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Annual Report Medical Officer of the of Health—1896. 9
It may, therefore, ho confidently hoped that within the next twelve months this
most desirable public institution will be available for the poor of your parish.
The mortality from measles, diarrhoea, and whooping cough 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.
Measles.
Measles is still the most deadly complaint in your parish. It heads the table of
mortality from zymotic diseases, both in St. George's, Southwark, and in the whole of
London.
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 hundred
attacked by the disease.
The Registrar-General, in his Annual Summary for 1896, says:—"Measles was the
certified cause of 3697 deaths (in London) during the year; these deaths being equal to
a rate of 0.82 per 1,000, as compared with 0.61, the decennial average rate. In London,
measles appears to have been more fatal last year than in any previous year on record,
with the single exception of the year 1864. Amongst metropolitan sanitary areas the
lowest rates were 0.15 in Stoke Newington, 019 in the City of London, and 0.33 in
St. Margaret, Westminster; the highest rates were 1.26 in St. George, Southwark,
1.33 in St. James, Westminster, 136 in St. Marylebone, and 1.71 in Woolwich."
As frequently pointed out by me before, I think that the compulsory notification
of cases of measles throughout London, with subsequent hospital treatment and
disinfection, could not fail, in a poor parish like St, George's, to result in a great
saving of life.
Increased Parish flortality from Diphtheria.
There has been an increase in deaths from diphtheria. During 1895 the total
cases were 19 only, as against 49 for the previous year, but the number has risen to 26
(not including 13 cases notified as membranous croup) in 1896. In St. George's it has
been less fatal than throughout London generally, in the proportion of 26 to 36. An
outbreak in Cornbury Street is dealt with in a special report, to be found in Appendix
In that report the means of prevention are discussed.
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."