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destroys the healthy tissues." Although he wrote nearly 30
years before the tubercle bacillus was discovered he noted
very wisely the influence of inadequate diet, over-work, exposure
to the weather and unwholesome habitation. Typhus he spoke
of quite rightly as "propagated by contagion"—it was in 1902
that Nicolle showed that this disease was carried by lice.
In 1856 sewage systems were primitive and water supplies
were frequently contaminated, and we read in the early reports
of the preparation of plans of open ditches and sewers—1¾ miles
of them—and of schemes for arching them over. At that time
223 cesspools were emptied, 336 filled up and 324 closets trapped
and connected with a sewer. There were numerous shallow
wells polluted with sewage—cholera was the result. An out-break
of typhoid in the Peckham Police Station was found to
be caused by a cesspool leaking into the soil below the duty room
—the "emanation from the cesspools" was of course not the
cause, the shallow well was infected. The year 1859 experienced
an unusually severe, prolonged and widespread invasion of
diphtheria — "there can be no doubt that it is to some extent
infectious and catching"—fourteen years later, when the
bacillus was isolated its high infectivity was made clear.
Concern was expressed at the low rate of vaccination against
smallpox, a disease which was beginning to spread again. In
the five years from 1861-1866 there were 135 deaths from
diphtheria, 73 from smallpox and 44 from cholera. A good
deal of the time of the Sanitary Inspectors, it is recorded, "was
occupied with matters relating to the Cattle Plague"; they had
62 cowhouses to inspect, compared with only one to-day. The
death rate among infants was very high (no records of deaths
under one year are available before 1865 when the infant death
rate was 162 as compared with 21 in 1955) and Dr. Bristowe
was (and rightly) of the opinion that a considerable number of
deaths might have been prevented. By 1906 the rate had
dropped to 134, and during that year 5,000 copies of a pamphlet
on infant feeding were distributed in the Borough. Dr. Stevens
the Medical Officer of Health reported the recommendations
of a conference he attended on the subject of infant mortality.
Among the recommendations of the conference were—instruction
in hygiene in the schools, the setting up of milk depots, the
notification of still-births, and the certification of all preparations
sold as food for infants. It was recommended also that "the
appointment of qualified women, especially trained in hygiene
of infancy, is necessary as an adjunct to public health work."
This suggestion received only lukewarm approval from the
Camberwell delegates who thought, however, that "it might
be given a trial." One of the duties of the Medical Officer of
Health in those early days was to make monthly tests of the
quality of the gas supplied; he no longer has to do that, but