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of old and young persons was largest; the deaths from communicable disease, almost
entirely scarlatina and whooping cough, steadily diminished, and there were
none from small-pox or the specific fevers. Owing partly to the intermittent water
supply, partly to the laying down of some new water mains, and partly to the frost, the
quality and quantity of the drinking water we received was very objectionable, as
proved by repeated analyses I made.
In February, the scarlatina epidemic from which we, like our neighbours, had
latelv suffered, appeared to have nearly ceased—only two deaths being registered. We
had, however, a death from real typhus, and one from small-pox (vaccination
doubtful). I heard of no more illness attributable to these, but some independent
centres of small-pox were found out, all of a mild type, and when advisable, thev were
at once sent to hospital, our regular routine of prompt disinfection and isolation with
re-vaccination, being more easily adopted in all such cases, than with scarlatinal
seizures, which last offer very grave difficulties of sanitation, owing to the parents' or
friends' repugnance to the necessary preventive measures. I traced a limited outbreak
of diphtheria occurring on a certain property, to the partial water famine just alluded
to. We retrograded in health position, taking the 8th during the month. In March,
our health state greatly improved, since for that month we occupied the 2nd highest
position on the Registrar General's Report of the Twenty Towns. There was practically
no zymotic disease but small-pox, of which we had two fatal cases, both of course
unvaccinated, as I learnt by personal observation. In April, we were fortunate enough
to retain our former place of health, the 2nd highest among the "twenty towns"
Scarlatina reappeared, but was not so formidable as previously, and we had to contend
with a type of sporadic low fever, which then seemed common in South London,
respecting the precise nature of which scarcely two practitioners agreed I should have
myself returned it as "simple fever," but some of my neighbours preferred to designate
it "typhus," and I must perforce accept their diagnosis. If it was typhus, it was
typhus of an unusually mild form and not contagious, (one death alone credited to it),
and although we too often only heard of it after several days had passed without proper
active measures being taken, in no instance did it spread itself in a house.
During the summer quarter we kept our 2nd health place as formerly, although the
scarlatina curve rose and there was some infantile diarrhœa and cholera; three cases
of the latter occurred, not eight, as stated by mistake in the weekly reports of the
Registrar General, an error I pointed out to him at the time and had corrected.
Though the September total death-rate was no more than 15.5 per thousand, the
deaths from zymotic disease equalled 3.4 per thousand, diarrhœa and scarlatina being
the chief causes of the increase, but we had no small-pox nor fever.
The usual inspection of the Cow-houses and Slaughterhouses was made by me,
and you accepted my recommendation not to oppose any of the licenses about to be
applied for. Various offensive trade nuisances were, with your sanction, dealt with by
your officers, necessitating their taking proceedings in three instances at Greenwich
Police Court and obtaining a conviction in each, with the effect of subsequent
abatement.