BAT 1 The Destry of the Parish of st. Mary, Battersea. REPORT upon the PUBLIC HEALTH AND SANITARY CONDITION OF The Parish of St. Mary, Battersea, DURING THE YEAR 1893, BY W. H. KEMPSTER, M.D., MEDICAL OFFICER of HEALTH. 1894. London : hitchcock, printer, streatham With the Compliments of the Medical Officer of Health. The Destry of the Parish of st. Mary, Battersea. REPORT ^^ upon the PUBLIC HEALTH AND SANITARY CONDITION of f ^ pamf| itf llUrg, Trntkma, DURING THE YEAR 1893, BY W. H. KEMPSTER, M.D., MEDICAL OFFICER of HEALTH. Fellow and Member of Council of the Incorporated Society of Medical Officers of Health & Treasurer of the Metropolitan Branch. Fellow and Member of Council of the British Institute of Public Health. Fellow of the Obstetrical Society. 1894. to the Destry of the Parish of st. Mary, Battersea. Gentlemen, An essential preliminary to the determination of the mortality and other rates for the parish of Battersea during the year 1893, is to ascertain the mean or average population which existed during that year. The annual increase of population in the parish between the census enumerations of 1881 and 1891, was 4,319 persons. If to the ascertained mean population for 1892, which was 155,856, the above number be added, a mean population for the year 1893 of 160,175 will result. Upon these numbers the various calculations which follow are based. It will be useful, and certainly interesting, to state the following facts with reference to the Metropolis at large as a preliminary, in order to have some standard by which to judge the various rates which are found to have existed in Battersea during 1893. The estimated mean population of the Metropolis when calculated in the usual manner, will be found to have reached in 1893 the enormous number of 4,306,411. The number of births registered during 1893, as returned by the Registrar General in his weekly returns, was 132,965, which, calculated by the estimated mean population given above would give a bijrth-rate equal to 31 per thousand for the year as the rate for London. 2 The deaths similarly recorded during the year 1893 num. bered 91,536; which, upon the same population, would give a death-rate for the year for the whole Metropolis of 21.3 per thousand. As it will be shown in the following pages that the birthrate for Battersea during 1893 was 32.6, and the death-rate, including non-parishioners in public institutions existing within the parish was 17.4, it follows that the birth-rate of Battersea was 1.6 per thousand above that of London, while the deathrate was 3.9 per thousand below the Metropolitan rate amongst persons dying in the parish, whether belonging thereto or not. During the year 1893 the deaths which took place within the boundaries of the parish, including all non-parishioners dying in the Union Infirmary and elsewhere, are shewn in Table A of mortality and may be thus summarised. East Battersea 1,159 West Battersea 1,278 (excluding public institutions) Wandsworth and Clapham Union Infirmary— (a) Parishioners 162 355 (b) Non-Parishioners 193 Polingbroke Hospital— (a) Parishioners 1 6 (b) Non-Parishioners 5 Masonic School— (a) Parishioners 1 1 (b) Non-Parishioners — Emanuel School— (a) Parishioners 1 2 (b) Non-Parishioners 1 Total 2,801 3 The resulting gross death-rate would be 17.4 per thousand for the year, being 0.2 above the death-rate for the last two years —1891 and 1892—which was 17.2; the death-rate for the ten years last past, having averaged 18.3 per thousand, showing that the mortality for 1893 was below that average. Deaths occurring within the parish, of persons not belonging thereto: In the Union Infirmary 193 In the Bolingbroke Hospital 5 In the Emanuel School i Elsewhere (in River Thames and Public Streets, &c.) 5 Total 204 It will be observed that two hundred and four nonparishioners died within the limits of the parish during 1893; eliminating these by relegating them to their respective parishes it is necessary to determine the number of Battersea parishioners who died in the various hospitals and other public institutions of the Metropolis and elsewhere. Deaths occurring outside the parish, of persons belonging thereto: Union Workhouse, Wandsworth 7 General and Special Hospitals 216 Metropolitan Asylums Board Hospitals 122 County and other Lunatic Asylums 28 Elsewhere (including River Thames) 4 Total 377 These tables shew that three hundred and seventy-seven persons belonging to Battersea died elsewhere; if the two hundred and tour non-parishioners be deducted from the year's mortality of 2,801, and the three hundred and seventy-seven be added thereto, there will be a total mortality of 2,974, which is equal to a corrected death-rate of 18.5 per thousand. This is Table A of Deaths during the Year 1893 in the Urban Sanitary District of Battersea, classified according to Diseases, Ages and Localities. Names of localities adopted for the purpose of these Statistics, Public Institutions being shewn as separate localities, [a] Mortality from all causes, at subjoined Ages. [i] Mortality from subjoined causes distinguishing Deaths of Children under 5 Years. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 At all [b] Under 1 year. [c] and under 5 [d] 5 and under 15 [e] 15 and under 25 [f] 25 and under 65 [g] 65 and upwards. [h] Small Pox. Scarlatina. Diphtheria. Membraneous Croup. fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa and Dysentery. Rheumatic Fever. Ague. Phthisis. Bionchitis, Pneumonia & Pleurisy Heart Disease, Injuries. All other Diseases. Total.  Typhus, j Enteric or Typhoid. Continued. Relapsing. Puerperal. East Battersea 1159 378 254 64 44 272 147 Under 5 6 25 1 70 44 50 1 7 153 5 13 257 632 5 upwards 3 12 7 8 2 7 2 5 7 74 148 45 30 177 527 West Battersea 1278 445 187 61 43 344 198 Under 5 7 32 1 7 13 59 56 1 129 20 307 632 5 upwards 1 19 6 7 7 6 5 5 84 159 64 27 256 646 Wandsworth & Clapham Union Infirmary St. John's Hill 355 19 13 3 16 175 129 Under 5 4 10 2 6 10 32 5 upwards 1 10 1 1 67 58 45 12 128 323 Bolingbroke Hospital, Bolingbroke Grove 6 .. 1 .. 1 3 1 Under 5 1 1 5 upwards 1 4 5 Westminster Union School, St. James' Road .. .. .. .. .. .. .. Under 5 5 upwards Emanuel School, Battersea Rise 2 .. .. 1 .. 1 .. Under 5 5 upwards 1 1 2 Masonic School for Girls, Battersea Rise 1 .. .. 1 .. .. .. Under 5 5 upwards 1 1 Whole Parish 2801 842 455 130 104 795 475 Under 5 13 57 1 8 83 107 116 1 10 288 5 33 575 1297 5 upwards 4 33 13 16 19 7 8 11 13 225 365 155 69 566 1504 The subjoined numbers have also to be taken into account in judging of the above Records of Mortality. Deaths occurring outside the district among persons belonging thereto 377 63 86 59 31 122 16 Under 5 7 13 57 3 2 7 22 6 3 29 149 5 upwards 5 2 29 8 1 2 1 1 33 21 22 18 85 228 Deaths occurring within the district among persons not belonging to 20 10 8 3 8 88 87 Under 5 2 6 4 6 18 5 upwards 1 1 7 1 33 30 25 10 78 186 5 the highest death-rate which can be attributed to Battersea, and there can be no doubt that many of the so-called parishioners who die elsewhere do not belong to the parish at all, but are employed and reside in other parishes, but when ill and admitted to Hospital give the residence of their parents and family in Battersea as their place of abode. The death-rate for the Metropolis for 1893, based upon 91,536 deaths in an estimated mean population of 4,306,411, was 21.3 per thousand showing a difference in favour of Battersea of 2.8 per thousand, after making allowances for the above corrected death-rates. Table A. This table is compiled uniformly in all sanitary districts by direction of the Local Government Board. The broad grouping is the mortality below five years, the infantile period of life, and above that age. Under five years, twelve hundred and ninety-seven deaths took place, or forty-six per cent, of the whole mortality. This shows an immense reduction of infantile mortality, which some years ago was usually sixty to sixty-four per cent, of the total mortality. Sanitarians have always deplored the enormous waste of life among very young children and the notable reductions of the proportional number of deaths at this age would seem to give evidence of improved sanitation and more intelligent care on the part of parents. On the other hand three hundred and eightyfive young children under five died from the principal zymotic diseases, against one hundred and ten at all other ages. It is evident that much remains to be done to protect the very young in this direction. Table I. In this table particulars are given of the deaths of Battersea parishioners in the various public institutions of the Metropolis. The particular institution in which death occurred whether within or without the parish is indicated, together with immediate cause of death, and these details require no comment. 6 TABLE I. Deaths of Battersea Parishioners in Public Institutions of the Metropolis. DISEASE. Totals Sex. Age. Institutions. Elsewhere Males Females Under 1 year 1 to 5 years All under 5 5 to 15 years 15 to 25 years 25 to 65 years 65 and upwards Union Infirmary. General and Special Hospitals Asylums' Board Hospitals County and other Lunatic Asylums Small-Pox 12 7 5 4 3 7 2 2 ... 1 ... 1 11 ... ... Scarlatina 15 10 5 1 12 13 2 ... ... ... ... ... 15 ... ... Diphtheria&Membranous Croup 86 49 37 7 50 57 25 2 2 ... ... 2 84 ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... Enteric & Typhoid 8 4 4 ... ... ... 4 4 ... ... ... 3 5 ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing „ ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal „ 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 8 5 3 2 1 3 ... ... 3 2 4 4 ... ... ... Measles 3 ... 3 ... 2 2 1 ... ... ... ... 3 ... ... ... Whooping Cough 2 1 1 2 ... 2 ... ... ... ... 2 ... ... ... ... Diarrhœa 12 7 5 11 ... 11 ... ... ... 1 4 8 ... ... ... Other Zymotics 4 1 3 ... ... ... ... ... 1 3 4 ... ... ... ... Rheumatic Fever ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 62 39 23 ... ... ... ... 11 49 2 29 27 ... 6 ... Tubercular 13 8 5 7 1 8 4 ... 1 ... 5 7 ... 1 ... Respiratory 76 41 35 12 12 24 2 4 32 14 33 40 3 ... ... Heart Disease 53 29 24 3 3 6 5 6 21 15 25 26 ... ... 2 Brain and Nerves 57 33 24 4 2 6 7 4 30 10 17 23 ... 17 ... Cancer 23 9 14 ... ... ... ... ... 22 1 9 14 ... ... ... Violence 24 19 5 ... 3 3 3 3 14 1 3 19 ... ... 2 Other Diseases 80 40 40 19 3 22 5 5 36 12 33 40 3 4 Total 539 237 302 72 92 164 60 41 212 62 169 217 121 28 4 7 The four deaths recorded as having occurred "elsewhere" are here definitely located : Male Army Clothing Stores, Pimlico. „ Pumping Station, „ ,, River Thames, near Vauxhall Pier. Female Chelsea Basin, Chelsea. In all five hundred and thirty-nine deaths occurred in public institutions, and those occurring without the parish are accounted for in Table I. The large majority were adults, as might be anticipated. One hundred and sixty-nine deaths of parishioners took place in the Union Infirmary, situated within the parish; two hundred and sixteen in the general and special hospitals of the Metropolis, one hundred and twenty-two in the Metropolitan Asylums Board Hospitals, twenty-eight in lunatic asylums, and four " elsewhere." Tables II and III give in tabular form the weekly returns of the district Registrars for East and West Battersea respectively during the year 1893. They show at a glance the incidence of births and deaths during the various periods of the year being for convenience of reference grouped in quarters. The births vary but slightly in numbers from quarter to quarter. The deaths in the whole parish were as follows: 1st Quarter 753 2nd „ 570 3rd „ 682 4th „ 796 Total 2,801 8 The first and last quartet's usually are characterised by a higher mortality than the spring and summer quarters, as in the colder periods of the year an excessive mortality occurs from diseases of the respiratory system. TABLE II. BIRTHS AND DEATHS, EAST BATTERSEA, 1893. Week ending:— BIRTHS. DEATHS. M. F. Total. M. F. Total. 7th January 19 18 37 24 20 44 14th ,, 27 26 53 19 14 33 21st ,, 29 36 65 13 17 30 28th ,, 25 23 48 7 10 17 4th February 21 29 50 11 7 18 11th „ 28 29 57 5 13 18 18th „ 22 22 44 12 9 21 25th „ 22 31 53 13 11 24 4th March 25 30 55 11 10 21 11th „ 28 22 50 8 13 21 18th ,, 24 32 56 5 7 12 25th ,, 25 26 51 12 7 19 1st April 31 29 60 11 18 29 1st Quarter 326 353 679 151 156 307 8th April 15 26 41 12 6 18 15th ., 22 35 57 13 11 24 22nd „ 23 30 53 13 6 19 29th 33 19 52 5 4 9 6th May 24 14 38 5 11 16 13th ,, 19 25 44 5 8 13 20th „ 26 28 54 8 6 14 27th „ 17 18 35 4 2 6 3rd June 27 16 43 9 4 13 10th 28 20 48 3 9 12 17th 18 18 36 9 7 16 24th 30 15 45 13 9 22 1st July 18 20 38 7 8 15 2nd Quarter 300 284 584 106 91 197 9 Births and deaths, East BattersEa, 1893, continued— Week ending BIRTHS. DEATHS. M. F. Total. M. F. Total.  8th July 17 23 40 6 12 18 15th „ 16 19 35 16 16 32 22nd „ 26 20 46 16 11 27 29th „ 23 17 40 14 11 25 5th August 26 21 47 12 19 31 12th „ 23 26 49 12 7 19 19th ,, 28 28 56 11 12 23 26th „ 27 17 44 10 7 17 2nd September 23 24 47 14 10 24 9th „ 21 15 36 6 11 17 16th „ 26 22 48 10 14 24 23rd „ 20 26 55 10 6 16 30th 13 30 43 13 11 24 3rd Quarter 298 288 586 150 147 297 7th October 21 38 59 9 5 14 14th „ 16 28 44 7 8 15 21st „ 24 27 51 12 6 18 28th „ 20 18 38 3 13 16 4th November 26 16 42 10 15 25 11th „ 20 17 37 10 11 21 18th „ 29 21 50 21 21 42 25th „ 22 16 38 18 24 42 2nd December 21 16 37 17 14 31 9th th „ 18 24 42 17 20 37 16th „ 16 18 34 25 22 47 23rd „ 15 20 35 5 17 22 30th „ 25 18 43 15 13 28 4th Quarter 273 277 550 169 189 358 Whole Year 1,197 1,202 2,399 576 583 1,159 10 TABLE III. . BIRTHS AND DEATHS, WEST BATTERSEA, 1893. Week ending:— BIRTHS. DEATHS. M. F. total. M. F. total. 7th January 23 27 50 15 33 48 14th „ 34 23 57 22 27 49 21st 33 28 61 17 16 33 28th „ 21 22 43 13 18 31 4th February 33 18 51 18 15 33 11th 32 26 58 15 13 28 18th 30 21 51 19 11 30 25th „ 26 29 55 27 9 36 4th March 20 21 41 20 29 49 11th „ 35 27 62 13 13 26 18th ,, 33 30 63 18 15 33 25th 24 32 56 12 17 29 1st April 31 33 64 11 10 21 1st Quarter 375 337 712 220 226 446 8th April 24 34 58 14 21 35 15th „ 22 34 56 19 14 33 22nd „ 30 37 67 11 22 33 29th „ 34 23 57 17 16 33 6th May 23 34 57 12 15 27 13th „ 33 28 61 9 15 24 20th „ 26 22 48 10 10 20 27th „ 20 17 37 16 13 29 3rd June 25 36 61 9 10 19 10th „ 25 35 60 21 10 31 17th „ 27 39 66 9 13 22 24th „ 31 29 60 19 17 36 1st July 29 20 49 16 15 31 2nd Quarter 349 388 737 182 191 373 11 Births and Deaths, West Battersea, 1893, continued. Week ending:— BIRTHS. DEATHS. M. F. total. M. F. total.[/##] 8th July 18 22 40 15 17 32 15th ,, 35 31 66 18 13 31 22nd „ 29 27 56 18 15 33 29th „ 32 25 57 9 12 21 5th August 21 26 47 15 17 32 12th „ 24 23 47 12 10 22 19th „ 32 29 61 16 15 31 26th „ 28 36 64 20 14 34 2nd September 33 28 61 13 20 33 9th ,, 36 24 60 18 10 28 16th „ 30 27 57 6 14 20 23rd „ 27 32 59 13 16 29 30th „ 28 14 42 23 16 39 3rd Quarter 373 344 717 196 189 385 7th October 31 34 65 14 12 26 14th „ 28 22 50 12 14 26 21st „ 21 34 55 13 9 22 28th „ 34 24 58 10 15 25 4th November 31 21 52 15 22 37 11th „ 32 25 57 21 14 35 18th „ 31 20 51 13 20 33 23th „ 24 26 50 15 18 33 2nd December 20 17 37 23 19 42 9th „ 21 23 44 20 17 37 16th „ 36 32 68 26 27 53 23rd „ 12 27 39 18 19 37 30th „ 18 16 34 9 23 32 4th Quarter 339 321 660 209 229 438 Whole Year 1,436 1,390 2,826 807 835 1642 12 TABLE IV. Return of Births and Deaths with other particulars as to the mortality during the several quarters of the year 1893. Battersea. 1893 Births Deaths Deaths. Small Pox Measles Scarlet Fever Diphtheria Whooping Cough Fever Diarrhoea Cholera Violence Inquests Public Institutions (including Nonparishioners.) Under 1 Year. Above 60 Years 1st Quarter E 679 307 78 70 .. 12 2 7 15 3 2 .. 9 26 .. W 712 446 122 122 •• 4 2 8 29 .. 8 .. 17 34 84 2 nd Quarter E 584 197 66 27 .. 15 1 3 13 1 7 .. 15 29 .. W 737 373 107 83 .. 3 .. 5 25 2 15 2 10 26 96 3rd Quarter E 586 297 126 38 .. 16 4 10 9 1 37 1 7 18 .. W 717 385 131 81 .. 3 3 20 12 2 38 3 11 22 84 4th Quarter E 550 358 108 68 .. 34 2 18 9 2 7 1 12 40 .. W 660 438 104 129 .. 3 3 19 3 3 6 .. 21 42 99 Whole Year E 2399 1159 378 203 .. 77 9 38 46 7 53 2 43 113 .. W 2826 1642 464 415 .. 13 8 52 69 7 67 5 59 124 303 Whole Parish 5225 2801 842 618 .. 90 17 90 115 14 120 7 102 237 303 The whole of the births and deaths in the two registration districts of Battersea, together with additional particulars as to causes of mortality, will be found in Table IV., which contains quarterly statistics on these various points. In Table V. will be found particulars of mean population, number of births, Birth-rate; number of deaths, Death-rate; number of deaths from zymotic diseases, including influenza, measles, and other non-notifiable infectious diseases,, together with the natural increase of population year by year from 1856; when modern methods of sanitation may be said to have originated by the enactment of the Metropolis Local Management and subsequent Acts, by virtue of which there were established Local Sanitary Authorities. The whole of the estimated mean populations have been re-calculated after the respective census enumerations and with the resulting birth and death-rates and other data, may be accepted as absolutely correct. It will be observed that the death-rate has been kept down to a lower level than when, at the commencement of the period, the parish was almost entirely rural in character, large 13 gardens of private houses and market gardens occupying a considerable proportion of the total area. TABLE V. Year. MeanPopulation for Year. Births. Birth rate. Deaths. Death rate. Zymotic Deaths. Natural Increase 1856 15,069 536 36.2 320 21.2 45 216 1857 15,970 582 36.0 343 21.4 46 239 1858 16,872 562 33.3 380 22.5 100 182 1859 17.774 685 38.5 394 22.1 96 292 1860 18,676 680 36.4 399 21.3 62 281 1861 19,582 750 38.3 505 25.7 112 245 1862 23,108 784 33.9 491 21.2 106 293 1863 26,635 1,042 39.1 522 19.5 86 520 1864 30,161 1,140 37.7 669 22.1 129 471 1865 33,688 1,357 40.2 785 23.3 177 572 1866 37,145 1,386 37.3 1,002 26.9 244 384 1867 40,741 1,734 42.5 870 21.3 122 864 1868 44.267 1,975 44.6 1,046 23.6 194 929 1869 47,749 2,096 43.8 1,121 23.4 247 975 1870 51,320 2,170 42.2 1,375 26.7 404 795 1871 54,847 2,220 40.4 1,472 26.8 463 748 1872 60,244 2,349 38.9 1,202 19.9 220 1,147 1873 65,614 2,659 40.5 1,307 19.9 205 1,352 1874 70,984 2,865 40.3 1,387 19.5 238 1,478 1875 76,354 3,080 40.3 1,724 22.5 307 1,356 1876 81,704 3,455 42.2 1,745 21.3 340 I,710 1877 87,094 3,481 39.9 1,725 19.8 280 1,756 1878 92,464 3,748 40.5 1,803 19.4 322 1.945 1879 97,834 4,001 40.8 1,980 20.2 355 2,021 1880 103,204 4,095 39.6 2,040 19.7 383 2.055 1881 108,342 4,452 41.8 2,033 18.7 381 2,419 1882 112,661 4,504 39.9 2,214 19.6 353 2,190 1883 116,980 4,711 40.2 2,344 20.0 369 2.367 1884 121,299 5,275 43.4 2,569 21.1 568 2,706 1885 125,618 4,654 37.0 2,566 20.4 432 2,088 1886 129,937 5,140 39.5 2,477 19.0 398 2,663 1887 134,256 5,186 38.6 2,451 18.2 502 2,735 1888 138,565 5,06l 36.5 2,187 15.7 363 2.874 1889 142,884 5,161 36.1 2,240 15.6 366 2,921 1890 147,203 5,105 34.6 2,854 19.3 543 2,251 1891 151,537 5,237 34.5 2,619 17.2 398 2,618 1892 155,856 4,990 32.0 2,692 17.2 473 2,298 1893 160,175 5,225 32.6 2,801 I7.4 564 2,424 In the four Tables that follow and in the" appended details will be found separate particulars of the mortality"occurring in East Battersea, West Battersea, among parishioners and nonv parishioners in the Union Infirmary and other public institutions situated within the parish of Battersea. They generally follow the method of classification which has been adopted in these reports for many years and are useful for purposes of comparison, 14 TABLE VI. STATISTICS OF MORTALITY. EAST BATTERSEA. Population (Census) 1891, 67,144. Estimated mean population for middle of 1893, 69,949. Total Deaths from each Class of Disease, &c. in the Sub-District. Sex. Age. Social Position Males. Females. Under 1 year. From 1 to 5 years. Total under 5 years. From 5 to 15 years. From 15 to 25 years. From 25 to 65 years. 65 years and upwards. Nobility and Gentry. Professional Class, Merchants, Bankers, &c. Middle and Trading Class, Shopmen, Clerks. &c. Industrial and Labouring es. 1, Zymotic. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 77 39 38 10 60 70 6 1 .. .. .. 2 4 71 Scarlet Fever 9 4 5 1 b 6 2 1 .. .. .. .. .. 9 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 7 3 4 .. .. .. 4 1 2 .. .. .. .. 7 Puerperal Fever 8 .. 8 .. .. .. .. 1 7 .. .. .. 1 7 Diphtheria 37 22 15 2 23 25 10 1 1 .. .. 1 2 34 Whooping Cough 46 18 28 10 34 44 2 .. .. .. .. .. 2 44 Erysipelas 3 2 1 1 .. 1 .. .. 2 .. .. .. .. 3 Diarrhoea, Dysentery and Cholera 55 24 31 43 7 50 .. .. 2 3 .. .. 4 51 Other Zymotic Diseases 30 18 12 .. 6 6 3 3 13 5 1 1 2 26 Tot.al of Zymotic Diseases 272 130 142 67 135 202 27 8 27 8 1 4 15 252 11. Constitutional. Gout .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever 8 4 4 .. 1 1 3 1 3 .. .. .. .. 8 Cancer & other Tumours 23 3 20 .. .. .. .. .. 17 6 .. .. 1 22 Other Constitutional Diseases 10 5 5 3 3 6 1 .. 2 1 .. .. .. 10 Tubercular. Phthisis 81 45 36 2 5 7 2 14 54 4 1 1 b 73 Tabes Mesa 34 21 13 29 5 34 .. .. .. .. .. .. 2 32 Hydrocephalus 12 6 6 7 5 12 .. .. .. .. .. .. .. 12 V Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. III. Local. Nervous 78 28 50 21 16 37 4 1 23 13 .. 2 1 75 Circulatory 50 20 30 3 2 5 .. 3 25 17 .. .. 2 48 Respiratory 301 147 154 77 76 153 14 7 78 49 .. 1 6 294 Digestive 44 30 14 20 3 23 3 4 7 7 2 .. 4 38 Urinary 18 13 5 .. .. .. .. 2 12 4 .. .. 1 17 Generative 3 .. 3 .. .. .. .. .. 3 .. .. .. .. 3 Locomotory 2 1 1 .. 1 1 .. .. 1 .. .. .. .. 2 Integumentary 2 2 .. 2 .. 2 .. .. .. .. .. .. .. 2 IV. Developmental. Premature Birth, Low Vitality and Congenital Defects 134 71 63 134 .. 134 .. .. .. .. .. 1 3 130 Old Age 36 19 17 .. .. .. .. .. .. 36 1 .. 3 32 V. Violence 43 29 14 13 .. 13 10 3 15 2 .. .. 3 40 VI. All other Diseases 8 2 6 ... 2 2 .. 1 5 .. .. .. .. 8 Totals 1159 576 583 378 254 632 64 44 272 147 6 9 47 1098 15 TABLE VII, STATISTICS OF MORTALITY, WEST BATTERSEA. [exclusive of Public Institutions.] Population (Census) 1891, 83,314. Estimated mean population for middle of 1893, 90,226. Total Deaths from each Class of Disease, &c. in the Sub-District. Sex. Age. Social Position Males. |Females. Under 1 year. From 1 to 5 years. Total under 5 years. From 5 to 15 years. From 15 to 25 years. From 25 to 65 years. 65 years and upwards. Nobility and Gentry. Proie.-sional Class, Merchants. Bankers, &c. Middle and Trading Class, Shopmen, Clerks. &c. Industrial and Labouring Classes. I, Zymotic. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 13 6 7 5 8 13 .. .. .. .. .. .. .. 13 Scarlet Fever 8 2 6 2 5 7 1 .. .. .. .. .. .. 8 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 7 6 1 .. 1 1 2 2 2 .. .. .. 1 6 Puerperal Fever 7 .. 7 .. .. .. .. 3 4 .. .. .. 1 6 Diphtheria 51 23 28 4 28 32 17 1 .. 1 .. 1 2 48 Whooping Cough 65 24 41 25 34 59 6 .. .. .. .. .. 1 64 Erysipelas 14 9 5 6 1 7 .. 1 5 1 .. .. .. 14 Diarrhoea, Dysentery and Cholera 61 34 27 52 4 56 1 .. 4 .. 2 .. 1 58 Other Zymotic Diseases 31 18 13 1 2 3 1 1 21 5 .. .. .. 31 Total of Zymotic Diseases 257 122 135 95 83 178 28 8 36 7 2 1 6 248 III. Constitutional. Gout 2 2 .. .. .. .. .. .. 2 .. .. .. .. 2 Rheumatic Fever 5 2 3 .. .. .. 1 2 1 1 .. .. .. 5 Cancer & other Tumours 39 12 27 .. .. .. 1 .. 24 14 1 .. .. 36 Other Constitutional Diseases 11 5 6 6 2 8 .. .. 1 2 1 .. .. 10 Tubercular. Phthisis 85 39 46 1 .. 1 7 14 61 2 1 1 4 79 Tabes Mesa 54 82 22 41 11 52 1 .. 1 .. .. .. 3 51 Hydrocephalus 12 6 6 6 3 9 3 .. .. .. .. .. .. 12 Scroiula .. .. .. .. .. .. .. .. .. .. .. .. .. .. III. Local. Nervous 96 44 62 20 20 40 4 4 21 27 1 .. .. 88 Circulatory 64 25 139 .. .. .. 3 3 40 18 3 .. 1 60 Respiratory 288 137 151 72 57 129 3 2 88 66 1 2 11 274 Digestive 79 45 34 32 4 36 8 3 23 9 .. .. 2 77 Urinary 27 16 11 .. .. .. .. .. 20 7 1 .. 2 24 Generative 7 .. 7 .. 1 1 .. 2 4 .. 1 .. .. 6 Locomotory 1 1 .. .. .. .. .. 1 .. .. .. .. .. 1 Integumentary 2 1 1 .. 1 1 .. .. .. 1 .. .. .. 2 IV.Developmental. Premature Birth, Low Vitality and Congenital Defects 157 82 75 157 .. 157 .. .. .. .. 2 1 1 153 Old Age 45 11 34 .. .. .. .. .. 3 42 3 .. .. 42 V. Violence 47 33 14 15 6 20 2 4 19 2 .. 1 .. 46 VI. All other Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 1278 615 663 445 187 632 61 43 344 198 17 6 39 1216 16 TABLE VIII. STATISTICS OF MORTALITY. Wandsworth and Clapham Union Infirmary. [Parishioners.] 1893. Total Deaths from each Class of Disease, &c. Sex. Age. Social Position Males. Females. Under x year. From i to 5 years. Total under 5 years. From 5 to 15 years. From 15 to 25 years. From 25 to 65 years. 65 years and upwards. Nobility and Gentry Professional Class, Merchants, Bankers, &c. Middle and Trading Class, Shopmen, Clerks, &c. Industrial and Labouring Classes. I. Zymotic. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 2 1 1 2 .. 2 .. .. .. .. .. .. .. 2 Erysipelas 3 1 2 .. .. .. .. .. 1 2 .. .. .. 3 Diarrhoea, Dysentry, and Cholera 1 1 3 2 2 4 .. .. .. .. .. .. .. 4 Other Zymotic Diseases 4 1 3 .. .. .. .. .. 1 3 .. .. .. 4 Total of Zymotic Diseases 13 4 9 4 2 6 .. .. 2 5 .. .. .. 13 II. Const, tutional. Gout 1 1 .. .. .. .. .. 1 .. .. .. .. .. 1 Rheumatic Fever 1 1 .. .. .. .. .. 1 .. .. .. .. .. 1 Cancer & other Tumours 8 3 5 .. .. .. .. .. 8 .. .. .. .. 8 Other Constitutional Diseases 1 .. 1 .. .. .. .. .. 1 .. .. .. .. 1 Tubercular. Phthisis 36 21 15 1 1 2 .. 2 31 1 .. .. .. 36 Tabes Meas 4 1 3 2 2 4 .. .. .. .. .. .. .. 4 Hydrocephalus .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scrofula 2 1 1 .. .. .. .. 1 .. 1 .. .. .. 2 III. Local. Nervous 20 11 9 .. .. .. 1 1 12 6 .. .. .. 20 Circulatory 21 12 9 .. .. .. .. .. 9 12 .. .. .. 21 Respiratory 30 17 13 1 1 2 .. 2 17 9 .. .. .. 30 Digestive 2 1 1 .. .. .. .. .. 1 1 .. .. .. 2 Urinary 8 4 4 .. .. .. .. 1 4 3 .. .. .. 8 Generative 3 .. 3 .. .. .. .. 1 1 1 .. .. .. 3 Locomotory .. .. .. .. .. .. .. .. .. .. .. .. .. .. Integumentary .. .. .. .. .. .. .. .. .. .. .. .. .. .. IV.Developmental. Premature Birth, Low Vitality and Congenital Delects 1 1 .. 1 .. 1 .. .. .. .. .. .. .. 1 Old Age 7 5 4 .. .. .. .. .. .. 7 .. .. .. 7 V. Violence 3 2 1 .. .. .. .. .. 3 .. .. .. .. 3 VI. All other Diseases 1 1 .. .. .. .. .. .. 1 .. .. .. .. 1 Totals 102 84 78 9 6 15 1 10 90 .. .. .. .. 162 17 TABLE IX, STATISTICS OF MORTALITY. Wandsworth and Clapham Union Infirmary. [Non-Parishioners.] 1893. Total Deaths from each Class of Disease, &c. Sex. Aos. Social Position Males. Females. Under i year. From i to 5 years. Total under 5 years. From 5 to 15 years. From 15 to 25 years. From 25 to 65 years. 65 years and upwards. Nobility and Gentry Professional Class, Merchants, Bankers. &c. Middle and Trading Class, Shopmen, Clerks, &c. trial and Labouring Classes. I. Zymotic. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. 1 .. .. .. .. .. 1 .. .. .. .. 1 Diphtheria .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 2 1 1 .. 2 2 .. .. .. .. .. .. .. 2 Erysipelas 7 5 2 .. .. .. .. 2 1 4 .. .. .. 7 Diarrhoea, Dysentry, and Cholera 7 4 3 4 2 6 .. .. .. 1 .. .. .. 7 Other Zymotic Diseases 3 1 2 .. .. .. .. .. 1 2 .. .. .. 3 Total of Zymotic Diseases 20 11 9 4 4 8 .. 2 3 7 .. .. .. 20 II. Constitutional. Gout 3 9 1 .. .. .. .. .. 1 2 .. .. .. 3 Rheumatic Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cancer & other Tumours 15 10 5 .. .. .. .. .. 8 7 .. .. .. 15 Other Constitutional Diseases 1 1 .. .. .. .. .. .. .. 1 .. .. .. 1 T ubercular. Phthisis 33 22 11 .. .. .. 1 1 30 1 .. .. .. 33 Tabes Mesa 2 2 .. 1 1 2 .. .. .. .. .. .. .. 2 Hydrocephalus .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scrofula .. .. .. .. .. .. .. .. .. .. .. .. .. .. III. Local. Nervous 19 7 12 .. .. .. .. .. 11 8 .. .. .. 19 Circulatory 24 11 13 .. .. .. 1 .. 9 14 .. .. .. 24 Respiratory 34 10 18 2 2 4 .. .. 9 21 .. .. .. 34 Digestive 2 2 .. .. .. .. .. .. 2 .. .. .. .. 2 Urinary 7 5 2 .. .. .. .. .. 6 1 .. .. .. 7 Generative .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 Locomotory .. .. .. .. .. .. .. .. .. .. .. .. .. .. Integumentary .. .. .. .. .. .. .. .. .. .. .. .. .. .. IV.Developmental. Premature Birth, Low Vitality and Congenital Detects 3 2 1 3 .. 3 .. .. .. .. .. .. .. 3 Old Age 19 7 12 .. .. .. .. .. .. 19 .. .. .. 19 V. Violence 9 6 3 .. .. .. .. 3 5 1 .. .. .. 9 VI. All other Diseases 1 1 .. .. .. .. .. .. .. 1 .. .. .. 1 Totals 193 105 88 10 7 17 2 6 85 83 .. .. .. 193 18 Particulars of deaths within the Parish in Public Institutions other than the Wandsworth and Clapham Union Infirmary. Parishioners. Bolingbroke Hospital Female 69 years Brain disease Masonic School Female 10 years Diphtheria Emanuel School Male 42 years Kidney disease Non-Parishioners. Bolingbroke Hospital Female 58 years Cancer „ „ Female 22 years Heart disease „ „ Female 33 years Urinary „ „ Female 36 years Tabes Mesa. „ „ Male 2 years Hydrocephalus Emanuel School Male 12 years Diphtheria Table B. This is the second table prescribed by the Local Government Board, and contains information relative to the population, births and notifications of infectious disease in the several localities and public institutions within the limits of the parish. The removal of cases of infectious disease to the hospitals of the Metropolitan Asylum Board are included in this table. The various public institutions, which are all situated in the Western division of the parish, are here treated as separate districts and have the census population assigned to them respectively, while the populations outside such institutions in the East and West Division of the parish have estimated mean populations calculated for them, in accordance with the rate of increase which prevailed during the last inter-censal period. Table b of Population, Births, and of New Cases of Infectious Sickness coming to the knowledge of the Medical Officer of Health, during the Year 1893 IN THE Urban Sanitary District of Battersea, classified according to diseases, ages and localities. Names of localities adopted for the purpose of these statistics. Public Institutions being shown as separate localities. Population at all ages. Registered Births. Aged under 5 or over 5 New Cases coming to knowledge of Medical Officer of Health No.of Cases removed for treatment in Isolation Hospitals. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Small Pox. Scarlatina. Diphtheria. Membranous Croup. fevers. Cholera. Erysipelas. Small Pox. Scarlatina. Diphtheria. Membranous Croup. fevers. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerpe Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Cholera. Erysipelas. Census. 1891. Estimate to middle of 1893. East Battersea 67144 69949 2399 Under 5 9 67 111 18 2 9 6 51 46 3 5 upwards 53 439 220 4 1 53 1 9 147 40 187 61 1 1 17 1 27 West Battersea 81999 88911 2826 Under 5 10 228 83 9 1 7 7 67 26 I 5 upwards 41 564 227 3 70 8 8 176 35 156 53 1 29 31 Wandsworth & Clapham Union Infirmary, St. John's Hill 615 615 Under 5 1 5 upwards 1 3 1 99 1 2 Bolingbroke Hospital, Bolingbroke Grove ... ... Under 5 5 upwards 3 Westminster Union Schools, St. James' Road 152 152 Under 5 5 upwards 25 1 25 1 Emanual Schools, Wandsworth Common 232 232 Under 3 5 upwards 2 1 Masonic School for Girls, Battersea Rise 316 316 Under 5 5 upwards 81 2 Whole Parish 150458 160175 5225 Under 5 19 295 194 27 3 17 13 118 72 4 5 upwards 94 1112 454 7 1 126 9 18 422 75 369 115 2 1 48 1 58 20 TABLE X. Particulars of Infectious Cases Notified during the year 1893. Number of Cases Notified Small Pox Scarlet Fever Diphtheria Membranous Croup Typhus Fever Typhoid Fever Continued Fever Relapsing Fever Puerperal Fever Erysipelas TOTAL. 113 1407 648 34 1 129 9 ... 18 439 2798 No. of Fatal Cases at home ... 17 90 ... ... 14 ... ... 15 27 163 TABLE XI. Particulart of cases of Infectious Disease Removed to Hospital during the year 1893. No. of Cases removed to Hospitals Small Pox Scarlet Fever Diphtheria Membranous Croup Typhus Fever Typhoid Fever Continued Fever Relapsing Fever Puerperal Fever Erysipelas . 88 487 187 2 1 48 ... ... 1 62 876 No. of Fatal Cases in Hospitals. 12 15 86 ... ... 8 ... ... 1 4 126 21 Beelow will be found a synopsis of the notifications received during 1893, removals to hospital:— Notifications. Removed to Hospital. Small Pox 113 88 Scarlet Fever 1,407 487 Diphtheria 648 187 Membranous Croup 34 2 Typhus Fever 1 1 Typhoid Fever 129 48 Continued Fever 9 — Relapsing Fever — — Puerperal Fever 18 1 Erysipelas 439 62 2,798 876 Ages:— Under 5 years 555 207 5 Years and upwards 2,243 669 2,798 876 Where occurring:— East Battersea 1,143 441 West Battersea 1,425 406 Union Infirmary 105 3 Bolingbroke Hospital 3 — Westminster Schools 26 26 Emanuel School 3 — Masonic Schools 83 — 2,798 876 The various isolation Hospitals to which the cases have been removed are as follows:— 22 Asylums Board Hospitals (chiefly Stockwell and Tooting Hospitals), St. George's, St. Thomas', Westminster, St. Bartholomew's, Belgrave, King's College, the. Bolingbroke and the London Fever Hospitals. Small A somewhat severe outbreak of this disease Pox. occurred during the year, chiefly in the summer months. In a large proportion of the cases tramps were definitely ascertained to be the medium of infection. By the courtesy of Mr. T. Duncombe Mann, the Secretary of the Metropolitan Asylums Board, and the very kind assistance of Dr. J. F. Rickett, the Medical Superintendent of the Hospital Ships at Long Reach, I am able to present a complete list of cases admitted thence from Battersea. In all eighty-two cases were admitted to the Ships, with eleven deaths, all the fatal cases occurring in persons unprotected by vaccination. Full particulars of the different cases will be found in the return, more especially as to the condition as to vaccination found on admission. One death occurred from small pox in the Highgate Hospital. In Table B the number of cases of small pox notified was one hundred and thirteen. A few of these were notified by more than one practitioner. Some were really cases of chicken pox and other affections which strongly resemble small pox, and are in certain stages difficult to differentiate from that disease, even by the most experienced observers. The same table shews that eighty-eight cases were sent to hospital. Eighty-three were received therein and the five others returned as not being cases of true small pox. 23 Small Pox Cases Admitted to the Metropolitan Asylums Board's Hospital Ships at Long Reach from Battersea, during the year 1893. No Name, Sex. Age. Address. Date ot Admission. Statement as to Primary Vaccination. No. ot Scars. Collective Area. Re-vaccinated. 1 R. J. H. M 27 41, Everett street Feb. 19 In infancy 2 0.47 sq. in. Not Recovered 2 W. H. M 13 Do. Mar. 6 ,, None — „ ,, 3 J. M. H. F 17 Do. „ 22 ,, 6 Indistinct „ ,, 4 A. S. F 60 121, Northcote road Apr. 12 In childhood 1 0. 07 sq. in. „ ,, 5 G. F. F 19 30, Marmion road „ 21 In infancy, unsuc. None — „ „ 6 G. S. M 19 89, Carpenter street „ 24 In infancy 4 1.56.sq.in ,, 7 J. S. M 67 122, Latchmere road May 5 Does not know None — — Died 8 W. K. M 43 33, Candahar road 8 In infancy 4 0.60 sq. in. about 12 years ago Recovered 9 B. T. M 53 11, Kerrison road ,, 9 „ 4 0.45 M„ „ Not ,, 10 E. R. F 33 65, Surrey lane „ 11 Not vaccinated None - — ,, 11 M. G. F 25 21, Elspeth road ,, 12 in infancy 4 0.39 sq.in. Not ,, 12 C. B. M 27 33, Hope street 22 „ 4 0.61 ,, „ „ „ 13 F. B. F 20 “ Nag's Head” „ 22 „ 1 0. 28 ,, ,, „ ,, 14 E. H. M 18 46, Grayshott road „ 22 Not None — — ,, 15 W. F. M 44 41, Falcon road „ 22 Does not know ,, - Not ,, 16 t. l. m 29 14, John street ,,22 In infancy 3 or 4 Indistinct ,, ,, 17 h. F. M 38 33, Candahar road „ 23 „ 2 0.78 sq. in. ,, ,, 18 IB. M 20 16, Church road „ 23 „ 4 1.48 ,, ,, ,, ,, 19 E. W. F 14 16, York road „ 23 ,, 4 1.73 ,, ,, ,, ,, 20 E. W. F 2 Do. ,, 23 Not vaccinated None — — ,, 21 J. P. M 25 11 Canterbury place „ 24 In infancy 1 0.18 sq.in. Not ,, 22 R. H. F 8 158 York road ,, 24 Not vaccinated None — — ,, 23 H W. M 26 8, Linda street ,, 27 In infancy 3 Indistinct Not „ 24 H. T. M 26 102, Ingrave street ,, 27 „ 3 2.01 sq.in. „ ,, 25 B. G. M 15 weeks 45 Surrey lane June 5 June 3, 1893 None — — Died 26 M. V. F 23 Relief Station,Latchmererd ,, 6 In infancy 4 0.68 sq. in. Not Recovered 24 25 small pox cases admitted to the Metrpolitan Asylums Board's Hospital Ships at Long Reach from Battersea, During the Year 1893. No Name. Sex Age. Address. Date oi Admission. Statement as to Primary Vaccination No. of Scars. Collective Area. Re-vaccinated. 27 M. B. F 8 156, York road June 6 In infancy None - Not Died 28 H C. M 22 Lodging House, Surrey lane ” 6 ” 4 1.36 sq,in, ” Recovered 29 w.I. M 31 126, Maysoule road ” 10 ” 1 0.42 ” ” ” ” 30 M. D. F 25 3, Corunna terrace ” 22 ” 2 Indistinct ” ” 31 C. D. F 45 43, Surrey lane ” 24 ” 1 0.23 sq,in, ” ” 32 M. B. F 29 156, York road ” 26 ” 3 0.46 ” ” ” ” 33 R. R. M 19 36, Woodgate street ” 26 ” 3 1.41 ” ” ” ” 34 A. B. F 20 22 , Acre street ” 30 ,, 2 1.58 ” ” ” ” 35 R. M. M 2½ 32, Alfred street July 4 Not vaccinated None - - Died 36 J.T. F 29 31, Sterndale road ” 4 In infancy 3 0.36 sq,in, Not Recovered 37 M. I. T. F 1 Do ” 4 Not vaccinated None - - Died 38 J.P. R. P. F 17 13, John street ” 4 In fancy 4 Indistinct Not Recovered 39 R. T. M 31 31, Sterndale road ” 5 ” 2 0.27 sq. in, ” ” 40 D. W. F 9 m'ths 23 „ ” 5 Not vaccinated None - - Died 41 E. T. F 32 31 „ ” 6 In infancy 4 2.24 sq. in, Not Recovered 42 E. T. F 1 month „ „ ” 6 Vaccinated 6/7/93 - - - Developed July 10, Died 43 A. F. F 10 16, Acre street ” 7 Not vaccinated None — Not Died 44 J. H. S. M 16 38, Dashwood road ” 7 In infancy 3 0.54 sq. in, Not known Recovered 45 A. S. F IA 12, Etruria street ” 8 ” 5 1.11 ” ” Not ” 46 J. M. M 36 1 ” 9 ” 3 1.39 ” ” 1881, successfully ” 47 w. w. M 17 18, John street ” 10 ” 3 0.64 ” ” Not ” 48 A. W. M 3 Do ” 10 Not vaccinated None - - Died 49 R. W. M 21 23, Sterndale road ” 11 In infancy 2 1.18 sq. in, Not Recovered 50 S. C. F 23 Do. ” 11 ” 4 0.64 ” ” ” ” 51 G. C. F 2 Do. ” 11 Not vaccinated None - - ” 52 H. C. M 5 Do. ” 11 Vac. 11th July,/93 Developed Devel Small pox 1 16th July ” 53 E. F. F 39 2, Rollo street July 17 In infancy 1 Indefinite Not Recovered 54 W. T. M 21 53, Beaufoy road ”17 ” 4 0.80 sq. in, Unrecorded ” 55 A. T. F 18 27, Arthur street ”17 ” 3 0.77 ” ” Not ” 56 J. l. M 14 37, Rollo street ”18 Not None - - ” 57 E. M. M 21 5, Gladstone strret ”19 In infancy 3 about 0.57 — ” 58 J.B. M 18 26, Alfred street ”19 Not None Not ” 59 T. C. M 11 18, Arthur street ”19 ” ” - - ” 60 A. B. M 22 88, Stewarts road ”20 In infancy 3 about 0.92 Not ” 61 A. P. M 1 9, Lockington road ”20 Not None - ” ” 62 M. D. F 29 20, Etruria street ”20 In infancy 4 2.38 sq. in, ” ” 63 A. C. M 8 23, Sterndale road ”22 ” None - ” ” 64 A. T. F 19 27, John street ”22 ” 4 2.50 sq. in, ” ” 65 J.H. M 19 123, Stewarts road ” 23 ” 2 1.04 ” ” Unrecorded ” 66 A. D. M 15 55, Wycliffe road ” 23 ” obscured by rush Not Died 67 A. W. F 7 18, Arthur street Aug.3 ” None - ” Recovered 68 M.A.D. F 35 65, Kilton street ”4 ” 6 1.85 sq. in, - ” 69 E. C. F 48 28, Montefiore street ”8 ” 1 0.10 ” ” Unrecorded ” 70 E. R. F 11 m'ths 33, Warriner gardens ”8 Not None - Not ” 71 W.J. D. M 26 61, Linford street ”13 In infancy 2 0.33 sq. in, ” ” 72 E. R. F 39 66, Gonsalva road ”16 ” 3 0.38 ” ” - ” 73 H. H. M 30 28, Montefiore street ”21 ” 4 about 1.82 Unrecorded ” 74 E. L. F 17 35, Chesney street ” 23 ” 4 1.99 sq. in, Not ” 75 T. W. M 34 22, Colestown street Sep. 7 ” 2 0.35 ” ” ” ” 76 C.P. F 21 Do. ”22 ” 4 0.69 ” ” ” ” 77 R. B. M 3 22. Atherton street ”23 Not None - ” ” 78 E. W. F 2 8. Granfield street ” 26 ” ” - ” ” 79 H. B. M 28 22. Atherton street Oct. 6 In infancy 1 0.90 sq. in, Not ” 80 A. W. F 3 8, Granfield street ” 9 Vac. Sep. 27,1893 3 scabs (not previously vaccinated) Died Rash a'p'red Oct.7 81 W. A. M 1½ 18, Bullen street ” 31 Not None - Recovered 82 W. C. M 39 16, Hafer road Not. 11 - - - - Not small pox 26 Scarlet Fever. The large number of one thousand, four hundred and seven cases of this disease were notified during 1893, of whom four hundred and eighty-seven were removed to hospital. The simultaneous outbreak of this disease in every quarter of the Metropolis caused the Metropolitan Asylums Board's hospital accommodation to be over-taxed, and many cases were greatly delayed in admission, with the result that the retention of those suffering from scarlet fever in homes where there was insufficient or no isolation caused the disease to spread. The opening of the Fountain Hospital at Tooting, however, enabled the Board to remove all cases where necessary, with the result that the epidemic diminished in activity and the number of cases fell rapidly. The provision of telephonic communication at the new offices directly with the Metropolitan Asylums Board is of the greatest possible service in securing the early removal of the infectious sick to the Board's hospitals. Diphtheria and Membranous Croup. Six hundred and forty-eight cases of diphtheria and thirty-four of membranous croup, an affection of the air passages indistinguishable in origin from diphtheria; together six hundred and eighty-two, were notified during the year. Diphtheria seems during the last few years to have become endemic in London and other large towns, in spite of the endeavours of the sanitary authorities to improve the general conditions of their respective districts. The last few years have been characterised by prolonged periods of dry weather, and to this may perhaps be attributed the prevalence of this type of disease. Enteric or Typhoid Fever. The large number of one hundred and twenty-nine cases were notified. The remarks as to the prevalence of diphtheria given above probably apply also to typhoid as the origin and mode of propagation of both diseases is very similar. 27 Erysipelas. Four hundred and thirty-nine cases of erysipelas were notified in 1893. This is a large increase in numbers and the mortality was twenty-seven, chiefly in the Union Infirmary, to which all such cases drift in case of poverty, other institutions not admitting this disease. Zymotic The table (XII.) of fatal diseases of the infectious Diseases. class given herewith shews that five hundred and sixty-four deaths arose therefrom. But one hundred and twentyone deaths arose from the principal notifiable diseases, scarlet fever, diphtheria and enteric fever, out of a total of two thousand, seven hundred and ninety-eight cases of those diseases notified during the year. Of the non-notifiable infectious diseases, in Table XII., measles, whooping cough, diarrhoea and “other infectious diseases,” which latter include forty-nine fatal cases of influenza, a total mortality of four hundred and forty-three occurred during 1893. It is to the great fatality of these unnotified infectious diseases that the zymotic death-rate of 3.5 per thousand is principally due. TABLE. XII. Comparative Table of Zymotic Mortality during the past 11 years. 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 Small-Pox 5 2 — — Measles 77 134 112 70 82 87 104 159 37 90 90 Scarlet Fever 43 31 8 14 68 25 12 10 10 15 17 Diphtheria 8 18 10 9 23 22 21 27 35 28 90 Enteric, &c. Fevers 26 45 18 23 17 13 15 21 19 8 14 Whooping Cough 99 106 121 104 112 119 81 146 104 100 115 Epidemic Diarrhœa 115 178 126 152 175 75 112 121 104 99 120 Other Zymotic Diseases 1 51 35 26 25 22 21 59 89 133 118 Total Deaths from Zymotic Diseases 369 568 432 398 502 363 366 543 398 473 564 Zymotic Death Rate 3.2 4.6 3.4 3.0 3.7 2.6 2.5 3.6 2.6 3.0 3.5 Death-rates from all Diseases 20.0 21.1 20.4 19.0 18.2 15.7 15.6 19.3 17.2 17.2 17.4 28 Table XIII. Comparative Table of all non-zymotic causes of Deaths during the past 11 years. 1883 1884 1885 1886 1887 1888 1889 1890|1891 1892 1893 Tubercular, including Phthisis 430 479 420 439 367 342 334 320 285 237 355 Of Brain, Nerves, Ac. 287 298 282 289 280 223 212 261 195 259 213 Of the Heart, &c. 129 148 159 159 128 113 108 148 141 183 159 Of the Respiratory Organs,excluding Phthisis 566 489 630 584 528 474 391 618 572 635 653 Of Digestive Organs 110 85 88 96 86 113 100 118 122 112 127 Of Uriuary Organs 48 34 46 31 53 24 39 34 49 72 60 Of Organs of Generation 20 16 23 14 19 6 14 15 16 15 14 Of Joints, Bones, &c. 19 16 8 20 30 9 3 4 7 2 3 Premature Birth, Low Vitality, Malformation, &c. 104 149 137 175 202 175 205 206 238 256 295 Of Uncertain Seat Cancer, Syphilis, Dropsy, &c. 75 91 105 106 105 79 96 70 89 233 130 Age 85 64 76 99 88 57 52 71 74 122 103 Violence 44 57 61 63 63 5o 60 77 60 81 102 Constitutional 24 9 4 5 — — — — 2 12 23 Total 1941 1935 2039 2080 1949 1671 1614 1942 1850 2219 2237 Table XIII., Non-zymotic deaths.—The mortality from these diseases does not materially vary from year to year, notwithstanding the increase in populotion, which shews a proportionately diminished mortality, and may be reasonably ascribed to an improved hygiene, the result of better and more vigilant sanitation. Phthisis and the other tubercular diseases are found to diminish in proportion to better sanitary conditions; a glance at the table will shew a progressive diminution in the number of fatal cases in a population which has increased 43 per cent. in the period included in the table. Respiratory diseases shew a high mortality, but only in proportion to the increased population, and maintained by the still lingering epidemic of influenza, which, after a former outbreak of the disease in 1846, was not finally got rid of for ten years, although the fatality grew less year by year. The other causes of death need no comment, except that the deaths from premature birth and low vitality at 29 birth become more numerous yearly, owing to improved registration, as formerly an infant living but a few hours was frequently buried as stillborn. Inquests. During the year 1893, 276 cases came under the notice of the Coroner. Thirty-nine of these were cases in which he decided that no further inquiry was necessary, and they are marked in the Registrar's Returns as “submitted to Coroner,” which is considered sufficient to authorise registration.” In the other 237 cases inquests were held with the following results, as given in the verdicts of the respective juries:— From Natural Causes 135 From Accidental Causes:— Suffocation 27 Burns 3 Scalds 4 Run over 6 Knocked down by a horse 1 Thrown from horse 1 Strangulation 1 Drowning 10 Fractures oi skull, &c. 19 Poisoning 2 Want of attention at birth 4 Stabbing 1 — 79 From Homicidal Causes:— Suicide—Hanging 3 Drowning 3 Cut Throat 1 — 7 Murder—Suffocation 1 Fractured Skull 1 — 2 Found Dead:— Drowned 9 Knocked down by trains 4 Fracture 1 - 14 Total 237 30 Eighteen deaths were due to suffocation whilst in bed with parents, the dates and days of the week being as follows:— 16th January. Monday. 23rd April. Sunday. 22nd „ Sunday. 30th „ Sunday. 29th ,, Sunday. 21st May Sunday. 20th February Monday. 25th June Sunday. 27th „ Monday. 29th October Sunday. 24th March Friday. 15th November Wednesday. 7th April Friday. 5th December Tuesday, 9th „ Sunday. 10th „ Sunday. 20th „ Thursday. 17th „ Sunday. Differently arranged, the following table shews the incidence of these cases on the several days of the week. It must be remembered that the day given is invariably that of the early morning during which the child is found dead :— no. of cases. Sunday 10 Monday 3 Tuesday 1 Wednesday 1 Thursday 1 Friday2 Saturday - Total 18 There would seem to be an undue preponderance of fatal cases on the Sunday morning, due probably to fatigue and, it is to be feared, in some cases excessive indulgence on Saturday night. The whole number, however, is small in so large a population. Social Position of Persons dying during 1093. Number. Per Cent. Nobility and Gentry 25 0.9 Professional Class 15 0.5 Middle and Trading Classes 88 3.2 Industrial and Labouring Classes 2,673 95.4 2,801 1oo.o 31 This table shews that the industrial classes form the great majority of the inhabitants of Battersea, the other classes, with the exception of the first, of whom the majority are people retired from active business; being engaged in ministering to the wants of the great mass of people. Water This most important subject has been under Supply for London. consideration by a Royal Commission which sat during 1892 and 1893. The Chairman was Lord Balfour, of Burleigh; Sir Archibald Geikie, Professor Dewar, Dr. Ogle, Mr. Mansergh, Mr. Hill and Sir George Bruce constituted the Committee, all men of eminence and selected for their intimate knowledge of the subject. No Commissioner was in any way connected with either of the London Water Companies, and Mr. Mansergh is the Engineer who is now bringing water to Birmingham from Wales, while Mr. Hill is supplying Manchester from Thirlmere. The witnesses examined include nearly one hundred of the leading sanitarians and engineers, together with representatives of the great public bodies of the Metropolis and elsewhere, the Local Government Board, the London County Council, the Corporation of London and the various Water Companies and others having interests in the Water Supply of the Metropolis. The conclusions of the Commission were arrived at unanimously, and are so well set out that in the following synopsis the language used by the Commission in its reports will be accurately reproduced. Briefly reviewing the inquiry, the main questions referred to and considered by the Commission were whether the water of the Thames and Lea Valleys was good, and whether enough of it could be obtained for the London of the future without injury to the interests of other districts in those water sheds. They find, as the Companies always maintained, that " the water as 32 supplied to the consumer in London is of a very high standard of excellence and of purity, and that it is suitable in quality for all household purposes," and also that the Thames and Lea Valleys may, without prejudice to the claims or material injury to the interests of districts outside the area of Greater London, be made to supply more than double the present population of the Metropolis with 35 gallons per head daily. The Commissioners recommend that the inspection of the River Thames should be more thoroughly done than it is at present, and that increased provision should be made, in the form of reservoirs for avoiding the taking in of water while the river is in a state of flood. Of all the sites that have been suggested to them as suitable for reservoirs they consider none in the Thames Valley so reliable as can be found upon the London clay, only a short distance above the Hampton intakes. This will be welcome reading alike to water drinkers and to those whose business it is, or may become, to supply water; and the forty-five sittings which have enabled the Commission with confidence and authority, to give it as their unanimous opinion, must be regarded as the best service that has been rendered to the London public since the Duke of Richmond's Commission sat some seventy-five years ago. From the Thames, when required, may be taken 300,000,000 gallons a day ; from the Lea, 52,500,000 gallons ; from wells in the Lea Valley, 40,000,000 gallons; and from wells in the Kent Company's district, 27,500,000 gallons; besides a further considerable quantity, should it ever be wanted, from the Valley of the Medway and the country to the east of it. The Commission, as might be expected, deal with the question broadly, without committing themselves to details. It would be going beyond the duty of useful criticism to discuss some of the interesting scientific, though minor, points upon which the Commissioners adopted views adverse to those of some of the distinguished witnesses who appeared 33 before them. There are, however, in the enquiry two points? which rather hang upon one another, and about which wo wish the Commission had told us a little more. These are:— (1) The effect which might be expected upon the Thames of taking double the present quantity of water direct from the river during periods of drought, (2) The amount of storage space to be provided above the intakes in order to make the taking of any more of this water unnecessary. It is obvious, from the evidence of the late Mr. Hawksley and others, that the water passing the intakes is purest when the river is lowest. In their report (paragraphs 73 to 78) the Commission deal at length with Mr. Peregrine Birch's proposal to take vast quantities more of this water when needed, and with the antidote Mr. More suggested, in the interests of navigation, in case another 100,000,000 gallons should be required from the river in the driest times. They say: — "The trouble resulting from additional abstraction, if any, would commence then below this (the new Richmond) weir; and what this would be, and how simply it could be remedied, has already been explained by reference to Mr. More's evidence. After carefully considering the evidence of Mr. Hawksley, Mr. Marten, Mr. Baldwin Latham and Mr. Birch we are of opinion that Mr. More's suggestion is a practicable one, and that no good reason, from an engineering point of view, has been adduced why it should not be carried into effect. But strong local objections would probably be raised against such a scheme and we do not intend to recommend it, as the sequel of our report will shew.” Mr. More's suggestion was that a lake of 25 acres be excavated in the Old Deer Park at Richmond to hold 8 feet of tidal water between high and low water marks; that this should be filled by the rising tide and discharged during the three or 34 four hours of lowest water. The alternative to this would appear, from some newspaper reports, to be the construction of 1,200 acres of reservoir 40 feet deep, and the passing into the tideway of the water most suitable for domestic supply. The Commissioners do not discuss the reasonableness of local objection to a 25 acre lake being cut in the Old Deer Park, nor express an opinion as to whether, as Mr. Birch told the Commission, the same result could be effected by the manipulation of the weirs; but they venture to predict that, whoever in future may own the London water works, the time will never come for passing on the best of the water by means of works including 1,200 acres of special reservoirs, although the 400 acres of reservoirs suggested by Messrs. Hunter and Fraser as desirable in future, so that the Companies may avoid taking in flood water, will, of course, be made as rapidly as the increased demands upon the works require them. The conclusion of the Commission is most distinct that there is ample supply of water derivable from the Rivers Thames and Lea, from wells in the chalk in the Lea Valley, and also in the district of the Kent Water Works Company, which will be sufficient to meet the requirements of London for fifty years to come. As to the purity of these supplies, the chemical and bacteriological evidence of Dr. Frankland, Dr. Odling, Frofessor Crookes, Professor Ray Lankester, Dr. P. F. Frankland and others, is most satisfactory ; and no evidence submitted as to impurity could stand the test of the investigations and inquiries of the Commissioners. In their report, however, they very properly advise that further efforts shall be made to keep pollution of all kinds out of the Rivers, and maintain their purity in every possible way. The report of the Commissioners, given below sums up the evidence and gives a general outline of the whole enquiry and is followed by the conclusions at which they finally arrived and their consequent recommendations. 35 The Commission, which was appointed in January, 1892, constituted for the purpose of ascertaining “whether, taking into consideration the growth of the population of the Metropolis and the districts within the limits of the Metropolitan Water Companies, and also the needs of the localities not supplied by any Metropolitan Company but within the watersheds of the Thames and the Lea, the present sources of supply of these Companies are adequate in quantity and quality, and, if inadequate, whether such supply as may be required can be obtained within the watersheds referred to, having due regard to the claims of the districts outside the Metropolis but within those watersheds, or will have to be obtained outside the watersheds of the Thames and the Lea.” For the purpose of acquiring the information necessary to enable them to form a judgment upon the questions submitted, the Commissioners placed themselves in communication with the Metropolitan Water Companies, the Corporation of the City of London, the London County Council, and the Councils of the countics of Bedford, Berks, Buckingham, Essex, Gloucester, Hants, Hertford, Kent, Middlesex, Oxford, Surrey, and Wilts. They also invited the Boards of Conservators of the Thames and Lea, and all the Urban and Rural Sanitary Authorities whose districts are wholly or partially situated within the watersheds of those Rivers, and all the Water Companies and Public Authorities who have waterworks in the same area to give them any information bearing on the subject which they might be in a position to afford. The Commissioners sat on 45 days, 32 of which were occupied in having oral evidence. There were 92 witnesses examined, most of whom were put forward by the Metropolitan Water Companies or the County Councils of London and the counties of Hertford, Middlesex, Surrey, Essex, and Buckingham, and by other public bodies in London and the neighbourhood. Some of the evidence” produced was of such a character that it was found necessary to employ an Assistant Commissioner to visit the localities under enquiry, and to ascertain upon the spot the precise facts. For this 36 purpose, with the sanction of the Treasury, Mr. R. E. Middleton, M. Inst., C.E. was appointed. The inquiry, as far as possible, was conducted in two divisions, the first of which comprised all the particular evidence as to the individual circumstances of the Water Companies at the present time, and the anticipations of the future which might be based upon them. Under this division was taken the evidence of the Metropolitan Water Companies as to the quantity of water which they were daily supplying per head of the population, the sources at their command to meet that supply, and the grounds upon which, in their opinions, future demands ought to be based; the evidence of the Officers of the Conservators of the Rivers Thames and Lea as to the powers of the Water Companies to abstract water from those Rivers and the measures taken to prevent their pollution; the evidence as to the amount of rainfall in the valleys of the Thames and Lea, and the existing pollutions of these Rivers; evidence prepared at the General Register Office as to the populations of the areas affected by the inquiry; and, lastly, evidence offered by councils of counties and by corporations and local boards within the watersheds. Nearly the whole of this division of the evidence was taken before the end of July, 1892; and the sittings of the Commissioners from the month of October of that year were mainly devoted to the second division of evidence, which included the general evidence of engineers, geologists, chemists, bacteriologists bearing upon the subject as a whole. The areas affected by the enquiry may be defined as extending over “Greater London” as that name is used in the General Register Office, where it is applied to the area included within the Metropolitan and City Police districts. Such area includes all parishes wholly comprised within a circle of 15 miles radius from Charing Cross, and all other parishes of which any part is included within a circle of 12 miles radius from the same centre. Greater Lcndon thus not only includes 37 the whole of the Administrative County of London, hut extends widely beyond it, and contains in all an area of 701 square miles. In the evidence given before the Commission the area within Greater London and outside the County of London was called the “Outer Ring,” and it is within this area that at present the most rapid increase of population appears to be taking place. The areas supplied form together a district which is usually spoken of as “Water London,” comprising about 620 square miles. The areas are not co-extensive with any districts ot which the populations are given by the Registrar-General in the census returns, and no exact statement of the population being obtainable from official returns the Companies found it necessary to rely upon estimates compiled from such other sources of information as they had at their command. According to the returns made by the Companies themselves the total population supplied by them in 1891 was estimated at 5,469,791; but it would seem, however, that 5,237,062 persons must be accepted as the closest approximation that could, under the circumstances, be made. In turning to the future requirements of this ever-increasing population, the first question that presented itself for discussion was what area ought to be taken into account; and it soon became apparent that neither Registration London nor the London of the County Council, nor even Water London, was sufficiently extensive for the purpose. Not only should suburban districts be included in the area to be reported upon by the Commission, but such more remote districts must be considered as might reasonably be expected to be reached by ths spreading of the population of London at no very distant time. After due consideration, the Commissioners determined to take as their basis that area known as Greater London, and to add to it certain parts of Water London which lie outside Greater London as now computed. The report states that the increase in population of this area, as shewn by the census returns for the last 50 years, has been far from equable. Taking, however, 38 the average annual increase per cent, in the whole period as a basis, they think it may safely be computed that the population of Greater London will continue to increase at the rate of 18.2 per cent, decennially, or in the ratio of 1.82 per cent, annually. The report sets out at length a table showing the yearly and monthly daily average both of water returned to the Official Water Examiner under the Metropolis Water Act, 1871, as supplied by the Companies in the year 1891. From this and similar calculations made from other returns, it appears that the quantity of water consumed per head of the population differs widely in the districts of the several Companies. Taking the population estimated by them as being actually supplied, the quantities consumed per head per day range from 26.71 gallons in the case of the West Middlesex Company to 47.72 gallons in that of the Grand Junction Company; the average over the whole of the population being 31.19 gallons per head per day. The report next gives the present sources from which the water supplied by the Companies is derived. These are of four kinds, viz.:—(1) the River Thames and Lea; (2) gravel beds adjoining the main stream of the Thames and other gravel beds at Hanworth; (3) natural springs; and (4) wells sunk into the chalk or other strata at such points in the water sheds as may have been selected. The Commissioners discuss these in the order named. All the Companies, except the Kent Company, are dependent for some part of their supply upon water derived either from the Thames or the Lea. Turning to the question of the “necessities of the future,” the Commissioners set out in the report the views of the several Companies, who adopted the same term, viz., 40 years, as the period for which it is desirable to look forward. The following table gives the figures laid before the Commission by each Company as to the estimated population and requirements of their district in 1931;— 39 Name of Company. Estimated Population In 1931. Estimated Daily Supply per head in 1031. Supp'y required per day. Supply available per day. New River 1,658,000 28.5 47,250,000 *56,500,000 East London 1,697,000 33.0 56,000,000 66,000,000 Chelsea 375,000 35.0 13,125,000 22,000,000 West Middlesex 959,187 28.0 26,857,236 24,500,000 Grand Junction 584,969 42.0 24,500,000 24,500,000 Lambeth 1,136,441 25.0 28,411,025 30,500,000 Southwark & Vauxhal 1,215,457 25.0 30.386,425 41,000,000 Kent 900,000 30.0 27,000,000 29,000,000 Total 8,526,054 29.73 253,529,686 294,000,000 * Deducting 330,000 gallons of unfiltered water from Hampstead Ponds. The suggestions made by the Companies for extending their works, and so augmenting the volume of distributable water, may be stated as follows:— (1) The abstraction of more water from the Thames without providing storage. (2) The abstraction of more water from the Thames and Lea with provision for storage. (3) The abstract of water from gravel beds adjoining the Thames. (4) The abstraction of more water from deep wells in the chalk formation. The report next proceeds to deal with the several suggestions which were laid before the Commissioners as to the construction of large storage reservoirs. Of the schemes submitted that of Messrs. Hunter and Fraser was considered the best. It was brought forward by Mr. W. Hunter, M. Inst., C.E., a Director, and Mr. Alexander Frazer, M. Inst., C.E., the Engineer of the Grand Junction Company. It consists in the construction of nine reservoirs upon land in the neighbourhood of Staines, at a spot only a few miles from the existing works of the Company. The storage capacity was to be obtained by excavating below the surface in almost flat ground, and forming the material removed into banks so as to increase the depth. By this combined process of sinking and raising a depth of 40 40 feet would he obtained; the digging being entirely in gravel, which overlies the clay to a depth of from 20 to 30 feet. The advantage rightfully claimed for this scheme was that it could be carried out by instalments, as might be from time to time required. After setting out the evidence given as to the estimated supply of water that would be procured from gravel beds and deep wells, the report summarizes the total capacity of the supply as returned by the representatives of the Companies as follows:—From the Thames, with additional storage 300,000,000 gallons per day; from the Lea, with the East London Company's projected storage 52,500,000 gallons; from chalk springs and wells 87,000,000 gallons; total, 439,500,000 gallons, or (say) 440 million gallons per day. The report next deals with the objections which have been raised to the proposals of the Companies in regard to increasing the draught upon the Thames, the Lea and the chalk formation for the purpose of meeting further demands; and the conclusions arrived at by the Commission are stated as follows: "From the River Thames."—In estimating the quantity of water which may be obtained from the Thames, we have given full consideration to the topographical, meteorological, geological, statistical and engineering evidence which has been laid before us by the representatives of all the parties, although we shall now quote figures only from a few of the proofs. The area within the Thames watershed down to Kingston was assumed by the Duke of Richmond's Commission (on evidence then received) to be 3,676 square miles; and this figure has been adopted by Mr. Hawksley, Mr. Baldwin Latham and others in the present enquiry as to the area down to Teddington Weir. Both Mr. More and Mr. Binnie have made new and independent admeasurements, and compute this area respectively at 3,766 and 3,789 square miles; and Mr. More (being Engineer of the Thames Conservancy) may be assumed to 41 possess the fullest acquaintance with the watershed, we propose to adopt his figures. From Mr. Topley we accept 3,548 square miles as being approximately the area above the intakes of the Water Companies. Mr. More has put in gaugings of the discharge of the Thames at Teddington for the years 1883 to 1891 with an added column showing the rainfalls. " In the third column of the table the average yearly discharge of the nine years at Teddington is given as 435,931,000,000 gallons. But this quantity is subject to some correction, for we found on investigating the details of the gauging atrangements at Teddington that it was desirable to check the results by simultaneous measurements at Molesey and Sunbury Weirs, and having entrusted this work to Mr. Middleton and considered his report we accept his opinion that Mr. More's quantities should be increased by 7 per cent. To the 435,931,000,000 gallons we therefore add 30,515,170,000 gallons, making 466,446,170,000 gallons. To this again must be added the average quantity taken by the Companies, viz., 30,896,000,000 gallons, giving a grand total of 497,342,170,000 gallons. Divided by 365 this gives a daily average of 1,362,581,288 gallons. Year. Total Quantity of Water abstracted by the Water Companies. Volume ot Discharge at Teddington Weir as guaged by the ThamesConservancy Total flow of River Thames Col. 2 x Col. 3. Average Annual rainfall on Thames Basin above intakes of the Water Companies. Gallons. Gallons. Gallons. Inches. 1883 26,197,000.000 659,657,000,000 685,584,000,000 28.41 1884 29,946,000,000 330,648,000,000 360,594,000,000 22.90 1885 29,654,000,000 339,130,000,000 428,784,000,000 29.15 1886 30,350,000,000 544,786,000,000 575,136,000,000 31.07 1887 32,154,000,000 390,296,000,000 422,450,000,000 21.32 1888 30,280,000,000 427,656,000,000 457,936,000,000 28.45 1889 31,419,000,000 437,059,000,000 468,478,000,000 25.64 1890 32,876,000,000 261,916,000,000 294,792,000,000 22.81 1891 35,185,000,000 472,228,000,000 507,413,000,000 33.31 Total 278,061,000,000 3,923,376,000,000 4,201,437,000,000 243.06 Average of the 9 years 30,895,000,000 435,931,000,000 466,827,000,000 27.01 “But during the nine years in question the rainfall averaged only 27.01 inches as compared with 28.50 inches which Mr. 42 Symons gives as the mean fall of a long term upon the watershed. We therefore increase the daily volume to 1,437,747,750 gallons, raising it in the ratio of 27.01 to 28-50 inches. This quantity must, however, be reduced in the proportion of the area above Teddington, viz., 3,766 square miles, to that above the intakes, which is 3,548 square miles, thus bringing down the nett daily quantity to 1,354,521,778 gallons. This, we believe, is a very close approximation to the daily average flow of the Thames down to the waterworks intakes during a long series of years, and we will call it, in round figures, 1,350,000,000 gallons. The average daily discharge of three consecutive dry years we estimate at 1,120,000,000 gallons, and of the driest year at 900,000,000 gallons. "These being the facts, we are of opinion that, by the construction in the neighbourhood of Staines, of reservoirs of adequate capacity, into which water shall be pumped and stored in times of excess, to be used in times of deficiency, at least 300,000,000 gallons a day may be obtained for the supply of London. We believe this can be done without taking in the more turbid of the flood waters, and without injuriously diminishing the volume of the River below the point of abstraction. To ensure the best results in both these respects, the taking of the water should be subject to strict regulations laid down by Parliament. The water allowed to be taken from the River should, in our opinion, include any water which may be pumped from the general beds in the vicinity of the River. “From the River Lea.—The available drainage area of the Lea above the lower intake of the East London Company is stated by Mr. Bryan to be 460 square miles; and the mean rainfall upon it is stated by Mr. Symons to be 26 inches. No gaugings of the discharge has ever been made at or below the intakes; but they have been kept for many years at Fielde's Weir, which has above it (as before stated) an area of 422 square miles, 43 From this point we have made out that, on the average of three consecutive dry years, 81,000,000 gallons a day will flow off by the River. We have no definite evidence as to the capability of the district below ; but from some remarks of Mr. Bryan's, we judge that he does not calculate upon getting an additional quantity proportional to the whole area, and we shall probably be safe in calling the total available quantity 85,000,000 gallons. Of this the New River Company draw 22,500,000 gallons direct from the River above Ware; and the East London Company have at times taken 37,000,000 gallons. Dealing with the River as a whole, this abstraction is, in our opinion, too great with the storage now in existance; but if other reservoirs were constructed, adequately increasing the storage capacity on well recognized lines, 52,500,000 gallons a day may be obtained. The taking of the water should be under regulations similar in character to those suggested for the Thames, viz.—the first flush of floods to be rejected, and in dry weather no water to be abstracted when the flow has run down to a quantity hereafter to be determined. "From Wells in the Lea Valley.— Into this part of the case we have already gone very fully; and we need only repeat here that in very dry years the Companies should not calculate upon obtaining more than 40,000,000 gallons a day. "From the Chalk on the South Side of the Thames.— From the existing wells of the Kent Company, and others which may be sunk within their district, we think that 27,500,000 gallons a day may safely be taken. From the tract of chalk coantry in the valley of the Med way and larger area farther eas!"ward to the coast, a very considerable addition is also undoubtably procurable. “The summary of the several quantities above stated is as follows :—From the River Thames, 300,000,000 gallons per day; from the River Lea, 52,500,000 gallons; from wells in the Lea Valley, 40,000,000 gallons; from wells in the, 'Kent Company's 44 district, 27,500,000 gallons—total 420,000,000 gallons, sufficient, at 35 gallons per head per day, for a population of 12,000,000.” Of these witnesses examined whose evidence was directly adverse to the reservoir and storage schemes put forward by the Companies, that of Mr. A. R. Binnie, M. Inst., C.E., Chief Engineer to the London County Council, was the most important. Mr. Binnie's evidence was to the effect that the supply that could be drawn from the Thames and the Lea was wholly insufficient to meet the future wants of Greater London; and he stated that, in his opinion, deeper storage reservoirs in the Thames Valley were impracticable, and, further, that any large increase in quantity pumped from the chalk formations would only ultimately diminish the amount of surface water in the various contributary streams, and therefore could not be reckoned on for increasing the supply. The weight of evidence given before the Commission went to rebut Mr. Binnie's evidence; and it will be seen from the extracts given from the report that the Commissioners did not accept his views. They unanimously recommended the adoption of additional storage works in the Thames Valley, and rejected those plans which advocated supplying the Metropolis with water from an entirely new watershed, as such a course would involve the water being brought from a great distance, which could only be carried out at a very serious and, in their opinion, unnecessary expense. The Commissioners' recommendations and conclusions are given here and on the succeeding pages. Recommendations as to the Prevention of Pollution. In order to preserve the wholesomeness of the water as delivered to the consumer, and in order further to meet the not unnatural sentiment against drinking water which, though wholesome, has been polluted at an early stage, all possible vigilance should be exercised to prevent unnecessary contaminations of the Thames and Lea and their tributaries, to insure the thorough treatment of all sewage before it is allowed to pass 45 into the Rivers by the most efficacious methods that science and experience may dictate, and to enforce the adequate storage and filtration of such water as is abstracted at the intakes. There can be no possible doubt that at the present time much filth of various kinds is discharged unnecessarily and illegally into the rivers ; and steps should be forthwith taken to put an end to this. The London County Council engage three Medical Officers of Health to inspect personally the whole course of the Thames and Lea and their tributaries, and to report in detail as to all sources of pollution they might detect. These three gentlemen appeared before us as witnesses, and handed in complete lists of the pollutions observed by them during their inspection. The pollutions mentioned are very numerous, as might naturally be expected, seeing that all that were detected, however trivial they might be, were entered in the account, and that, including the tributaries, many hundreds of miles of watercourse must have been examined. The point, however, to which we especially wish to direct attention, is that in a very large proportion of the cases the pollution recorded was preventible and illegal, being in direct contravention of the Rivers Pollution Prevention Act, of which one of these witnesses stated that “all through the country I think the Rivers Pollution Prevention Act has been more or less a dead letter. I do not think it has been put in force in many instances.” Some advances, however, have been made during the past 25 years in the construction of sewage works in the valleys of the Thames and Lea. Where such works have been constructed on an efficient system the sewage can be so effectually dealt with at all times, except times of flood, that the effluents are clear and innocuous. We understand that in some of the places which still require sewage farms or works for the efficient treatment of sewage operations are already in progress for providing 46 them, and we are of opinion that, in the rest, steps for the attainment of the same subject should be taken without delay. We are aware that all sewage farms and sewage works are liable, through carelessness or accident, to do their work at times with less than proper efficiency, For the purpose of keeping them up to a sufficient standard frequent inspection by an authority appointed for the purpose is, in our opinion, absolutely necessary. In the Thames Basin not only the River Conservancy, but the County Councils and the Sanitary Authorities have the power of putting the Rivers Pollution Prevention Act into operation. The Sanitary Authorities, however, speaking generally, do not appear to consider such action to be any part of their duty, unless the pollution be such as to affect the health of their own limited district; and both Sanitary Authorities and County Councils have hitherto practically left the matter to the Conservancy—the Councils, as one of their Chairmen told us, being “very desirous to avoid anything like friction with a body which has concurrent jurisdiction with ourselves,” and the Sanitary Authorities pleading that “The Thames Conservancy are paid for doing a great deal of this work.” Some of the County Councils appear, however, to recognise their obligation, for the Chairman of the Sanitary Committee of the Surrey Council informed us that they “hold it distinctly to be their duty to carry out the provisions of the Rivers Pollution Act, and that you may rely that Surrey will take up that work, and that it will have the full support, certainly of Middlesex and London, and probably of every County Council in the district, in keeping the river as pure as it is no.v, and I should hope much purer.” It appears that in the Lea Valley the only body upon which devolves the duty of seeing that this Act is enforced is the Lea Conservancy Board, to which this power is given exclusively by the 9th Section of the Rivers Pollution Act, 1878. As regards the Thames Conservancy Board, its effectual action is hindered by several causes. In the first place, its jurisdiction over the 47 tributary streams is limited to a distance of ten miles from the main river, so that any pollution may occur higher up with perfect impunity. Secondly, it is evident that no really satisfactory supervision can be exercised over several hundreds of miles of waterway without a considerable staff of inspectors; and the staff which the Conservancy at present maintains, which consists of two Chief Inspectors, two Assistant Inspectors and four River Keepers, appears to us to be utterly inadequate for the purpose, especially when it is borne in mind that these officials have other duties to perform besides that of inspection. The small size of the inspecting staff appears not to be due to any unwillingness on the part of the Conservancy to perform their duty, but to the limited funds at their disposal. A third hindrance to the effectual action of the Conservancy is caused by the very cumbrous procedure they have to adopt when they come to deal with a recalcitrant offender. It is true that the procedure under the Conservancy Acts is not so cumbrous as under the Rivers Pollution Prevention Act. Still, even under these, it appears that, when a pollution has been discovered, twelve months' notice must be given before any further steps can be taken, and that even then the difficulties and delays are by no means exhausted. Such abatements of pollution as the Conservancy have been able to obtain have been rather by gentle persuasion than by legal proceedings; but “they believe that, if the Acts were simplified, and the action of them made more expeditious, they could entirely stop the pollutions throughout the whole district.” In this expression of opinion on the part of the Conservancy Board, as also in their further suggestion that their powers should not be limited to a distance of ten miles from the main river, but should be extended to the whole course of the tributaries, and that it should be made an offence to pollute a tributary, we fully concur, whilst we would add the further recommendation already mentioned by us that the staff engaged in inspection should be very considerably increased—the 48 necessary funds for this purpose being provided by the Water Companies, or such other bodies as are permitted to take water from the rivers. And though in the above remarks we have specially referred to the Thames, we intend our recommendations to apply equally to the Lea and its tributaries. Reference is made to the sewage of Hertford, and to the state of Manifold Ditch, in the evidence of Major Lamorock Flower and Mr. W. C. Young, of Messrs. Longmore, U. A. Smith, and Cramp, and of Drs. Stevenson and Turner, and the result of enquiries and visits by our Assistant Commissioner will be found in his report. Some of our number have also visited the locality and inspected the sewage works, and we are of opinion that the state of matters now existing ought to be remedied without delay. To effect this it will be necessary to strengthen the hands of whatever authority may be entrusted in future with the prevention of such pollution. Our attention has been called to the traffic in gas lime, manure, and town refuse which exists upon the Lea, as far, at any rate, as Hertford. Large heaps of such matter are placed on the edges of the hanks and within a few feet of the stream itself. It is obvious that, in times of rain and flood, they become a source of pollution which is quite unnecessary, and might be easily avoided by the exercise of a little care and foresight. We recommend that no collections of manure and refuse should be allowed within a certain specified distance of the river, or of any side stream or tributary ; and that the duly be imposed upon some authority of seeing that this prohibition is enforced. As to the Treatment of the Water after Abstr\ction from the River. We have further to consider what steps should be adopted to insure the proper treatment of the water that is taken from these rivers for the supply of London. For the water that flows down to the intakes must be subjected to certain important 49 processes before it is brought into a suitable condition for delivery and consumption. These processes consists of subsidence and filtration ; and the quality of the water when delivered depends largely upon the thoroughness with which they are carried out. It does not come within the terms of our reference to lay down what should be the exact regulations as regards filtration—that is, to say what should be the proportionate area of the filtering beds, the depth of sand, the frequency of renewal, or the rate at which the water should be allowed to percolate ; nor, as regards the subsidence tanks, how many days storage should be deemed sufficient, so as to obviate the necessity of taking in turbid storm water, and to allow due settlement. But we cannot shut our eyes to the fact that the provision for these purposes differs enormously in the different Companies, and in some of them is, to our minds, quite inadequate. Regulations on these matters should be drawn up after competent enquiry, and adherence to these regulations should be strictly enforced. This enforcement should be entrusted to the Public Water Examiner, who should have the legal right of entry into all the water-works, and the duty of reporting periodically as to the due observance of the conditions laid down. At present the Examiner is only admitted to the works on sufferance, and though he has informed us that he has always been admitted, not only without hesitation, but with all courtesy, by the various Companies, it is plain that the standing ground of a man who is inspecting by right is very different from that of one who is only present by courtesy. Conclusions. We are strongly of opinion that the water as supplied to the consumer in London is of a very high standard of excellence and of purity, and that it is suitable in quality for all household purposes. We are well aware that a certain prejudice exists against the use of drinking water derived from the Thames and 50 the Lea, because these rivers are liable to pollution, however perfect the subsequent purification, either by natural or artificial means, may be. But, having regard to the experience of London during the last thirty years, and to the evidence given to us on the subject, we do not believe that any danger exists of the spread of disease by the use of this water, provided that there is adequate storage, and that the same is efficiently filtered before delivery to the consumers. With respect to the quantity of water which can be obtained within the watersheds of the Thames and the Lea, we are of opinion that, it the proposals we have recommended are adopted, a sufficient supply to meet the wants of the Metropolis for a long time to come may be found without any prejudice to the claims, or material injury to the interests, of any district outside the area of Greater London. We are of opinion that an average daily supply of 40,000,000 gallons can be obtained from wells and springs in the chalk of the Lea Valley without affecting any material interests, but that, if this quantity be exceeded, it is probable that the springs and wells in the parts of the Valley immediately adjacent to the wells and all the districts farther down the Valley may be injuriously affected. From wells in the chalk area on the south side of the Thames, in the district of the Kent Company, we are of opinion that a daily average supply of 27,500,000 gallons may be obtained. We think it of very great importance that distinct obligations should be laid upon any Company or Local Authority which is allowed to pump water from the chalk for purposes of public supply to keep accurate observation of the effect of their operations on the level of the water in the wells from which they pump, and return the results to the Water Examiner under such regulations as may be framed. The great difficulty which we have had to encounter has been in getting accurate and reliable information as to the actual 51 effect of the operations now carried on. The importance of procuring this will increase each year as the limit of what can be taken from any district with safety is gradually being reached. From the River Lea we are of opinion that with adequate additions to the present system of storage, 52,500,000 gallons may be taken daily. We are of opinion that, by the construction of storage reservoirs in the Thames Valley, at no great distance above the intakes of the Companies, it will be possible to obtain an average daily supply of 300,000,000 gallons without taking in any objectional part of the flood water. The average daily flow of the Thames at Teddington Weir, adding the water taken by the Companies, is about 1,350,000,000 gallons per day. It will thus be seen that, when 300,000,000 gallons are taken, there will be left to flow down into the tidal portion of the river an average daily quantity of not less than 1,000,000,000 ; and we think that regulations could be framed under which the quantity we suggest could be taken, not only without reducing the flow of the river on the rare occasions of exceptional drought to the present minimum, but in such a way as to secure that the volume of water left in the river at these times should be substantially greater than it is under existing conditions. To our minds, one great advantage of such a scheme of storage reservoirs is that it can be carried out progressively to meet the increasing demands for water; and, should the population not grow so rapidly as we have thought it right to contemplate, the extensions may be from time to time deferred as successive decennial enumerations reveal that the ratio of increase is remaining stationary or even falling. From the sources and by the methods we have mentioned, a daily supply of 424,000,000 gallons can, in our opinion, be obtained. This is a sufficient quantity to supply 35 gallons per head to a population of 12,000,000 persons, which is about three-quarters of a million in excess of what the total population of Greater London, together with the outlying parts of Water London, will have become in 1931, even if the ratio of increase in the last 52 decennial period from 1881 to 1891 is fully maintained. We are further of opinion that a large supply of water might be obtained from the chalk area east of the Kent Companies' district in the basis of the Medway, and in the district further east, without any risk whatever of damage to that area. THE LONDON COUNTY COUNCIL AND THE WATER SUPPLY. The water Committee of the County Council issued a memorandum by its Chairman and a series of reports by the principal officers of the Council on the report of the Royal Commission on the Metropolitan Water Supply by which it will be seen that the conclusions of the Royal Commission are controverted to a certain extent by an admirable synopsis of the views of the London County Council and its chief officials appeared in the British Medical Journal, and which is here closely followed. The Want of Finality in the Commission's Recommendations. Mr. Basset Hopkins, the Chairman of Committee in his memorandum, insists strongly on the narrowness of the scope of the inquiry by the Royal Commission, and points out that mischievous consequences may follow, and the Council may be grievously hampered in its action if people accept the idea that the report was the result of an all-embracing investigation of the general subject. The real question which is of most interest to Londoners is what is the best course for London to pursue under the circumstances ? But this never entered into the reference to the Commission, and in considering their report it has constantly to be borne in mind that whatever they say in support of the prospective sufficiency (for forty years only) of the watersheds of the Thames and Lea has no bearing on the real question whether new gathering grounds ought not to be sought for outside that area altogether. 53 Considerable stress is laid on the shortness of the term of forty years to which the Commission have limited their forecast. The capacity of the Thames and Lea watersheds as sources of supply may be expected to have reached, or nearly reached, their limit about the year 1931, and then it will be impossible any further to delay turning to some outside source. By that time, however, the best gathering grounds in the country, which "are already being rapidly taken possession of by other municipalities," may be lost to us. In regard to this, one has to bear in mind the long time which is required for the execution of the vast works necessary in large water schemes, and Mr. Binnie, the Council's chief engineer, says plainly that the people of London, "will, at some not very distant date (probably twenty years hence) have to contemplate the exhaustion of the supplies which can be obtained in the Thames Valley " and the necessity of looking elsewhere for an increased supply. " One of the greatest blots upon the finding of the Royal Commission " is that " it can in no way be considered a final settlement of case." This limitation of forecast to forty years is all the more curious in view of the fact that two members of the Royal Commission, giving evidence before the House of Lords on the Birmingham water scheme, gave much longer periods as the time for which estimates should be made, Mr. G. H. Hill stating that provision for a large town should be for a period of not less than fifty years, and Mr. James Mansergh, the engineer to the scheme, indicating that he calculated his supply for some sixty-four years, and on that basis laid out the works which the Corporation of Birmingham are now carrying out. The Effect of Dry Seasons. Mr. Binnie shows in a striking way the difference between averages and actualities in regard to the flow of water down a river bed. The Royal Commissioners contemplate taking 300 million gallons from the Thames daily, trusting to the fact that the average daily flow at Teddington weir is about 1,350 54 million gallons ; but Mr. Binnie shows that during certain dry months the total average flow would often only slightly exceed the amount of water required by the Companies, and in such a case as that of September last year the total flow would not come up to the requirements. If the extreme minimum flow per twenty-four hours is taken, the difficulty of providing a supply both for the River and the Metropolis is still more apparent. Tests Not to be Relied on. There is a good deal of common sense in some of the remarks in the reports about the safety, or otherwise, of polluted waters. Mr. Binnie draws attention to the fact that " the Royal Commissioners received, although they do not quote it, some very strong evidence from one of the highest authorities, namely, Sir G. Buchanan, M.D., F.R.S., late Chief Medical Officer to the Local Government Board." This evidence was to the effect that neither chemical nor bacteriological tests were to be relied on as to the purity of water, that we did not know how small an amount of morbific material, if it gained access to the water, might set up disease, and that the way to gain information as to purity and safety was to search out the conditions surrounding water courses and water services. Asked what would be his treatment of the water if it were found to be polluted, he could only answer that " there was nothing for it but either to boil the polluted water, or else to leave it alone." In face of such evidence from such an authority we turn with interest to the paragraphs in Mr. Binnie's report summarising the pollutions of the Thames water, which the Commission thinks good enough for London. It seems that at the census of 1891 there was a population of 1,056,415 persons draining into the river above the intakes, and that in the last thirty years this population had increased from 816,814 to its present number. That, however, gives but a poor idea of the increase which is going on in the urban population living on 55 the banks of the Thames and its Tributaries, many of these towns having more than doubled their size in thirty years. " Besides this human population there are probably 1,600,000 animals inhabiting the above area. Consequently it is clear that if the Thames is to be retained as a source of water supply, the people of London must drink the more or less clarified excreta of this vast population. To show what is likely to happen in the future, it is mentioned that in the present session of Parliament " the authorities of Swindon and Tilehurst, Pangbourne and district are applying for further water powers. What must be the result ? They will either pump from wells or the River comparatively clean water which now flows down to supply London, and after defiling it by passing it through their bodies and water closets will return it directly or indirectly into the Thames to flow down and be drunk by the people of London." Impossible to Keep Out Sewage. Now about the purification of this water. Dr. Frankland is quoted as saying " That it is practically impossible to keep sewage or sewage effluents out of the River. " There is no positive evidence that the filtered water is unwholesome, but the lives of a large community ought not to be dependent on the efficient filtering plant of commercial companies. Under present circumstances, a serious epidemic of typhoid or cholera in the Thames basin above the intakes, would be attended with great risk to the water drinkers of London. Such experiments should not be tried upon large communities." It would appear, then, that while Edinburgh, Glasgow, Liverpool, Manchester, and Birmingham find it necessary " to go to great distances to secure undoubtedly pure and 56 inated water, even to the extent of excluding the flow from cultivated land, yet it is quite sufficient for the people of London to supply them with the effluent water of their neighboars' water closets. Other Towns Seek Purer Water The oddity is that the very time the Royal Commission was sitting some of its members were giving evidence on this very point of polluted gathering ground, showing how the matter had been lcoked at by other municipalities, and how in certain cases reservoirs, collecting grounds, and plant had had to be abandoned in consequence of increasing pollution of the watershed. Speaking of the Trent, a member of the Royal Commission says : " It is a river that flows through an enormous tract of agricultural country, producing water which nowadays one would not think of supplying." And yet poor London would be thankful if the Thames did but drain only an agricultural district; unfortunately the Royal Commission received ample evidence of the pollution of the River not only by towns but " by cesspools, privies, sewage farms, house-boats, and manufacturing and manurial refuse," and also had before them the evidence of Sir G. Buchanan, who assured them that to judge of the purity of water they must go and see where it comes from. The extraordinarary thing is that the Commission, after seeing where it came from, and with what it was befouled, still maintained that it was good to drink. The report of the Parliamentary agent, Mr. H. L. Cripps, begins by drawing attention to the fact that in the proceedings before the Commission the witnesses were not cross-examined, and that, although the evidence records a valuable series of opinions upon different sides of many questions, its value is less than would have been the case had it been tested by crossexamination, 57 The Growth of Riverside Population. The similarity of the estimates, made by the Royal Commission and the County Council, as to the future rate of growth of London, makes it probable that the result arrived at is fairly correct, namely, that in 1931 a population of about eleven and a quarter millions of persons will have to be provided for. There is no reason, however, to believe that this great multitude will be evenly spread over the area under consideration, and if the growth of London should largely extend up river, if with improved railway facilities the population of the Thames basin should increase at the rate at which some of the riverside urban districts have lately done, it may easily happen that the water of the river may become unmanageably foul even before it fails in quantity. Mr. Cripps, however, points out that, taking the estimate of the Commission, our respite even as regards quantity is really not for forty years. Three years have already gone by, and considering the length of time which would be necessary for working out and executing any scheme for fetching water from a new source of supply, he thinks that it would be impossible for the governing authority of London to defer the selection of some such new source more than fifteen or twenty years. The Quality of Present Sources of Supply. Mr. Shirley Murphy, Medical Officer to the London County Council, confines his observations to that portion of the report of the Royal Commission which relates to the quality of the present sources of supply. The Royal Commission had before it evidence, he says, which showed that the rivers from which the Water Companies draw their supplies receive from the towns situated on their banks at varying distances above the intakes sewage effluents, which, after treatment of the sewage, either by filtration through land or by chemical processes, enter smaller rivers. In addition to these numerous pollutions from smaller populations discharging into cesspools and ditches reach, untreated, the streams at times of heavy rainfall. Such 58 sewage must not infrequently contain the excremental matter of persons suffering from typhoid fever and may not improbably in the future contain from time to time the excreta of persons suffering from cholera. The virus of both these diseases has been found by past experience to have been disseminated by water and to have produced fatal results in persons drinking such water. " Not only are these diseases known to be waterborne, but experience has shown that a very small amount of the excremental matter of persons suffering from them is capable under favourable circumstances of infecting vast volumes of water." Insufficiency of Natural Purification. After describing the various circumstances which are shown by the Commission to contribute to the purification of the rivers, Mr. Murphy says: " The fact may be accepted that these powers exist and are operating in the Thames and Lea to an extent which contributes in no small degree to the safety of the London water consumer." Yet the Commission evidently does not look upon these natural processes as in themselves sufficient to render the water fit for domestic purposes, but is only satisfied in such agencies and the operations of the water companies combined, suffice to ensure that wholesome water is supplied to the consumer. As it is probable that the completeness of the future operations of the water companies may depend upon the necessity which can be shown for efficient filtration, it is a matter of great importance that the natural processes of purification should not be held to be more deserving of confidence than they really are. After a careful study of the statements in the Commission's report, Mr. Murphy is led to think that some of the reasons given for assuming that the London population is not exposed to risk are less deserving of acceptance than appears at first sight. 59 Dilution of Polluting Matter. The Royal Commission has evidently been much impressed by the dilution to which any excremental matter must be subjected in the rivers. Taking the smallest annual flow in the Thames over Teddington weir in any one year, from 1881-91, and the largest number of cases of enteric fever in any one of those years, they show that this would give 294 million gallons to one case. But as Mr. Murphy says, the risks to London water supplies are less from the average number of cases of enteric fever in the water area in a year than from the occurrence of a number of cases at one time in a community discharging its sewage into the river. Typhoid is not distributed equally throughout the year, and regard must always be had to the possibility of some exceptional outbreak— due to milk, for example—giving rise to hundreds of cases of the malady in towns situated a limited number of miles above the intake, and discharging their sewage into the rivers ; for there has been experience of a town having to discharge its sewage, untreated into the river owing to the temporary failure in its machinery for treatment, and this at a time when the town was suffering from an epidemic of enteric fever. Comparison Between Wells and Rivers. The Royal Commission would appear to admit that, in the case of the Caterham Well, the typhoid poison was waterborne ; but, appealing to the arithmetical test of dilution, they maintain that no argument derived from that case can be applied to a river, in which the volume of water is so much greater. But Mr. Murphy shows that we have no accurate knowledge of the amount of water which a single case can render virulent, and that certainly no safe deduction of this kind can be made from the occurrence at Caterham; for the man who there gave rise to the infection was only employed in the well during a portion of the day, and in his evidence he insisted that, when in the well, he always used the bucket, and that his evacuations were sent to the surface. The contamination may therefore have 60 been due to the mere splashings from the bucket, and may have been extremely small. Moreover, we have no proof whatever that in this case it contaminated as much water as it was capable of doing. While, then, the Caterham case may fairly be taken as proof of the water carriage of typhoid poison, it can in no way be taken as indicating the concentration necessary to enable it to maintain its virulence. The Commission elaborately calculates the number of typhoid fever cases which must exist in the Thames Valley to foul the London water to the same extent as was assumed to be the case in the Caterham well, and shows a result which is obviously absurd ; but Mr. Murphy cleverly paraphrases the same calculation for the purposes of the Tees Valley and shows the result there also to be equally absurd; and yet, as we all know, typhoid fever in that case did break out from the use of the water notwithstanding all the calculations. Dr. Barry and the Commission. Mr. Murphy carefully criticises the action of the Commission in putting on one side the conclusions of Dr. Barry in regard to the Tees epidemic, which, he says, "I am satisfied must be accepted as certainly as the evidence concerning the Broad Street well of 1854 and the Caterham well of 1875, evidence which the Royal Commission evidently accepts as amounting to proof." Although there are important differences between the Tees and the London rivers, the fact that filtration failed to protect the consumers of the Tees water raises questions as to the dependence which can be placed on filtration for complete and uninterrupted protection. This question of the power of filtration to produce uninterrupted supplies of good water from foul sources is, and will continue to be, of the supremest importance to Londoners so long as their supplies are drawn from the river, and we cannot 61 but think that, while the present supply is made use of, the London people, as represented by their County Council, would do well to endeavour to get into their own hands the right to inspect the whole process of filtration and summarily to debar the access of foul water to the pipes. It is abundantly clear that it is wrong to trust to the examination of the water in bulk. The product of each filter bed must be continuously watched, and unhesitatingly refused if below the standard; and it is not improbable that a short experience of the difficulty of providing a continuously pure water under such circumstances would soon lead to a general acceptance of the necessity for new sources of supply. The very full information afforded in the report of the Royal Commission is of the utmost possible value as assisting to give definite form to a general comprehension of the real condition of the water supply of the Metropolis, present and future. It has always been a cherished article of faith in this country that the water of the River Thames is of unsurpassable quality for all domestic purposes. Nothing can be found in the report which in any way disturbs this conviction, and it may be assumed, as has always been urged in these reports, that the water supplied to London, if properly treated by the avoidance of pollution, ample storage (in order to avoid the necessity of taking in water from the river when in flood, as the organic pollution is then at the maximum), and efficient filtration, is all that can be desired. The second point as to how long the quantity will suffice for the needs of ever-growing London is also fully gone into, and half-a-century is defined as the probable period. Of course there is much to be said on the other side, and that is lucidly given in the objections to the report of the Royal Commission urged by the London County Council and its officers. Although very little is definitely said on the subject, the impression which the perusal of the report leaves upon the mind is that the whole control of the water supply, from the sources 62 to the final delivery to the consumer, should be in the hands of one authority, and that the time has arrived when competing companies, the result of private enterprise, should no longer be left in possession of a monopoly of the primary necessity of existence. The information on the whole subject of the Metropolitan Water Supply given above will enable it to be clearly understood, and to place in a permanent form for future reference the necessary data, and will, it is to be hoped, justify this somewhat lengthy resume. Bye-laws under the Public Health (London) Act, 1891. This Act provides that every Sanitary Authority in the Metropolis shall make bye-laws under the following Sections. Sec. 16. For the prevention of nuisances. Sec. 39. Water closets sufficiently supplied with water. Sec. 50. The Cleansing of cisterns. Sec. 94. Houses let in lodgings or occupied by members of more than one family. The Vestry has made such bye-laws and they have been approved by the Local Government Board, they are now in force and are here set out. PUBLIC HEALTH (LONDON) ACT, 1891, SECTION 16. Bye-Laws made by the Parish of St. Mary, Battersea, in the County of London being the Sanitary Authority for the said Parish, For the Prevention of Nuisances. Interpretation of Terms. Throughout these bye-laws the expression "the Sanitary Authority" means the Vestry of the Parish of St. Mary, Battersea, in the County of London. 63 For the prevention of nuisances arising from any snow, ice, salt, dust, ashes, rubbish, offal, carrion, fish, or filth, or other matter or thing in any street. 2. The occupier of any premises fronting, adjoining, or abutting on any street not repairable by the inhabitants at large shall, as soon as conveniently may be after the cessation of any fall of snow, remove or cause to be removed from the footways and pavements adjoining such premises and forming part of such street all snow fallen or accumulated on such footways and pavements in such a manner and with such precautions as will prevent any undue accumulation in any channel or carriageway or upon any paved crossing. The person in occupation of or having the charge, management or control of the premises, or if there is no such person, then any person in occupation of or having the charge, management, or control of any part of the premises, and in the case of any premises the whole of which is let in tenements or to lodgers, the person receiving the rent payable by the tenants or lodgers, either on his own account or as the agent of another person, shall for the purposes of this bye-law be deemed to be the occupier. 3. Every person who shall remove any snow from any premises on to any carriageway shall deposit the same in such a manner and with such precautions as to prevent any accumulation thereof in any channel or upon any paved crossing. If in the process of such removal any snow be deposited upon any footway or pavement in any street, he shall forthwith remove such snow from such footway or pavement. 4. Every person who shall throw any salt upon any snow on the footway of any street shall do so in such quantity and in such manner as effectually to dissolve the whole of such snow, and he shall forthwith effectually remove from the footway the whole of the deposit resulting from the mixture of the salt with the snow. 64 He shall not place any part of such deposit on the carriageway of such street elsewhere than in proximity to any channel at the side of such carriageway, and he shall not remove any part of the same into any such channel unless it is sufficiently liquid to flow along such channel. No person shall throw any salt upon any snow on the carriageway of any street, unless it shall be practicable forthwith effectually to remove the whole of the deposit resulting from the mixture of the salt with the snow. Every person who shall throw any salt upon any snow on any such carriageway shall forthwith effectually remove the whole of the deposit, but he shall not place any part thereof on the footway of such street or on any paved crossing, or on the carriageway in such a manner as to interfere with the carriage traffic, nor shall he place any part thereof in the channel at the side of the carriageway, unless it is sufficiently liquid to flow along such channel. 5. A person shall not throw, cast, or lay, or cause to be thrown, cast, or laid, any dust, ashes, rubbish, offal, carrion, fish, or filth or other like matter or thing in or upon any part of a street: Provided always that this bye-law shall not apply to any act which is for the time being an offence within the meaning of any public general Statute, or of any bye-law made by the London County Council and in force in the place where such act is done: Provided also that it shall not be an offence against this bye-law to lay any ashes or other suitable material in any street in time of frost to prevent accidents. 6. Every person who shall lay or cause to be laid in any street any litter or other matter in case of sickness to prevent noise, shall lay the same so that it may be evenly distributed over the surface of the part of the street intended to be covered, and shall, when the occasion ceases, within forty-eight hours 65 after remove or cause to be removed from such street the litter or other matter so laid in such street. For preventing nuisances arising from any offensive matter running out of any manufactory, brewery, slaughter-house, knacker's yard, butcher's or fishmonger's shop, or dunghill, into any uncovered place, whether or not surrounded by a wall or fence. 7. The occupier of a manufactory, brewery, slaughterhouse, knacker's yard, butcher's or fishmonger's shop, or of any premises comprising a dunghill, shall not cause or suffer any offensive matter to run out of such manufactory, brewery, slaughter-house, knacker's yard, butcher's or fishmonger's shop, or dunghill, into any uncovered place, whether or not surrounded by a wall or fence, so as to be likely to become a nuisance. For the prevention of the keeping of animals on any premises in such place or manner as to be a nuisance or injurious or dangerous to health. 8. The occupier of any premises shall not keep nor allow to be kept any animal on such premises in such a place or in such a manner as to pollute, or to be likely to pollute, any water supplied for use or used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man, or any water used or likely to be used in any dairy. 9. Every occupier of a building or premises wherein or whereon any horse or other beast of draught or burden, or any cattle may be kept, shall deposit or cause to be deposited in a suitable receptacle all dung, manure, soil, filth, or other offensive or noxious matter other than urine and other liquid filth, which may, from time to time, be produced in the keeping of any such animal in such building or upon such premises. He shall likewise provide in connexion with such building or premises a sufficient drain, constructei in such a manner, and of such materials, and maintained at all times in such a 66 dition, as effectually to carry away all urine and liquid filth or refuse therefrom. Except where the Sanitary Authority by notice duly given under the statutory provision in that behalf shall have otherwise required, he shall, once at least in every week, remove or cause to be removed from such building or premises all dung, manure, soil, filth, or other offensive or noxious matter produced in or upon such building or premises, and deposited in a receptacle as hereinbefore required. Provided that this requirement shall not apply to the occupier of any stable or cow-house from which the Sanitary Authority remove or contract for the removal of manure and other refuse matter. Where for the purpose of preventing the keeping of any horse or other beast of draught or burden or any cattle on any premises so as to be a nuisance or injurious or dangerous to health, it is necessary that the floor of the building in which such animal is kept should be impervious to liquid matter, no person shall keep any animal in such building unless or until the floor thereof shall have been paved with a hard and impervious pavement evenly and closely laid and so sloped as to effectually carry off all liquid matter therefrom to a properly trapped inlet to the drain hereinbefore required to be provided. As to the paving of yards and open spaces in connexion with dwelling houses. 10. The owner of every dwelling-house in connexion with which there is any yard or open space shall, where it is necessary for the prevention or remedy of insanitary conditions that all or part of such yard or open space shall be paved, forthwith cause the same to be properly paved with a hard, durable, and impervious pavement, evenly and closely laid upon a sufficient bed of good concrete, and so sloped to a properly constructed channel as effectually to carry off all rain or waste water therefrom ; and he shall cause such pavement to be kept in proper repair. 67 Penalties. 11. Every person who shall offend against any of the foregoing bye-laws shall be liable for every such offence to a penalty of five pounds, and in the case of a continuing offence to a further penalty of forty shillings for each day after written notice of the offence from the Sanitary Authority : Provided, nevertheless, that the justices or court before whom any complaint may be made or any proceedings may be taken in respect of any such offence may if they think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. PUBLIC HEALTH (LONDON) ACT, 1891, SECTION 39. BYE-LAWS Made by the Vestry of the Parish of St. Mary, Battersea, in the County of London, being the Sanitary Authority for the said Parish, with respect to The keeping of Water Closets supplied with sufficient water for their effective action. Interpretation of Terms. 1. Throughout these bye-laws the expression "the Sanitary Authority " means the Vestry of the Parish of St. Mary, Battersea, in the County of London. With respect to the keeping of Waterclosets supplied with sufficient Water for their effective Action. 2. The occupier of any premises in or for which any watercloset is for the time being provided, shall cause such watercloset to be at all times properly supplied with a sufficient quantity of water for securing its effective action. 68 Where, however, any watercloset is provided for the use of persons occupying two or more separately occupied premises, and there is a person having the care and control of such water-closet, the foregoing requirement shall apply to such person. The person in occupation of or having the charge, management, or control of the premises, or if there is no such person then any person in occupation of or having the charge, management, or control of any part of the premises, and in the case of any premises the whole of which is let to lodgers, the person receiving the rent payable by the lodgers, either on his own account or as the agent of another person, shall for the purposes of this bye-law, be deemed to be the occupier. Penalties. 3. Every person who shall offend against the foregoing bye-law shall be liable for every such offence to a penalty of five pounds, and in the case of a continuing offence to a further penalty of forty shillings for each day after written notice of the offence from the Sanitary Authority : Provided, nevertheless, that the justices or court before whom any complaint may be made or any proceedings may be taken in respect of any such offence may, if they think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. PUBLIC HEALTH (LONDON; ACT, 1891, SECTION 50. b y e - l a w s Made by the Vestry of the Parish of St. Mary, Battersea, in the County of London being the Sanitary Authority for the said Parish with respect to The Cleansing of Cisterns. Interpretation of Terms. 1. Throughout these bye-laws the expression "the Sanitary Authority " means the Vestry of the Parish of St. Mary, Battersea, in the County of London. 69 For securing the cleanliness and freedom from pollution of tanks, cistcrns, and other receptacles used for storing of water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man. 2. The owner of any premises who shall provide thereon a tank, cistern, or other receptacle to be used for storing of water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man, shall cause the same to be so constructed and placed that it may conveniently be cleansed. 3. The owner of any premises on which a tank, cistern or other receptacle not provided by the occupier of such premises is used for storing of water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man, shall cause every such tank, cistern or other receptacle which is erected outside a building or which being erected inside a building is not placed in a suitable chamber or otherwise constructed or placed so as to prevent the pollution of the water therein, to be provided with a proper cover. 4. The occupier of any premises on which a tank, cistern, or other receptacle is used for storing of water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man, shall empty and cleanse the same, or cause the same to be emptied and cleansed, once at least in every six months, and at such other times as may be necessary to keep the same in a cleanly state and free from pollution. He shall causa every such tank, cistern, or other receptacle which is erected outside a building, or which, being erected inside a building, is not placed in a suitable chamber, or otherwise constructed or placed so as to prevent the pollution of the water therein, to be kept at all times properly covered. Provided that in every case where any tank, cistern, or other receptacle 70 used for storing of water used or likely to be used by man for drinking or domestic purposes, or for manufacturing drink for the use of man, is used for supplying water to persons occupying two or more separately occupied premises, the foregoing requirements shall apply to the owner of such premises instead of to any occupier thereof. The person in occupation of, or having the charge, management, or control of the premises, or if there is no such person then any person in occupation of, or having the charge, management or control of any part of the premises, and in the case of any premises the whole of which is let to lodgers, the person receiving the rent payable by the lodgers, either on his own account, or as the agent of another person, shall, for the purposes of this bye-law be deemed to be the occupier. 5. The occupier of any premises or any other person shall not obstruct or interfere with the owner of such premises, or with any person duly authorized by him in that behalf, in the execution of any work to which the foregoing bye-laws relate. Penalties. 6. Every person who shall offend against any of the foregoing bye-laws shall be liable for every such offence to a penalty of Jive pounds, and in the case of a continuing offence to a further penalty of forty shillings for each day after written notice of the offence from the Sanitary Authority : Provided, nevertheless, that the justices or court before whom any complaint may be made or any proceedings may be taken in respect of any such offence may, if they think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. 71 PUBLIC HEALTH (LONDON) ACT, 1891, SECTION 94. bye - laws Made by the Vestry of the Parish of St. Mary, Battersea, in the County of London, being the Sanitary Authority for the said Parish, with respect to Houses Let in Lodgings, or occupied by Members of more than one Family. Interpretation of Terms. 1. In these bye-laws, unless the context otherwise requires the following words and expressions have the meanings hereinafter respectively assigned to them ; that is to say,— " Sanitary Authority " means the Vestry of the Parish of St. Mary, Battersea. " Lodging-house " means a house or part of a house which is let in lodgings or occupied by members of more than one family: " Landlord," in relation to a house or part of a house which is let in lodgings or occupied by members of more than one family, means the person (whatever may be the nature or extent of his interest in the premises) by whom or on whose behalf such house or part of a house is let in lodgings cr for occupation by members of more than one family, or who for the time being receives, or is entitled to receive the profits arising from such letting : " Lodger " in relation to a house or part of a house which is let in lodgings or occupied by members of more than one family, means a person to whom any room or rooms in such house or part of a house may have been let as a lodging or for his use and occupation. 72 Exempted Houses. 2. In either of the following cases a lodging-house shall be exempt from the operation of these bye-laws : that is to say,— (a.) Where the rent or charge payable by each lodger, and exclusive of any charge for the use by such lodger of any furniture, is at a rate of seven shillings and sixpence per week or upwards. (b.) Where the rent or charge payable by each lodger, and inclusive of any charge for the use by such lodger of any furniture, is at the rate of ten shillings per week or upwards. fa.) For fixing the number of persons who may occupy a house or part of a house which is let in lodgings or occupied by members of more than one family : (b.) For the registration of houses so let or occupied: (c.) For the inspection of such houses: (d.) For enforcing drainage for such houses, and for promoting cleanliness and ventilation in such houses : (e.) For the cleansing and lime-washing at stated times of the premises: (f.) For the taking of precautions in case of any infectious disease. 3. The landlord of a lodging-house or a lodger therein shall not knowingly cause or suffer a greater number of persons than will admit of the provision of three hundred cubic feet of free air space for each person of an age exceeding ten years, and of one hundred and fifty cubic feet of free-air space for each person of an age not exceeding ten years to occupy, at any one time, as a sleeping apartment, a room which is used exclusively for that purpose, and which is under the control of such landlord, or which has been let to such lodger, respectively, as the case may be. 4. The landlord of a lodging-house, or a lodger therein, shall not knowingly cause or suffer a greater number of persons 73 than will admit of the provision of four hundred cubic feet of free air space for each person of an age exceeding ten years, and of two hundred cubic feet of free air space for each person of an age not exceeding ten years to occupy, at any one time, as a sleeping apartment, a room which is not used exclusively for that purpose, and which is under the control of such landlord, or which has been let to such lodger, respectively, as the case may be. 5. The landlord of a lodging-house, within a period of fourteen days after he shall have been required by a notice in writing, signed by the Clerk to the Sanitary Authority, and duly served upon or delivered to such landlord, to supply the information necessary for the registration of such house by the Sanitary Authority, shall, himself, or by his agent duly authorised in that behalf, sign and furnish to the Sanitary Authority a true statement of the following particulars with respect to such house ; that is to say,— (a.) The total number of rooms in the house : (b.) The total number of rooms let in lodgings or occupied by members of more than one family : (c.) The manner of use of each room : (d.) The number, age, and sex of the occupants of each room used for sleeping : (e.) The Christian name and surname of the lessee of each room ; and (/.) The amount of rent or charge per week payable by each lessee. 6. In any case where the landlord of a lodging-house occupies or resides in any part of the premises, or retains a general possession or control of the premises, such landlord, and in any case where the landlord of a lodging-house does not occupy or reside in any part of the premises, or retain a general possession or control of the premises, every lodger who is entitled to have or to exercise the control of the outer door of the 74 premises shall, at all times when required by the Medical Officer of Health, the Sanitary Inspector, or any other officer specially appointed or authorised by the Sanitary Authority in that behalf, afford any such officer free access to the interior of the premises for the purpose of inspection. 7. Every lodger in a lodging-hou?e shall, at all times when required by the Medical Officer of Health, the Sanitary Inspector or any other officer specially appointed or authorised by the Sanitary Authority in that behalf, afford any such officer free access for the purpose of inspection to the interior of any room or rooms which may have been let to such lodger. 8. Where the Medical Officer of Health, the Sanitary Inspector, or any other officer specially appointed or authorised by the Sanitary Authority in that behalf, has, for the purpose of inspection, obtained access to the interior of a lodging-house or to the interior of any room or rooms in such house, a person shall not wilfully obstruct any such officer in the inspection of any part of the premises, or, without reasonable excuse, neglect or refuse, when required by any such officer, to render him such assistance as may be reasonably necessary for the purpose of such inspection. 9. In any case where a lodger in a lodging-house is entitled to the exclusive use of any court, courtyard, area, or other open space within the curtilage of the premises, such lodger, and in any case where two or more lodgers in a lodging-house are entitled to the use in common of any court, courtyard, area, or other open space within the curtilage of the premises, the landlord shall cause such court, courtyard, area, or other open space to be thoroughly cleansed from time to time as often as may be requisite for the purpose of keeping the same in a cleanly condition. 10. The landlord of a lodging-house shall cause every drain or means of drainage with which any water-closet belonging to 75 Such house may communicate to be maintained at all times in good order and efficient action. He shall also cause all such means of ventilation as may be provided in or in connexion therewith to be maintained at all times in good order. 11. Every lodger in a lodging-house shall cause all solid or liquid filth or refuse to be removed once at least in every day from every room which has been let to him, and shall once at least in every day cause every vessel, utensil, or other receptacle for such filth or refuse to be thoroughly cleansed. 12. In every case where a lodger in a lodging-house is entitled to the exclusive use of any staircase, landing, or passage in such house, such lodger shall cause every part of such staircase, landing, or passage to be thoroughly cleansed from time to time as often as may be requisite. 13. A lodger in a lodging-house shall not cause or suffer any animal to be kept in any room which has been let to such lodger or elsewhere upon the premises in such a manner as to render the condition of such room or premises filthy. 14. The landlord of a lodging-house shall cause every common passage or staircase in such house to be thoroughly cleansed from time to time as often as may be requisite. 15. The landlord of a lodging-house shall, in the month of April in every year, cause every part of the premises to be cleansed. He shall, at the same time, except in such cases as are herein-after specified, cause every area, the interior surface of every ceiling and wall of every watercloset belonging to the premises, and the interior surface of every ceiling and wall of every room, staircase, and passage in the house to be thoroughly lime-washed, 76 Provided that the foregoing requirement with respect to the lime-washing of the internal surface of the walls of rooms, staircases and passages shall not apply in any case where the internal surface of any such wall is painted, or where the material of or with which such surface is constructed or covered is such as to render the lime-washing thereof unsuitable or inexpedient, and where such surface is thoroughly cleansed, and the paint or other covering is renewed, if the renewal thereof be necessary for the purpose of keeping the premises in a cleanly and wholesome condition. 16. The landlord of a lodging-house shall provide adequate means of ventilation in or in connexion with every common passage or staircase in such house, and shall cause such means of ventilation to be maintained at all times in good order. 17. The landlord of a lodging-house shall cause all such means of ventilation as may be provided in or in connexion with any room in such house to be maintained at all times in good order. 18. In every case where, in pursuance of any statutory provision in that behalf, an order of a justice has been obtained for the removal from a lodging-house to a hospital of a person who is suffering from any dangerous infectious disease and is without proper lodging or accommodation, the landlord of such house, and the lodger to whom any room whereof such person may be an occupant has been let shall, on being informed of such order, forthwith take all such steps as may be requisite on the part of such landlord and of such lodger, respectively, to secure the safe and prompt removal of such person in compliance with such order, and shall, in and about such removal, adopt all such precautions as, in accordance with any instructions which such landlord and such lodger, respectively, may receive from the Medical Officer of Health of the Sanitary Authority, may be most suitable for the circumstances of the case. 77 Penalties. 19. Every person who shall offend against any of the foregoing bye-laws shall be liable for every such offence to a penalty of five pounds, and in the case of a continuing offence to a further penalty of forty shillings for each day after written notice of the offence from the Sanitary Authority: Provided, nevertheless, that the justices or court before whom any complaint may be made or any proceedings may be taken in respect of any such offence may, if they think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. There are other bye-laws which m.iy be made by the Sanitary Authority, and which are now under consideration. They are :— Ser. 66. Removal to hospital of infected persons. This is now effected under the provisions of the various acts and regulations of the Metropolitan Asylums Board. Sec. 88. Bye-laws for the Mortuary. Regulations are in existence for the control of the Mortuary and the Mortuarykeeper, under which the Mortuary has hitherto been regulated. Sec. 95. Tents and Vans. Bye-laws were made by the District Board some years since, which have been acted on until the present time. Sanitary The following Bills were introduced into Legislation during 1893 ment during the Session. Only those affecting the Vestry as the Sanitary Authority, are here noticed, together with their ultimate fate. Drainage A Bill to enable Local Authorities to separate Separation . Bill. house drainage from rain and surface water,—Bill was dropped. 78 Plumbers' This Bill was re-introduced in the House of tion Bill. Commons, which was reported upon by the Standing Comriiittee on Trade and not further proceeded with. Public A Bill to amend the Public Health Acts with Health Acts spect to Common Lodging Houses. The Bill was Amend- ments Bill, eventually withdrawn. Public The Bill dealt only with the financial clauses of Health J (London) the Act and finally received the Royal assent, but Amend- does not need further mention here. ments Bill. Public This Bill was brought in to extend and amend the (London) Public Health (London) Act, 1891, under which Act B'"' the Vestry derives its sanitary powers. It was, however, dropped. River Merely explanatory of the Rivers Pollution Pollutions Bill. tion Act, 1876. Passed and received Royal assent. Rivers A Bill to extend to the whole of the country the Pollution Prevention provisions of the Mersey and Irwell Act, 1892, to improve the law for preventing the pollution of streams. The Bill was withdrawn. Sanitary RegistraThis Bill has been before Parliament on several tion Bill. occasions. The object of the Bill is to provide that a distinct class of inspectors, to be called Licentiates in Sanitary Practice, are to inspect every dwelling house, school, college, hospital, asylum, workhouse, factory, workshop, hotel and lodging house. As this would clash with the work of local Sanitary Authorities and their Sanitary Inspectors opposition arose and the Bill was dropped. Local GovThis Bill does not affect the action of Sanitary eminent (England Authorities or their officers, but regulates election of and Wales) mem|iers, qualifications, &c., and finally received the Royal assent. 79 TABLE XIV. Return of sickness and causes of death among the Parish poor during the year 1893 under the treatment of the District Medical Officers, compiled from the Medical Relief books. ZYMOTIC OR EPIDEMIC DISEASES. Grand Totals of Cases and Deaths from all Diseases. Battersea. Poor Law Medical Districts. Small-Pox. Measles. Scarlatina. Diphtheria. Whoop ng Cough. Enteric & other Fevers. Erysipelas. Puerperal Fever or Metria. Diarrhoea, Dysentery, or Cholera. Influenza. Other Zymotic Diseases. Total. No. 1 1 13 15 5 23 _ 5 _ 44 15 _ 121 Casks No. 2 5 16 22 13 18 2 3 _ 81 37 3 200 No. 3 5 4 24 11 14 — 14 2 36 18 6 134 Whole Parish 11 33 61 29 55 2 22 2 161 70 9 455 No. 1 _ _ _ _ _ _ _ _ _ 1_ 1 Deaths No, 2 — — — — 1 1 — _ 1 1 — 4 No. 3 _ _ 1 _ _ _ _ _ 1 _ _ 2 Whole Parish — — 1 — 1 1 — _ 2 2 — 7 OTHER DISEASES. Battebsea. Poor Law Medical Districts. Diseases of the Tubercular Class. Of Brain, Nerves, &c. Of Heart. Of Respiratory Organs. Of Digestive Organs. Of Kidneys. Premature Birth, Low Vitality, Malformation,&c Age. Violence. All other Diseases. Total. No. 1 22 35 14 241 61 7 8 244 22 586 1,235 1,356 Cases No. 2 31 48 37 339 62 10 5 193 27 890 1,642 1,842 No. 3 411 39 9 339 77 7 3 191 48 957 1,710 1,844 Whole Parish 93 122 60 919 200 24 11 628 97 2433 4,587 5,042 No. 1 1 2 _ 3 1 1 _ 3 _ 2 13 14 Deaths No. 2 1 3 1 7 1 1 2 _ — 1 17 21 No. 3 — 3 2 4 — — — 1 — 1 11 13 Whole Palish 2 8 3 14 2 2 2 4 — 4 41 48 80 The proportion of deaths to cases treated is under one per cent. The respective districts have been altered in extent and boundaries during the past year and do not correspond with the districts of former reports, so that no comparison would be of value. TABLE XV. Supplemental Return, 1893.] VACCINATION. Registration Sub-District. Number of Births returned in the Birt.i Lint Sheets—1892. Nos. of those births duly entered by the 31st .liiniuiry, 1893, in Cols 10, 11, and 13. of the Vaccination Register, (Birth List Sheets), viz :— No. of Births which on the 31st Jan. 1893, remai ied unentered in the Vaccination Register on account. Number of those Births remaining 011 31st January neither duly entered in Vaccination Register (Col. 3, 4, .0, and 6 of this Return) nor accounted in the Report Bk. Col. 10, successfully vaccinated. Col. Insusceptible of vaccination. Had small-pox. Col. 13, Dead unvaccinated. Postponement by Medical Certificate. Removed to Districts their vaccination officers of which have been apprised. Removed to places unknown. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) East Batteuska 2423 1682 20 ... 177 ... 77 3 202 262 West Battersea 2589 1787 9 ... 229 ... 95 6 217 246 Totals ... 5012 3469 29 ... 406 ... 172 9 419 508 This is the return usually given by the Vaccination Officer at the end of each year. It is always a year in arrear of other returns and applies only to children born before January 31st, 1893. Out of 5,012 registered births 3,469 have been successfully vaccinated, 406 have died before vaccination, chiefly premature births, 172 have been postponed for health conditions, 29 are said to be insusceptible of vaccination, a very doubtful condition, due probably to failure from the use of stored lymph, 428 had removed and it is to be hoped have been vaccinated elsewhere, and 508 are unaccounted for. 81 TABLE XVI. SUMMARY OF SANITARY OPERATIONS, 1893, IN THE WHOLE PARISH. 1888 1889 1890 1891 1892 1893 Total Sanitary operations ... ... ... ... 38,779 54,577 Number of Houses Inspections 25,115 25,386 25,100 23,213 23,587 25,091 Bakehouses Inspections ... ... ... ... 215 296 Bakehouses Nuisances abated ... ... ... ... 18 Urinals Inspections 11 7 ... 46 251 260 Notices Served under 18 & 19 Vic. cap. 120 ... ... ... ... ... 120 Intimations Served, 54 & 55 Vic. cap. 76 (Sec. 3) 1,994 3,083 2,564 2,774 3,691 4,420 Notices Served under Sec. 4 324 298 323 119 921 1,211 Notices Served under Sec. 62 and 65 ... ... ... ... 1,588 2,572 Complaints Received & attended to ... ... ... ... ... 4,089 Number of Houses Disinfected 361 227 594 940 1,227 2,o69 Houses Supplied with Disinfectants 2,338 1,011 2,354 2,423 3,026 5,275 Overcrowding Abated 20 35 30 20 34 38 Premises Cleansed and Repaired 265 210 188 174 189 280 Drains Tested By Smoke ... ... ... ... 700 1,491 „ Water ... ... ... ... 178 491 Defective Drains Cleansed and Repaired 820 1,061 1.493 1,048 1,107 1,564 Drains Relaid in accordance with Vestry's Drainage Regulations ... ... ... ... 220 917 Sink & Rain Water Pipes disconnected from drains to discharge over stoneware syphon gulley 1,021 2,017 1,764 972 1,360 562 Water Closets Cleansed & Repaired 91 179 113 246 237 314 Cesspools Abolished 17 4 ... ... 1 4 Mews & Stables Drained & Paved 25 7 ... 26 86 30 Yards Drained and Paved 7 272 344 139 161 253 Accumulations of Manure Removed 24 33 58 43 41 70 Dust Receptacles Provided 329 554 517 452 738 772 Dust Complaints Received and forwarded to the Surveyor ... ... ... ... ... 271 Leaky House-roofs and Gutters Repaired 72 164 198 198 185 84 Houses Supplied with Water 28 15 40 138 151 130 Water Closets Supplied with Water 920 1,749 884 1,106 860 731 Cisterns Covered, Cleansed and Repaired 402 452 299 308 409 469 Pig Nuisances Abated ... ... 5 2 5 3 Keeping of Animals in unfit state ... ... ... ... ... 13 Smoke Nuisances Reported and dealt with ... ... ... ... 10 26 Certificates of Disinfection Granted ... ... ... ... 1,044 1,659 Water Supply Certificate Granted (Sec. 48) ... ... ... ... 16 118 Proceedings Ordered by Vestry and Sanitary Committee 97 374 413 345 444 1,211 Summonses Issued 23 36 29 12 14 73 Magisterial Orders Obtained and Enforced 23 36 29 12 14 70 Sanitary Conveniences provided to Factories and Workshops under Sec. 38 ... ... ... ... 4 8 First and second notices after 1891 became Notices under sec. 3 and 4 Public Health (London) Act. 82 sanitary operations During the year 1893 the Sanitary Department has been re-organised and the staff increased. The staff now consists of one Chief Sanitary Inspector, six District Sanitary Inspectors, each having charge of one of the six districts into which the parish has been divided for that purpose. The work done has increased in proportion as during the year the total Sanitary operations carried out by the department will be found by reference to Table XV. to have reached the large number of 54,577, the total for 1892 having been 38,779, These numbers include letters, telegrams and returns and notices to Metropolitan Asylums Board, Public Schools and Libraries and other public bodies. The number of House Inspections was 25,091, which would seem to imply that every house in the parish, estimated to be 21,400 in number, had been inspected, but, unfortunately, many houses were in such an unsanitary state as to require several visits. Drains were tested by smoke in 1,491 instances and by water in 491, the total number of drains tested being 1,982, a much larger number than during any previous year. The necessity for such testing is evinced by the fact that more than 70 per cent, of the old drains tested by smoke were found defective. Efforts will be made in future to inspect every house during each year. As the result of these inspections it was found necessary to serve 4,420 notices under Section 3 of the Public Health (London) Act, 1891, and subsequently by order of the Sanitary Committee as the Sanitary Authority, all powers under the various acts regulating the Sanitation of the Metropolis having been expressly delegated to them by the Vestry ; 1,211 notices under Section 4 were served. In addition 2,572 notices were served under Sections 62 and 65, and 120 under the Metropolis 83 Locai Management Act; being a total of 8,323 notices served by the department. The number of houses disinfected after infectious disease was 2,069,and 5,275 supplies of disinfectants were given free of charge to persons in whose abodes infectious disease existed. Certificates of disinfection after infectious disease were granted in 1,659 instances to the schools attended by children residing in the houses in which disease occurred or to parents where required to enable work to be resumed. The total number of complaints received and attended to during 1893 was 4,089. A register for such complaints for each sanitary district is kept and submitted to the authority at each meeting. Proceedings under the various Sanitary Acts. During the year legal proceedings were ordered in forty-nine cases involving sanitation and Public Health and twenty-four for offences under the Food and Drugs Acts, together seventy-three. Magisterial orders were obtained and enforced or the orders of the authority complied with in seventy instances, the majority being to remedy sanitary defects in dwellings or for breaches of the Adulteration Acts. Some of the cases were of a different nature and are detailed below. Exposure while suffering from infectious disease. On the Nov. 3rd the Chief Sanitary Inspector detected J. W. C., an assistant at a fried fish shop, who had been notified a few days before as suffering from scarlet fever, serving persons in the shop. After the man denying his name and with considerable difficulty the Chief Inspector definitely established his identity. He informed me of the facts and I accompanied him to the house where I found the man desquamating profusely after scarlet fever and at once arranged for his removal to hospital as he was in the most infectious stage of the disease. Proceedings were 84 instituted against the tnan on his recdvery and he was fined £3 and costs. TheChief Sanitary Inspector called my attention tothe condition of a calf which had been slaughtered at a licensed slaughterhouse in Usk Road together with four others. The latter were fit for food, but the flesh of the calf in question was inflamed and flabby and the animal had evidently been affected by wasting inflammatory disease and was consequently unfit for human food. The carcase was seized by the Chief Inspector and conveyed to the Police Court, the magistrate condemned the meat and ordered it to be destroyed. The name and address of the owner of the calf were given by the slaughterhouse keeper and he was summoned for sending a diseased animal to a licensed slaughterhouse, the law directing that animals unfit for human consumption shall be sent to a knackers. He was convicted and fined £1 and 23s. costs, the magistrate not being convinced that he had knowledge of the condition of the calf in question, but finding that it was not necessary to prove such knowledge as the offence is complete without it. On Sunday, June 8th, the Chief Inspector seized in the Battersea Park Road from a butcher's premises meat exposed for sale and another quantity deposited for sale. The meat in question was condemned by the magistrate and destroyed and the butcher subsequently fined £10 for exposing for sale and £5 for depositing for sale, with 5/- costs. On the same day the Chief Inspector seized under similar circumstances meat at a shop in Falcon Road, which was subsequently condemned and destroyed. The butcher here was also fined £10, £5, and 5/- costs. The Chief Inspector found that gut scraping was carried on in unlicensed premises at I, Weston Diseased Meat. Gut Scraping. 85 Street. The London County Council were informed of this and proceedings taken by them, and the person carrying on the business without a license, under section 19 of the Public Health Act, was fined £2 and costs. The penalty in this case was paid into the Vestry's account, as provided in section 119 of that Act, under which all fines recovered under the Act are payable to them, whether they or any other body prosecutes. At 87, Church Road a similar business was carried on, and owing to numerous complaints as to nuisances by neighbouring inhabitants the Chief Inspector found the premises upon inspection to be in a very offensive condition. The London County Council were also informed of the circumstances, but no prosecution was instituted as the occupier was a foreigner, totally ignorant of the law on the subject. The nuisance was, however, suppressed. The Belleville Road Board School was inspected, the drains tested and the sanitary arrangements carefully examined, with the result that they were found defective, and the drains, water closets, &-c., were entirely reconstructed, the latter being moved to more suitable positions. The Tennyson Road Board School was also examined in a similar manner, with the result that the Sanitary arrangements were found to be defective and dangerous. Plans were approved by the Sanitary Committee for the entire reconstruction of the drains, and the sanitary offices will be moved to more suitable positions. The Raywood Street Board School was found to have its Sanitary arrangements in a defective condition, and notices to make good such defects were served on the School Board for London. The same condition of things was found to exist at the Holden Street Board School, and a similar course adopted. At the Christ Church Schools the entire Sanitary arrangements were found to be defective, and were entirely reconstructed. Sanitary Condition of Schools. 86 At the St. James' Industrial School the drains were found to be very defective, and were entirely reconstructed. At the Vicarage School the Sanitary arrangements were found to be good. At the Masonic Girls' School the drains at the Junior School were found to be seriously defective, they were reconstructed and kept outside the buildings altogether. The whole of the urinals at the various publichouses in ths parish were inspected by the Chief Inspector, who reported thereon to the Sanitary Committee. Very numerous defects were discovered and orders were made for them to be remedied and put in a proper sanitary condition. At some of the workshops in the Parish inspection has been made of the sanitary accommodation provided for the workpeople engaged therein. At the Iron Foundry in the Culvert Road it was found that there was a want of sufficient conveniences required by See. 38 of the Public Health Act. The necessary works were carried out upon requisition by the department. At a Builder's Works in the Queen's Road, defective accommodation and insanitary conditions were found to exist. These were at once put in proper condition and suitable provision made. The Theatres and Music Halls, were at the request of the London County Council inspected with reference to the sufficiency and condition of their sanitary offices. The following were specially inspected, Munt's Hall, the Washington Music Hall, Park Town Theatre, Lammas Hall and Stanley Hall. Notices were served to remedy sanitary defects in cases where such existed and all cases were complied with. Statements were made to the Vestry to the effect that the houses in Barmore Street were in a generally insanitary condition, but inspection did not bear out the assertions made, as Urinals, &c. 87 the houses had been regularly inspected and about one-third of the drains recently reconstructed. Ths total defects discovered were but trifling and were remedied upon orders being made. Some of the occupiers had notices served to prevent the basement being used as sleeping rooms contrary to Section 96 of the Public Health Act. Water Quarterly samples were taken for analysis from Analysis. the Southwark and Vauxhall and the Lambeth Companies. The water has been in a much better condition than at the early part of the year when it was inefficiently filtered and dirty. In these respects a great improvement is the result of more efficient filtration and better condition of water generally, owing to the provision of improved appliances. Samples of well water used for domestic purposes were taken from 94, Winstanley Road and 3, Newcomen Road, and upon analysis the water in both cases was found to be unfit for domestic use. The wells were consequently closed and a supply laid on from the Water Company. Unfit food. The following were submitted by the vendors during the year and were all condemned as unfit for human food and destroyed at the Destructor. The persons bringing the unsound articles were given certificates to enable them to get back the money paid to salesmen. 10 bushels of plums. 1 box cod's roe—about 1 cwt. 1 basket crabs—about 120. 1 box fresh herrings. 80 lbs. cod fish. 70 lbs. of hake. 1 trunk of fresh haddocks—about 1 cwt. 1 barrel conger eels—about 2 cwt. 15 boxes kippers—about 600. 3 bushels chestnuts. 88 Pig keeping. Swine were found to be kept at 15, Weston Street, at Byram House, Clapham Common, and at the Farm, Wandsworth Common. As these were all within forty yards of a public place the usual proceedings were ordered to be taken and the keeping of pigs ceased. i Slaughter The usual inspection of these premises was made cowhouses, by a Sub-Committee. The renewal of the license to a cowhouse to a dairy in Hope Street was objected to on the grounds of defective paving and improper receptacles for food, together with the housing of a number of young cattle in unlicensed sheds. The renewal of the license was opposed at the meeting of the Public Health Committee of the London County Council, when the license was only renewed on the understanding that the Vestry's requirements were carried out, which has since been done. A bakehouse is defined in the Act of 1891 as " any place in which are baked bread, biscuits or confectionery, from the baking and selling of which a profit is derived. 1 here are in the Parish one hundred and nine premises conforming to this description. They were formerly inspected by the factory inspectors, and as bakehouses in the Metropolis were many and the inspectors but few, the majority were found to be, when the duty of inspection was transferred to the Local Sanitary Authority, to be in a most insanitary condition; defective drains, closets opening into and ventilated by the bakehouse, and a general condition of dirt and neglect of the most ordinary sanitary precautions prevailing. Since the transfer of inspection to the Local Authority, every bakehouse in the parish has been inspected half-yearly and the results entered in the register and submitted to the Sanitary Committee. In the few cases in which defects are found to exist re-inspection takes place until defects are remedied. Rakehouses. 89 It would be conducive to the proper regulation of bakehouses if they were licensed by a central authority in the same way as cow and slaughterhouses ; the duty of inspection, however, to remain as at present with the Local Authority. Complaints were made of noise and dust together with smoke from the Atmospheric Grain Elevator C)., in the Anhalt Road. The allegation was found to be substantially correct. All the defects were subsequently remedied except the noise which does not come within the province of the department. In addition to ordinary disinfection after infectious disease, a cab was disinfected after the conveyance of an infected person to hospital, free of charge at the Vestry's premises at the destructor. In the event of the boiler being put in use, a suitable apparatus for disinfecting bedding, clothes, &c. by steam and hot air might be worked very inexpensively. The main sewer running from west to east along the York Road and Battersea Park Road has during the last few years been ventilated by up-cast shafts, to the great advantage of the residents in the locality drained by the sewers. The line of sewer running south to north, from Nightingale Lane by Northcote Road, Falcon Road and High Street, in my opinion requires better ventilation, more especially in the higher levels. A very large proportion of complaints as to effluvium nuisances from sewer gas come from these localities. The Surveyor is about to erect some ventilators in Bolingbroke Grove, which will relieve the pressure of gases in the sewers and house drains. The whole line of sewer from south to north requires similar treatment. Grain Elevator. Disinfection. Sewer Ventilation 90 Sanitary Staff. The increased staff have, as the table of Sanitary operations shews been able to get through a much larger amount of work than during any previous year. The removal to the new offices has, by giving increased space, enabled me to exercise a much closer supervision than formerly. I have to express my satisfaction with the great zeal and energy shown by the Chief Sanitary Inspector, Mr. Isaac Young, during the year under report. The district Sanitary Inspectors have got through their numerous and sometimes disagreeable duties with great efficiency and with creditable regard for the feelings of those amongst whom it is their duty to act. The increased amount and greater variety of duties cast upon the Medical Officer of Health by the legislation of the last few years renders it necessary for him to be able to rely upon the skilled and trained assistance of his colleagues. The great experience of the Vestry Clerk, Mr. Wilkins, has always been placed freely at my disposal, for which I beg to record my sincere thanks. I may pay similar tribute to my other colleagues, Mr. J. T. Pilditch, the Surveyor; Mr. C. E. Cassal, the Public Analyst; Mr. W. W. Young, the Solicitor, and indeed the whole staff of the Vestry. The Sanitary Committee and the Vestry generally have been good enough to accord me the same support with which I have been honoured for many years ; without which support no officer responsible for the health and lives of the inhabitants of so large and important a Parish as Battersea, could hope to be able to efficiently carry out the duties which devolve upon him. W. H. KEMPSTER, M.D., Medical Officer of Health for Battersea.