London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1904

[Report of the Medical Officer of Health for London County Council]

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Females.

Decennia.0.15.25.35.45.55.65 4.All ages.
1851.601,0001,0001,0001,0001,0001,0001,0001,000
1861.709359421,004991974954846962
1871.80697783881937915859705833
1881.90492572705786783755661666
1891.1900392433503667696662654544

A table published in the sixtieth report of the Registrar.General enables comparison between the
deaths at ages 10.15, 15.20, 20.25 and 25.35 in successive decennia, to be made for the provinces and
London, and it is there pointed out that at each of these ages the death rates of females in the provinces
was in excess of those in London, but that this difference was a decreasing one ; also that, in less degree,
the same disparity attaches to young males. Explanation of the difference between the death rates at
younger ages of the provincial and London populations is probably, as pointed out by Dr. Tatham, to
be found in the tendency of persons of this age, when they are not tied to town by the responsibilties
of a family to return to their homes in the country when failing in health from phthisis. Some
further explanation is, however, necessary to account for the observed fact that the difference between
the rates in the provinces and London at these ages is decreasing.
Reference to diagram XVIII. shows the decline in the mortality from phthisis in the two sexes in
London and the greater decline in the female mortality is conspicuous. The diagram also shows that
the decline has been subject to slight interruptions to which climatic conditions may perhaps contribute
this is especially suggested by diagram XIX. showing seasonal mortality, from which it will be seen that
the maximum mortality occurs at the beginning and end of the year, the mortality being at a minimum
in the summer months.
The measures which are being adopted for the prevention of phthisis mortality include the adoption
of such precautions as can be taken in view of the generally accepted opinion that the disease is communicable
from one person to another by means of the sputum of those who are suffering from this
malady. The County Council has made a by.law forbidding expectoration on the floors and walls of
public conveyances, public halls, waiting rooms and places of entertainment. Efforts are being
made to teach phthisical patients to expectorate into suitable receptacles, and sanitary authorities are
encouraging the notification to their medical officers of health of cases of phthisis occurring in their
districts. At a conference of sanitary authorities held at the County Hall in 1904, a resolution was
adopted that a system of voluntary notification is desirable and should be made general throughout
London. In London at the present time a system of voluntary notification of phthisis is established
as follows—
Districts in which phthisis is notified—
Kensington St. Marylebone Southwark
Hammersmith Islington Bermondsey
Fulham Stoke Newington Lambeth
Chelsea Holborn Wandsworth
Westminster, City of Finsbury Greenwich
Hampstead London, City of Woolwich
Districts in which phthisis is not notified—
Paddington Stepney Deptford
Hackney Poplar Lewisham
Shoreditch Battersea St. Pancras
Bethnal Green Camberwell
Thus in eighteen of the twenty.nine sanitary areas of London this system has been adopted.
The sufferers thus notified are visited and advised as to the precautions which should be taken in their
homes and when not objected to. disinfection of the premises follows removal or death.

In many of the annual reports the number of cases notified during the year is stated, and the following figures are thus supplied—

District.Number of cases notified.District.Number of cases notified.District.Number of cases notified.
Kensington203Stoke Newington53Lambeth306
Hammersmith143Holborn344Wandsworth118
Fulham165Finsbury210Greenwich123
Chelsea16Southwark323Woolwich186
Westminster, City of148Bermondsey128

In the annual reports relating to Stoke Newington and Finsbury the opinion is expressed that
much of the value of notification is lost owing to the fact that notice of the existence of the illness is
not given until it has reached an advanced stage. In some reports, moreover, the need for compulsory
notification is urged. In 1903 Sheffieldeld obtained parliamentary powers for this purpose, and
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