Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Southwark, The Vestry of the Parish of St. George the Martyr]
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Parish of St. George the Martyr, Southwark.
This waste of life, in my opinion, may be traced to the following causes:—
(1) Measles, although highly infectious, is non-notifiable, and, therefore, outside
the control of your Sanitary Authority.
(2) It is generally looked upon as a mild disorder that wants little or no treatment,
whereas it requires careful isolation and nursing, as it is liable to many grave
accidents.
(3) Bad environment: measles does little harm among the well-to-do, but
among the poor it is estimated that twenty to thirty die out of every 100 attacked
by the disease.
The Notification of Measles.
With regard to this important question, I think that the compulsory notification
of cases of measles, with subsequent hospital treatment and disinfection, could not
fail to result in a great saving of life. If compulsory notification be a fit and proper
step in other zymotic disorders, such as scarlet fever or diphtheria, there is no
reason, as far as one can see, why measles, which actually claims a greater number
of victims, should not also be notifiable.
During the year 1895 measles caused 71 deaths in your parish, whereas scarlet
fever killed 14, diphtheria 19, typhoid 9, and small-pox 0. In London, during the same
period, 2,632 deaths resulted from measles and 55 from small-pox. If measles were
included under the list of notifiable diseases, no doubt a large increase of hospital
accommodation would be required, at any rate for several years to come. Into that
aspect of the case, however, it is not my duty to enter. As your Medical Officer I
have only to point out that in measles we find an ever-increasing course of avoidable
death in this parish, and one which, in my opinion, would be materially reduced if
dealt with in the same manner as most other infectious diseases.
To some extent a precisely similar line of reasoning applies to whoopingcough,
which during the year 1895 was answerable for 56 deaths in St. George's, as
against 1,483 in London.
The affection is highly infectious, liable to lung complications, and is regarded
by parents as a trifling disorder, requiring little or no treatment.
Decreased Parish Mortality from Diphtheria.
There has been a remarkable falling off in deaths from diphtheria. During
last year (1895) the total cases were 19 only, as againt 49 for the preceding year. In
St. George's it has been less fatal than throughout London generally, in the proportion
of 19 to 31.
The Salvation Army Shelter.
This institution, as I mentioned in last year's report, was founded by Mr.
Booth for the night shelter of poor persons. Although, no doubt, started on
philanthropic lines, a charge is made for accommodation, and there is no attempt to
disguise the fact that enterprises of a similar kind are not only self-supporting, but
are even carried on at a profit. Notwithstanding this commercial aspect of the
case, in the Court of Appeal, Her Majesty's Judges decided that these Shelters did
not fall within the regulations of the Common Lodging Houses Act. Another
judicial decision showed that such institutions did not come under the Public Health
(London) Act so far as disinfection was concerned. On that occasion Mr. Justice
Wills said that "the case was clearly one in which the Act ought to apply, but
does not."
Table V.
Years. | St. George, Southwark. | London. |
---|---|---|
Death-rate per 1,000. | Death-rate per 1,000. | |
1841—50 inclusive | 30 | 25 |
1851—60 ,, | 27 | 24 |
1861—70 ,, | 27 | 24 |
1871—80 „ | 25.2 | 22.4 |
1881—90 „ | 25.0 | 20.5 |
1892 | 25.2 | 20.3 |
1893 | 27.6 | 21.3 |
1894 | 23.9 | 17.7 |
1895 | 23.7 | 19.7 |