4261 THE Urban District Council of Acton. ANNUAL REPORT OF THE MEDICAL OFFICER FOR THE YEAR 1895. ACTON: Printed by J. Knowles, Market Place & Hooper's Mews. THE Urban District Council of Acton. ANNUAL REPORT OF THE MEDICAL OFFICER, FOR THE YEAR 1895. ACTON: Printed by J. Knowles, Market Place & Hooper's Mews. The Urban District Council of Acton. ANNUAL REPORT OF THE MEDICAL OFFICER FOR THE YEAR 1895. To the Chairman & Members of the Acton District Council. Gentlemen, Eighteen Hundred and Ninety-Five maintained its character for Meteorological eccentricity to the last. After nearly the coldest weather of the Century in its first three months, and the warmest on record in its last three months, it ended with a day that, so far as temperature went, would not have been considered anything exceptional in June. The severe frost caused much suffering and inconvenience to householders owing to the early freezing of the mains, and also of the pipes connecting the main with the domestic arrangements; but I trust this trouble, so far as the mains are concerned, will not 4 recur, as they have been lowered to 2 feet 6 inches below the surface, and arrangements have been made so that, should it be found necessary to turn the water off, it will only temporarily inconvenience a few inhabitants. Among other sanitary improvements may be mentioned the relaying of the Uxbridge Road and High Street with wood pavement, and the extension of the Tramway to the top of Acton Hill. The drainage of the district has received careful attention during the year. Soil Sewers were laid in Birkbeck Avenue, Wolseley Road, Creswick Road, Mill Hill Grove, portion of Avenue Road, and the Willesden Sewer from Willesden Lane to Old Oak Wharf; the total length of these sewers being 7,203 lineal feet. I am pleased to note that you contemplate securing means of dealing more satisfactorily with cases of Infectious Disease, which I find impossible to isolate. I regret that so far you have not seen the advisability of erecting a Destructor Furnace, but I trust that this important sanitary measure will again engage your attention, for I am firmly convinced that it is the only satisfactory way of dealing with dust-bin refuse, especially now that so much household rubbish which used to be burnt goes into the dust-bin, owing to the introduction of gas cooking stoves and closed kitcheners. 5 I think all the old brick dust-bins should be abolished, and superseded by the "Sanitary Bin," a portable zinc or galvanized iron receptacle; and the rule should be enforced in every household that all moist or putrescible matter be burnt. The District was almost entirely free from Zymotic disease during the months of April and May, such an immunity has not been the case for some years. We had a mild outbreak of Scarlet Fever during the Autumn and early winter months; at this time Scarlet Fever was prevalent all over London and we were fortunate in having so few cases to deal with. Influenza became epidemic in the first week of February, and continued till the middle of March, causing nineteen deaths. Many who died from diseases of the lungs probably owed their trouble primarily to this complaint. The visitation was more severe than the previous epidemics in this district, and being highly infective, spread rapidly. The further study made by the Medical Profession as to the natural history of Influenza, goes to show that it is a disease against which it is most difficult to apply measures of prevention with any substantial prospect of success. WATER SUPPLY. The supply has been constant except during the long frost previously alluded to. I take this opportunity of laying great stress on the importance (wherever there is a constant service) of drawing water used for drinking and cooking purposes, from a draw-off tap direct from the rising main, and not from the cistern where it has been exposed to warmth and pollution. 6 Recent extensive experiments have proved that the only domestic filters capable of removing all bacteria, are the PasteurChamberland and the Berkefeld. The latter is cheap, easily taken to pieces and cleaned. Charcoal cannot be too forcibly condemned as a filtering medium; forming as it does with the arrested organic matter, a veritable hotbed for the growth and multiplication of the bacteria. POPULATION. In the middle of 1895, the population was calculated to be 27,648, an estimated increase of 48 since the middle of 1894. The following table shows the number of the population and the inhabited houses at the four preceding censuses. Year. Inhabited Houses. Population. 1861. 610 3,151 1871. 1,568 8,306 1881. 2,844 17,110 1891. 4,084 24,207 BIRTHS. The total number of births registered was 874, as against 834 in 1894, an increase of 40. The Birth rate is 31.6 per thousand persons living, as against 30.2 in 1894. 7 DEATHS. The number registered throughout the year was 478; this includes 33 residents of Acton who died in Public Institutions outside the Parish. The annual death rate calculated upon a population of 27,648 was i7'2 per thousand, as against 14.2 in 1894. The average death rate for London was 194 per thousand, against 21.1, 20.3, 20.9 and 17.4 in the four preceding years. The following table shows the various ages at which death occurred in the District. Under 1 year 147 Under 5 197 1 year and under 5 50 5 „ „ 15 21 Over 5 281 15 „ „ 25 20 25 „ „ 65 132 65 and upwards 108 478 478 The following table compares the death rate of children under one year per thousand registered births, and the birth rate for the last nine years. 8 Birth Rate Per Thousand. Deaths of Children under 1 year. Per Thousand Registered Births. 1887 28.7 147 1888 31.1 182 1889 34.1 175 1890 28.3 151 1891 30.8 146 1892 30.5 185 1893 31.9 192.5 1894 30.2 160.6 1895 31.6 168.1 Researches have shown conclusively that one of the chief difficulties in the artificial feeding of infants, is in keeping the milk of the cow, or other animal, free from the contagion of bacilli, which are always floating in the atmosphere. Milk is found to be an admirable medium for the cultivation of these microbes, and the result of the infant imbibing these organisms is, that it is seized with diarrhoea and vomiting, which, unchecked speedily exhaust vitality and extinguish life. The only way to combat this evil is by sterilizing the milk, and if this were compulsory in our country as it is in some parts of America, our high infant mortality would soon be diminished. ZYMOTIC DEATH RATE. The total number of deaths registered for the principal Zymotic diseases was 67, as compared with 63 in 1894; this gives a Zymotic death rate of 2.4 per thousand. 9 In the following table the death rate and Zymotic death rate are so arranged that comparison can be made for the last eight years. 1888. 1889. 1890. 1891. 1892. 1893. 1894. 1895. Small Pox — — — — — — — — Measles 1 25 11 9 24 2 15 6 Scarlet Fever 2 1 3 4 — 10 3 3 Diphtheria 2 8 7 2 4 2 5 5 Whooping Cough 9 13 3 6 25 5 17 5 Typhoid Fever — 1 1 — 3 4 2 2 Diarrhœa and Dysentery 10 12 18 24 34 60 17 44 Puerperal Fever — — — — 1 6 4 2 Total number of Deaths} from 7 Zymotic Diseases) 24 60 43 45 91 89 63 67 Deaths from other causes 282 377 298 368 334 396 330 411 Total Deaths 306 437 341 413 425 486 393 478 Death rate from sevenl 1.09 2.8 1.9 1.8 3.6 3.4 2.2 2.4 Zymotic diseases per thousand Death rate from other causes per thousand 12.9 16.1 12.0 15.3 13.4 15.2 12 14.8 General Death rate per thousand 13.99 18.9 13.9 17.1 17 18.6 14.2 17.2 NOTIFICATION OF INFECTIOUS DISEASES. There were 161 cases notified, as against 167 in 1894. The following table gives the number reported each year since the Act came into force. 10  1890. 1891. 1892. 1893. 1894. 1895. Small Pox — — 13 7 2 — Scarlet Fever 108 63 74 192 86 67 Diphtheria 14 8 27 41 22 32 Membranous Croup 4 — 13 1 — — Typhoid Fever 13 13 15 19 15 28 Continued Fever — — — 1 — — Puerperal Fever 1 — 1 2 1 3 Erysipelas 22 18 37 77 41 31 162 102 180 340 167 161 REMARKS. I have at your request drawn up instructions to householders regarding isolation and disinfection. On receiving a Notification of Infectious Disease I forward at once a copy of the pamphlet, and I find it answers its purpose admirably and is of great assistance. SCARLET FEVER. It is satisfactory to see again a diminution in the number of cases, especially when we consider the number of poor children in the district, and the fact that an epidemic of this disease was 11 more or less prevalent all over London during the latter part of the year. There were only three deaths. DIPHTHERIA There were 32 cases notified; most of these were fortunately very slight attacks. Without a bacteriological examination, it is impossible to say whether a certain form of sore throat is not the actual disease, hence, many medical practitioners prefer to notify suspicious cases. I think the Medical Officer should be informed of the addresses of any children who might be attending school with sore throats. There were five deaths from Diphtheria during the year. TYPHOID FEVER. Twenty-eight cases were notified. One was attributed to oysters, and in others defective drainage was discovered and rectified. There were two deaths. PUERPERAL FEVER. Three cases were notified, two ending fatally; they were attended by women whose ignorance as regards cleanliness and antiseptic precautions was apparent. 12 SUMMARY OF SANITARY WORK. Visits to insure continued isolation of infectious patients 180 Rooms disinfected (bedding, &c., by super-heated steam) 83 Disinfectants supplied bottles 90 Dwellings inspected 343 House drains and sanitary fittings tested 120 Sanitary defects discovered 274 House drains taken up and reconstructed 104 Visits to inspect sanitary work in progress, and to ascertain whether notices were being complied with 666 Soil pipes ventilated 15 Soil pipes taken outside house walls 9 Waste pipes made to discharge in open air over trapped gullies 37 House cisterns removed from inside w.c. x Rain water pipes disconnected from soil drains at houses 15 Insanitary closets replaced by sanitary apparatus 82 "Sewer air intercepters" and air inlets fixed 80 Water-waste preventers for flushing closets 22 Defective roofs made good 12 Defective guttering replaced or made good 12 Dilapidated walls and ceilings repaired at houses g Complaints registered 186 13 Notices served, which were supplemented by letters and personal interviews with owners of the property 146 ORDINARY NUISANCES ABATED. Sewer manholes and road gullies 15 Smoke 2 Manure, fish offal, and other deposits 35 Cesspools abolished 11 Insanitary dwellings 9 Overcrowding 10 Cellar Flooding 16 Animals and Poultry 16 Gipsy encampments removed 20 Non-supply of water to houses 11 Receptacles for stable refuse provided 2 Piggeries abolished 5 GENERAL SANITARY INSPECTIONS. Bakehouses 20 Dairies 8 Cowsheds 73 Slaughterhouses 126 Piggeries 183 Brickfields 54 14 ARTICLES OF FOOD CONDEMNED AS UNFIT FOR HUMAN CONSUMPTION. Carcass of Beef. 3 Cases of Haddock, 1 Barrel of Herrings. 7 Cases of Plaice. A considerable quantity of Apples and Tomatoes. Believe me, Gentlemen, Yours obediently, G. A GARRY SIMPSON, Medical Officer. 7, Churchfield Road, East Acton, W.