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2
Dr. Hamer's Report.
The district under the jurisdiction of the Lewisham Board of Works comprises the parish of
Lewisham and the hamlet of Penge, and extends over an area of 6,543 acres, and had at the census of
1896, a population of 104,521. The parish of Lewisham comprises 5,773 acres, and had in March,
1896, a population of 83,213. This parish includes, besides Lewisham village, the localities commonly
referred to as Blackheath, Ladywell, Brockley (part of), Catford, Forest-hill, Upper and Lower
Sydenham and Southend.
It had become apparent at the end of September, 1896, that diphtheria was showing exceptional
prevalence in Lewisham parish, and that a locality situated at the northern part of the parish was
particularly involved. Before the date of the commencement of the present inquiry (October 19th) an
area had been marked off by the officers of the Lewisham Board of Works as " the affected area," and it
was to this area that my attention was in the first instance directed. It was at once manifest that this
" affected area " had, during the preceding three or four weeks, suffered in an altogether exceptional
manner from diphtheria prevalence, and as knowledge of attacks of diphtheria which had recently occurred
came to hand, it was plain that the locality was, though in less degree, still so suffering.
The area was marked out in the first instance in quite an arbitrary manner, and it appeared,
subsequently, convenient for the purposes of statistical inquiry to deviate slightly from the boundaries
as originally defined. It was found, in fact, that the special incidence of the diphtheria had been
manifested in five of the twenty-four areas into which the Lewisham registration sub-district had been
divided in the year 1896 for the purposes of the census. These five " enumeration districts," originally
defined for census purposes, fitted with considerable exactness the area specially affected by diphtheria
prevalence, and it was obviously convenient therefore to slightly extend the boundaries of the " affected
area " as prescribed in the first instance, so as to enable the results of the census enumeration to be
made use of in connection with the inquiry.
In speaking therefore of the " affected area," it must be understood that the area comprised
by these five districts (enumeration districts Nos. 1, 2, 3, 4 and 17) is referred to. This
area extends on the north to the limit which divides Lewisham from the adjoining sanitary district of
Greenwich. In pursuing eastwards the boundary of the affected area this limiting line must be
abandoned at the point where it meets the Ravensbourne river, the course of that river followed to its
junction with the Quaggy, and the course of the Quaggy to the point where that stream crosses Highstreet,
Lewisham. The boundary then follows the High-street, but leaves it at Romer-place (including
the houses on the south side of that place) and proceeds westwards, joining the Ravensbourne just below
Riverdale-mill. It then follows the course of the river to the South Eastern Railway line, and proceeds
southwards in the direction of that line as far as Ladywell station. From this point, passing round the
southern end of Algiers-road, the western boundary of the area traverses in a northerly direction the slope
of the "Hilly-fields," and runs east of Tyrwhitt-road to the point of junction of Lewisham and Greenwich
districts.
The area thus defined comprises about ¼ of a square mile, and contained in March, 1896, 1,442
inhabited houses, with a population of 7,882 persons; the shape of the area is irregular, a general
idea of its position and surroundings must however be given. The valley of the Ravensbourne, in
the neighbourhood of Lewisham village, runs north and south, having the high ground of Hillyfields
on the west, and the slopes leading to Blackheath and Lee on the east. The Tunbridge
line of the South Eastern Railway pursues at this point a course almost parallel to the Ravensbourne,
running between the river and the ridge of high ground on its western side. The affected
area lies in the Ravensbourne valley, and is approximately rectangular in shape, the long sides of the
rectangle running north and south, in the same direction as the Ravensbourne river and the line of
railway. The river and the railway both traverse the area, the railway dividing it into two nearly
equal parts, the river lying nearer to its eastern than to its western boundary.
The area thus comprises a belt of land on the east of the river, and on the west of the river
includes a similar low-lying belt of land situated between the river and the railway. On the west of
the railway the area also includes a strip of ground of greater altitude lying between the railway
and the crest of the ridge of Hilly-fields.
The highest ground included in the area is thus at its western limit, and is for the most part
not built over, the inhabited portions of the area lying west of the South Eastern Railway are situated
at from 35 to 70 feet above Ordnance datum, while the lower lying ground on the eastern side of the
railway is, speaking generally, elevated only from 20 to 35 feet above that datum.
Over the whole of that part of the area which lies to the east of the railway line there is a superficial
deposit of river gravel. In the north-western corner of the area is situated a chalk pit in which
there is a well known exposure of the strata superimposed upon the chalk. Some of the surface ground
in this part of the area, and lying to the west of the railway line is chalk, further south the Thauet
sand, which immediately overlies the chalk, and still further south the Woolwich and Reading beds
come to the surface. In the south-western part of the area the surface soil is formed by an outlier of
the London clay. Thus over a considerable part of the affected area the subsoil is porous, and inquiries
made at several houses in which cases of diphtheria had occurred showed the walls of the ground-floor
rooms to be free from evidence of damp. Having regard to the position of the low-lying parts of the
area, it may be assumed that the ground water level is liable to sudden and considerable fluctuations,
and it appears that in times of heavy rain damage to property and inconvenience have been caused by
floods.
The houses may be broadly divided into two classes, in the first class may be placed the
houses fronting on Lewisham High-street and on Loampit-vale, and in the second class the (for the
most part) more recently constructed houses situated in streets communicating with these two main
thoroughfares. The houses of the second group are usually two storeys high, and they possess in most
cases a fair amount of space in front and at the rear. They are often occupied by more than one family ;