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

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St George (Southwark) 1858

[Report of the Medical Officer of Health for Southwark, The Vestry of the Parish of St. George the Martyr]

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2 Parish of Saint George the Martyr, Southwark.
60; of 1856, 194; of 1855,323; and thus is fore-shadowed the entire suppression of this disease. In
a recent visit I traced out a few cases, a fair specimen of the way it usually appears in a neighbourhood;
I must premise that this now under notice is one of our bad spots. In Northampton Court a man had
it very severely, but recovered; he came from a house in the country where a young man died of this
disease, and so imported it; I have reason to believe that neither had been vaccinated. A neighbour's
two children who had been vaccinated now took it, but very slightly—only a few spots appeared; then it
attacked another neighbour's family, selecting a filthy house with almost every known sanitary defect, and
people without any idea of cleanliness; passing over two children who had been vaccinated, it attacked
all the others who had not been so protected; they have had severe preliminary fever and severe small pox;
one is since dead. Scarlet fever, from which there have been 10 deaths and 38 cases recorded, appeared
in one of the worst spots in the parish in January; the week following another case and a death in the
same street; then in one of our closest courts. It appeared in successive weeks in Belvidere-buildings,
Gray-street, Tower-street, and Lee's-place; now for the first time it spread to clean and well-ordered
places. A case registered as dyptheria occurred and died; the sister a few days after was attacked with
scarlatina maligna and died, no doubt affected by this previous case registered as dypiheria; then a child
opposite also died. So in the Kent-road district, it began in one of the very worst localities in the circle
of Potier-street, Little Hunter-place and Rephidon-street, and then extended to opener and better places.
Thus it is that modern society neglects the social condition of its poor, and the poor with a well-ordered
revenge bring disease and death as the consequence. In the healthier parts of our parish, there have also
been many cases of sore-throat remotely simulating dyptheria and other affections of the tonsils and
throat, and which have been generally readily cured. Lost year most of the cases now called dyptheria
would no doubt have been called sore-throat, cynanche, and the like: several such have been noticed in
Bethlem Hospital. Among the diseases related to me and worth further notice was one at Bethlem,
a case of purpura (a low state of health with livid or blood-coloured spots on the skin allied to sea
scurvy) in a man who from antipathy avoided vegetable diet; Dr. Helps said, probably from that cause;
the case was readily cured by supplying the deficiency in the usual manner.
In the sixth Table, which shows the particulars of every death, in disease, age and sex; I introduce
for the first time the number for the corresponding quarter last year; you may thus see the varying
severity of every individual disease, quarter by quarter, and year by year; we shall thus note which most
to guard against. It is here shown that 174 out of 338 died under 10 years of age; rather more than
half thus early. Dr. Letheby speaks of one-third as a high rate of mortality among children; what then
must ours be which keeps rather steadily at half, or a little over. The fact is, there is in this part of London
little or no provision for the out-door exercise of children, and but little inducement for parents to take them
out; contrast the ricketty, pale thin forms that are always in-doors, and so fastidiously cared for, with
even the ragged and filthy urchins who roll about at our feet; we shall see at once that the latter, with
all their privations and ignorance, are in comparison rough and healthy, and in their way enjoy life.
Among "The Friends," who appear upon the whole to be the most practically sensible people living;
the children who die under 10 years of age are, not one in two as with us, but one in eight only; if we
had bequeathed such healthy constitutions, and had acted as wisely afterwards by our children as "The
Friends" have, we should have lost only 42 children instead of 174. In this Table appear 42 deaths
from consumption: it has but recently become prominent how very preventable a disease this is. As to
the causes, no doubt it is hereditary, but it must of course be produced before it can be bequeathed;
and the disease appears to be produced most generally by ignorance or disregard of the natural laws of
health; of every 100 deaths in the Guards, 67 are caused by consumption; and these are picked lives;
the principal causes have here been made obvious enough; sleeping closely in ill-ventilated rooms,
over-crowding and bad ventilation, so that persons cannot without disgust enter in the morning where
the sleepers are; the rooms are so offensive. I have often experienced this in my early visits among the
sick poor, and in my visits as your Officer of Health, one of the most prominent complaints I hear, is the
offensiveness of the houses in the morning, and the need of throwing open doors and windows "to let
the smell out." The list of streets and courts where these deaths mostly occur in our parish point
there to the same causes, filthy dwellings, over-crowding and an absence of that ventilation or continual
sweetening process which would well nigh prevent it at all. William-street, Webber-row, Hunter-street,
Clarendon-street, Surrey-street, George-street, show by far the most deaths from this disease.
The births recorded, were 540, of which 289 were males, and 251 females; of the deaths, 179
were males, and 159 females; other circumstances being equal, an increase appears of 202; that being
the excess of births over deaths for the quarter; the real annual increase as calculated is 592.
The water supply appears to be as good as can be reasonably expected :*—
Total Impurity. Organic Impurity.
Lambeth Company January, 19.84 2.40
February, 19.88 1.28
March, 18.40 1.30
Southwark Company January, 21.28 0.92
February, 19.72 1.16
March 21.10 1.70
* Dr. Thomson's Analysis,

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