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10 Parish of St. George the Martyr, Southwark
(1) Poverty.
(2) Mode of feeding of infants.
(3) Maternal neglect and carelessness in infant management.
(4) Unwholesome or improper place of storage for food and vessels connected
with food.
The main suggestions to be made are to provide
(1) Sound drainage system both of houses and of subsoil.
(2) Impervious flooring to houses, so as to exclude ground air.
(3) Free ventilation inside and outside houses.
(4) Careful storage of food.
(5) Systematic inspection of dairies, cow sheds and dairy farms.
(6) Boiling of milk, especially in summer.
(7) Education of mothers as to the proper way of rearing infants.
Measles.
Measles is the next most deadly complaint in your parish, and leads to a waste
of life which, 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.
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.
Diphtheria Mortality.
There has been a further increase in deaths from diphtheria. In 1895 there
were 19 deaths, 26 in 1896, and 28 in 1897. (These figures including membranous
croup, according to the method of the Registrar-General.)
There can be no doubt that the density of population has a considerable influence
upon the prevalence of this disease. Keeping that point in view and the further fact
of its incidence upon children, it would be prudent, I think, to consider the desirability
of the frequent and systematic inspection of all schools. It is in such places that
early and undetected cases of diphtheria, in the sore-throat stage, are to be found
under circumstances that afford every opportunity for the spread of infection.
In a special report on the Cornbury Street outbreak of diphtheria included in my
Annual Report of 1896, I pointed out the value and necessity of obtaining an early
diagnosis in doubtful sore-throat. From that special report the following passage may
be quoted:—"Early Diagnosis.—It is well known to medical men that some cases of