • • • • • • • 1 9. Of Joints, Bones, &c. 5 4 1 • • • 1 • • • • • • 1 1 1 2 • • • 1 • • • 3 1 10. Of Skin 2 1 1 1 • • • • • • • • • 1 1 • • • • • • • • • • • • • • • 1 1 11. Premature Birth, Low Vitality, Malformation, &c. 47 26 21 42 5 • • • • • • 47 • • • • • • • • • • • • 1 7 13 26 12. Of Uncertain Seat • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 13. Age 22 5 17 • • • • • • • • • • • • • • • • • • • • • 8 14 2 7 6 7 14. Violence 12 9 3 1 2 3 5 2 2 • • • 1 1 1 9 15. Not Specified 83 40 43 27 10 2 1 40 5 21 16 1 12 13 26 32 Totals 544 263 281 140 90 23 17 268 55 89 106 26 41 80 157 266 43 Births and Birth-rate.—The births registered during the year were 1082, of whom 556 were males and 526 females. The birth-rate was 29 7 per 1000 or 2.97 per cent. Deaths and Death-rate.—The total number of deaths registered during the year 1880 was 544, of whom 263 were males and 281 females, giving a deathrate of 14.9 per 1,000, or 1.49 per cent. This low rate is most satisfactory to this parish, and indicates an increased healthiness of the district. As in my former reports, I again express the hope that these preventible diseases— the opprobrium of medical science—may be steadily diminished, if not ultimately exterminated. Years. 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 Small-pox 6 94 14 0 0 2 14 12 3 0 2 Measles 14 2 30 11 20 3 13 5 23 17 19 Scarlatina 45 20 6 2 33 22 13 4 12 12 21 Diphtheria 2 3 3 3 4 6 0 • • • 3 1 3 Whoopingcough 9 18 25 14 15 17 17 12 29 25 25 Typhus,&c. 12 10 11 10 6 2 5 4 5 9 4 Diarrhœa 31 31 39 25 27 22 24 18 26 17 36 & Cholera — — — — — — — — 2 — 2 Totals 119 178 128 65 105 74 86 55 103 81 112 Zymotic Diseases.—In the following table I have arranged the deaths due to the principle Zymotic diseases so as to compare the vear under review with the 10 preceding years. 44 Of this class there were as many as 112 during the year, which is the largest number since 1872, when they amounted to 128. Measles and Scarlatina were but little in excess of the average for the years in the above series, but diarrhœa was higher than in any year in the table except 1872. Still, our Zymotic mortality will compare favourably with the rest of the metropolis. Density of population, which is increasing year by year, is favourable to the propagation of these diseases. Small Pox was fatal in two cases, not of the pauper class. With few exceptions, all were anxious to avail themselves of the hospital accommodation which was promptly afforded. Ten cases occurred among the Union poor, and were removed to hospital. Ages of Deceased.—The mortality occurring at the extremes of life is a subject which has long engaged my attention, and to which I have often referred in my previous reports. The mortality among children under 10 is the saddest feature. Under that age 250 deaths occurred; viz., 46 per cent. of the total mortality. Many of these are due to diseases incidental to children, but many others to want of proper nursing and maternal care. The practice of mothers going to work too soon leads to the sacrifice of many lives. The mortality among aged persons is a less disagreeable subject. There were 159 deaths of persons upwards of 60. The oldest was a female who died at the advanced age of 91 years. Inquests.—During the past year 17 inquests were held. The verdicts were as follows:— I. Accident 6 II. Suicide 6 III. Natural 5 45 Besides these, there were 12 deaths put on the register without certificates from medical men. These deaths are on the increase year by year. These cases should be referred by the local Registrar to the Medical Officer of Health, otherwise the protection afforded by the death-register to the lives of the people is much diminished. Sanitation.—A review of the Table VI., Appendix, will satisfy the reader that a great deal of Sanitary Work has been accomplished during the year, and that those who were engaged in it did not neglect their duties. I would suggest, however, that covered carts be used for scavenging purposes, as dust blown from them is likely to become a means of propagating disease. Cow and Slaughter-Houses.—The Annual Inspection by the Surveyor, the Inspector of Nuisances, and myself, was made as usual. In some cases repeated visits had to be made, owing to the slow compliance of the owners to make necessary alterations. Heater Supply.—In my last Report (1879), I expressed the opinion that water could be got both readily and cheaply from the chalk hills of Kent, water which is of equable temperature throughout the year, and which would require neither filtration nor storage. The filtering beds of the present Company before cleansing are very filthy. The Hampton intake is about 25 miles from London Bridge, and the water could be obtained from Kent at much the same distance. Of the schemes suggested for procuring water for South London, the above is the least expensive and most practicable. The Thames is objectionable as a source of supply for drinking water. JOHN MAC DONOGH, Medical Officer of Health for Clapham. 46 WANDSWORTH. The following statistics, derived, from an analysis of the Registrar-General's returns and the parochial records of sickness and mortality, show that, notwithstanding the prevalence of an epidemic of Scarlatina of considerable extent and severity, an unusually low rate of mortality and a high rate of natural increase obtained in this sub-district during the year 1880. VITAL STATISTICS. Population.—The population of this parish at the recently taken census numbered 28,005; in 1871 it numbered 19,783; in 1861, 13,346; and in 1851, 9,611; so that during the ten years, 1851-61, it increased at the rate of 38.8 per 1,000 annually; during the ten years, 1861-71, at the rate of 48.2 per 1,000 annually, and during the past ten years at the annual rate of 41.5 per 1,000. The lately enumerated inhabitants consisted of 13,332 males and 14,673 females, the latter showing, as at former census, a great numerical preponderance, the cause of which is not sufficiently apparent. They were dwelling in 4,255 houses, averaging therefore 6.58 persons in each house; 410 houses were uninhabited. At the census of 1871 the average number of persons living in each house was 6.67, and in 1861 it was 7.05, so that, notwithstanding the sanitary disadvantages necessarily resulting from a more condensed population as regards 47 the area of the sub-district, the greater sanitary disadvantages arising from overcrowding in houses have become diminished by greater and more improved house accommodation. Birth-rate.—The births registered during the past year numbered 810; 415 of males, and 395 of females. The average annual number of the past ten years was 687. The birth-rate of the past year was 30.53 per 1,000, and the rate of natural increase 15.08 per 1,000 of the population. Mortality.—The total deaths registered amounted to 484, 248 of males, and 236 of females; 110 occurred in the following public institutions, viz.: 90 in the Surrey County Lunatic Asylum; 10 in the Hospital for Incurables; 4 in St. Peter's Hospital; 5 in the Prison; and 1 in the Reformatory for boys. Death-rate.—The death-rate, calculated from the recent census of the population and the total deaths registered, was 17.67 per 1,000. So determined, however, this rate, favourable as it is, does not, as has been explained in previous reports, represent the natural rate of mortality of this sub-district, in consequence of the undue exaltation of the death-register by the mortality of the County Lunatic Asylum, the Hospital for Incurables, and St; Peter's Hospital ; institutions, the inmates of which are derived, with a fractional exception, from without the parish, undergo no natural increase, and are subject to a very high mortality, and are, moreover, sufficiently numerous to cause a death-rate so derived to fluctuate with the mortality resulting in them. It is, therefore, found necessary to make correction for these institutions by eliminating their mortality, together with their population, from the calculation, and for greater accuracy to add to the latter the deaths of Wandsworth % 48 parishioners who went into the Metropolitan Asylum District Hospitals, and the Infirmary of the Union, during the year, and died there. The death-rate thus determined was 15.45 per 1,000 persons living on an average during the year. It will be well here to review the rates of mortality which have prevailed over a considerable period of time, for the purpose of affording, by comparison, an index of sanitary progress. With this object the following rates are introduced in a tabular form:— DEATH-RATES. Without correction for Institutions. Corrected for Institutions. Mean annual death-rate—1851-60 26.01 ...... „ „ „ 1861-70 20.61 18.52 „ „ „ 1871-80 18.37 15.64 Death-rate during the year, 1880 17.67 15.45 The gradual but very notable lessening of the rate of mortality over so long a period as 30 years, during which time the population has become nearly trebled, and the consequent sanitary disadvantages of a more concentrated population correspondingly increased, furnishes very satisfactory evidence of the sanitary improvement, as represented by prolongation of life, which has been accomplished during the existence of the Board. The following table contains, as usual, a summary of all the causes of death, arranged in accordance with the classification of the Registrar-General, shewing the sex, social position, and ages at death at the different periods, and particularizing the several diseases of the Zymotic class. 49 STATISTICS OF MORTALITY. WANDSWORTH. Total Deaths from each Class of Disrate, Ac., in the Sub-District. Sex. Age. Social Position. Population in 1871—10,783. 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 Claas, Merchants, Bankers, &c. Middle A Trading Class, Shopmen, Clerks, Ac. Industrial and Laboring Classes. Population in 1881—28,008. Official Population in middle of 1880—27,380. Area in Acre.—2,478. DISEASES, And other causes of Death. Disease. Classifled. Classes:— 1. Zymotic Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 9 6 3 3 3 1 9 ... ... ... ... ... ... 3 6 Scarlatina 24 13 11 3 12 7 23 1 ... ... ... 1 ... 3 20 Diphtheria 4 3 1 ... 2 1 3 ... ... 1 ... 1 ... ... 3 Quinsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup 7 2 5 ... 6 1 7 ... ... ... ... ... ... 3 4 Whooping Cough 15 8 7 5 10 ... 15 ... ... ... ... ... ... 3 12 Fever 6 5 1 ... 1 3 6 ... ... ... ... ... ... 2 4 Erysipelas 2 ... 2 ... ... ... ... ... 1 1 ... ... ... ... 2 Childbirth 5 ... 5 ... ... ... ... 5 ... ... ... ... ... 1 4 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... Diarrhœa A Dysentery 20 12 8 12 2 1 15 ... ... 4 1 1 1 5 13 Cholera ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... Totals of Zymotic Class 92 49 48 23 36 14 78 6 1 6 1 3 1 20 68 2. Tubercular 60 28 32 11 7 1 25 18 13 4 ... 1 2 13 4-4 3. Of Brain, Nerves, Ac 106 55 51 21 5 4 32 i 16 33 24 1 3 4 20 79 4. Of the Heart, Ac. 23 10 13 ... ... 1 3 3 9 6 2 1 1 6 15 5. Of Respira???y Organs 89 49 40 21 15 ... 39 5 19 26 ... 3 5 13 68 6. Digestive Organs 21 10 11 7 1 ... 9 2 4 6 ... 1 1 9 10 7. Urinary Organs 11 7 4 ... ... 1 2 5 3 1 ... ... 2 3 6 8. Of Organs of Generation 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 9. Of Joints, Bones, Ac 3 1 2 ... ... ... 1 1 1 ... ... 1 ... 2 ... 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality, Malformation, &c. 27 16 11 27 ... ... 27 ... ... ... ... ... ... 8 19 12. Of Uncertain Seat 17 6 11 1 ... ... 3 2 5 7 ... 3 2 6 6 13. Age 23 10 13 ... ... ... ... ... ... 9 14 2 ... 7 14 14. Violence 11 7 4 4 1 1 7 ... 4 ... ... ... ... 3 8 15. Not Specified ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... Totals 484 248 236 115 66 22 226 58 93 89 18 18 18 110 338 50 In estimating the relative proportion borne by the several classes of disease, in the causation of the mortality proper to this parish, it becomes necessary to exclude Class 3 (Diseases of the Brain and Nervous system) from consideration, for the same reasons as those which has been referred to as principally disturbing the determination of the death-rate, viz., the mortality of the County Lunatic Asylum, which alone formed 18.5 per cent. of all deaths. The first in order of fatality, exclusive of Class 3, was as usual, Class 1 (the Zymotic Epidemic—Contagious) forming 19 per cent. of all deaths. The second, closely approximating the preceding in fatality, was Class 5 (Diseases of the Respiratory Organs), forming 18.3 per cent. Of this class Bronchitis was the most fatal, and indeed was the most fatal of all diseases, forming nearly 12 per cent. of all deaths, and thus occupying the position usually held by Consumption, which formed 9 per cent. only. Class 2 (The Tubercular, which includes Scrofula and Consumption) was the next, and formed a little over 12 per cent. The other classes do not exhibit any variation requiring comment; the most noticeable feature in the table being, as in the year preceding, the numerical preponderance, although by no means to the same extent, of diseases of the epidemic class, and of diseases of the organs of respiration over their respective averages. Age at death.—Infant Mortality.—Upwards of 23 per cent. of all deaths occurred to infants during their first year of life; 37 per cent. and upwards to children under 5 years of age, and upwards of 46 per cent. to persons under 20 years of age. Senile Mortality,—23 deaths were registered as having resulted from natural decay alone; but 56 deaths, or upwards of 11 per cent., took place above the age of 70; viz., from 70-75, twenty-four; 75-80, eighteen; 80-85, nine; 85-90, four ; and one at the age of 91. 51 The mean age at death of all who died during the year was 30½ years (nearly). Social position of the deceased.—70 per cent. (nearly) of all deaths, and 74 per cent. (nearly) of the deaths from epidemic diseases occurred amongst the labouring classes. This is a lower proportion, in relation to the other classes collectively, than has hitherto prevailed, and a reference to the statistics under this heading, contained in previous reports, will show that this relative proportion of mortality from general as well as epidemic disease borne by the labouring classes has gradually diminished, a result which may be fairly accepted as an indication of much sanitary improvement effected amongst them. Epidemic diseases—their prevalence and fatality.— The following table shows the deaths which have resulted from the seven principal Epidemic Diseases during the past and ten preceding years, and the relation which they bore to the deaths from all causes:— Years. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough Cholera. Diarrhœa. Fever—Typhus and Typhoid. Total Deaths from Epidemics. Total Deaths from all causes. Per cent.ee of deaths from Epidemics to deaths from .11 causes. 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 5 52 453 11.5 1875 1 2 5 2 14 ... 17 5 46 420 10.9 1876 1 17 12 1 10 2 16 12 71 461 15.4 1877 ... ... 21 ... 11 ... 16 9 57 384 14.8 1878 ... 4 2 4 6 ... 19 3 38 422 9.0 1879 1 16 15 1 . 44 ... 7 8 92 516 17.8 1880 • • • 9 24 4 15 ... 20 6 78 484 16.1 D* 52 The fatality from these diseases during the past year closely coincided with the preceding decennial average; for if the same proportion of deaths from these relative to population, had prevailed during the past year as had been maintained on an average during the ten preceding years, the deaths during the past year would have numbered 76. The actual number was 78. Scarlatina was the prevailing epidemic, contributing 24 of the 78 deaths; it was present during the whole year, and its fatality was nearly twice the average amount. All the other diseases of this class were below the average. Measles prevailed during the first six months of the year, Whooping-cough during the first and third quarters, and Fever and Diarrhoea irregularly throughout the year. Isolated cases of Small-pox occurred in January, April, May, July, September, and October. The months in which the deaths from these diseases occurred and the mean temperature of each quarter are shewn in the following table. 7 cases of Small-pox and 8 of Fever were sent to Hospital for treatment, and therefore do not appear in the table; 2 of the cases of Fever terminated fatally. DISEA.SE. January February March April May June July August September October November December Mean Temp. 39.8 Mean Temp. 52.4 Mean Temp. 61.4 Mean Temp. 44.0 Small Pox ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 2 1 4 ... 1 ... ... ... ... ... ... Scarlatina 7 1 3 2 2 3 1 1 ... 4 ... ... Diphtheria ... ... ... 2 ... ... 1 ... ... ... ... 1 Whooping Cough 5 4 2 ... ... 1 ... 2 ... 1 ... ... Diarrhœa ... ... 1 ... ... ... 4 6 6 1 1 1 Fever ... 1 ... 1 1 1 ... ... 1 ... 1 ... Totals 13 8 7 9 3 6 6 9 7 6 2 2 53 Sickness and Mortality amongst the parochial poor, —The nature, extent, and fatality of the sickness which came under treatment amongst the parochial poor during the year is contained in table 5, Appendix. The total amount of sickness was considerably less than the average (13½ per cent.), the deaths were but slightly below the average. Epidemic diseases and their resulting fatality were both of nearly the average amount. The prevailing epidemic was Scarlatina, which formed nearly a fourth part of all that class of diseases, but was attended with comparatively little fatality. Violent deaths.—Inquests.— Uncertified deaths.— 29 Inquests were held during the year, with the following results, viz :— Deaths from natural causes 21 Accident 5 Deaths from violence Suicide 1 ++ Cause unknown 2 The uncertified deaths of last year were few in number, 3 only; it is much to be regretted, however, for the sake of security to life and every other interest of society, that the necessity for the due attestation by a registered medical practitioner of the cause of death in every instance has not yet been recognized by the law. See observations on this subject in Report for 1865 and seq. Sanitary proceedings.—Table 6, Appendix, contains as usual a Summary of the principal Sanitary proceedings which were carried out during the year. They will be found to have been far more extensive and important than heretofore,especially such as related to the inspection, the disinfection, and purification of infected houses, and the removal of nuisances. Some of the latter were of an important character, and required the intervention of the 54 law for their removal. Such were the prohibition of the Gipsy Encampment in Wardley Street, the closing of dilapidated houses in Field's Alley, and the suppression of the pig nuisances in Bendon Valley; these latter consisted of 6 piggeries, containing in the aggregate 331 pigs, with plant for hundreds more; one piggery alone containing 120 pigs —the whole said to have belonged to one proprietor. In consequence of the numerous and increasing attempts which have been made of late to create extensive piggeries in this parish, I venture to again draw attention to the subject. It must be patent that an extensive piggery like those referred to cannot be kept, even under the most favourable circumstances, without creating conditions prejudicial to health; for assuming that their ordure is removed daily, and that their styes are repeatedly cleansed, the very processes of such removal and of such cleansing become in themselves an insufferable nuisance. By the Act of 57 George III., cap- 29, sec. 68, the keeping of swine within 40 yards of any street or public place was wisely prohibited. There is nothing in any subsequent Act which annuls, or is even inconsistent with this wise provision, but on the contrary, Section 91 of the Metropolis Local Management Act confirms it, and Section 55 of the Sanitary Act of 1866, respects its operation as follows :—" All powers given by this Act shall be deemed to be in addition to and not in derogation of any other powers conferred on any Local authority by Act of Parliament, law, or custom, and such authority may exercise such other powers in the same manner as if this Act had not passed." If Section 91 of the Metropolis Local Management Act, and Section 68 of 57 George III., which are both in present force, be read together, the obvious conclusion is that the law does not allow the keeping of swine within 40 yards of any public place, and not beyond that distance if it be proved to the satisfaction of a Justice that a nuisance or injury to health is created thereby. If such be not the law, then it will be well for this and other populous localities if a law of like import be enacted. Altogether, the Sanitary aspect of pig- 55 keeping, as carried on in this District, utterly irrespective of position, density of population, and other Sanitary conditions, demands the serious consideration of the Board. The Cow-houses and Slaughter-houses were all examined previously to a renewal of their owners' licenses, and found in a very satisfactory condition. There is the same general complaint by the inhabitants of the town of the very serious nuisance arising from the Sewer gases which escape from the ventilators of the main sewers. With reference to this great intrinsic defect of the present system of drainage, I beg to reproduce an Extract from my Report for the year 1807 : " A sufficient and continuous flow of water is what is most needed for the prevention of the evil, and which would reduce the necessity for ventilation to a minimum, not only by a more rapid removal of the sewage, but by the absorption of gases and the prevention of decomposition. For it is evident that water being the vehicle which has taken the place of the horse and cart of the old system, forms the most important element in the present system of sewerage, and to be efficient in the performance of the work assigned to it must be of sufficient quantity for the purpose." GEORGE EDWARD NICHOLAS, M.D., Medical Officer of Health for Wandsworth. 56 STREATHAM, INCLUDING BALHAM AND TOOTING. The Census taken early in 1881 enables me to give more accurate information regarding the health of the district than has been possible hitherto. It will be remembered that attention was drawn in former Reports to the probable under-estimate of the population, which would, in some degree, vitiate those Reports, and it is now proved that I was right in assuming that the rate of mortality was really far below the one given in those Reports. It is satisfactory to be able again to announce that the health of the District, during the year 1880, compares favourably with former years, and with that of the healthiest localities. This is the case, notwithstanding the fact that in a portion of the parish there was a somewhat severe and fatal epidemic of Scarlet Fever; still the general health of the people was good, and the deathrate was below the ordinary low death-rate of this subdistrict. 57 Vital Statistics. Population.—In round numbers the population of this sub-district, in the middle of the year under review, was 25,000 persons living of all ages, shewing an average increase of over 1,000 a year during the last ten years; these figures nearly correspond with the estimate I formed of our population, and justifies the opinion I expressed in former Reports, that the death-rate was really 2 per 1,000 less than the one calculated by the official estimate of the population. Birth-Rate.—There were 703 births registered; 360 were of males, and 343 of females; the birth-rate was 28.1 per 1,000 persons living, of all ages, during the past year. The excess of births over deaths was 355, giving a rate of natural increase of 14.2 per 1,000. Deaths and Death-rate.—The total number of deaths registered was 348, showing an increase of 59 on the number recorded in the previous year; 161 of these deaths were of males, and 187 of females. The deathrate, calculated from the whole of the deaths registered and the foregoing corrected estimate of the population, was 13.9 per 1,000 persons living during the year. The following table shows clearly the cause of death, sex, age, and social position of all persons whose deaths were registered during the year. 58 STATISTICS OF MORTALITY. STREATIIAM. INCLUDING TOOTING & BALHAM. 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, Bunkers, &c. Middle & Trading Class, Shopmen, Clerks, &c. Industrial and Laboring Classes. Population in 1871—14,475. Population middle of 1880-25,000. Area in Statute Acres-3465. DISEASE8. And other Causes of Death. Classes:— 1. Zymotic Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 1 ... ... 1 ... 1 ... ... ... ... ... ... ... 1 Scarlatina 34 9 25 3 17 7 34 ... ... ... ... ... 3 2 29 Diptheria 7 7 ... ... 2 3 7 ... ... ... ... ... 5 1 1 Quinsy 1 1 ... 1 ... ... 1 ... ... ... ... ... ... ... 1 Croup 4 4 ... ... 3 1 4 ... ... ... ... ... ... ... 4 Whooping Cough 8 3 5 4 4 ... 8 ... ... ... ... ... ... 1 7 Typhus and other Fevers 5 1 4 1 ... ... 3 1 1 ... ... ... ... 1 4 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Metria, Childbirth 2 ... 2 ... ... ... ... 2 ... ... ... ... ... 1 1 Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea & Choleraic Disease 6 3 3 4 1 ... 5 1 ... ... ... ... 1 1 4 Totals of Zymotic Class 68 29 39 13 28 11 63 4 1 ... ... ... 9 7 52 2. Tubercular 38 14 24 4 4 3 14 15 8 1 ... 1 4 10 23 3. Of Brain, Nerves, &c 54 32 22 12 11 ... 23 2 9 16 4 8 5 15 26 4. Of the Heart, &c. 17 8 9 2 ... ... 3 1 1 11 1 1 3 4 6 5. Of Respiratory Organs 52 25 27 11 5 1 17 5 9 15 6 6 9 12 25 6. Of Digestive Organs 24 11 13 4 ... ... 4 2 9 9 ... ... 4 6 14 7. Of Urinary Organs 5 4 1 ... ... ... ... 1 1 3 ... 1 ... 2 2 8. Of Organs of Generation 5 ... 5 ... ... ... ... ... 2 3 ... 1 ... ... 4 9. Of Joints, Bones, &c. 3 2 1 ... ... 1 ... 2 ... ... ... ... ... 3 10. Of Skin ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11. Premature Birth, Low Vitality,Malformation, &c. 37 19 18 34 3 ... 37 ... ... ... ... ... 2 5 30 12. Of Uncertain Seat 9 5 4 ... 1 ... 1 2 2 3 1 1 1 2 5 13. Age 25 3 22 ... ... ... ... ... ... 15 10 6 3 4 12 14. Violence 11 9 2 1 ... ... 1 1 5 3 1 ... ... 5 6 15. Not Specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 348 161 187 81 52 15 164 33 49 79 23 28 40 72 208 59 Zymotic Diseases—their prevalence and fatality. The following Table contrasts all the deaths which resulted from the seven principal epidemic diseases during the past and seven preceding years:— DISEASE. 1873 1874 1875 1876 1877 1878 1879 1880 Seven Principal Epidemics. Small Pox ... 2 ... ... 4 1 ... ... Measles 3 9 2 2 2 11 2 1 Scarlatina 1 3 4 4 1 2 5 34 Diphtheria ... 1 3 7 3 3 9 7 Whooping Cough 8 3 5 7 6 11 21 8 Typhus, &c 7 2 .2 5 5 1 3 5 Diarrhoea and Choleraic Disease 10 6 9 6 4 13 3 6 Total 29 26 25 31 25 42 86 61 It will be seen from this Table that there were 61 deaths from the principal infectious diseases; more than half these deaths were caused by Scarlet Fever. An epidemic of this disease prevailed during the Spring and early Summer months in a portion of the District. The fatal cases were chiefly amongst the industrial classes; indeed, they were the principal sufferers from the disease. The progress of an epidemic of this kind is extremely difficult to check; the best directed efforts of the Sanitary Officers are too often thwarted by the people themselves, who ignore the slighter cases of the disease, which become fresh centres of infection, and thus prolong the epidemic. I may here refer the reader to the abstract of Sanitary Works, page 86 to show what has been done in the inspection, fumigation, disinfection, and cleansing of houses after this and other infectious diseases. 60 There was no fatal case of Small-pox, only one of Measles, and eight of Whooping Cough. None of these diseases were prevalent during the year. The mortality from the remaining diseases in this class differ so slightly from the average of the seven previous years that they require no separate notice. The mortality from epidemic diseases yields a percentage of 19.5 upon the number of deaths from all causes during the year. Other diseases.—The Tubercular appear to have caused 38 deaths, and show an increased mortality. I believe deaths not really tubercular are sometimes placed in this class. I refer particularly to the disease called Tabes Mesenterica, to which, not a very common one, the deaths of so many children are ascribed, whereas, in fact, some of these deaths arise from inanition, and are not tubercular diseases at all. Phthisis Pulmonalis contributes the most deaths to this class, and this year, as in the one preceding it, the number was largely over the average; doubtless the inclement weather of both seasons told equally against the Phthisical, and those suffering from other organic diseases. There was an increased mortality from diseases of the brain and nerves. On the other hand only seventeen deaths arose from heart disease, which is below the number recorded in any one of the seven previous years, excepting that of 1871, when the figures were exactly similar. These two diseases caused respectively 15.5 and 4.8 per cent. of all causes of death. The mortality from respiratory diseases was below that of the previous year, and caused 14.9 per cent. of all deaths. The number of deaths in class 11 are nearly double those of any one of the seven previous years, and form 61 upwards of 10 per cent. of all causes of death. This loss of infant life is truly deplorable, for I believe many such deaths might be prevented were it not for the ignorance, and culpable, if not criminal, neglect of parents; the terms low vitality, debility from birth, Tabes Mesenterica, are too often used to describe deaths, only too surely, I fear, the result of a course of insufficient or improper feeding. In class 13 there are 25 deaths, a large number to be attributed to old age alone; they form upwards of 7 per cent. of all deaths. The other classes differing but little from their averages, require no special remark. The following Table contrast all deaths from nonZymotic diseases during the past eight years:— Years 1873 1874 1875 1876 1877 1878 1879 1880 Tubercular 35 35 34 31 23 30 32 38 Of Brain, Nerves, &c 28 42 41 39 33 57 41 54 Of the Heart, &c 23 17 20 18 33 31 34 17 Of Respiratory Organs 49 19 34 52 36 44 64 52 Of Digestive Organs 12 17 21 22 25 29 16 25 Of Urinary Organs 6 3 6 6 7 7 10 5 Of Organs of Generation 3 2 ... 6 11 2 1 5 Of Joints, Bones, &c ... 1 1 2 7 2 ... 3 Of Skin 1 ... 1 ... 2 ... 1 ... Premature Birth, Low Vitality, Malformation, &c. 16 12 14 14 15 17 19 37 Of Uncertain Seat 6 4 8 2 4 3 6 9 Age 17 8 20 23 14 17 12 25 Violence 5 6 6 9 5 3 13 11 Not Specified 4 1 2 1 ... ... ... ... Totals. 205 167 208 225 215 242 249 281 62 Age at death.—Infant mortality.—The mortality of children was unusually high, owing to the greater prevalence of Scarlet fever, and to other diseases more particularly affecting children; 23 per cent. of all deaths occurred during the first year of life; upwards of 38 per cent. to children under five years of age, and 47 per cent. to persons of 20 and under. At the other extreme of life the mortality was below that of the previous year, but 25 deaths were registered as resulting from old age alone, and there were 54 deaths of persons over 70 years of age, viz., from 70 to 80, 29; 80 to 90, 21; and from 90 and upwards, 4. Sickness and mortality among the Union poor.— Table V. in the Appendix shews the number of persons who were under treatment, as well as the deaths which took place among the out-door Union poor of the district. There were 130 cases under treatment during the year, but these figures do not fairly represent the number of new cases, as a large proportion of our parish poor are old and infirm persons, and being permanently on the books, are treated over and over again for the same or different diseases, without obtaining a fresh order, or being entered as a new case on the register. In the Zymotic class there were 23 cases; these include 9 of Scarlet Fever, 3 of Small-pox, 5 of Whooping Cough, 2 of Measles, and 4 of Diarrhoea, without any fatal case. In the other classes there were 3 deaths from respiratory diseases, 2 from consumption, and 7 from other diseases. 63 Social Position.—The following table gives the percentage of deaths in the various classes during the year:— Nobility and Gentry 28 = 8.04 Per Cent. Professional Class 40 = 11.50 „ Middle and Trading Class 73 = 20.98 „ Industrial and Labouring Class 207 = 59.48 „ Total number of deaths, 1880 348 100.00 Inquests, Violent Deaths, &c.—12 Inquests were held, with the following results:— I. Natural (1) Congestion of the Lungs 1 „ (2) Convulsions 1 „ (3) Epileptic Convulsions 1 „ (4) Bronchitis, accelerated by Intemperance 1—4 II. Accidental (1) Exposure to Cold 1 (2) Asphyxia from meat impacted in the Larynx 1 (3) Concussion of the Brain from Falls 2 (4) Injury to the spine 1—5 III. Suicidal (1) Cut-throat 2 (2) Drowning 1—3 12 Sanitary Proceedings.—Table VI. in the Appendix contains a summary of the Sanitary operations; it will be seen that 1,115 houses were inspected, and 73 notices served for the abatement and removal of nuisances; 88 houses were disinfected after the occurrence of infectious diseases, and when necessary, infected clothing and bedding were burned. A large amount of work was done in the formation of new sewers and branch drains; (5 pig nuisances and 17 accumulations of offal and manure were removed, besides other works fully set forth in the table. 64 The Slaughter-houses and Cow-sheds have undergone the usual annual inspection by the Surveyor and myself. The Slaughter-houses were found to be in a very satisfactory condition. On the other hand some of the Cow-sheds were either not rebuilt, or else not fitted up in accordance with the new regulations, and it was therefore necessary to oppose the renewal of the owners' licenses, and they were suspended accordingly until the necessary alterations, amounting in some instances to complete rebuilding of the sheds, had been carried out. FIELD FLOWERS SUTTON, M.D., Medical Officer of Health for Streatham, including Balham and Tooting. 65 PUTNEY AND ROEHAMPTON. We have the advantage this year of estimating our sanitary statistics upon the tolerably accurate enumeration of our population, which the census of 1881 has given us. As we bring our report as nearly as may be to the middle of the year 1880, we must deduct from the figures, of which we are now in possession, the increase our population is supposed to have made from that time to the date of the census. Population.—The census returns gave our population on April 4th, 1881, at 13,221, viz.: 5,397 males, and 7,824 females. The average number of persons per house was 6.2. There were 2,525 families living in 2,121 houses, indicating that 401 families found accommodation in a house already occupied. This number is considerably in excess of the population we were, until E 66 now, calculating upon, and proves how greatly the ratio of increase in the decennial period, 1871-81, exceeded that of the period 1861-71. Even the estimate formed upon the rate of births (though a much more reliable method of arriving at the population) fell somewhat short of the actual numbers. Deducting, as we have to do, three quarters of a year's increase from the above figures, we find that the population of this sub-district, in the middle of the year 1880, was 12,938. Births and Birth-rate.—The birth-register during 1880 contains 348 entries, of which 163 were males and 185 females. This shows an increase of 21 upon 1879. The birth-rate was 27.3 per 1,000, or 1 birth in every 37 persons. Deaths and death-rate.— The deaths registered during the year 1880 numbered 177, 85 of males, and 92 of females. [In 1879, 179, and in 1878, 186 were registered.] This number is less by 3 than that given by the Registrar-General in his annual summary for 1880 (p. xxxii.). The inaccuracy of his figures arose from the fact that the local Registrar had registered three deaths a second time, the mistake occurring in different weeks, and therefore unobserved by the clerks at Somerset House. The death-rate was 13.6 per 1,000. 67 The table below gives a retrospect of the births and deaths during the 11 years 1870.80. YEARS. Births. Birth-rate. Number of Deaths from nil Causes. Death-rate. Rate of Natural Increase. 1870 271 29.5 145 15.7 13.7 1871 275 28.9 151 15.8 13.0 1872 279 28.4 144 14.6 14.0 1873 320 30.6 125 13.3 18.3 1874 290 27.8 156 15.0 12.8 1875 292 27.8 167 15.7 11.6 1876 300 27.3 143 13.0 14.3 1877 851 31.1 170 15.0 16.0 1878 338 29.1 186 16.0 13.1 1879 327 27.4 179 15.0 12.2 1880 348 27.3 177 13.6 13.2 The difference between the births and deaths was 171, and the rate of natural increase 13.2 per 1,000. It is satisfactory to note that with increase of population we have decrease of the death-rate. The table which follows is, in an abridged form, the same as that employed by the Registrar-General, and also arranged according to the classification of diseases drawn up by the College of Physicians of London, for use in certifying the causes of death. Some sub-classes, which appeared to me unnecessary, have been omitted, and others which I deemed useful in classifying the causes of death, adopted. e* 68 STATISTICS OF MORTALITY. PUTNEY and ROEHAMPTON. Total Deaths from each Class of Disease, &c., in the Sub-District. Sex Age Social Position Population (Census) 1881 13,221. Official Population in middle of the year 1880. 12,938. Area in Statute Acres-2,176. Males. Females. Under 1 year. From 1 to 5 years. From 6 to 10 years. At 10 and under 20 years of age. At 20, and under 40 years of age At 40, and under 60 years of age. At 60, and under 80 years of age. 80 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, &o. Middle & Trading Class, Shopmen, Clerks, &o. Industrial & Labouring DISEASES, And other Causes of Death. Classes:— Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlatina 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... 1 Diptheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhoid & Typhus Fever 4 1 3 1 1 ... 2 ... ... ... ... ... 1 2 1 Remittent and other Fevers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... I. Zymotic Puerperal Diseases 1 ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 9 3 6 6 3 ... ... ... ... ... ... ... 1 2 ??? Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ??? Diarrhoea, Dysentery, & Cholera 10 5 5 9 1 ... ... ... ... ... ... ... 2 1 ??? OtherZymo- tic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ??? Totals of Zymotic Class 25 9 16 16 5 l 2 1 ... ... ... ... 4 5 ??? II.Constitutional Gout, and Rheumatism 4 1 3 ... ... 1 ... ... ... 3 ... 2 ... 1 ??? Cancer &other Tumours 6 2 4 ... ... ... ... 1 1 3 1 2 1 ... ??? Tubercular 18 8 10 2 3 ... ... 7 4 2 ... ... 2 5 ??? III. Local Nervous 33 19 14 3 5 ... ... 3 6 14 2 2 6 12 ??? Circulatory 13 6 7 ... ... ... ... 3 4 4 2 2 2 5 ??? Respiratory 27 15 12 8 4 ... ... 4 3 8 ... 2 4 5 ??? Digestive 13 3 10 5 1 ... 1 ... 3 2 1 1 2 4 ??? Urinary 6 5 1 ... ... ... ... 1 1 4 ... ... 2 1 ??? Generative ... ... ... ... ... ... ... ... ... ... ... ... ... ... ??? Locomotory ... ... ... ... ... ... ... ... ... ... ... ... ... ... ??? Integumentary 1 1 ... 1 1 ... ... ... ... ... ... ... ... 1 ??? IV. Developmental Premature Birth, Atrophy, &c. 16 9 7 15 1 ... ... ... ... ... ... ... 7 5 ??? Old Age 9 4 5 ... ... ... ... ... ... 2 7 2 2 3 ??? V. Violence 6 3 3 3 ... ... 1 1 1 ... ... ... ... 1 ??? Totals 177 85 92 53 20 2 4 21 23 42 13 13 32 48 ??? 69 Zymotic diseases.—A slight increase has taken place since last year in the deaths from Zymotic diseases. The total deaths were 24. In 1879 there were 20. There is a decrease upon the total for 1878, however. The following Table shows at a glance the mortality of the 11 years, 1870-80, from Zymotic disease. Years. 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 Small-pox ... 1 ... ... ... ... 1 ... 1 ... .. Measles 4 1 ... 2 3 ... 1 2 7 ... ... Scarlatina 3 21 7 ... ... ... 3 6 ... 3 1 Diphtheria 1 1 1 ... 1 4 ... 1 1 ... ... Whoopingcough 3 1 6 1 ... 9 7 ... 4 8 9 Tyhoid&c. ... 1 ... 2 ... ... ... 4 3 2 4 Diarrhœa & Cholera 8 6 5 1 6 7 5 , 7 10 7 10 Totals 19 32 19 6 10 20 17 20 26 20 24 Percentage or Deaths from Epidemics to deaths from all causes. 12.4 21.4 13.1 4.8 6.4 11.9 13.2 13.0 13.8 11.2 13.5 It may be seen that the year under review was chiefly prolific in Whooping Cough, Typhoid Fever, and Diarrhoea, whilst the other diseases were only represented by one fatal case of Scarlatina. 70 The Table below arranges the Zymotic diseases according to the quarter of the year in which they severally occurred. DISEASE. 1880 First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Mean Temperature 39°8 52°4 61°4 44°0 Small Pox ... ... ... ... Measles ... ... ... ... Scarlatina ... ... ... 1 Diphtheria ... ... ... ... Whooping Cough 3 3 1 2 Diarrhœa ... 2 7 1 Fever 1 1 2 ... Total 4 6 10 4 Whooping Cough was most prevalent at the beginning of the year, and Diarrhoea as usual in the third quarter. The mean temperature for the year was 49°.4 or 3°.2 higher than that of last year, and slightly higher than the average. The rainfall for the year was 29.8 inches or 2.1 inches less than last year. Both the temperature and rainfall are nearly identical with those of 1878. The rainfall is 4.4 inches above the average of 65 years, and especially occurred in the autumn and winter months. Thus we have the necessary conditions to an excessive death-rate from diarrhœa. II. Constitutional and Local diseases, &c.—The only fact of interest in regard to these diseases is the low death-rate from Tubercular disease. Fewer deaths have been returned from that cause in 1880, than any year except 1870. A glance at the Table below will suffice for any further comments on this class. The increase in the mortality from Premature Birth, &c., must be reqgarded with suspicion. Many lives are sacrificed from insufficient care or ignorant handing soon after birth. Years. 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 c ' Gout and Rheumatism ... ... ... ... ... ... ... ... 3 1 4 Cancer and Tumours ... ... ... ... ... ... ... ... 7 3 6 Tubercular 18 22 24 19 24 26 26 26 32 23 18 L Nervous 18 19 20 26 39 23 26 29 28 34 33 Circulatory 9 9 14 13 8 13 6 8 12 13 13 | Respiratory 31 29 26 21 30 36 23 29 37 42 27 Digestive 17 8 7 12 11 7 5 12 10 9 13 Urinary 5 1 5 4 3 8 7 11 2 4 6 Generative ... 1 ... 2 ... 1 1 2 ... 1 ... Locomotory 1 ... 1 1 ... 1 1 2 ... ... ... Integumentary ... ... ... ... ... ... ... 1 ... 2 1 D Premature Birth, Atrophy, &c. 8 11 5 7 7 16 10 8 7 8 16 Old Age 8 7 3 3 6 11 8 8 7 5 9 V—Violence 4 4 6 5 6 4 7 9 5 7 6 (Other diseases) 6 7 13 3 12 1 1 3 ... ... ... Totals 125 118 124 116 146 147 121 148 150 152 152 71 72 Ages of deceased.—The deaths of children under 1 year amounted nearly to 30.0 per cent. of the total deaths, under 5 to 40.2 per cent. The figures in 1879 were 24.5 and 37.9 per cent. at the respective ages. This increased loss of life among children is to be deplored. Above 60 55 persons died, yielding a per-centage of 31.0. Of these 13 were upwards of 80 (about 7 per cent.). The oldest was a woman within 2 years of being a centenarian; the next a man of 91. As usual, the majority of very aged persons were females. Social Position.—The proportion of the classes is as follows:— Nobility and Gentry 7.1 Professional Class 18.2 Middle Class 26.9 Industrial Class 47.8 Inquests.—Twelve inquests were held during the year, the verdicts may be classified as follows:— I. Accident—Suffocation, 2; Drowning, 1. II. Natural—Apoplexy, 5; Brain Disease, 1. III. Suicide—Hanging, 1. IV. Found Drowned, 2. Sanitary Proceedings.— I am indebted to the courtesy of our Surveyor, Mr. Radford, for the information regarding the Sanitary operations of the Board in this sub-district, which will be found in the last Table of the Appendix. The large number of inspections made is evidence of the zeal and activity of that gentleman and his assistants. Few cases required more than the preliminary notice to secure the needed attention. 73 Cow and Slaughter Houses, &c.—No cause of complaint in regard to these premises has arisen during the year. The regulations of last year are working satisfactorily. Adulteration of Milk has been discovered, however, and I would suggest for the protection of the milk seller, as well as the buyer, that the cans should be sealed at the premises, provided with a tap to draw off the milk, and distinctly labelled new, or skimmed milk, according to their contents. The Water Supply.—Dr. Frankland, in his Annual Report to the Registrar General on the Water Supply of the Metropolis (Registrar General's Annual Summary, pp. 44-49), says: more than half of the water supplied by the eight companies which supply the inner circle of London, was often grossly polluted by sewage matters, and all but a mere fraction of the remainder occasionally so polluted. The Thames water was more polluted by organic matters in 1880 than in any previous year of which he has given the proportion. This was due to the frequent flooding of the river, and the washing into it of filthy matter from cesspools, sewers, &c. The difference between the purity of a deep-well water and the Thames is very striking (as 1263 to 393.) This standard of impurity is much in excess of the quality of potable water according to the opinion of the late River Commissioners. I am glad to note, however, that the Southwark and Vauxhall, and the Chelsea Companies delivered the best filtered water of all the River Companies. This question demands the earliest attention on the part of the Government. ALEXANDER WALKER, M.D., Medical Officer of Health for Putney and Roehampton. 74 APPENDIX OF STATISTICAL TABLES. TABLE I. Summary of Deaths and their Causes, registered in the entire District during 1880, 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. Total Deaths from each class of Disease, &c., in the entire District. Sub-Districts. Sex. Age. Social Position Clapham—Population in 1871, 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. .Protessional Class, Merchants, Bankers, &c. Middle and Trading Class, Shopmen, Clerks. A a. Industrial and I abouring Classes. Census 1881. 210,397. Official Population for middle of year, 1880. 205,400. Area in Statute Acres, 11,695. DISEASES, And other Causes of Death. Classes:— 1. Zymotic Small Pox 3 2 ... 1 ... ... 1 2 2 1 ... 3 ... ... ... ... ... ... 1 ??? Measles 59 19 9 30 ... 1 31 28 15 39 3 59 ... ... ... ... ... 2 14 ??? Scarlatina 173 21 24 93 1 34 76 97 14 87 53 169 4 ... ... ... 2 6 27 ??? Diphtheria 19 3 4 5 ... 7 15 4 1 11 4 18 ... ... 1 ... 1 5 2 ??? Quinsy 1 ... ... ... ... 1 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ??? Croup 19 3 7 5 ... 4 10 9 1 15 3 19 ... ... ... ... ... ... 6 ??? Whooping Cough 123 25 15 66 9 8 51 72 51 65 7 123 ... ... ... ... ... 2 22 ??? Typhus & other Fevers 44 4 6 25 4 5 21 23 2 6 11 30 8 5 1 ... ... 1 8 ??? Erysipelas 10 1 2 7 ... ... 1 9 2 2 ... 4 ... 2 2 2 ... ... ... ??? Metria, Childbirth 23 3 5 12 1 2 ... 23 ... ... ... ... 21 2 ... ... ... ... 3 ??? Carbuncle ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ??? Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ??? Diarrhœa &Choleraic Disease 213 38 20 139 10 6 111 102 153 30 2 187 7 2 14 3 4 9 27 ??? Totals of Zymotic Class 687 119 92 383 25 68 318 369 242 256 83 613 40 11 18 5 7 25 110 ??? 2. Tubercular 625 65 60 444 18 38 314 311 208 83 19 356 157 95 17 ... 8 21 87 ??? 3. Of Brain and Nerves 464 44 106 227 33 54 246 218 116 73 11 214 32 83 120 15 20 35 89 ??? 4. Of the Heart 193 40 23 100 13 17 89 104 4 1 1 17 28 63 79 6 18 12 41 ??? 5. Of Respiratory Organs 657 84 89 405 27 52 331 326 196 138 7 353 40 103 134 27 21 38 89 ??? 6. Of Digestive Organs 155 9 21 88 13 24 72 83 38 10 5 63 13 40 38 1 3 11 35 ??? 7. Of Urinary Organs 66 11 11 33 6 5 45 21 5 3 3 13 16 20 17 ... 3 5 12 ??? 8. Of Organs of Generation 20 1 1 13 ... 5 1 19 ... ... ... ... 6 7 7 ... 1 ... 1 ??? 9. Of Joints, Bones, &c 15 5 3 4 ... 3 9 6 ... 2 ... 4 2 5 4 ... 2 ... 5 ??? 10. Of Skin 8 2 ... 5 1 ... 6 2 6 1 ... 7 1 ... ... ... ... ... 2 ??? 11. Premature Birth, Low Vitality,Malformation, &.C. 266 47 27 139 16 37 153 113 257 9 266 ... ... ... ... 1 21 45 ??? 12. Of Uncertain Seat 110 ... 17 74 10 9 38 72 12 6 1 23 15 24 43 5 9 5 18 ??? 13. Age 136 22 23 57 9 25 44 92 ... ... ... ... ... 1 59 76 17 12 29 ??? 14. Violence 96 12 11 56 6 11 74 22 23 7 8 45 16 25 8 2 1 2 20 ??? 15. Not Specified 95 83 ... 12 ... ... 46 49 29 11 2 47 8 23 16 1 12 13 25 ??? Totals 3591 544 484 2040 177 348 1786 ;1807 1136 600 140 2021 374 500 560 138 123| 200 608 ??? 75 TABLE II. Births registered during the year 1880. SUB-DISTRICTS. Males. Females. Total. Clapham 556 526 1,082 Wandsworth 415 395 810 Battersea East-Males, 1153; Females, 1104 West-Males, 943; Females, 895 2,096 1,999 4,095 Putney and Rœhampton 163 185 348 Streatham, including Tooting and Balham 360 343 703 Total 3,590 3,448 7,038 *** The excess of Births over Deaths in the entire District is 3,445. TABLE III. METEOROLOGICAL TABLE FOR LONDON, 1880. (Deduced from Observations at Greenwich, under the Superintendence of the Astronomer Royal, and compiled from Quarterly Tables, furnished to the Registrar General by James Glaisher, 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 was Lowest Reading at Night. Highest Reading at Night. Mean. DitF. from Average of 109 years. Diff. from Average of 39 years. Mean. Diff. from Average of 39 years. Mean. Diff. from Average of 39 years. Mean. Diff. from Average of 39 years. Mean. Diff. from Average of 39 years. Mean. Diff. from Average of 39 years. Mean (Sat.=100). Diff. from Average of 39 years. Mean. Diff. from Average of 39 years. Mean. Diff. from Average of 39 years. Amount. Diff. from Average of 65 years. At or below 30". Between 30° and 40°. Above 40°. 1880. ° ° ° ° ° ° ° ° ° in. in. grs. gr. in. in. grs. grs. in. in. Sums. ° ° YEAR. 49.4 +0.8 0.0 47.0 +0.4 44.4 +0.8 15.2 —0.7 0.305 +0.015 3.4 +0.1 84 + 2 29.810 +0.037 542 +1 29.8 +4.4 100 119 147 13.5 60.3 First Quarter 39.8 + 1.0 —0.1 38.0 0.0 35.6 +0.2 12.4 + 0.6 0.211 +0.004 2.4 0.0 85 + 1 29.925 +0.162 556 +4 3.2 -1.8 51 32 8 13.5 49.1 Second do. 52.4 +0.1 —0.5 49.0 —0.2 45.5 +0.1 18.8 —1.2 0.309 + 0.002 —0.1 78 + 2 29.781 —0.001 538 0 5.0 —0.9 17 38 63 22.8 53.2 Third do. 61.4 +1.7 + 1.2 58.5 + 2.2 56.0 +3.1 17.9 —1.8 0.449 +0.045 5.0 +0.5 83 +5 29.783 —0.013 538 —2 8.8 +1.4 0 5 87 37.2 60.3 Fourth do. 44.0 +0.3 —0.6 42.4 —0.2 40.4 —0.2 11.6 —0.2 0.252 —0.007 2.9 —0.1 88 + 1 29.749 0.000 547 + 1 12.8 + 5.7 32 44 16 16.3 50.8 In this Table, + and — respectively signify that the numbers in the preceding column are above or below the average to the extent of the quantities to which these signs are prefixed. 77 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 1870-80. Years. deaths from the sete5 principal Epidemics in each Site-District. Entire District. Clapham. Battersea. Wandsworth. Putney. Streatham. Total Deaths from the Seven Epidemic*. Total Deaths Registered from all causes. Percentage of Deaths from the Seven Epidemics to Total Deaths. 1870 119 101 113 19 37 692 2659 260 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 32 351 2580 13.6 1871 114 238 52 10 26 440 2796 15.7 1875 74 307 46 20 25 472 3096 15.2 1876 86 340 71 19 31 547 3154 17.4 1877 55 280 57 22 25 439 2991 14.2 1878 103 322 38 26 42 531 3275 16.9 1879 81 355 92 20 36 584 3526 16.9 1880 112 383 78 25 61 659 3593 18.3 *** The Diseases included in the above Table constitute, as in the RegistrarGeneral's Returns, the principal maladies only of the Zymotic class—viz.: Small Pox, Measles, Scarlatina, Diphtheria, Whooping Cough, Diarrhoea and Cholera, and Fever TABLE V. Cases of Sickness amongst the Poor under the treatment of the Union Medical Officers, with the Deaths from each class of Disease, daring the year ended 31st December, 1880. 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 Diphtheria 4—Whooping Cough. 5—Diarrhoea and Dysentery. 6—Cholera. 7—Fever. 8—Erysipelas. 9—Puerperal Fever. 10—Lung Diseases, except Phthisis. 11—Phthisis. 12—Hydrocephalus, Atrophy, Scrofula, and Convulsions of Children. 13—Other Diseases. 14—Violence, Privation, and Premature Birth. Total Deaths in each Sub-District. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. j Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Clapham 512 10 ... 12 2 7 ... 23 2 41 2 ... ... 68 1 ... ... ... ... 68 5 11 3 11 5 237 12 24 ... 32 Wandsworth 621 8 ... 16 ... 26 3 8 4 32 ... ... ... 8 1 9 ... ... ... 157 9 8 4 9 1 317 11 23 ... 33 Battersea East 1001 17 ... 7 ... 44 2 40 4 38 1 ... ... 8 ... 3 ... ... ... 160 5 56 9 10 2 605 10 13 ... 33 West 260 8 ... ... ... 2 ... 3 ... 11 ... ... ... 4 1 3 ... 1 1 66 5 3 2 5 ... 150 2 4 ... 11 Puthey and Rœhampton 156 ... ... ... ... ... ... ... ... 14 1 ... ... ... ... 2 ... ... ... 30 3 2 1 ... ... 101 5 7 ... 10 Streatham, including Tooting and Balham 131 3 ... 2 ... 9 ... 5 ... ... ... ... ... ... ... 1 ... ... ... 24 3 3 2 ... ... 75 7 5 ... 12 Totals 2681 46 ... 37 2 88 5 79 10 140 4 ... ... 88 3 18 ... 1 1 505 30 83 21 35 8 1485 47 76 ... 131 *** The ratio of deaths to cases treated is nearly 5.0 per cent. 78 79 TABLE VI. Summary of the Sanitary Operations in the entire District during the year 1880. Clapham. Battersea. Wandsworth. . Putney and Rœhampton. Streatham, including Tooting and Balham. Totals. Number of Houses and Premises inspected 2,000 3,659 479 1,304 1,115 8,557 1st Notices served 207 394 123 97 70 891 2nd Notices served 35 58 ... 12 3 108 Cesspools emptied and cleansed ... ... ... ... 4 4 Cesspools abolished 2 14 ... 2 6 24 Waterclosets constructed or repaired 18 144 12 5 137 316 Houses supplied with water ... 27 12 . 7 10 56 Drains constructed or connected with Sewer 17 595 152 57 1,058 1,909 No. of feet of New Sewers and Branch Drains 2,625 23,903 5,740 1,410 29,589 63,327 Drains repaired or trapped, or obstructions removed 55 250 30 . 19 37 391 Open Ditches, Ponds, Ac., cleansed 1 ... 4 7 ... 12 Dust-bins provided 42 170 30 ... 39 287 Pig Nuisances removed 2 25 14 ... 6 47 Accumulations of Offal, Manure, &c., removed 20 26 11 22 17 96 Unwholesome and dilapidated Houses cleansed or repaired 57 230 56 13 88 450 Cases investigated by Magistrates 3 13 6 2 ... 24 Compulsory Orders obtained 3 12 5 2 ... 22 Compulsory works executed ... 12 ... 2 ... 14 Works remaining in abeyance from various causes ... ... ... ... ... ...