London's Pulse: Medical Officer of Health reports 1848-1972

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Southwark 1894

Annual report for 1894 of the Medical Officer of Health

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14
Parish of St. George the Martyr, Soiithivark.
1.—The presence of foul sewers in which the solids stagnate, while the liquids
percolate through the walls and joints into the surrounding soil.
2.—The constant danger of sewage-flooding in basements—in many of which food
and drinks are prepared and stored—due to the inadequacy of main sewers under the
control of the London County Council.
3.—The failure to put into practice the pail-system of dust removal throughout
the parish, advised in my Annual Reports for 1892 and 1893.
4.—The absence of a sufficiently prompt and systematic method of house-refuse
removal in and about dwellings.
5.—The need of a more frequent and thorough flushing of the sewers and watering
of the streets.
6.—The want of adequate attention to the cleanliness of hye-streets, courts, and
alleys, situated in the poorer quarters of the parish.
The deaths from tubercular diseases, which include tabes mesenterica, popularly
known as " consumption of the bowels," tubercular meningitis, hydrocephalus,
(water on the brain) and scrofula, are probably due largely to the use of unboiled
milk, derived from cows suffering with tubercle in the glands of the udder.
As mentioned in my Report for 1893, this fact points to the need of an increased
supervision of dairies.
The many causes leading to loss of infant life in St. George's may be thus
summarised:— (1) Bad environment, such as insanitary conditions, overcrowding
and absence of parks and open spaces. (2) Improper and insufficient food.
(3) Mismanagement by mothers through ignorance. (4) Early marriages. (5)
Debility of mothers. (6) Maternal neglect, due to mothers being more or less
employed away from home in factories and workshops. (7) Use of opiates : usually
in the form of patent medicines.
The mortality of children between the ages of two and five years is recorded as due
chiefly to bronchitis and pneumonia, and to such preventable diseases as measles,
whooping cough, diarrhoea, diphtheria, and scarlet fever.
Apart from general moral and sanitary measures, I have no special remedies
to suggest for counteracting the excessive infantile mortality, other than those
urged in my Annual Repor^for 1892-3.
They are the provision of :—
(1) Open breathing spaces.
(2) Creches or day nurseries for the better protection of infants
during the hours they are deprived of maternal care.
It would be idle for me again to enlarge on the advantages resulting from open
spaces—since my advice on this matter has been so often proffered, hitherto, I regret
to say, without, any practical result.
In my Reports for 1892 and 1893, I advised the establishment of creches in your
parish.
These are wanted owing to the large number of mothers resident in this district,
who are engaged in factories and workshops, and are therefore unable to attend to
^heir domestic duties during the greater part of the day.
It goes without saying that creches should know nothing of creeds and religions;
and it seems to me that their best chances of success would be secured by co-operation
between employers and workpeople.