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

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Shoreditch 1864

[Report of the Medical Officer of Health for Shoreditch, Parish of St. Leonard]

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in the advance of general hygienic measures, which will gradually
diminish the sources of origin of the disease. Scarlatina has proved
fatal in a higher proportion in Shoreditch than in London generally.
Diarrhoea has not been unusually prevalent. This summer disease, it is
well-known, affects persons of all ages, but it is not often fatal except to
infants. Two great causes produce it,—First, defective local sanitary
conditions; secondly, atmospheric influences, checking and disturbing the
the functions of the excreting organs; to these might be added errors of diet,
such as eating unwholesome food and fruit. Diarrhoea has been rather less
fatal in Shoreditcli than in all London. Pneumonia I have classed as an
epidemic, because I have observed that in a great many instances it is
caused by living in crowded unwholesome dwellings, and exposure to
other sources of aerial poisons; still it is so closely dependent upon
cold, that we observe less fluctuation in the annual deaths, than in any
other epidemic. It is more fatal in severe winters. Hence, last year, the
deaths exceeded those of any preceeding year.
Fever.—The attention of the student of sanitary laws has always
been drawn with especial interest to Fever. In former reports, I have
dwelt with considerable detail, upon the sanitary bearings of the diseases
classed together under this title. Included in the Shoreditch register
are the fever deaths in St. Lukes' Workhouse; in this institution, are
received a large number of cases of Typhus from the Refuge. These are
therefore indicated in a separate column. The proper fever deaths in
Shoreditch exhibit a diminishing ratio since 1862. Typhus has been
unusually prevalent in London during the last three years. It is a disease
that bears a closer relation to that form of poison which arises Iron overcrowding
and destitution, than to those which depend upon bad drainage.
Typhoid, fever which is undoubtedly more intimately connected with the
sewage-poison, has been steadily diminishing in frequency. The Poor Law
Medical Officers return 854 cases of Fever; but these include necessarily
many cases of very different type, and even many which it would be impossible
to range under the specific heads of Typhus or Typhoid. 123
cases of Fever, most of them included in the just-cited returns of the
Poor Law Medical Officers, were sent to the Fever hospital at Islington.
Making allowance for these cases and other causes of disturbance, the