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A CENTURY OF PUBLIC HEALTH.
The Metropolis Local Management Act, 1855, directed each
Vestry to appoint a Medical Officer of Health and to publish
a report of the measures taken by them for the removal of
nuisances, and the improvement of the sanitary conditions
of the Parish. Camberwell's first Medical Officer of Health,
Dr. J. S. Bristowe, M.D., F.R.S., was appointed in 1856.
In this, the report of the Medical Officer of Health a hundred
years later, it may be of interest to draw a few comparisons
between the state of the public health then and now. At that
time sanitary reform was at its beginning, stimulated by the
work of Chadwick and others. Infectious disease was rife
(the first of the great cholera outbreaks occurred in 1831) but
until the bacteria that caused them were discovered they were
virtually uncontrollable. When Dr. Bristowe published his
first report Pasteur was formulating the germ theory of diseases,
but many years were to elapse before the bacteria that caused
infections like tuberculosis (1882), cholera and diphtheria (1883)
and tetanus (1884) were discovered. Let us compare the death
rates from the main infectious diseases and carcinoma in
Camberwell in 1856 with those to-day. (There was no record of
the number of cases of infectious diseases because notification
did not commence until nearly fifty years later.)
Cause of death
1856 1955
No. of Rate per No. of Rate per
deaths 1,000 pop. deaths 1,000 pop.
All causes (all ages) 1,259 20·5 1,878 10·5
Diarrhoea, bronchitis and
pneumonia (under 3 years) 120 2·0 6 0·03
All causes (under 5 years) 430 7·0 70 0·4
scarlet fever 44 0·7 Nil. -
Smallpox 4 0·06 Nil. —
Whooping cough 30 0·5 1 0·006
Measles 7 0·1 1 0·006
Croup 15 0·2 Nil. —
Tuberculosis (all forms) 179 2·9 30 0·16
Poliomyelitis No record 1 0·006
Carcinoma (all forms) No record 404 2·3
Carcinoma (of lung and bronchus) No record 114 0·6
Dr. Bristowe spoke of tuberculosis as "due to a peculiar unhealthy
form of constitution, and a tendency to deposition in
organs of a substance which rapidly breaks down, ulcerates and