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9
Annual Report of the Medical Officer of Health—1895.
The mortality from measles, whooping cough, and diphtheria is seen from
the foregoing table to be excessive in St. George's as compared with all London.
The absence of deaths from small-pox is in itself a valuable evidence as to the
efficiency of modern preventive measures of vaccination, together with notification
and prompt isolation.
The most remarkable point in the table is, perhaps, the diarrhoea mortality.
On the one hand, the actual number of deaths in St. George's shows a
decrease of one-tenth in 1895 as compared with 1894. On the other hand, the London
mortality shows an increase, and in 1895 is double that of 1894 (49 to 24). If the
deaths from diarrhoea in St. George's had taken place in the same proportion as in
London generally, there would have been 147 deaths to register from diarrhoea in
1895. This statement of results must be recognised as significant, even if we make
full allowance for the fact that in St. George's we are dealing with small figures as
compared with the general returns of the Metropolis.
Thus far all is plain sailing, a mere analysis of figures, but when we come to
the consideration of cause and effect, the subject becomes involved in many difficulties.
Epidemic diarrhoea is usually associated with hot weather, and to that active
influence the exceedingly high mortality from diarrhoea in the year 1895 is generally
attributed.
The condition of high temperature, however, with its influence on water, on milk,
food generally, and on various other conditions of environment, applies equally to
St. George's, Southwark, and to the whole of London. So that the summer drought of
1895 does not seem to afford an adequate explanation of the diarrhoea deaths in this
parish. Without attempting to analyse this extremely intricate and difficult problem,
it may be pointed out that diarrhoea in itself is a symptom of a disease. The
decrease in the death figures from diarrhoea may, in my opinion, be not unreasonably
attributed to the following facts:—
(1) An increased sanitary standard in your parish.
(2) A more scientific recognition on the part of medical men of the diseases
hitherto returned under the heading of diarrhoea. In conclusion, it may be
remarked there is hardly any subject brought within the scope of the Registrar
General's Department which appears to afford a more promising field for systematic
research than the scientific investigation of the mortality from diarrhoea.
Diarrhoea, like measles, claims every year its toll of victims from amongst this
teeming population. As a homely disease it would seem to have hitherto escaped a
due measure of curative and. preventive treatment. In the interest of the crowded
population of this district, I would suggest that in future diarrhoea be included in the
list of diseases to be compulsorily notified to the Sanitary Authority of this parish.
It may be as well to add that in all probability cases of typhoid fever (especially in
childen) and of advanced kidney disease are often certified as diarrhoea.
Measles,
Measles is still the most deadly complaint in your parish. It is not notified,
and so works its ravages practically unchecked. The following view of the case was
presented to your Vestry on the 4th of June, 1895*:—
The death rate from measles is high, and heads the table of mortality from
zymotic diseases, both in St. George's, Southwark, and in the whole of London.
In St. George's it has been more fatal than throughout London generally, in the
proportion of 71 to 36.
* In this Report the figures for the year 1895 have been substituted for those of 1894.