THE ANNUAL REPORT
ON
THE HEALTH
OF THE
Parish of St. Mary Abbotts,
KENSINGTON,
DURING THE YEAR
1874.

To the Vestry of the Parish of St. Mary Abbott’s, Kensington.

Gentlemen,

DEATH RATE, 1874.

Under the heads of the various diseases, and in Tables 3 and 3a (Appendix), I have specified in detail the causes of death; but in these introductory general remarks it will not be out of place to refer to the mortality in the parish as a whole from some of the principal classes and orders of diseases.  Thus the seven principal diseases of the zymotic class (or rather six, for there was no death from small-pox) were accountable for 388 deaths—a mortality equivalent to 2.8 per 1,000 persons living, and to 144 out of every 1,000 deaths.  Chest diseases, other than phthisis, killed 554 persons (an increase of 71 over 1873), equivalent to 4 per 1,000 of the population, and to 208 per 1,000 deaths.  Tuberculous diseases (including phthisis, scrofula, rickets, and tabes) were the causes of 326 deaths, or 2.3 per 1,000 living, and 121 per 1,000 deaths.  Nearly allied to these diseases, if not identical in origin, are the wasting diseases of children, viz., those registered as marasmus, atrophy, debility, want of breast milk, and premature birth.  These killed 209 children under five years of age, equal to 1.5 per 1,000 living, and to 77 per 1,000 deaths.  The convulsive diseases of infants (hydrocephalus, infantile meningitis, convulsions, and teething) were fatal to 161 infants under five, or 1.1 per 1,000 living, and 59 per 1,000 deaths (vide Table 4, Appendix).  Constitutional diseases caused 591 deaths = 4.2 per 1,000 living, and 232 per 1,000 deaths.  Local diseases caused 1,143 deaths = 8.3 per 1,000 living, and 434 per 1,000 deaths.  Developmental diseases caused 356 deaths = 2.5 per 1,000 living, and 138 per 1,000 deaths.  Violent deaths (50) were equal to .3 per 1,000 living and to 18 per 1,000 deaths.  The deaths of which the causes were not specified, or were ill-defined, were 22 in number = .1 per 1,000 of the population and 7 per 1,000 deaths.

Upon enquiry being made of the dairyman who supplied the affected families with milk, he acknowledged that two, if not three, of his cows were “wrong in their quarters”—i.e., they had diseased udders; but he hoped that the small amount of bad milk they yielded would not be felt with the large quantity of good milk with which it was mixed!  In each case the supply of milk from that particular dairy was cut short, and as regards the families interested, a limit was thus set to the endemic.  But what mischief, if any, was done in other directions does not appear, and it is too late to enquire.

The other cases referred to were eleven of diarrhæa, which occurred at about the same period of time.  The milk supply was derived in part from a dairy and in part from cows kept for private use, the one point in common between the two sheds being that “distillers’ wash” formed part of the food of the cows.  There is no history of any illness or disturbance of the secretion of the cows themselves.

I regret that I had not an opportunity of investigating these cases—and especially the first series—at the time of their occurrence, as they might have thrown some light on an obscure but very important, an increasingly important subject—viz., that of disease in animals as a factor of disease in man.  Professor Parkes states, inter alia, that milk contaminated with pus from an inflamed udder will give rise to stomatitis (inflammation of the mouth) in children and to apthæ (thrush) on the mucus membrane of the lips and gums.  But there is no mention of these symptoms in the cases under review.  Parkes also refers to the power of milk which contains large quantities of the fungus Oidium lactis, or Pennicillium, to produce dyspeptic symptoms, and even cholera-like attacks.  Gastric irritation and febrile gastritis are also enumerated among the effects following the ingestion of impure milk.

In the case before us, it would appear that the dairyman knew that some of his cows were “wrong in their quarters,” and yet, though their milk could be of small value (for disease diminishes the yield rapidly and greatly), families were exposed to the risk of illness, and in one case the calamity of death was brought on a household, that no portion of the profits of business might be lost.  We may charitably and reasonably believe that the dairyman anticipated no such consequences; but what so likely to prevent the recurrence of such a catastrophe as a consciousness of the risk incurred by vending diseased milk?

Before quitting this subject I may express my opinion that dairies are multiplied more than is desirable, and as a consequence (I have adverted to the subject in another part of this report), the sheds are often of a very unsatisfactory character.  Large dairies, under careful supervision, managed with a due regard to sanitary requirements in man and animals, and situated in the suburbs or outskirts of the metropolis, would be a boon the value of which is likely to be the more appreciated as facts such as those noted above accumulate.

POPULATION, &c.

The estimated population of Kensington at the middle of the year was 138,000, an increase of 5,000 over 1873.  The Town sub-district contained about 105,000, and the Brompton sub-district about 33,000 in round numbers.  The males numbered about 56,240, and the females 81,760:—excess of females over males, 25,520.  In every 1,000 there were approximatively 407 males and 593 females.  The subjoined table shows the number of persons of each sex, arranged in groups of ages, at the Census, 1871:

AGES OF MALES AND FEMALES, 1871.

The superficial area of the parish is 2,190 acres, viz., 1,497 in the Town sub-district, and 639 in Brompton.  Some 300 or 400 acres are still uncovered by buildings.  The density of the population is about 74 persons to an acre.  The total number of houses, including empties and those in course of erection, slightly exceeds 20,000.  The inhabited houses at the middle of the year were about 17,667, an increase of 747 over the previous year.  There were about 7.8 persons to each house on an average throughout the parish; but at the census, 1871, it appeared that the average in the Brompton Sub-district was only seven.

The subjoined table is of interest, showing as it does the remarkable growth of the parish in wealth and population during the present century:

MARRIAGES.

The marriages celebrated during the year were 1,311; one marriage to 105.2 of the population.  Nineteen persons were married out of every 1,000 living.  The marriage rate in all England in 1872 (last year of publication) was 17.5.  The marriages in Kensington were celebrated as follows:

The marriages in the three previous years were: 1871, 1,131; 1872, 1,132; 1873, 1,241.

BIRTHS.

The births registered—registration not being compulsory—were 4,351.  The annual birth rate in Kensington was 31.7 per 1,000 persons living, and in the Metropolis 35.7.  The births in the Town sub-district were 3,536, and in Brompton 815: 2,216 males and 2,135 females were born.  The males formed about 51, and the females 49 per cent of the births—104 males being born to 100 females: about the same proportion as in all England.  One child was born to 31.6 of the population.  The birth rate in the Town sub-district was 33.6, and in Brompton 24.8 per 1,000.  The deficient birth rate, as compared with that of the Metropolis and England, is the result of the great disproportion in the relative number of the sexes already alluded to; the rate, however, is slightly increasing, as may be seen by reference to Tables 1 and 2 (Appendix.)

The subjoined table shows the quarterly number of births in each sub-district:

DEATHS.

The deaths under one year of age (762) bear the proportion of 17.5 per cent. on the registered births (London 15.5), and they were equal to 28.5 per cent. of the total deaths (London 24.6.)  The deaths under five (1,188) were equal to 27.7 per cent. on the number of births, and to 45.4 per cent of the total deaths; the relative proportions in all London being 26.3 and 41.6.  The deaths at 60 years of age and upwards (582) formed 21.7 per cent. of the total mortality in Kensington, the relative proportion in all London being 21.6.

Impressed with the imperfections of mere general death rates and proportional relations as given above, I have, at considerable labour, estimated the population in groups of ages, and worked out the death rate for each group—showing the number of deaths per 1,000 persons living, as follows:

It must be obvious that the truest mode of calculating death rates is that used in the above Tables, and the result of such calculations is by no means unfavourable to the character for salubrity of the parish of Kensington.  Did time permit of following out the method for the sexes, and in the two sub-districts, the results would, I doubt not, be very much more favourable for Brompton, and for the female sex, than they are for the entire parish, and for both sexes.

SPECIAL CAUSES OF DEATH.

Zymotic Diseases.—The deaths from the seven principal diseases of the zymotic class, named below, were 388 in number, viz.: 332 in the Town sub-district and 56 in Brompton, an increase of 98 over the previous year: 96 of the additional deaths belonging to the Town sub-district.  Nevertheless, the mortality from these maladies was little above the average of the previous 10 years (380), and considerably below the corrected number, after due allowance for the increase of population.  The deaths were equivalent to 2.8 per 1,000 persons living, and to 144 per 1,000 deaths, as against an average of 178 in the 10 years 1864–73.  The deaths in London in 1874 from the same diseases were 147 per 1,000 deaths, and in all England in 1872 (the latest year of publication), 188.

Deaths from the seven principal Zymotic Diseases.

Scarlet Fever was fatal in 32 cases—an increase of 22 over the mortality of the previous year.  28 of the deaths took place in the Town sub-district, and 4 in Brompton—21 of the victims being under 5 years of age.  The disease was, to a certain extent, epidemic in the Autumn, and, fears being entertained that it might spread, through the agency of the Board Schools, precautions were taken by the London School Board, acting on the suggestions I laid before your Vestry, to prevent children attending school from infected houses.  The evil blew over as the winter advanced; but, in accordance with the usual course of epidemic scarlet fever, a more severe outbreak may be looked for during the current year, the signs of which are not wanting at the present writing.

“The child died at the end of the second week, and the existence of scarlet fever in the house became known to us only on the registration of the death: too late, in fact, for the mischief was done.  The two rooms occupied by this family contained seven persons, viz., the parents and five children.  Successively the father and two more children fell sick, and were removed to the hospital, where they are all doing well.  The rooms and clothing were disinfected, and the mother and two remaining children were reluctantly compelled to leave the house; but no sooner had they done so than the elder child fell sick, and was sent to the hospital.  The mother and her infant are at present well.  The day following the burial of the deceased child another family of nine persons left the house.  They have been traced, and two children found to be ill.  They are tolerably well isolated, however, and seem likely to do well.  I am trying, nevertheless, for the sake of the rest of the family, to have them removed.  The lessons taught by this story are too obvious to need recapitulation; I will only observe, therefore, what the facts have strongly suggested to my own mind, viz., that among the many requirements in sanitary legislation, none is more needed than power to provide quarantine for the apparently healthy members of poor families in which infectious disease has broken out.”