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Annual Report of the Medical Officer of Health—1895.
11
The need of an extension of the powers of your Local Authority in dealing with
shelters of the kind may be judged from the following considerations:—
(1) In 1893 thirty-one cases of small-pox were referred, directly or indirectly,
to the Blackfriars Army Shelter, and nine such cases in 1895.
(2) The overcrowding which is clearly shown in the two Special Reports on the
subject (for which see page 26 of the Appendix). For my own part, as your responsible
Medical Officer, so long ago as 1892 I felt it my duty to point out that the presence of
a Shelter, in the midst of this crowded district, constituted a real danger to the rest
of the community—that is to say, in the absence of thorough and efficient control.
Respiratory Diseases.

In 1892 the total mortality under this heading was 539, which fell to 419 in 1893,
and to 363 in 1894, and has risen to 394 in 1895. This rate is above that of the
whole of London. The excess may, I think, be traced to the overcrowded state of
the parish, both as to tenements and to workshops, and to the number of indoor
occupations which predispose to respiratory diseases.
A good deal of the mortality among young children is due to lung troubles, which
often follow measles and whooping cough.
The returns of deaths from consumption are not so heavy as one would expect in
so densely crowded and poverty-stricken a district. At the same time it should be
noted that the registrars have to depend for these figures on the death certificates,
and there can be no doubt that a certain number of cases are not correctly described.
This applies especially to alcoholism, and to such hereditary and constitutional disorders
as syphilis or consumption.
Mortality of Infants and Children.
The death-rates of infants under one year, and of children under five years, afford
valuable indirect evidence of the sanitary well-being of a community.
By this I do not mean that all preventable infant and child mortality is to be
attributed to defective sanitation. Other factors—to be mentioned further on—
doubtless play a considerable part in either destroying or crippling the lives of these
slum-bred children.
The fact remains, however, that the most sensitive test of the sanitary condition
of a district lies in the death-rate prevailing among its young population. During
1895 the number of infants who died within the first year of life in St. George's
was 452. These figures give the high rate of 208 deaths to every 1,000 births in St.
George's, as compared with 165 deaths per 1,000 births for London. The average
rate for the four years 1892-3-4-5, for St. George's, was 206, and for the Borough
Road Sub-district 235, as against 155 for London.