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11
section V.—On the Diseases and Deaths in the Practice of the Public
Medical Institutions of St. Giles's in 1864.
The past year was of course a busy one at the Parish Infirmary and
Bloomsbury Dispensary. The statistics of each institution are given in the
tables that follow. The parochial medical practice shows a high number of
cases under treatment in each of its three departments. The in-patients of
the pauper hospital were more numerous than in any of the years that have
been examined in these reports, with one exception only. The out-patients
of the parochial dispensary have also applied in greater number than in any
other recent year. And of the paupers who received medical assistance at
their own homes, many more new cases came under treatment than in 1862
or 1863, in both of which years their number was unusually high.
The rate of death among the patients of the workhouse was of course
very high, owing to the nature of the complaints treated; and it was even
higher in 1861 than usual, by reason of the greater prevalence of typhus,
among other serious diseases. (See Table following page.)
It has been mentioned that persons suffering from fever and small.pox
taken into the workhouse infirmary from houses where these diseases had
originated were not treated without fatal results to some other inmates of the
workhouse who had caught the diseases. In view of this circumstance the
Directors of the Poor have resolved to take no more cases of small.pox and
typhus into the Workhouse Infirmary, but to send them to the special Smallpox
and Fever Hospitals.
The Bloomsbury Dispensary has had almost as many patients in 1861
as in the three previous years, in which their numbers had been steadily
above the average. The annexed table shows how many poor persons above
the rank of paupers have availed themselves of this excellent charity, aud it
shows also how many have been visited at their own homes and how many
have died.

At the Lying-in Hospital in Endell Street five deaths only occurred in
the year. All of these were infants, no mother having lost her life out of all
who came to the Hospital to be delivered.
SECTION VI.—On the Uncertified Deaths, and on the Inquests of 1864.
When attention was first drawn in these reports to the practice of
registering deaths without medical certificate, upon the mere statement of
friends and neighbours as to the cause of death, there were each year between
40 and 50 of such instances. In 1863 this number was reduced to 26, and
in 1864 certificates of the cause of death have been produced to the registrars
in all but 15 cases out of the 1601 registered by them. This improvement in
practice is strong evidence that there would be no difficulty in enforcing the
production of a medical certificate in all cases if the law chose to require it.