On this day … 3 July 1886

The medical journal, The Lancet, published an article that painted Preston as the unhealthiest place to live of all the twenty-eight largest towns in England. The article was prompted by a severe epidemic of measles that had resulted in 86 deaths in just six weeks.

The article makes clear that the principal victims of this epidemic, which followed two in 1882 and 1884, and the other diseases endemic in the town were infants aged under one. And the principal cause? Poor sanitation. It was a public health scandal and the blame rested squarely on the council.

The number of deaths per thousand in Preston exceeded the average for deaths in all the large towns by 25 per cent: five deaths in Preston compared with four deaths on average in the other towns.

A gravestone in Preston cemetery recording the deaths of ten children in one family

For infants, the statistics were even more chilling. Deaths among those aged under one in Preston exceeded the average by more than a third. They were the principal victims of โ€˜summer diarrhoeaโ€™, for which deaths in Preston exceeded the average of the other towns by more than half, and enteric fever.

After 1886, the general death rate for Preston began to fall, but for infant deaths it kept on rising until the beginning of the next century. And who was to blame? Well Prestonโ€™s medical officer of health Dr Henry Ormerod Pilkington (pictured) was in no doubt:

Dr Pilkington, Preston medical officer of health in the 19th century
Dr Henry Ormerod Pilkington

โ€˜Much has been done by municipal action [to improve matters], but it is with the parents, with those who have the nursing and home management of these little ones, that the fault mainly lies โ€ฆโ€™

That quote is taken from Nigel Morganโ€™s โ€˜Deadly Dwellingsโ€™, a superb treatment of housing and public health in Preston in Victorian times.


The Lancet July 3, 1886. Volume Two, Page 26

HEALTH OF PRESTON

The borough of Preston is now suffering from a severe epidemic of measles, which caused no fewer than 86 deaths in the six weeks ending last Saturday, equal to an annual rate of 72 per 1000 of the estimated population. The epidemic commenced in February, since which 116 deaths from the disease have been registered within the borough. This fatality is the more noteworthy since epidemics of measles prevailed in this town in 1882 and 1884, causing 25 and 61 deaths respectively.

In connexion with the high death-rate from all causes that has prevailed in recent years, it is impossible not to view this exceptional mortality from measles as evidence of unsatisfactory sanitary condition.

Preston was added to the list of large towns dealt with by the Registrar-General in his Weekly Return at the beginning of the year 1882, and it appears that the mean annual death-rate in the borough in the four years 1882-5 was 269 per 1000, which was higher than the mean rate in the same period in any other of the twenty-eight large towns, and exceeded the average rate in those towns by no less than 54 per 1000.

In other words, the mortality in Preston during those four years exceeded the mean mortality in the twenty-eight towns (including Preston) by fully 25 per cent., signifying that in equal numbers living there were 5 deaths in Preston to every 4 in the twenty-eight towns.

The excess of mortality among infants in Preston was proportionally greater than the mortality at all ages. Infant mortality, measured by the proportion of deaths under one year to registered births, averaged 214 per 1000, against 160 in the twenty-eight towns, showing an excess equal to 34 per cent., or more than a third.

Summer-diarrhoea mortality in Preston was more than twice as great, and โ€œfeverโ€ mortality (principally enteric) nearly twice as great, as the mean mortality in the twenty-eight towns.

It should be stated that the present population of Preston is locally considered to be under-estimated, but even should this be to some extent the case, it would not in any way affect the excess of infant mortality measured by the proportion of deaths of infants to registered births, and the marked decline in the recorded birth-rate of the borough since 1881, is against the probability of any considerable under-estimate of its population.


Sources
https://archive.org/details/sim_the-lancet_1886-07-03_2_3279
Images of Dr Pilkington and the gravestone taken from Nigel Morgan’s Deadly Dwellings. The book was one of three that Nigel wrote on housing and health in nineteenth-century Preston. The others were Vanished Dwellings and Desirable Dwellings. The last was not published in Nigel’s lifetime. It is now on on line here: Desirable Dwellings


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