BAT 5 The Destry of tbc parish of Sf. Mary, Battersea. REPORT upon the PUBLIC HEALTH & SANITARY CONDITION of The parish of St. Mary, Battersea, Including the work of the Public Health Department, DURING THE YEAR 1897, by W. H. KEMPSTER, M.D., MEDICAL OFFICER OF HEALTH. Treasurer of the Incorporated Society of Medical Officers of Health and Vice-President of the Metropolitan Branch. Fellow and Member of Council of the Royal Institute of Public Health. Fellow of the Obstetrical Society. 1898. The Vestry of the Parish of St. Mary, Battersea. Chart indicating number of Births and Deaths registered weekly as occurring within the Parish during the year 1897 To the Vestry of the parish of St. Mary, Battersea. Gentlemen, A recapitulation of the main facts of the Census enumeration of 1896 is necessary in order that the following statistics may be seen to be correctly based. The Census taken on March 29th, 1896, shewed that the increase of population in the preceding five years had not quite kept pace with that which prevailed during the last few intercensal periods; in fact, since 1871-81 the rate of increase has uniformly decreased, the probable reason of which is that nearly all the available building land in the parish has been covered. The following are the particulars of the last three census enumerations, the number of inhabited houses, of persons, and of inhabitants per house being given for the several wards into which the parish is at present divided. Census 1881. Census 1891. Census 1896. Inhabited Houses. Population. No. of Inhabitants per House. Inhabited Houses. Population. No. of Inhabitants per House. Inhabited Houses. Population No. of Inhabitants per House. Ward 1 2,665 23,667 8.9 3,327 27,899 8.3 3,442 29,178 8.4 „ 2 5,120 37,011 7.2 6,748 50,087 7.4 6,846 52,653 7.7 „ 3 4,536 31,652 6.9 5,457 40,217 7.3 5,705 43,119 7.5 „ 4 2,284 14,932 6.5 5,247 32,255 6.1 6,428 40,165 6.2 Totals 14,605 107,262 7.3 20,779 150,458 7.2 22,421 165,115 7.4 4 Table shewing the population in relation to houses in each ward as indicated by the Census of 1896. Wards. Houses. Population. Inhabited. Empty. Occupied by day only Building. Male. Female. Total. No. 1 3,442 48 39 14 14,967 14,211 29,178 „ 2 6,846 101 84 5 26,279 26,374 52,653 „ 3 5,705 74 79 — 21,637 21,482 43,119 „ 4 6,428 272 61 153 17,939 22,226 40,165 Whole Parish 22,421 495 263 172 80,822 84,293 165,115 5 This table shews that there were, at the date of the 1896 census, 22,421 inhabited houses in the parish, four hundred and ninetyfive empty, two hundred and sixty-three used for business purposes only and not inhabited at night, and one hundred and seventy-two building. It may be safely assumed that most of the empty houses have since been occupied, as well as the houses which were then building, with the exception of some of the flats recently erected, there being a demand for houses in Battersea at present exceeding that of any previous period. The persons were eighty thousand eight hundred and twentytwo males; eighty-four thousand two hundred and ninety-three females, and a total population of one hundred and sixty-five thousand one hundred and fifteen. As the census of eighteen hundred and ninety-one shewed a population of one hundred and fifty thousand, four hundred and fifty eight, it follows that the increase was fourteen thousand, six hundred and fifty seven, or an average increase of two thousand, nine hundred and thirty-one per annum. It will be necessary, in order to calculate the birth, death and other rates to arrive at the mean or average population of the year 1897, which is obtained by adding a proportionate number, one fourth of the year's increase of population, so as to shew the population estimated to exist on the middle day of the year. The estimated mean population of the parish for 1897 was 168,778, and it is upon this number that the birth and death rates which follow are calculated. Details as to the Metropolis are added for the purpose of comparison. The estimated mean population of London for 1897 was 4,463,169, the number of births registered during the year was 133,618 and the consequent birth rate 30 per thousand. The number of births registered in Battersea in 1897 was 5,266 giving a birth rate of 31.2 per thousand or 1.2 per thousand above that for the Metropolis. 6 The deaths in London numbered 80,943, with a consequent Metropolitan death rate of 18.2 per thousand. The deaths registered in Battersea numbered 2,620, the mortality (uncorrected) being equal to 15.5 per thousand or 2.7 per thousand below that for London. It will be observed that the birth and other rates approximate very closely to those of the Metropolis at large, of which indeed Battersea is now becoming an integral part, losing much of its suburban character and acquiring that of a town district. That the death rate has not increased is evidence of care in sanitary administration which has always distinguished this parish and the tendency to equalization and constant lowering of the mortality over the whole Metropolis is probably in great part due to the fact that the methods adopted for many years past in this parish have now met with almost universal adoption over the rest of the Metropolis. The death rate for the year under report, r5'5 Per thousand per annum, is, with the exception of 1894 when it was 15.4, the lowest in the past forty-two years, when these statistics commenced. An epidemic wave of zymotic disease was experienced in the Metropolis during 1897, causing an increase of notifications over the three preceding years and almost equalling that of 1893. The number of notifications received by me for the last five years is given below:— Year. Number of Zymotics notified 1897 2,569 1896 1,929 1895 1,657 1894 1,845 1893 2,798 It has been shewn above that the total number of deaths in Battersea during 1897 was two thousand six hundred and twenty 7 giving an uncorrected death rate of 15.5 per thousand. If this be corrected by deleting the deaths of two hundred and seventy non-parishioners which took place in the parish, viz.:—Wandsworth and Clapham Union Infirmary, two hundred and thirtynine, Bolingbroke Hospital, eleven, the Westminster Schools, one and elsewhere nineteen, and adding three hundred and eightyseven deaths of Battersea parishioners which took place in the various public institutions, a total mortality of Battersea parishioners of two thousand seven hundred and thirty-seven will result, giving a corrected death-rate of 16.2 per thousand per annum. Table A. This table is compiled in all sanitary districts under the express direction of the Local Government Board, for the purpose of securing uniformity of tabulation in all parts of the country, of the important particulars contained therein. It is at the same time expressly stated that the Medical Officer of Health of any district is at liberty, in addition, to continue to use any other form of tabulation which, in his opinion, illustrates more fully the sanitary condition of the district for which he acts. For purposes of comparison with the vital statistics of the past forty-one years, since the year 1856, other tables which have been employed in this parish are also given herewith, and will be found denoted by numbers, those of the Local Government Board being denoted by the letters A. and B. In Table A. will be found particulars of mortality in the various Registrar's districts and public institutions which are also treated as separate districts. They comprise the Registrar's districts of East and West Battersea, and the following public institutions, situated within the parish, viz.:—Wandsworth and Clapham Union Infirmary, Bolingbroke Hospital, and the Westminster Union Schools. The broad grouping of ages is under and above five years of age, so as to clearly define the mortality of each of these periods of life, more especially the infantile ages under five, as the Table A of Deaths during the Year 1897 in the Metropolitan 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. Mortality from all causes, at subjoined Ages. 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 ages. Under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and up. wards Small Pox. Scarlatina. Diphtheria. Membranous Croup. fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia, &c. Heart Disease. Influenza. Injuries. All Other Diseases. Total. Typhus. Enteric Fever. Continued. Relapsing. Puerperal. East Battersea 969 378 177 35 28 257 94 Under 5 ... 3 21 2 ... 1 ... ... ... ... 2 23 35 58 ... 7 102 2 1 19 279 555 5 upwards ... 1 8 1 ... 2 ... ... 1 ... 1 1 1 3 5 85 79 38 5 24 139 414 West Batttersea 1192 431 170 46 35 312 198 Under 5 ... 2 14 1 ... ... ... ... ... ... 1 49 40 69 1 5 93 1 ... 18 307 601 5 upwards ... 1 5 ... ... 5 ... ... ... ... 3 3 1 7 6 97 91 90 6 28 247 591 Wandsworth and Clapham Infirmary 436 36 7 4 13 204 172 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 2 ... ... 4 ... ... ... 32 43 5 upwards ... ... ... ... ... ... ... ... 1 ... 2 ... ... 2 11 66 69 57 1 12 172 393 Bolingbroke Hospital 22 ... 2 3 4 11 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 15 4 20 Westminster Union Schools. 1 ... 1 ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 2620 845 357 88 80 784 466 Under 5 ... 5 35 3 ... 1 ... ... ... ... 3 72 80 129 1 12 200 3 1 38 619 1202 5 upwards ... 2 13 1 ... 7 ... ... 2 ... 6 4 2 12 22 248 239 186 12 80 582 1418 The subjoined numbers have also to be taken into account in judging of the above Records of Mortality. Deaths occurring outside the District of Persons belonging thereto. 387 36 82 45 31 171 22 Under 5 ... 31 39 ... ... 1 ... ... ... ... ... 2 1 3 ... 5 5 2 ... 3 26 118 5 upwards ... 9 17 ... ... 9 ... ... 1 ... ... ... ... ... 3 27 9 41 ... 18 135 269 Deaths occurring within the District of Persons not belonging thereto. 270 27 6 4 10 121 102 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 1 ... ... 4 ... ... ... 23 33 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 24 41 42 1 26 87 237 9 greatest waste of life has occurred in the past at the early years, and although great improvement has taken place in this respect during the year 1897, still much remains to be done in this direction. For instance, three hundred and twenty-nine out of a total of one thousand two hundred and two deaths under five years were from Zymotic diseases, a proportion which ought to be largely diminished. This, however, shews a great diminution compared with former years. Particulars of the other ages at death are also given in this table. The two thousand six hundred and twenty persons, including non-parishioners, who died in the parish during 1897, would give a gross death rate of 15.5 per thousand living during the year, and were distributed as follows:— East Battersea 969 West Battersea 1,192 (excluding public institutions) Wandsworth and Clapham Union Infirmary— (a) Parishioners 197 (b) Non-parishioners 239 Bolingbroke Hospital— (а) Parishioners 11 (b) Non-parishioners 11 Westminster Union Schools— (a) Parishioners — (b) Non-parishioners 1 Total 2,620 10 Deaths occurring within the parish, of persons not belonging thereto: In the Union Infirmary 239 In the Bolingbroke Hospital 11 In the Westminster Union Schools 1 Elsewhere 19 Total 270 Deaths occurring outside the parish, of persons belonging thereto: Union Workhouse, Wandsworth 15 General and Special Hospitals 210 Metropolitan Asylums Board Hospitals 94 County and other Lunatic Asylums. 54 Elsewhere (including River Thames) 14 Total 387 The fourteen deaths recorded as having occurred "elsewhere" are here located : Male River Thames. ,, Grosvenor Road Station. ,, Kings Road, Chelsea. ,, Do. do. „ River Thames. „ Do. ,, Salvation Army Rescue Home. ,, Kennington Road. ,, On Railway. ,, Cedars Road, Clapham. ,, Stepney Causeway. „ On way to Hospital. Female Upper Richmond Road, Putney. „ River Thames. 11 TABLE I. Deaths of Battersea Parishioners in Public Institutions of the Metropolis. Deaths of Parishioners in outlying Public Institutions. Totals. Sbx. Age. Institutions. 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 Workhouse. General and Special Hospitals. Asylums Board Hospitals. County and other Lunatic Asylums | Elsewhere. DISEASE. i.—ZYMOTICS. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlatina 40 21 19 5 26 31 7 2 ... ... ... ... 40 ... ... Diphtheria 56 23 33 3 36 39 16 ... 1 ... ... 8 48 ... ... Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 10 6 4 ... 1 1 2 1 6 ... ... 5 4 1 ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 1 ... ... ... ... ... ... ... 1 ... 1 ... ... ... Measles 2 2 ... ... 2 2 ... ... ... ... ... 1 1 ... ... Whooping Cough 1 ... 1 ... 1 1 ... ... ... ... ... 1 ... ... ... Diarrhœa 3 1 2 3 ... 3 ... ... ... ... ... 3 ... ... ... Other Zymotics ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total Zymotics 114 54 60 11 66 77 25 3 9 ... ... 20 93 1 ... Rheumatic Fever 3 ... 3 ... ... ... 3 ... ... ... ... 3 ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 32 19 13 1 4 5 3 3 21 ... 3 24 ... 5 ... Tubercular 1 ... 1 ... ... ... ... 1 ... ... ... 1 ... ... ... Respiratory 14 9 5 3 2 5 ... 1 8 ... ... 12 ... 1 1 Circulatory 43 24 19 1 1 2 5 6 24 6 2 32 ... 6 3 Nervous 63 48 15 1 1 2 6 5 43 7 5 19 ... 38 1 Cancer 24 14 10 ... ... ... ... ... 20 4 2 22 ... ... ... Violence 21 18 3 ... 3 3 ... 3 r4 1 ... 13 ... ... 8 All Other Diseases 72 40 32 19 5 24 3 9 32 4 3 64 1 3 1 Totals 387 226 161 36 82 118 45 31 171 22 15 210 94 54 14 12 Table I. This table contains details of the deaths of Battersea parishioners in Metropolitan public institutions without the parish. The disease from which death ensued, the sex, age, and particular class of institution are herein indicated, as well as the localities in which other parishioners lost their lives or were found dead, which latter require no comment, the causes of death being set out in the table. Table I. shews that three hundred and eighty-seven Battersea parishioners died in outlying public institutions, in addition to the one hundred and ninety-seven dying in the Union Infirmary, (vide Table VIII) and eleven in the Bolingbroke Hospital, making a total number of five hundred and ninety-five deaths in public institutions. During the year 1896 five hundred and seventy deaths similarly occurred. . Tables II. and III., give in tabular form the weekly returns of the District Registrars of Births and Deaths for East and West Battersea respectively, and include the deaths of all persons within the parish and in public institutions, whether parishioners or not. They shew the incidence of births and deaths at the various periods of the year, being grouped in quarters for that purpose, with additional particulars as to causes of death to be found in Table IV. It is shown by these tables that the births and deaths exhibited an unusual uniformity during the several quarters of the year, the result doubtless of the mild winter and spring, during which seasons the mortality is frequently considerably in excess of that of the others. The particulars of deaths of non-parishioners dying within the parish will be found in Table IX. and following tables. 13 TABLE II. BIRTHS AND DEATHS IN EAST BATTERSEA, 1897. births. deaths. Week ending:— Males. Females. Total. Males. Females. Total. 9th January 1897. 19 27 46 10 8 18 16th „ „ 30 27 57 9 6 15 23rd „ „ 15 25 40 10 15 25 30th „ „ 35 29 64 11 15 26 6th February „ 13 21 34 7 14 21 13th „ „ 27 20 47 10 10 20 20th „ „ 26 23 49 11 7 18 27th „ „ 30 23 53 11 8 19 6th March „ 25 20 45 5 6 11 13th „ „ 27 25 52 11 9 20 20th „ „ 30 31 61 17 11 28 27th ,, „ 24 24 48 8 8 16 3rd April ,, 25 20 45 10 10 20 1st Quarter 326 315 641 130 127 257 10th April „ 29 27 56 7 8 15 17th „ „ 24 21 45 10 8 18 24th „ „ 26 23 49 10 7 17 1st May „ 29 22 51 10 14 24 8th „ „ 25 20 45 9 8 17 15th „ „ 11 17 28 8 9 17 22nd „ „ 24 32 56 10 7 17 29th „ „ 23 22 45 5 5 10 5th June ,, 30 22 52 7 5 12 12th „ „ 23 18 41 8 6 14 I9th „ „ 22 22 44 7 7 14 26th ,, „ 18 10 28 11 3 14 3rd July „ 21 19 40 5 5 10 2nd Quarter 305 275 580 107 92 199 14 Births and Deaths, East Battersea, 1897—continued. Week ending:— births. deaths. Males. Females. Total. Males. Females. Total. 10th July, 1897 18 24 42 9 6 15 17th „ „ 19 22 41 12 9 21 24th „ „ 25 23 48 9 6 15 31st „ „ 25 22 47 8 11 19 7th August „ 18 14 32 24 14 38 14th „ „ 23 25 48 15 12 27 21st „ „ 20 26 46 15 21 36 28th „ „ 24 25 49 9 16 25 4th September „ 25 18 43 13 7 20 11th „ „ 28 21 49 5 7 12 18th „ „ 26 25 51 9 2 11 25th „ „ 28 22 50 3 8 11 2nd October ,, 31 33 64 13 2 15 3rd Quarter 310 300 610 144 121 265 9th October „ 23 26 49 9 8 17 16th „ „ 25 28 53 9 7 16 23rd „ „ 26 27 53 9 6 15 30th „ „ 15 27 42 10 8 18 6th November „ 25 20 45 10 8 18 13th „ „ 23 22 45 20 8 28 20th „ „ 33 32 65 12 7 19 27th „ „ 20 21 41 5 5 10 4th December ,, 25 16 41 8 10 18 11th „ „ 20 31 51 14 9 23 18th „ „ 28 22 50 14 12 26 25th „ „ 17 13 30 6 6 12 1st January „ 21 14 35 11 17 28 4th Quarter 301 299 600 137 111 248 Whole Year 1,242 1,189 2,431 518 451 969 15 TABLE III. BIRTHS AND DEATHS IN WEST BATTERSEA, 1897. Week ending BIRTHS. DEATHS. Males. Females. Total. Males. Females. Total. 9th January, 1897 26 24 50 18 11 29 16th „ „ 17 22 39 17 16 33 23rd „ „ 34 28 62 13 18 31 30th „ „ 25 39 64 14 24 38 6th February „ 31 32 63 16 19 35 13th „ „ 27 24 51 10 13 23 20th „ „ 33 21 54 12 10 22 27th „ „ 29 37 66 11 19 30 6th March „ 20 32 52 14 20 34 13th „ „ 33 32 65 10 20 30 20th ,, „ 24 24 48 21 17 38 27th „ „ 32 34 66 21 15 36 3rd April „ 31 21 52 12 18 30 1st Quarter 362 370 732 189 220 409 10th April „ 30 29 59 9 12 21 17th „ „ 27 20 47 10 15 25 24th ,, „ 28 20 48 20 16 36 1st May „ 26 31 57 21 17 38 8th „ „ 21 24 45 18 18 36 15th „ „ 28 22 50 15 8 23 22nd ,, „ 20 19 39 20 11 31 29th „ „ 24 23 47 6 15 21 5th June „ 23 26 49 15 8 23 12th „ 22 19 41 18 10 28 19th „ „ 32 19 51 9 15 24 26th „ „ 27 17 44 9 11 20 3rd July „ 46 27 73 16 10 26 2nd Quarter 354 296 650 186 166 352 16 Births and Deaths in West Battersea, 1897—continued. Week ending:— BIRTHS. DEATHS. Males. Females. Total. Males. Females Total. 10th July, 1897 31 35 66 13 13 26 17th „ „ 30 24 54 15 9 24 24th „ ,, 28 27 55 22 15 37 31st „ „ 26 34 60 18 21 39 7th August „ 22 29 51 16 24 40 14th „ „ 28 26 54 19 20 39 21st „ „ 27 33 60 27 20 47 28th „ „ 35 27 62 21 21 42 4th September „ 21 21 42 13 12 25 11th „ ,, 31 35 66 19 11 30 18th ,, „ 28 26 54 19 17 36 25th „ „ 28 25 53 15 11 26 2nd October „ 30 33 63 17 14 31 3rd Quarter 365 375 740 234 208 442 9th October 28 35 63 12 11 23 16th „ ,, 31 27 58 15 10 25 23th „ „ 33 28 61 22 10 32 30th „ „ 30 24 54 15 18 33 6th November ,, 28 31 59 10 23 33 13th „ „ 28 33 61 15 24 39 20th „ „ 33 31 64 12 21 33 27th „ „ 39 17 56 24 17 41 4th December „ 24 15 39 14 23 37 11th „ „ 29 23 52 18 12 30 18th „ „ 31 35 66 16 15 31 25th „ „ 23 24 47 19 20 39 1st January, 1898 16 17 33 22 30 52 4th Quarter 373 340 713 214 234 448 Whole Year 1,454 1,381 2,835 823 828 1,651 17 TABLE IV. Quarterly and Annual Summaries of Births and Deaths. Battersea. 1897. 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 641 257 81 42 ... 1 ... 7 12 1 2 ... 12 34 ... w 732 409 103 131 ... ... 1 3 9 1 2 ... 11 32 116 2nd Quarter E 580 199 68 33 ... 1 ... 5 10 ... ... ... 9 33 ... w 650 352 66 124 ... 2 ... 5 14 ... 2 ... 28 48 116 3rd Quarter E 610 265 147 16 ... 5 ... 11 8 1 52 1 11 24 ... W 740 442 182 91 ... 4 1 5 14 2 69 2 22 38 111 4th Quarter e 600 248 82 38 ... 18 3 9 6 1 3 ... 11 29 ... w 713 448 116 113 ... 45 2 7 9 2 5 ... 14 35 116 Whole Year E 2431 969 378 129 ... 24 4 32 36 3 60 1 43 120 ... w 2835 1651 467 459 ... 52 3 20 46 5 78 2 75 153 459 Totals 5266 2620 845 588 ... 76 7 52 82 8 138 3 118 273 459 The Births and Deaths during the various quarters in the whole parish are here set out:— Births. Deaths. 1st quarter 1,373 666 2nd „ 1,230 551 3rd „ 1,350 707 4th „ 1,313 696 Totals 5,266 2,620 Table V. contains a veritable sanitary history of the parish of Battersea since 1856, the year in which modern sanitation first came into existence under the provisions of the Metropolis Local Management Act of 1855, and by which sanitary authorities, in the form of Vestries and District Boards, the latter consisting of small parishes grouped together, were first constituted for London as a whole. This parish at that time consisted of a congeries of small villages, between which extended market gardens ; the inhabitants b 18 TABLE V. COMPARATIVE STATISTICS OF BIRTHS, MORTALITY, &c. Year. Mean Population 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 I6,872 562 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 I9•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 1,710 1877 87,094 3,48I 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 151,190 5,237 34•6 2,619 17•3 398 2,618 1892 154,121 4,990 32•3 2,692 17•4 473 2,298 1893 157,052 5.225 33•2 2,801 17•8 564 2,424 1894 159,984 5.024 31•4 2,404 15•4 468 2,620 1895 162,915 5,264 32.•3 2,901 17•8 491 2,363 1896 165,847 5,358 32•.3 2,941 17•7 608 2,419 1897 168,778 5,266 31•2 2,620 15•5 391 2,646 The years marked thus were census years. 19 and dependents of some few dozens of large houses, the residences chiefly of merchants, with the workers at the market gardens, constituting the principal population. It will be observed that the population was then but 15,069, and at the census of 1861, had but reached the number of 19,582. The birth rate was then a little higher than now. The death rate, however, although the population was very sparse, was much higher than at present. It has been laid down as an axiom that mortality increases in direct proportion to the density of population, and it is the aim of modern sanitation to limit or prevent such increase. That the same parish, of course with the same superficial area, should, with a ten-fold population have a reduced instead of an augmented death rate, shews that the authority having charge of the sanitation, which includes the health condition and duration of lives of the inhabitants, has performed its public duties in an exemplary manner. It will be observed that the year 1897 comes out very favourably by contrast. Tables VI., VII., VIII., and IX., with addendum, contain particulars of the mortality respectively of East Battersea, West Battersea, and in the Union Infirmary, giving separately parishioners and non-parishioners, and in the addendum of the other public institutions situated within the parish. These tables have been used from 1856, and are continued for purposes of comparison with former years as well as being the basis upon which all the other mortality tables are founded. 20 TABLE VI. STATISTICS OF MORTALITY. EAST BATTERSEA. Population (Census) 1896, 71,730. Estimated mean population tor middle of 1897, 72,875. Total Deaths from each Class of Disease. &c. Sex. Age. Social Position Males. Females. Under 1 year. 1 to 5 years. All under 5. From 5 to 15 years. From 15 to 25 years. From 25 to 65 years. 65 years and upwards. Nobility, Gentry, &c. Professional Class. Merchants, Bankers, &c. Middle and Trading Class, Shopmen, Clerks, &c. Industrial and Labouring Class. I. Zymotic. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 24 14 10 3 20 23 1 ... ... ... ... ... ... 24 Scarlet Fever 4 2 2 ... 3 3 ... ... 1 ... ... ... ... 4 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 3 3 ... 1 ... 1 ... ... 2 ... ... ... 2 1 Puerperal Fever 1 ... 1 ... ... ... ... ... 1... ... ... ... ... 1 Diphtheria 32 15 17 ... 23 23 9 ... ... ... ... ... ... 32 Whooping Cough 36 15 21 9 26 35 1 ... ... ... ... ... 1 35 Erysipelas 3 2 1 2 ... 2 ... ... 1 ... ... ... ... 3 Diarrhœa, Dysentery & Cholera 61 30 31 49 9 58 ... ... 2 1 ... ... ... 61 Influenza 6 4 2 ... 1 1 ... ... 4 1 ... 1 ... 5 Other Zymotic Diseases 1 1 ... ... ... ... ... ... 1 ... ... ... ... 1 Total of Zymotic Diseases 171 86 85 64 82 146 11 ... 12 2 ... 1 3 167 II. Constitutional. Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatism 5 5 ... ... ... ... 1 ... 3 1 ... ... 2 3 Cancer & other Tumours 21 5 16 ... 1 1 ... 1 14 5 1 ... 7 13 Other Constitutional Diseases 7 6 1 6 1 7 ... ... ... ... ... ... 1 6 Tubercular. Phthisis 92 54 38 4 1 7 3 14 67 1 ... 2 6 84 Other Tubercular Diseases 45 29 16 22 17 39 3 2 1 ... ... 1 2 42 III. Local. Nervous 80 45 35 27 15 42 2 1 23 12 ... ... 2 78 Circulatory 40 21 19 1 1 2 4 2 26 6 ... ... 4 36 Respiratory 181 98 83 61 41 102 4 2 47 26 ... 2 9 170 Digestive 93 49 44 56 10 66 1 3 17 6 ... 2 7 84 Urinary 29 15 14 ... 1 1 1 ... 22 5 ... 1 2 26 Generative 4 ... 4 ... ... ... ... ... 4 ... ... ... ... 4 Locomotory 2 1 1 ... 1 1 ... i ... ... ... ... 1 1 lntegumentary ... ... ... ... ... ... ... ... ... ... ... ... ... ... IV. Developmental. Premature Birth, &c. 120 69 51 120 ... 120 ... ... ... ... ... ... 3 117 Old Age 30 7 23 ... ... ... ... ... 2 28 ... ... 5 25 V. Violence 43 27 16 17 2 19 4 1 17 2 ... 1 ... 42 VI. All other Diseases 6 1 5 ... 2 2 1 1 2 ... ... ... ... 6 Totals 969 518 451 378 177 555 35 28 257 94 1 10 54 904 21 TABLE VII. STATISTICS OF MORTALITY. WEST BATTERSEA. Population Census) 1896, 93,385. Estimated mean population including institutions, for middle of 1897, 95,903. Total Deaths from each class of Disease. 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 Classes, &c. I. Zymotic. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 52 24 28 11 38 49 3 ... ... ... ... ... ... 51 Scarlet Fever 3 2 1 ... 2 2 1 ... ... ... ... ... ... 3 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 5 2 3 ... ... ... 1 2 2 ... ... ... 1 4 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 20 12 8 1 14 15 5 ... ... ... ... ... 1 19 Whooping Cough 41 16 25 20 20 40 1 ... ... ... ... ... ... 41 Erysipelas 4 1 3 1 ... 1 ... ... 2 1 ... ... ... 4 Diarrhœa, Dysentery & Cholera 76 33 43 58 11 69 ... ... 2 5 1 1 6 68 Influenza 6 4 2 ... ... ... ... 1 4 1 ... ... ... 6 Other Zymotic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total of Zymotic Diseases 209 94 113 91 85 176 11 3 10 7 1 1 9 196 II. Constitutional. Gout 3 3 ... ... ... ... ... ... 1 2 1 ... 1 1 Rheumatism 7 2 5 1 ... 1 2 2 1 1 ... ... ... 7 Cancer & other Tumours 50 14 36 ... ... ... ... ... 35 15 3 1 8 38 Other Constitutional Diseases 5 2 3 4 ... 4 ... ... 1 ... ... ... 1 4 T ubercular. Phthisis 102 55 47 3 2 5 4 16 74 3 ... 2 7 93 Other Tubercular Diseases 46 24 22 24 16 40 3 1 2 ... ... ... 3 43 III. Local. Nervous 94 48 46 29 17 46 5 1 25 17 1 1 10 82 Circulatory 91 41 50 ... 1 1 7 3 52 28 1 2 5 83 Respiratory 184 96 88 52 41 93 5 2 46 38 3 1 10 170 Digestive 80 30 5o 45 6 51 5 ... 18 6 1 2 5 72 Urinary 31 17 14 ... ... ... ... 3 22 6 ... ... 5 26 Generative 7 ... 7 ... ... ... ... 2 5 ... ... ... ... 7 Locomotory 1 ... 1 ... ... ... ... ... 1 ... ... ... ... 1 Integumentary 1 1 1 ... ... ... ... ... 2 ... ... ... ... 2 IV. Developmental. Premature Birth, Low Vitality, and Congenital Defects 165 90 75 165 ... 165 ... ... ... ... ... 5 7 153 Old Age 64 29 35 ... ... ... ... ... 2 62 4 1 5 54 V. Violence 47 31 16 16 2 18 4 1 12 12 ... ... 1 46 VI. All other Diseases 6 2 4 1 ... 1 ... 1 3 1 ... ... 2 4 Totals 1192 579 613 431 170 601 46 35 312 198 15 16 79 1082 22 TABLE VIII. STATISTICS OF MORTALITY. Wandsworth and Clapham Union Infirmary. [Parishioners,] 1897. 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. All under 5 years. From 5 to 15 years. From 15 to 25 years. From 25 to 65 years. 1 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 1 ... 1 ... ... ... ... 1 ... ... ... ... ... 1 Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 2 ... 2 ... ... ... ... ... ... 2 ... ... ... 2 Diarrhœa, Dysentery & Cholera 3 ... 3 1 ... 1 ... ... ... 2 ... ... ... 3 Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Zymotic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total of Zymotic Class 6 ... 6 1 ... 1 ... 1 ... 4 ... ... ... 6 II. Constitutional. Gout 2 2 ... ... ... ... ... ... 2 ... ... ... ... 2 Rheumatism 5 2 3 ... ... ... ... ... 4 1 ... ... ... 5 Cancer & other Tumours 9 2 7 ... ... ... ... ... 3 6 ... ... ... 9 Other Constitutional Diseases 3 1 2 2 ... 2 ... ... 1 ... ... ... ... 3 Tubercular. Phthisis 43 34 9 ... ... ... 1 2 39 1 ... ... ... 43 Other Tubercular Diseases 1 ... 1 ... ... ... ... ... 1 ... ... ... ... 1 III. Local. Nervous 25 15 10 ... 1 1 ... ... 15 9 ... ... ... 25 Circulatory 17 6 11 ... ... ... ... 2 12 3 ... ... ... 17 Respiratory 32 16 16 1 1 2 ... 1 16 13 ... ... ... 32 Digestive 9 6 3 5 ... 5 1 ... 3 ... ... ... ... 9 Urinary 6 4 2 ... ... ... ... ... 4 2 ... ... ... 6 Generative ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locomotory 3 ... 3 ... ... ... ... ... 2 1 ... ... ... 3 Integumentary 2 2 ... ... ... ... ... ... 2 ... ... ... ... 2 IV.Developmental. Premature Birth, Low Vitality and Congenital Defects 1 ... 1 1 ... 1 ... ... ... ... ... ... ... 1 Old Age 27 12 15 ... ... ... ... ... ... 27 ... ... ... 27 V. Violence 6 4 2 ... ... ... 1 ... ... 5 ... ... ... 6 VI. All other Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 197 106 91 10 2 12 3 6 104 72 ... ... ... 97 23 TABLE IX. STATISTICS OF MORTALITY. Wandsworth and Clapham Union Infirmary. [Non-Parishioners,] 1897. 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 Class. I. Zymotic. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough 5 5 ... 3 2 5 ... ... ... ... ... ... ... 5 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea, Dysentery & Cholera 1 ... 1 1 ... 1 ... ... ... ... ... ... ... 1 Influenza 1 1 ... ... ... ... ... ... 1 ... ... ... ... 1 Other Zymotic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total of Zymotic Diseases 7 6 1 4 2 6 ... ... 1 ... ... ... ... 7 II. Constitutional. Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatism 6 2 4 ... ... ... ... ... 1 5 ... ... ... 6 Cancer & other Tumours 16 7 9 ... ... ... ... ... 8 8 ... ... ... 16 Other Constitutional Diseases 4 2 2 4 ... 4 ... ... ... ... ... ... ... 4 Tubercular. Phthisis 23 16 7 ... ... ... ... ... 21 2 ... ... ... 23 Other Tubercular Diseases 2 1 1 1 1 2 ... ... ... ... ... ... ... 2 III. Local. Nervous 4 18 23 1 1 ... 1 3 21 14 ... ... ... 41 Circulatory 40 14 26 ... ... ... ... 1 16 23 ... ... ... 40 Respiratory 41 29 12 2 ... ... ... 1 21 17 ... ... ... 41 Digestive 19 7 12 14 1 15 ... ... 3 1 ... ... ... 19 Urinary 3 2 1 ... ... ... ... 1 2 ... ... ... ... 3 Generative 2 ... 2 ... ... ... ... ... 1 1 ... ... ... 2 Locomotory ... ... ... ... ... ... ... ... ... ... ... ... ... ... Integumentary ... ... ... ... ... ... ... ... ... ... ... ... ... ... IV. Developmental. Premature Birth, Low Vitality, Congenital Defects ... ... ... ... ... ... ... ... ... ... ... ... ... ... Old Age 29 12 17 ... ... ... ... ... 2 27 ... ... ... 29 V. Violence 6 5 1 ... ... ... ... 1 3 2 ... ... ... 6 VI. All other Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 239 121 118 26 5 31 1 7 100 100 ... ... ... 239 24 Particulars of deaths in Public Institutions within the Parish other than the Wandsworth and Clapham Union Infirmary. Parishioners. Bolingbroke Hospital Male 20 years Accident—fracture of skull ,, ,, Male 50 years Brain ,, ,, Male 70 years Accident—run over ,, ,, Male 30 years Justifiable homicide —fracture of skull ,, „ Male 32 years Accident—fall ,, „ Male 24 years Accident—run over ,, „ Male 26 years „ —poisoning ,, ,, Female21/12 years Digestive ,, ,, Male 1 year Accident—burns ,, „ Female 13 years Accident—fall ,, „ Male 83 years Accident—run over Non-Parishioners. Bolingbroke Hospital Female 24 years Generative „ „ Male 37 years Accident—fall ,, ,, Male 52 years Accident—fall ,, ,, Female 50 years Cancer ,, ,, Male 26 years Accident—fall ,, ,, Male 5 years Accident—run over ,, ,, Male 39 years Accident—fall „ ,, Male 23 years Accident—fall ,, ,, Male 5 years Accident—run over ,, ,, Male 30 years Heart ,, ,, Female 12 years Tubercular disease Westminster Union Schools Male 20/12 years Bronchitis Of the deaths under one year, two hundred and eighty-six were from premature birth, malformation, or low vitality at birth, nearly one-third of the total number of deaths recorded at that age. 25 All deaths under five years, the infantile period of life, were equal to forty-six per cent. of the total deaths. This is an improvement even upon that which has been maintained during recent years; formerly sixty per cent, of the total deaths were usually under five years, showing an immense saving of infantile life, which can only be ascribed to the improved sanitation which has prevailed in this parish for many years. At the other extreme of life, four hundred and sixty-four persons died above sixty-five years of age, including the deaths of aged parishioners in the Union Infirmary, where the deaths of one hundred and seventy-two aged non-parishioners also took place. In public institutions outside the parish twenty-six Battersea people died above sixty-five years, making a total of three hundred and eighty-eight parishioners dying at this advanced age. Table B. This, the second table prescribed by the Local Government Board, contains particulars of the population, births, notifications of infectious disease in the several localities and various public institutions (themselves treated as separate localities), situated within the parish, and the cases of infectious disease removed from their homes in these several localities for treatment in the Metropolitan Asylums Board isolation hospitals. The cases of erysipelas are mostly removed to the Infirmary of the Wandsworth and Clapham Union, situated on St. John's Hill, within the parish, as also cases of puerperal fever, other hospitals not providing accommodation for these two diseases. It will be observed that the several localities and institutions have populations assigned to them. The out-door districts of East and West Battersea have populations based upon the ascertained increase of population during the last inter-censal period, while the institutions have the census populations of 1896 given. Table B of Population, Births, and of New Cases of Infectious Disease coming to the knowledge of the Medical Officer of Health, during the Year 1897 in the Metropolitan Sanitary District of Battersea, Classified according to Diseases, Ages and Localitities; Names of localities adopted for the purpose of these statistics. Public Instituions being shown as separate localities. Population at all ages. Registered Births. Aged under 5 or over 5. New cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Number of such Cases removed from their homes in the several localities for treatment in Isolation Hospital. 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. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Census. 1896. Estimated to middle of 1897. East Battersea 71,730 72,875 2,431 Under 5 ... 246 118 5 ... 4 ... ... ... ... 12 ... 169 64 2 ... ... ... ... ... ... ... 5 upwards 3 461 277 9 ... 34 ... ... 1 1 105 1 269 95 ... ... 11 ... ... ... ... 2 West Battersea 91,928 94,446 2,835 Under 5 ... 252 71 2 ... 5 ... ... ... ... 4 ... 169 37 ... ... 2 ... ... ... ... ... 5 upwards 2 641 131 ... 1 52 ... ... 6 ... 86 ... 404 60 ... ... 32 ... ... 1 ... 12 Wandsworth and Clapham Union Infirmary 708 708 ... Under 5 ... 3 ... ... ... ... ... ... ... ... 1 ... 3 ... ... ... ... ... ... ... 5 upwards ... 8 ... ... ... ... ... ... ... ... 17 ... 8 ... ... ... ... ... ... ... Bolingbroke Hospital 39 39 ... Under 5 5 upwards Westminster Union Schools 183 183 ... Under 5 3 3 5 upwards 6 1 6 1 Masonic School, Battersea Rise 316 316 ... Under 5 5 upwards 1 Emanuel School, Battersea Rise 211 211 ... Under 5 5 upwards Totals 165,115 168,778 5.266 Under 5 504 189 7 9 17 344 101 2 2 5 upwards 5 1117 409 9 1 86 7 1 208 1 687 156 43 1 14 27 TABLE X. Particulars of Infectious Cases Notified during the year 1897. Small Pox Scarlatina Diphtheria and Membranous Croup Typhus Fever Enteric Fever Continued Fever Relapsing Fever Puerperal Fever Cholera Erysipelas totals. Cases Notified. 5 1621 614 1 95 ... ... 7 1 225 2569 Deaths at Home. ... 7 52 ... 8 ... ... 2 ... 9 78 TABLE XI. Particulars of Cases of Infectious Disease removed to Hospital. Small Pox Scarlatina Diphtheria and Membranous Croup Typhus Fever Enteric Fever Continued Fever Relapsing Fever Puerperal Fever Cholera Erysipelas totals Cases removed to Hospitals. 1 1031 259 ... 45 ... ... 1 ... 14 1351 Deaths in Hospital. ... 40 56 ... 10 ... ... 1 ... 2 109 28 Below will be found a synopsis of the notifications received during the year, with removals to hospital:— Notified. Removed to Hospital. Small Pox 5 1 Scarlatina 1,621 1,031 Diphtheria and Membranous Croup 614 259 Typhus Fever 1 — Enteric Fever 95 45 Continued Fever — — Relapsing Fever — — Puerperal Fever 7 1 Cholera 1 — Erysipelas 225 14 2,569 1,351 Ages:— Under 5 years 726 449 5 years and upwards 1,843 902 2,569 1,351 Where occurring:— East Battersea 1,276 613 West Battersea 1,253 717 Union Infirmary 29 11 Bolingbroke Hospital — — Westminster Schools 10 10 Masonic School 1 — 2,569 1,351 29 The various Hospitals to which the cases were removed are as follows:— Asylums Board Hospitals. Victoria Hospital. St. Thomas's Hospital. St. George's Hospital. London Fever Hospitals. Wandsworth & Clapham Union Infirmary. Small-Pox. Five cases of Small-Pox were notified during 1897; of these, four were not genuine cases of the disease, but of other diseases difficult to differentiate in the early stages. The genuine case was removed to the Small-Pox ship at Erith. The patient was a man employed at the Docks, where the disease was probably contracted. As there have been complaints that persons suffering from this and other infectious diseases have been conveyed in public conveyances, the following notice has been issued to those concerned, such as cabmen and conductors of tram cars and omnibuses. The Vestry of the Parish of St. Mary, Battersea.—Notice to owners of public conveyances, drivers, &c.—The Vestry of the Parish of St. Mary, Battersea, desire to draw the attention of the public to sec. 70, of the Public Health (London) Act, 1891, which enacts that it shall not be lawful for any owner or driver of a public conveyance knowingly to convey, or for any other person knowingly to place in any public conveyance a person suffering from any dangerous infectious disease, or for a person suffering from any such disease to enter any public conveyance, and if he does so he shall be liable to a fine not exceeding £10; and if any person so suffering is conveyed in any public conveyance, the owner or driver thereof as soon as it comes to his knowledge shall give notice to the Sanitary Authority, and 3O shall cause such conveyance to be disinfected, and if he fails to do so he shall be liable to a fine not exceeding £5, and the owner or driver of such conveyance shall be entitled to recover in a summary manner from the person so conveyed by him or from the person causing that person to be so conveyed a sum sufficient to cover any loss and expense incurred by him in connection with such disinfection. A chamber has been provided at the Vestry's Depot, Culvert Road, where conveyances can be disinfected free of charge. The Metropolitan Asylums Board will remove in one of their ambulances any person suffering from infectious disease to places other than the Board's hospitals upon application and payment of the sum of five shillings. In the case of inability to pay such sum application should be made to the Public Health Department of the Vestry, by whom such removal will be effected. Scarlet Fever. One thousand six hundred and twenty-one notifications of this disease were received, and one thousand and thirty-one of the less effectively isolated cases removed to hospitals of the Metropolitan Asylum Board, and to the London Fever Hospital, leaving five hundred and ninety which were treated at home. The deaths in hospital, to which the worst type of cases is generally removed, were forty, or just under four per cent. of cases, while of the cases treated at home, the majority of which were of a very slight nature, involving perhaps only scarlatinal sore throat, rather over one per cent. died. One thing is certain, that the generally improved sanitary conditions, including early removal of cases which could not be effectively isolated, have reduced the mortality of this disease to a remarkable extent. In one case during the year it was found necessary to obtain a magistrate's order to enforce removal to hospital. The patient 31 occupied a gipsy caravan in High Street, and it was absolutely impossible to provide means of isolation. An ambulance was sent, but the parents positively refused to allow the child to be removed. Notice was therefore served upon the occupier, and application made to the magistrate for his order, which was granted, and forthwith carried into effect. Several class rooms at Winstanley Road Board School were disinfected in consequence of the prevalence of scarlet fever amongst the children attending the school. Early in March complaint was made as to undue prevalence of scarlet fever in No. 1 District, and especially in connection with St. George's Schools, New Road. The matter was enquired into, and it was found that during the first three months of the year twenty-five cases of notifiable infectious disease occurred in houses where the children were attending St. George's School, that such diseases included twenty scarlet fever, three diphtheria, one erysipelas, and one membranous croup; that the streets affected by these twenty-five cases were Corunna Road, two houses, twocases; Wadhurst Road, three houses, three cases; Stewarts Road, six houses, seven cases; Ascalon Street, two houses, three cases; Thessaly Square, one house, one case; Corunna Place, two houses, two cases; Patmore Street, two houses, two cases; Mundella Terrace, one house, one case; Mundella Road, one house, one case; Tidemore Street, one house, one case; Dashwood Road, one house, one case; Savona Street, one house, one case; and that the cases had occurred during the undermentioned periods:—Period ending January 2nd, three cases; two weeks ending January 16th, two cases; two weeks ending January 30th, twocases; two weeks ending February 13th, eleven cases; two weeks ending February 27th, eight cases; and that no cases had occurred since that date. The figures given tend to prove that no undue number of cases had occurred at the School in question, the attendance 32 being nearly up to its maximum accommodation, which is for boys 290, girls and infants 252 each, or a total of 794 scholars. The drains of the school had been recently reconstructed, new water closets and flushing cisterns provided, and the general class rooms, etc., were found to be in cleanly condition, and fairly well ventilated. The whole of the houses in which the cases had occurred were visited, and it was found that there were no insanitary conditions to account for the cases, and further, that there was no cause for alarm, seeing that twelve streets were affected, giving an average of two cases per street for the three months under report. Diphtheria and Membranous Croup. Diphtheria and Membranous Croup were notified in six hundred and fourteen cases. They are grouped together as it is impossible to distinguish them practically. Two hundred and fifty-nine cases were removed to hospital, many in a dying condition, for the sake of having tracheotomy performed as a last resort. Fifty-six of these latter cases died, giving a hospital mortality of just under twenty-two per cent. Of the cases treated at home three hundred and fifty-five in number, fifty-two died equal to 14.6 per cent. This disease appears to have become endemic in the Metropolis. During those periods of and the year in which difficulty has occurred in the prompt removal of cases to hospital, owing to insufficient accommodation, the Metropolitan Asylums Board has issued orders to the medical attendants enabling them, if they desire it, to obtain anti-toxin from any of the Board's ambulance stations for the purpose of treating patients therewith. Hospital Provision for Scarlet Fever and Diphtheria At the end of July and early in August difficulty was occasionally experienced in obtaining hospital accommodation for Scarlet Fever and Diphtheria patients, and continued throughout September, October and November. In many cases the patients 33 had recovered before accommodation could be provided. Throughout December and to the time of writing, prompt removal has been maintained, and an appreciable diminution in the prevalence of the diseases has resulted. Enteric and other Fevers. Ninety-five cases of Enteric Fever were notified during the year in addition to one of Typhus and and seven of Puerperal Fever. Of the Enteric cases forty-five were removed to hospital with a mortality of ten equal to twenty-two per cent. Of the fifty cases treated at home, sixteen died equal to a mortality of thirty-two per cent. The difference in favour of hospital treatment lies in the fact that the diet is strictly regulated there, many deaths arising at home from injudicious feeding with solids before the bowels are fitted for their reception, ulceration of the bowels being usual in this disease. In October last in consequence of the prevalence of Enteric or Typhoid Fever in the Metropolis and in this parish I prepared a special report shewing the action taken upon the notification of Typhoid Fever. Upon the receipt of such notification a disinfector is immediately despatched to the infected premises with a supply of disinfectants and apparatus for the flushing of the house drains. The District Sanitary Inspector visits the premises and ascertains whether sufficient means of isolation are provided, and if necessary adopts measures for the removal of the patient to hospital, makes investigations as to whether patient has in any way subjected himself to infection, examines and tests drains and sanitary appliances, inspects the cistern and water fittings, and makes enquiries as to the source of milk supply, and as to schools attended by children in the house or places and nature of employment of adults. Notices of the case are immediately forwarded to the headmasters of the schools attended. Disinfection of the bedding and premises is carried out after the removal of the patient or at the termination of the case. c 34 Thirty-six cases occurred during the months of September and October, but in two cases only was the source of infection directly traceable, the cause of the epidemic being probably seasonal and climatic. In two other cases the disease was undoubtedly contracted outside the parish. During the two succeeding months to the end of the year only eight cases were notified, and there has not since been any unusual prevalence of the disease. One death occurred of a case of Puerperal Fever removed to hospital. Of the six remaining at home two died. The case of Typhus was sent back from hospital as being really Pneumonia. Erysipelas. For some reason this disease has increased during the last few years in the Metropolis. During 1897 two hundred and twenty-five cases were notified, of these fourteen were removed to hospital, of whom two died. Of the two hundred and eleven remaining at home nine died. Those removed were admitted into the Wandsworth and Clapham Union Infirmary in the majority of instances. The term Erysipelas covers so many degrees and forms of inflammatory affections, that no further discussion of the subject would be profitable. Table XII. is a table shewing the incidence of notifiable disease in the different sanitary districts, and, taking into consideration the numerical differences of population, the numbers are more equal than may appear at first sight. Diarrhœa. One hundred and forty-four fatal cases were registered from this cause alone, the majority being hand-fed infants. To reduce this mortality the Health Committee has for some years issued the following handbill during the hotter months, when disorders of the digestive tract are most prevalent. It is hoped that much good has been done and many lives saved by this means, as a notable diminution in the number of fatal cases has always been manifest after its issue. One case was notified as Cholera. It proved to be of the English Cholera type, and the patient recovered. 35 TABLE XII. Particulars of the Prevalence of Notifiable Infectious Disease in the several Sanitary Districts. New Cases Coming to Notice. Number of such Cases Removed to Isolation Hospitals. Sanitary Districts. Small Pox Scarlatina Diphtheria and Membranous Croup Typhus Fever Enteric Fever Continued Fever Relapsing Fever Puerperal Fever Cholera Erysipelas Totals Small Pox Scarlatina Diphtheria and Membranous Croup Typhus Fever Enteric Fever Continued Fever Relapsing Fever Puerperal Fever Cholera Erysipelas Totals No. 1 2 277 114 ... 19 ... ... 1 1 50 464 1 199 49 ... 8 ... ... ... ... 3 260 „ 2 1 328 237 ... 17 ... ... ... ... 58 641 ... 205 96 ... 7 ... ... ... ... 2 310 „ 3 1 376 86 1 25 ... ... 5 ... 45 539 ... 266 35 ... 13 ... ... 1 4 3i9 „ 4 1 229 74 ... 13 ... ... ... ... 24 341 ... 114 35 ... 5 ... ... ... ... 1 155 „ 5 ... 355 76 ... 15 ... ... 1 ... 40 487 ... 223 32 ... 9 ... ... ... ... 2 266 „ 6 ... 56 27 ... 6 ... ... ... ... 8 97 ... 24 12 ... 3 ... ... ... ... 2 41 Whole Parish 5 1621 614 1 95 ... ... 7 1 225 2569 1 1031 259 ... 45 ... ... 1 ... 14 1351 36 PRECAUTIONS AS TO DIARRHŒA. In consequence of the prevalence of Diarrhœa amongst young children, more especially those brought up by hand, the Vestry as the Sanitary Authority acting under the advice of their Medical Officer of Health, beg to direct the attention of Parents and others having care of young children to the great advisability of boiling all water and milk used for feeding such children. Care should be taken as to the sound condition of every article of food for children, anything not fresh being withheld. Fruit especially should not be given if in the slightest degree decomposed. Cleanliness of person and dwellings with frequent flushing of house drains is of the greatest value. Disinfectants in case of illness are supplied free of charge on application to the Public Health Department, Town Hall Road, between the hours of 9 a.m. and 5 p.m., and on Saturdays, between 9 a.m. and 1 p.m. Measles The number of cases which occurred during the Whooping earlier months of 1897 cannot be ascertained, as these, Cough. the most fatal of all zymotic diseases, still remain non-notifiable. Again in December I reported relative to the prevalence of Measles, and the number of fatal cases becoming so grave I was directed to re-issue a bill giving the public instructions as to the necessary precautions to be observed during an epidemic of this disease, and they are here appended. Seventy-six fatal cases of Measles were recorded during the year, the number during 1894 having been one hundred and fiftyone, during 1895 ninety-nine, and in 1896 one hundred and eighty-five. 37 PRECAUTIONS TO BE OBSERVED DURING THE EPIDEMIC OF MEASLES. The Vestry, as the Sanitary Authority for the Parish, and as advised by the Medical Officer of Health, desire to direct the attention of parents and others to the importance of checking the spread of Measles, which is now prevalent in an epidemic form and is causing much mortality by complications, such as Bronchitis and Pneumonia. All children suffering from Measles, even in the earliest stage, before the eruption appears, should be isolated from others. The first symptons of Measles are running at the eyes and nose, with repeated sneezing and a puffy appearance of the face and eyelids and, a few days after, the appearance of the rash which is raised and red or purplish in colour. The child should be kept in bed from the first appearance of the symptons until the rash has finally disappeared, in order to avoid the danger of lung complications, which are the real causes of death, uncomplicated measles not being usually fatal. Medical aid should be sought in every case where difficulty of breathing is observed. Disinfectants in a dilute form should be freely used in every case of measles in a warm bath at the onset and termination of the disease, and to sponge the face and other parts during the illness. In case of inability to obtain suitable disinfectants the same will be supplied, free of charge, on application to the Public Health Department, Town Hall Road, Lavender Hill. The epidemic of measles was accompanied and followed as usual by deaths from various respiratory disorders. From 38 Whooping Cough eighty-three deaths were registered, a large majority complicated by Measles. Thus from the two diseases combined one hundred and sixty-one deaths occurred, comparing unfavourably with a total of one hundred and seventy-five deaths from all the notifiable zymotic diseases an unanswerable argument in favour of the compulsory notification of all infectious diseases, they in the prenotification period, being said to be equally intractable to supervision and modification, an idea which the present greatly diminished case mortality demonstrates to be incorrect. Influenza. The mortality from this disease diminished during the year under report from forty-five, in 1896, to thirteen, in 1897. The enormous number of deaths from diseases of the respiratory organs was no doubt increased by the prevalence of Influenza, mild cases being very prevalent. During the greatest prevalence of Influenza the Health Committee have on several occasions issued the following PRECAUTIONS AGAINST INFLUENZA. The Vestry of the Parish of St. Mary, Battersea, as the Sanitary Authority and as advised by the Medical Officer of Health, in consequence of the renewed prevalence of Influenza, desire to direct the attention of the public to the extremely infectious character of the disease, and to point out that to the exposure of those in an infective condition from Influenza, by neglect to isolate themselves during the period of such infective condition, the spread and maintenance of the disease is chiefly due. It is probable that the breath of those so affected is the principal medium by which infection is conveyed. The early symptoms of Influenza are chiefly chills and shivering, accompanied by great muscular weakness and prostration, often amounting to inability to stand or move, with pains in the spine or other parts of the body. It is desirable that persons 39 thus affected should at once go to bed and there remain until convalescence is established in order to avoid the dangers of Pneumonia or Bronchitis, which are the chief complications to be feared, as likely to lead to fatal results. Early recourse to medical assistance is desirable in every case, both for the determination of the real nature of the disease and for the prevention of the more serious complications. A most important memorandum was issued in 1895 by the Medical Officer of the Local Government Board, and been produced as the result of questions in Parliament, addressed to Ministers, on the subject of a very fatal outbreak at the end of 1894 and beginning of 1895, and is here set out. Influenza became epidemic in England in the winter of 1889-90; it recurred in epidemic form in the spring of 1891, and was maintained up to June of that year; a third epidemic took place in the winter of 1891-92, and after a minor recrudescence in the spring of 1893, a fifth prevalence on a wide scale took place in the winter of 1893-94. England is now passing through a sixth epidemic period. Two detailed reports have been issued by the Board on the subject. The first was Dr. Parsons, "On the Influenza Epidemic of 1889-90," with an introduction by Sir George Buchanan, M.D., F.R.S., the Board's Medical Officer at that date. The second was a "Further Report on Epidemic Influenza, 1889-92," by Dr. Parsons, with papers on the Clinical and Pathological aspects of the Disease, by Dr. Klein, F.R.S., and an introduction by Sir R. Thorne Thorne. A "Provisional Memorandum upon Precautions advisable at times when Epidemic Influenza threatens, or is prevalent," was also drawn up in January, 1892, and was issued by the Board to local sanitary authorities. The further study made by the Medical Department as to the natural history of Influenza, and as to its clinical and 40 teriological characteristics, goes to show that it is a disease against which it is most difficult to apply measures of prevention with any substantial prospect of success. Influenza is highly infective from person to person; its infectious quality is often manifested before the disease is fully recognised ; its incubation period is one of the shortest of all infectious diseases; it varies so much in intensity that many cases are never diagnosed at all; one attack confers no marked immunity against another; and the infection is largely eliminated by means of the lungs, the sputa of the sick being invariably charged, during the acute stage of the disease, with its pathognomonic micro-organism. The disease calls primarily for measures of isolation and of disinfection, but there are difficulties in making any such measures universally applicable. Wherever they can be carried out, the following precautions should, however, be adopted:— 1st. The sick should be separated from the healthy. This is especially important in the case of first attacks in a locality or a household. 2nd. The sputa of the sick should, especially in the acute stage of the disease, be received into vessels containing disinfectants. Infected articles and rooms should be cleansed and disinfected. 3rd. When Influenza threatens, unnecessary assemblage of persons should be avoided. 4th. Buildings and rooms in which many people necessarily congregate should be efficiently aerated and cleansed during the intervals of occupation. It should be borne in mind that the liability to contract Influenza, and also the danger of an attack, if contracted, are 41 increased by depressing conditions, such as exposure to cold, and to fatigue whether mental or physical. Attention should hence be paid at epidemic periods to all measures tending to the maintenance of health, such as the use of clothing of suitable warmth, and a sufficiency of wholesome food. Persons who are attacked by Influenza should at once seek rest, warmth, and medical treatment, and they should bear in mind that the risk of relapse, with dangerous complications, constitutes a chief danger of the disease. It will be perceived that the contents of the above memorandum are in accord with the precautions issued by this parish early in 1894, and now re-issued for the guidance of the public, as set forth on page 38. The Plague. In August a notice was received from the Port Medical Officer, Greenwich, that a person, apparently in good health, had proceeded to this district after disembarkation from ss. Britannia, from Bombay, and the person and premises were kept under due observation during the period of incubation, without any symptoms of the disease appearing. Infectious Disease at Cowsheds, Dairies, &c. In the event of an outbreak of infectious disease occurring at the premises of a milk-purveyor or dairyman, the London County Council who undertake the registration of such premises are at once communicated with: all milk upon the premises is destroyed, and business is suspended until disinfection of the premises and all trade utensils has been carried out, and a certificate thereof granted by the Medical Officer of Health, after the termination of the case or the removal of the patient to hospital. With a view to uniformity throughout the Metropolis, the 42 London County Council has adopted a form of certificate authorising the resumption of the sale of milk, a copy of which is appended and is now in general use for that purpose. In the Administrative County of London. In the matter of the Dairies, Cowsheds and Milkshops Orders ol 1885 and 1886, and in the matter of The Regulations thereunder of the London County Council, being the Local Authority for the Administrative County of London. I, the undersigned, being the Medical Officer of Health of the undermentioned District, in pursuance of No. 29 of the aforesaid Regulations, do hereby declare that the building or premises known as in the said District, in which building or premises an outbreak of infectious or contagious disease to wit occurred on or about the day of 189, and in which building or premises milk is purveyed or sold by one have been disinfected, and that the said building or premises are in my opinion free from infection. As witness my hand this day of 189. Medical Officer of Health of the District of Battersea, in the Administrative County of London. 43 Steam Disinfection. On several occasions during the last few years the Health Committee has considered as to the advisability of carrying out steam disinfection without the intervention of a contractor. In November, 1895, a letter was received from the Metropolitan Asylums Board, recommending that Sanitary Authorities provide their own steam disinfectors, and have the work carried out by their own officials. The subject was at that time adjourned for three months, when the Committee recommended the renewal of the contract. In July last year the Committee again considered the matter and a Sub-Committee consisting of Messrs. Chown, Whitehouse, May, E. G. Marshall and Gurling were appointed, which SubCommittee visited several of the Metropolitan Disinfecting stations, but decided to again adjourn the matter until it could be ascertained what steam would be permanently available for the purpose of a steam disinfector, either in connection with the Electric Lighting Works at the rear of the Town Hall or elsewhere. Closing of Public Elementary Schools. A memorandum, prepared in the Medical Department of the Local Government Board on the circumstances under which the closing of Public Elementary Schools or the exclusion therefrom of particular children may be required in order to prevent the spread of disease was issued in July last. This gives information derived from the reports of the Board's own Medical Inspectors, and of local Medical Officers of Health, respecting school closure and exclusion from schools as precautions against infection, with a view to indicating the best means of preventing the spread of disease by school children, while avoiding any unnecessary interruption of the work of education. 44 The regulations of the Education Department (Art. 88) prescribe, as one of the general conditions required to be fulfilled by a Public Elementary School in order to obtain the grant, that the managers must at once comply with any notice of the Sanitary Authority, acting on the advice of the Medical Officer of Health, requiring them for a specified time, with a view to preventing the spread of disease, or any danger to health likely to arise from the condition of the school, either to close the school, or to exclude any scholars from attendance, but provides for their appeal to the Department, after complying, if they consider the notice unreasonable. It has not been found necessary during the year to make use of this provision for the closing of any school, it having been found so far sufficient to exclude scholars from infected houses from attendance for that purpose, daily returns being forwarded to the Head Masters of Schools notifying the existence of infectious disease at the residences of scholars attending such schools. Table XIII. illustrates the epidemic or zymotic mortality for the past eleven years with the resulting death rates. The number of deaths from each class of disease is shewn. The zymotic death rate for 1897 was 2.3 per thousand persons, being low.er than in any other year in the ten years preceding. 45 TABLE XIII. Comparative Table of Zymotic Mortality during the past 11 years. 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 Small Pox ... ... ... ... ... ... ... ... ... ... ... Measles 82 87 104 159 37 90 90 151 99 185 76 Scarlet Fever 68 25 12 10 10 15 17 5 10 5 7 Diphtheria 23 22 21 27 35 28 90 67 60 50 52 Enteric, &c., Fevers 17 13 15 21 19 8 14 13 15 11 8 Whooping Cough 112 119 81 146 104 100 115 77 52 137 82 Epidemic Diarrhœa 175 75 112 121 104 99 120 93 151 169 141 Other Zymotic Diseases 25 22 21 59 89 133 il8 62 104 45 25 Total Deaths from Zymotic Diseases 502 363 366 543 398 473 564 468 491 602 391 Zymotic Death Rate 3•7 2•6 2•5 3•6 2•6 3•0 3•5 2•8 2•9 3•6 2•3 Death-rates from all Diseases 18•2 15•7 15•6 19•3 17•3 17•4 17•8 15•4 17•8 17•7 15•5 TABLE XIV. Comparative Table of all non-zymotic causes of Deaths during the past 11 years 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 Tubercular, including Phthisis 367 342 334 320 285 237 355 394 353 374 355 Of Brain, Nerves, &c. 280 223 212 261 195 259 213 211 334 211 241 Of the Heart, &c. 128 113 108 148 141 183 159 173 213 182 189 Of the Respiratory Organs,excluding Phthisis 528 474 391 618 572 635 653 471 623 531 439 of Digestive Organs 86 113 100 118 122 112 127 197 114 154 202 Of Urinary Organs 53 24 39 34 49 72 60 57 56 88 69 Of Organs of Generation 19 6 14 15 16 15 14 12 7 22 14 Of Joints, Bones, &c. 30 9 3 4 7 2 3 6 - 5 6 Premature Birth, Low Vitality, Malformation, &c. 202 175 205 206 238 256 295 273 332 298 286 Of Uncertain Seat Cancer, Syphilis, Dropsy, &c. 105 79 96 70 89 233 130 114 108 122 141 Age 88 57 52 71 74 122 103 118 128 207 150 Violence 63 56 60 77 60 81 102 70 102 117 118 Constitutional ... ... ... ... 2 12 23 20 40 28 19 Total 1949 1671 1614 1942 1850 2219 2237 1936 2410 2339 2229 46 Inquests. During the year 1897, 329 deaths were referred to the Coroner. In fifty-six instances 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 273 cases inquests were held with the following verdicts:— From Natural Causes 155 From Accidental Causes:— Suffocated in bed with parents 21 Asphyxia 10 Run over 8 Falls, &c. 28 Scalds and Burns 7 Drowned 7 Poisoning 1 Other Injuries 8 — 90 From Homicidal Causes:— Suicide—Gunshot 2 Cut throat 2 Poisoning 1 Drowned 1 Decapitation on Railway 1 Murder—Asphyxia 2 7 Justifiable Homicide—Fracture of Skull 1 2 Open Verdicts:— 1 Asphyxia 2 Neglect at Birth 4 Found Drowned 9 Other Injuries 3 18 Total 273 47 Twenty-one deaths were due to suffocation whilst in bed with parents, the dates and days of the week being as follows : 12th January Tuesday 1st February Monday 5th „ Friday 7th ,, Sunday 10th March Wednesday 10th April Saturday 18th ,, Sunday 21st ,, Wednesday 24th „ Saturday 23rd June Wednesday 28th ,, Monday. 1st July Thursday. 20th „ Tuesday. 7th September Tuesday. 2nd October Saturday. 10th ,, Sunday. 12th „ Tuesday. 10th November Wednesday. 15th „ Monday. 21 st ,, Sunday. 24th ,, Wednesday. Differently arranged:— Sunday 4 Monday 3 Tuesday 4 Wednesday 5 Thursday 1 Friday 1 Saturday 3 21 Social Position of Persons Dying During 1897. Number. Per Cent. Nobility and Gentry 16 0.6 Professional Class 26 1.0 Middle and Trading Class 133 5.1 Industrial and Labouring Class 2,445 93.3 2,620 100.0 Water Supply for London. This most important subject, more especially with reference to the health and sanitary condition of the inhabitants of this vast metropolis, among whom of course are included the many thousands of persons who are inhabitants of Battersea, is now engaging general attention. In my report for 1895 the subject was very fully discussed, and as the 48 matter is one involving as it does the expenditure of many millions of the public money as well as the health and lives of the community, and in which every public man should take a strong personal interest, a condensed account of the present position of the question is again given. This most important subject has been under 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. Briefly reviewing the inquiry, the main question referred to and considered by the Commission was 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 watersheds. They find, as the Companies always maintained, 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," 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. 49 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. 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 before them. There are, however, in the enquiry two points which rather hang upon one another, and about which we 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 the water 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. The conclusion of the Commission is most distinct that there is ample supply of water derivable from the River 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 d 50 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, Professor 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 Commissioners then state that— "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 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 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, if 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 51 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 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 what 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 objectionable 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 52 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 decennial period from 1881 to 1931 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 its Views upon the Water Supply. Of these witnesses examined whose evidence was directly adverse to the reservoir and storage schemes put forward by the Companies, that of Sir A. R. Binnie, M. Inst., C.E., Chief Engineer to the London County Council, was the most important. Sir A. R. 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 53 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 contributory streams, and therefore could not be reckoned on for increasing the supply. The Water Committee of the London 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. An admirable synopsis of the views of the London County Council and its chief officials appeared in the British Medical Journal, which is here closely followed. 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 on 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. 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 54 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 poseession 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 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 the 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 50 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. Sir A. R. 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 contemplating taking 300 million gallons from the Thames daily, trusting to the fact that the average daily flow at Teddington weir is about 1,350 million gallons; but he 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, 1893, 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. 55 There is a good deal of common sense in some of the remarks in the reports about the safety, or otherwise, of polluted waters. Sir A. R. 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 Sir A. R. 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 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. Mr. Shirley Murphy, Medical Officer of the London County Council, confines his observations to that portion of the report of 56 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 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 shewn 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. In the present state of knowledge on such matters we are driven back to much the same opinion as that held by the late Sir George Buchanan, who said that he did not think that it was possible, either by chemical, microscopical, or bacteriological processes, to say when a water was or was not injurious, and that there was no way of arriving at a solution of this question except by inspecting the sources of supply, and seeing if they were or were not polluted. According to this criterion London river water stands absolutely and hopelessly condemned. 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 to the final delivery to the consumer, should be in the hands of one 57 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. Since writing above, the Government have intimated that a Royal Commission would be appointed to consider the whole subject of the Metropolitan Water Supply, together with the report of the London Water Commission, and the President of the Local Government Board, in answer to a question in the House of Commons, stated that the terms of the reference would direct the Commission to inquire and report (1) whether, having regard to financial considerations, and to the present and prospective requirements as regarded water supplied within the limits of the supply of the Metropolitan Water Companies, it was desirable, in the interests of the ratepayers and water consumers, that the undertakings of the water companies should be acquired and managed, either (a) by one authority, or (b) by several authorities, and, if so, what should be the authority or authorities, and to what extent physical severance in regard to supply of the several companies should take place. They would also be asked to say—(1) whether any division within the limits of supply of the companies was practicable and desirable, and if so what were the legal powers necessary to give effect to any such arrangement; and (2) if the undertakings were not so acquired, whether additional power of control should be exercised by the local or other authorities; and, if so, what those powers should be; and (3) whether it would be practicable to connect any two or more of the different systems of supply of the eight Metropolitan Companies; and, if so, by whom and in what proportion should the cost of connection be borne, and what were the legal powers necessary. Public Health (London) Act, 1891. The procedure of the Public Health Department is almost entirely based upon the provisions of the Public Health (London) Act, 1891, which consolidated 58 and amended the various Acts under which the Sanitation of London had been previously carried out. It contained also many valuable provisions which had hitherto only been extra Metropolitan and contained in the Public Health Act, 1875, under which provincial Sanitary Authorities had effected great improvement in the Sanitation of their districts. A condensed synopsis of its provisions here will be useful for reference. Sec. 1 provides for house to house inspection by the Sanitary Authority, for which additional Inspectors with separate and smaller districts have been appointed within the last few years. Sec. 2.—A nuisance must be abated that is dangerous or likely to be dangerous to health. Under the Metropolis Management and other Acts it was necessary to prove actual injury to health. Sec. 3 provides that information of a nuisance may be made to the Sanitary Authority, who shall serve intimation to parties responsible. Sec. 4.—The most essential difference between the procedure under the Public Health (London) Act, 1891, and the various other preceding Acts, is that formerly if a notice to abate a nuisance from the Sanitary Authority was not complied with, proceedings had to be commenced before a justice and evidence produced to satisfy him that a nuisance injurious to health existed when, if satisfied that such nuisance existed and was injurious to health an order would be made for the abatement of the same. If this order was disregarded and the necessary works not executed it was necessary to commence fresh proceedings to recover penalties. The Sanitary Authority under this section itself considers the matter and makes orders, if necessary suing for penalties for non-compliance therewith. Absence of proper water-fittings is constituted a nuisance under section 4, and by section 5 a house may be closed for this 59 reason. The authority can specify works and insist upon the carrying out of the same under the latter section, and now does so in a large proportion of cases. Sees. 5, 6 and 7 contain provisions for orders, penalties and appeals, and enables the Sanitary Authority itself to carry out necessary works in default of responsible owner, &c. Sec. 11 provides for recovery of expenses and costs consequent thereon, and Sec. 13 enables the Authority to take action in the first instance in the higher Courts should it think fit. Under Sec. 14 an important proviso is introduced, as a Sanitary Authority has power to take proceedings for the abatement of nuisances arising in the district of another authority should the nuisance injuriously affect the inhabitants of their own district. Sec. 15 renders liable to a penalty of £5 any person wilfully injuring or destroying any closet or sanitary apparatus, and will probably be useful in restraining persons from wantonly damaging fittings. Bye-laws are to be made by the authority for the prevention of nuisances or keeping of animals so as to be a nuisance or injurious to health, and as to paving yards. The London County Council has made Bye-laws under the following sections which are now operative :— Sec. 16-1.—Removal of fcecal matter. ,, Removal and disposal of refuse. ,, Cleansing and filling up of cesspools and privies. Sec. 39-1.—Water closets and soil pipes. „ Ashpits. „ Receptacles for dung, cesspools, &c. 6o The Vestry has made Bye-laws under the undermentioned Sections of the Act:— Sec. 16.—Prevention of nuisances. „ 39.—Keeping of water closets. „ 50.—Cleansing of cisterns. ,, 94.—Houses let in lodgings. These are in active operation, and can be obtained at the office of the Public Health Department by any ratepayer desiring a copy. There are other bye-laws which may be made by the Sanitary Authority, and which are now under consideration. They are:— Sec. 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-keeper under which the Mortuary has hitherto been regulated. Sec. 95. Tents and vans. Bye-laws were made by the District Board some years since, under the Housing of the Working Classes Act, 1885, which have been acted on until the present time. By Secs. 23 and 24 the control of smoke nuisances other than in private dwellings is placed under the Sanitary Authority instead of the Police, and has considerably increased the work of the Public Health Department. Work-shops, Work-places and Factories are also placed under the supervision of the Sanitary Authority with certain duties as to giving notice to the Factory Inspector when children, 61 young persons, or women are employed. It is also the duty of the Authority to see that proper and separate accommodation is provided for each sex. Sec. 47 provides that a medical officer of health or sanitary inspector shall examine all articles intended for the food of man if unsound, and shall seize the same and obtain an order from a Justice for its destruction. The fine is raised to a maximum of £50 for every animal or parcel of food condemned, and should a person be so convicted twice in twelve months the Court may order a notice of the facts to be affixed to his premises for a period not exceeding twenty-one days. Should a person find himself in the possession of unsound food he himself may give notice to the Vestry, who must remove the same as trade refuse and this procedure would seem to relieve him of the penalties mentioned. Sec. 48 contains the important provision that a newly-erected dwelling-house must not be occupied until a certificate has been obtained of the Sanitary Authority to the effect that a proper and sufficient supply of water exists. This section seems to be now more generally understood and imposes much work on the Public Health Department. The following sections 49, 50, 51, 52, 53 and 54, apply inter alia to water supply generally. Secs. 55, 56 and 57 re-enact, as elsewhere stated, the provisions of the Infectious Disease (Notification) Act. Secs. 59, 60 and 61 require the authority to make provisions for the disinfection of clothing, &c., which provision has been duly made by the Vestry. The subsequent sections provide that infectious refuse shall not be treated so as to be dangerous to the public health, and prescribe penalties on persons letting houses or apartments in which infectious disease has occurred without having the same properly disinfected and obtaining a certificate thereof, which certificate is given to applicants free of charge on 62 application to the Public Health Department. Other important provisions for the prevention of the spread of infectious disease follow in subsequent sections; but they have long been in operation in this parish. In fact, it may be said generally that the methods of Sanitary procedure which may have gradually evolved in this parish during the last twenty years, were adopted by the framers of the Act as its basis. Provision is made for Mortuaries and post-mortem examinations; such has existed in Battersea for many years. The Mortuary accommodation is, however, becoming somewhat inadequate for the needs of this ever increasing parish, and it is proposed to provide a new Mortuary with Coroner's Court. The present Mortuary, originally said to be the best arranged in London, in a commendable spirit of emulation, other parishes have improved upon, until we are at the present time somewhat short of the standard of excellence. The plans of the Surveyor, if carried out, will provide a building far in advance of the majority of Metropolitan Mortuaries, but there is a difficulty in deciding as to the most suitable site. Customs and Inland Revenue Act, 1891. This Act, which is simply an extension of the provisions of the Customs and Inland Revenue Act, 1890, exempting houses structurally fitted in the opinion of the Medical Officer of Health for occupation as separate tenements at an annual rental not exceeding £20 from the liability to house duty. The 1891 Act raised the amount to £40 annual rental. These Acts have added much to the duties of the Medical Officer, as personal inspection is imperative and certain forms of certificate have to be sent by him to the Surveyor of Taxes. Many hundreds of tenements have been inspected and certified since the Act came into force in January, 1891, and many flats are now being built and converted in the parish in order to obtain exemption or abatement of the house duty. The numbers inspected yearly from 1890, in which two hundred and forty-three were inspected, and after the execution of necessary 63 works re-inspected and certified were for 1891, one hundred and nineteen; for 1892, one hundred and sixty-five; for 1893, two hundred and one; for 1894 and 1895, each ninety-one; during 1896, one hundred and twenty. During 1897 forty-three applications were made, and certificates given in twenty-seven cases. Sixteen others were not issued after inspection; ten of the latter were suspended until sanitary defects were remedied. Of the certificates refused under this Act during the year, two referred to houses in Leathwaite Road. The houses in question, although not insanitary, were not originally built or adapted by additions for the sole purpose of providing separate dwellings, nor did they afford suitable accommodation for each family and due provision for sanitary requirements. The Act requires that in order that a certificate may be granted by the Medical Officer of Health, the house be so constructed as to afford such accommodation and due provision. In connection with the granting of these certificates, the following recommendations were adopted by the Metropolitan Branch of the Incorporated Society of Medical Officers of Health on the 12th February, 1897:— 1. That in no case should a Medical Officer of Health examine a house with a view to giving a Certificate under these Acts, until he is absolutely satisfied— as advised in the letter from the Local Government Board, dated the 15th August, 1892—that the house in question comes within the sections of the Acts. 2. That a Certificate under these Acts should state that the following requirements are complied with: 64 (a) A definite minimum height and superficial area for living and sleeping rooms, as defined by the London Building Act, 1894. (b) That there is a sufficient and available supply of water on each floor. (c) That there is at least one water closet, properly supplied with water for every twelve occupants (or less) on each floor. (d) That the drainage of the premises is in accordance with the regulations recognized by the Authority in whose jurisdiction the house is situated. (e) That accommodation for clothes washing is provided, sufficient for the number of persons inhabiting the house. (Signed) W. H. KEMPSTER, President, Chairman of the Committee. Sickness and Mortality amongst the Parish Poor. Table XV. sets out the character and forms of sickness under the care of the District Medical Officers of the parish poor during 1897. The proportion of deaths to cases is under two per cent. The more serious cases are sent into the Infirmary generally, which will to a certain extent account for so small a death rate. 65 TABLE XV. Sickness and Mortality amongst the Parish Poor during the year 1897 ZYMOTIC OR EPIDEMIC DISEASES. Battersea. Small-Pox. Measles. Scarlatina. Diphtheria. Whooping Cough. Enteric & other Fevers. Erysipelas. Puerperal Fever or Metria. Diarrhoea, Dysentery, or Cholera. Influenza. Other Zymotic Diseases. Total. Grand Totals of Cases and Deaths from all Diseases. Cases ... 39 19 12 23 3 23 ... 88 58 4 269 Deaths ... 5 ... 1 1 ... 11 ... 2 1 ... 11 OTHER DISEASES. Battersea. 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. Cases 133 152 45 734 170 12 4 127 78 2005 3460 3729 Deaths 15 5 2 15 2 2 3 5 1 8 58 69 e 66 TABLE XVI. Battersea Vaccination Returns, January to December, 1897. Registration Sub-District. Number of Births returned in the Birth List Sheets—1897. Nos. of those births duly entered by the 31st January, 1896,in Cols. 10, 11, and 13, of the Vaccination Register. (Birth List Sheets), viz.:— No. of Births which on, the 31st March, 1898,remained unentered in the Vaccination Register on account. Number of those Births remaining on 31st January neither duly entered in Vaccination Register (Col. 3, 4. 5, and 6 of this Return) nor accounted in the Report Book Col. 10, successfully vaccinated. Col. Insusceptible of vaccination. 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 Battersea 2427 1243 2 ... 237 ... 112 ... 193 640 West Battersea 2843 1546 30 ... 281 ... 90 ... 227 669 Totals 5270 2789 32 ... 518 ... 202 ... 420 1309 Table XVI. is a copy of the annual table presented by the Vaccination Officer to the Guardians. The numbers under the headings fully shew the condition of vaccination in Battersea during 1897. Vaccination. In the Annual Report for 1896 a very copious resume of the report of the Royal Commission on Vaccination was given. It will not be necessary to reproduce the body of the report, but the conclusions of the majority report as well as that of the minority are epitomised and here given as well as the Bill before parliament at the time of writing, for 67 the purpose of carrying most of the recommendations of the Commission into effect. After setting out at great length the advantages and disadvantages of arm to arm vaccination the report goes on to say that it is obvious that the employment of calf-lymph only would wholly exclude the risks as regards both Syphilis and Leprosy. Respecting the latter disease, however, there appears to be reason to doubt whether any risk exists, and at any rate it does not concern the British population. Even in Leprosy districts the employment of English human lymph would be, so far as Leprosy is concerned, as safe as that from the calf The risk of Syphilis, although real, is an exceedingly small one, even when humanized lymph is employed, and may probably be wholly avoided by care in the selection of the vaccinifer. As regards all the other dangers, whether of severe illness or temporary inconvenience, the two forms of lymph appear to stand on the same level. The instances of inflamed arms, of Erysipelas, of Vaccinia Maligna, and Eczematous eruptions are not more common after the use of human lymph than after that from the calf. Some of the best qualified witnesses who have afforded us their assistance have expressed a deliberate preference for armto-arm vaccination, believing that the advantages of calf-lymph are more imaginary than real. A careful examination of the facts which have been brought under our notice has enabled us to arrive at the conclusion that, although some of the dangers said to attend vaccination are undoubtedly real and not inconsiderable in gross amount, yet when considered in relation to the extent of vaccination work done they are insignificant. There is reason further to believe that they are diminishing under the better precautions of the present day, and with the addition of the further precautions which experience suggests will do so still more in the future. We put the use of calf-lymph in the forefront because, as we have said, this would afford an absolute security against the communication of Syphilis. Though we believe the risk of such 68 communication to be extremely small where humanized lymph is employed, we cannot but recognize the fact that however slight the risk, the idea of encountering even such a risk is naturally regarded by a parent with abhorrence. We think, therefore, that parents should not be required to submit their children to vaccination by means of any but calf-lymph, but this should not prelude in the use of humanized lymph in case they so desire. So long as the State, with a view to the public interest, compels the vaccination of children, so long even as it employs public money in promoting and encouraging the practice, we think it is under an obligation to provide that the means of obtaining calf-lymph for the purpose of vaccination should be within reach of all. We have no hesitation, therefore, in recommending that steps should be taken to secure this result. Whether the duty of providing calf-lymph should be undertaken by the Local Government Boards in the several parts of the United Kingdom, or whether some other method would be more advantageous, can be better determined by those who have had practical acquaintance with the working of the vaccination laws. In connection with this subject, our attention has been drawn to the experiments recently made by Dr. Copeman as to the effect of the storage of vaccine lymph in glycerine. The conclusions at which he arrives are that the addition of glycerine, whilst it leaves the efficacy of the lymph undiminished or even increases it, tends to destroy other organisms. If it be the fact that the efficacy of the lymph remains unimpaired, its storage in glycerine would largely diminish the difficulties connected with the use of calflymph, which are inseparable from calf to arm vaccination. The investigation has not yet reached a point at which it is possible to pronounce with certainty whether the anticipated results would be obtained. And it was at one time suggested that the introduction of glycerine was likely to be mischievous. The question is one a further investigation of which is obviously desirable. 69 If lymph is to be preserved in glycerine, due care would be requisite to ensure its purity and the absence of contamination in its introduction. We think that, whether mixed with glycerine or not, each tube should contain only sufficient lymph for the vaccination of one person. We have no difficulty in answering the question, what means other than vaccination can be used for diminishing the prevalence of Small-Pox? We think that a complete system of notification of the disease, accompanied by an immediate hospital isolation of the persons attacked, together with a careful supervision, or, if possible, isolation for sixteen days of those who had been in immediate contact with them, could not but be of very high value in diminishing the prevalence of Small-Pox. It would be necessary, however, to bear constantly in mind as two conditions of success, first, that no considerable number of Small-Pox patients should ever be kept together in a hospital situate in a populous neighbourhood, and secondly, that the ambulance arrangement should be organised with scrupulous care. If these conditions were not fulfilled, the effect might be to neutralise or even do more than counteract the benefits otherwise flowing from a scheme of isolation. The question we are now discussing must, of course, be argued on the hypothesis that vaccination affords protection against Small-Pox. Who can possibly say that if the disease once entered a town, the population of which was entirely or almost entirely unprotected, it would not spread with a rapidity of which we have in recent times had no experience, or who can foretell what call might then be made on hospital accommodation if all those attacked by the disease were to be isolated? A priori reasoning on such a question is of little or no value. We can see nothing, then, to warrant the conclusion that in this country vaccination might safely be abandoned, and replaced by a system of isolation. If such a change were made in our 70 method of dealing with Small-Pox, and that which had been substituted for vaccination proved ineffectual to prevent the spread of the disease (it is not suggested that it could diminish its severity in those attacked), it is impossible to contemplate the consequences without dismay. To avoid misunderstanding, it may be well to repeat that we are very far from underrating the value of a system of isolation. We have already dwelt upon its importance. But what it can accomplish as an auxiliary to vaccination is one thing, whether it can be relied on in its stead is quite another thing. Our attention has been drawn to the circumstances that outbreaks of Small-Pox have not unfrequently had their origin in the introduction of the disease to common lodging-houses by tramps wandering from place to place. In view of this we make the following recommendations:— (i.) That common shelters which are not now subject to the law relating to common lodging-houses should be made subject to such law. (ii.) That there shall be power to the local authority to require medical examination of all persons entering common lodging-houses and casual wards to see if they are suffering from Small-Pox, and to offer a reward for prompt information of the presence of the disease. (iii.) That the local authority shall have power to order the keeper of a common lodging-house in which there has been Small-Pox to refuse fresh admissions for such time as may be required by the authority. (iv.) That the local authority should be empowered to require the temporary closing of any common lodginghouse in which Small-Pox has occurred. (v.) That the local authority shall have power to offer free lodgings to any inmate of a common lodging-house or 71 casual ward who may reasonably be suspected of being liable to convey Small-Pox. (vi.) That the Sanitary Authority should give notice to all adjoining Sanitary Authorities of the occurrence of Small-Pox in common lodging-houses or casual wards. (vii.) That where the disease occurs the Public Vaccinator or Medical Officer of Health should attend and vaccinate the inmates of such lodging-houses or wards, except such as should be unwilling to submit themselves to the operation. In connection with the subject with which we have been dealing we may advert to the suggestion that the vaccination and the Sanitary Authority should in all cases be identical. It has been pointed out that whilst the isolation of patients in hospitals and otherwise is provided for by the Sanitary Authority the extent of the provision requisite to deal with an outbreak of an epidemic of Small-Pox may depend upon the degree in which the vaccination laws have been enforced. More hospital accommodation may be required where vaccination has been neglected than where the vaccination laws have been complied with. It is contended that sanitation and vaccination, concerning as they both do the health of the people, should be under the jurisdiction of a single authority, and that the Sanitary Authority is the appropriate one for that purpose. Indeed, the advantage of placing in the same hands the supervision of vaccination and of the other measures designed to prevent the spread of disease are so great and obvious that the proposal to do so deserves most serious consideration. At the same time, we fully recognise the importance of achieving it as far as possible, and we should regard with favour such changes as would render the amalgamation of the vaccination and sanitary authorities feasible, or indeed any steps taken in that 72 direction, even although they should only partially effect the object in view. The report then goes on to discuss as to whether any alterations should be made in the arrangements and proceedings for securing the performance of vaccinations, and, in particular, in those provisions of the Vaccination Acts with respect to prosecutions for non-compliance with the Law. This will be found at length in my report for 1896. The Commissioners signing the majority report conclude as follows:— "It is to be hoped that our Report will stimulate belief in the efficacy of vaccination, that it will remove some misapprehensions and reassure some who take an exaggerated view of the risks connected with the operation, as well as lead to a more ready enforcement of the law by local authorities. We desire to call attention again to the recommendation, which we made in our fifth interim report, that persons committed to prison by reason of the non-payment of penalties imposed under the vaccination laws, should no longer be treated as criminals. We stated in that report our reasons for this recommendation, to which we still adhere. If, however, the changes in the compulsory provisions of the vaccination laws which we have suggested were adopted, the matter would lose much of its importance. All which we humbly submit for Your Majesty's gracious consideration. The report was signed by the following commissioners :— Lord He???schell. Sir James Paget. Sir Charles Dalrymple. Sir W. Guyer Hunter. Sir Edwin H. Galsworthy. John S. Dugdale. M. Foster. Jonathan Hutchinson Frederick Meadows White. Sam. Whitehead. John A. Bright. August, 1896. Bret Ince, Secretary. 73 The undersigned do not find themselves able to go so far in recommending relaxation of the law as is suggested. We think that in all cases in which a parent or guardian refuses to allow vaccination, the person so refusing should be summoned before a magistrate, as at present, and that the only change made should be to permit the magistrate to accept a sworn deposition of conscientious objection, and to abstain from the infliction of a fine. We are also of opinion that, in spite of the difficulties as set forth, a second vaccination at the age of twelve ought to be made compulsory. W. Guyer Hunter. Jonathan Hutchinson. We, the undersigned, desire to express our dissent from the proposal to retain in any form compulsory vaccination. We cordially concur in the recommendation that conscientious objection to vaccination should be respected. The objection that mere negligence or unwillingness on the part of parents to take trouble might keep many children from being vaccinated would be largely, if not wholly, removed by the adoption of the Scotch system of offering vaccination at the home of the child, and by providing for medical treatment of any untoward results which may arise. We therefore think that the modified form of compulsion recommended by our colleagues is unnecessary and that in practice it could not be carried out. The hostility which compulsion has evoked in the past toward the practice of vaccination is fully acknowledged in the Report. In our opinion the retention of compulsion in any form will, in the future, cause irritation and hostility of the same kind. The right of the parent on grounds of conscience to refuse vaccination for his child being conceded, and the offer of vaccination under improved conditions being made at the home of the 74 child, it would in our opinion be best to leave the parent free to accept or reject this offer. Sam. Whitbread. W. J. Collins.* John A. Bright. J. Allanson Picton.* * Note.—Dr. Collins and Mr. Picton sign the above note of reservation, though they have not signed the Reports. After giving in detail their grounds of objection to compulsory vaccination the dissentient Commissioners, Dr. Collins and Mr. Picton, make the following recommendations. The whole of their report was given in extenso in the annual report for 1896. In accordance with the sub-head No. 2 of the reference to the Commission, we would suggest the following as the means other than vaccination which should be employed for protection of a community from small-pox— 1. Prompt notification of any illness suspected to be smallpox. Improved instruction in the diagnosis of small-pox. v 2. A hospital, suitably isolated, of adequate accommodation, in permanent readiness, and capable of extension if required. No other disease to be treated at the same time in the same place. 3. A vigilant sanitary staff, ready to deal promptly with first cases, and, if necessary to make a house-to-house inspection. The medical officer of health to receive such remuneration as to render him independent of private practice. 4. Prompt removal to hospital by special ambulance of all cases which cannot be properly isolated at home. Telephonic communication between Health Office and Hospital. 5. Destruction of infected clothing and bedding, and thorough disinfection of room or house immediately after removal of the patient. 75 6. Daily observation (including, where possible, taking the temperature and inspection for rash) of all persons who have been in close contact with the patient during his illness; such supervision to be carried out either in quarantine stations (away from the hospital) or at their own homes. 7. Closure of schools on the occasion of the occurrence of small-pox among the scholars or teachers. 8. Hospitals and quarantine stations to be comfortable and attractive, and so administered as to secure the confidence of the public. Hospital treatment to be free to all classes, and compensation to be paid to those detained or otherwise inconvenienced in the public interest, at the public expense. 9. Tramps entering casual wards to be medically inspected, their clothing disinfected, and bath provided. The measures for detection and isolation of small-pox in common lodging-houses suggested in a previous section of the report to be carried out. 10. International notification of the presence of small-pox, and special vigilance at sea-ports in communication with infected places, after the plan adopted in the case of cholera. 11. Attention to general sanitation—prevention of overcrowding, abundant water supply, and frequent removal of refuse. We recommend that the law be amended by the repeal of the compulsory clauses of the Vaccination Acts. But in consideration of the prevalent belief in the value of vaccination as a prophylactic for an indefinite period, and we suggest that in 76 other respects the law should be left as it is, subject, however, to such modifications as are recommended for the diminution of attendant risks. The precedent established in the case of the abolition of compulsory church rates might be followed with advantage. In that case all machinery for laying and collecting the rate was left intact though the power of enforcement was taken away. The effect of our recommendation, if adopted, would be that vaccination would continue to be provided as at present for those who desire to avail themselves of it, but efforts to secure vaccination would be limited to moral influence—in a word, the whole country would be in a position of those unions in which the guardians have abandoned compulsion. The grounds on which we object to the enforcement of vaccination by penalities necessarily lead us also to object to any method of indirect compulsion. We regard as both expedient and unjust exclusion from any branch of public service because of the refusal to submit to vaccination or re-vaccination. The injustice is perhaps most severely felt in the case of candidates for employment as pupil-teachers in public elementary schools. There are now districts in which, owing to the general opposition to vaccination, scarcely a girl or boy can be found who is legally eligible, and candidates have to be brought in at great inconvenience from surrounding districts.. The existence of an exceptional case or cases in which such rejected candidates have, at some time afterwards, taken small-pox is, in our view, no justification for the continuation of this grievance. Statistics furnished to the Commission prove that large numbers of vaccinated or re-vaccinated persons have taken the disease; and we are not aware of any evidence to show that vaccinated pupilteachers have any special immunity. If our recommendations were carried out the danger of contagion would be greatly diminished in schools, as elsewhere. On the whole, then, while there is much in the report of our colleagues from which we dissent, and we have accordingly 77 abstained with reluctance from adding our signatures to theirs, we are at one with them in holding that it is unwise to attempt to enforce vaccination on those who regard it as useless and dangerous. We, however, go further, and agree with our colleagues, Mr. Whitbread and Mr. Bright, that it would be simpler and more logical to abolish compulsory vaccination altogether. W. J. Collins. J. Allanson Picton. The methods recommended by the dissentient Commissioners, Dr. Collins and Mr. Picton, have been carried out in London for some time past, long before the issue of the reports, with the exception that tramps entering a casual ward are not examined unless they complain of, or exhibit symptoms of illness. All the other points recommended are carefully carried out in this parish. The following is the text ot the Bill being introduced at the time of writing by Mr. Chaplin, the President of the Local Government Board, Mr. Balfour, Sir Mathew White Ridley, and the Attorney General, which seems likely to pass with important modifications. VACCINATION BILL, 1898. 1.—(1.) The period within which the parent or other person having the custody of a child shall cause the child to be vaccinated shall be twelve months from the birth of the child, instead of the period of three months mentioned in section sixteen of the Vaccination Act of 1867, and so much of that section as requires the child to be taken to a public vaccinator to be vaccinated shall be repealed. (2.) The public vaccinator of the district shall, if the parent or other person having the custody of a child so requires, visit the home of the child for the purpose of vaccinating the child. 78 (3.) If a child is not vaccinated within nine months after its birth, the public vaccinator of the district shall visit the home of the child, and shall offer to vaccinate the child with glycerinated calf lymph. 2. An order under section thirty-one of the Vaccination Act of 1867, directing that a child be vaccinated, shall not be made on any person who has previously been convicted of noncompliance with a similar order relating to the same child. 3. The Local Government Board shall have the same powers of making rules and regulations with respect to public vaccinators (whether under contracts made before or after the passing of this Act) as they have with respect to vaccination officers, and any rules and regulations made by the Board with respect to vaccination, whether under this or any other Act, shall, while in force, have effect as if enacted by this Act. 4. The enactments mentioned in the schedule to this Act are hereby repealed to the extent specified in the third column of that schedule. 5.—(1.) This Act shall not extend to Scotland or Ireland. (2) This Act shall come into operation on the first day of January, One thousand eight hundred and ninety-nine. (3). This Act may be cited as the Vaccination Act, 1898, and the Vaccination Act of 1867, the Vaccination Act, 1871, the Vaccination Act, 1874, and this Act shall be construed together as one Act, and may be citied collectively as the Vaccination Acts of 1867 to 1898. 79 SCHEDULE. Repeals. Session and Chapter. Short Title. Extent of Repeal. 30 & 31 Vict. c. 84. TheVaccination Act of 1867. Section six. Section seven from "and shall provide all stations" to the end of the section. So much of section eight as fixes the amount of payment thereunder. Section twelve. In Section fifteen, from "according to the provisions" to "performing the operation." Section sixteen, the words "within three months after the birth of such child" and from "within three months "after receiving" to "period as aforesaid," and from " and the public vaccinator" to the end of the section. Section seventeen, to "vaccinations and," and in the same section the words "if the vaccinator so direct," and the words "and inspected as "on the previous occasion." Section nineteen. In section twenty, the words "brought to him for vaccination." In section twenty-nine the words "to take such child "or," the words "to be "taken," and the words "according to the provi"sions of this Act." 34 & 35 Vict. c. 98. The Vaccination Act, 1871. Section ten. In section eleven the words "take or" and the words "to be taken." 80 This bill has been read a second time and referred to Grand Committee. SANITARY LEGISLATION DURING 1897. The Sanitary Laws passed during the year include the Cleansing of Persons Act, Infant Life Protection Act, and the Metropolis Water Act. The Cleansing of Persons Act empowers the sanitary authority, if they think fit, to afford free use, upon application, of any apparatus at their disposal, for the cleansing of persons and clothing infested with Vermin. The Infant Life Protection Act provides for the registration by the London County Council of any premises where more than one infant is farmed out, and will probably be the means of reducing infantile mortality. Metropolis Water Act, 1897. One of the most important sections affecting Public Health is No. 2, which empowers the sanitary authority to assist any water consumer in obtaining the settlement of questions affecting water consumers generally in the district, more especially relative to the duties and liabilities of water companies with regard to the quantity or quality of water supplied by them. The following important Bill was also before Parliament. Adulteration (Food Products) Bill, 1898. A Bill to consolidate and amend the laws relating to the sale of Foods and Drugs was prepared and brought into Parliament in session 1897 by Mr. Kearley, Sir Jas. Woodhouse, Mr. Horace Plunkett, Mr. Lambert and others, but only passed the first reading, and has been re-introduced during the present session as the Adulteration (Food Products) Bill, 1898. 81 The Bill, if adopted, would repeal the Sale of Food and Drugs Act, 1875, the Sale of Food and Drugs Act Amendment Act, 1879; and the Margarine Act, 1887. It is to be hoped that it will pass, as it will remove many difficulties which now exist in carrying out these Acts. Penalties. Sec. 3 provides for a penalty not exceeding £10 for a first offence; not less than £5 and not exceeding £50 for a second offence; and for a third or subsequent offence not less than £20 nor exceeding £100, or, in the discretion of the magistrate, three months' imprisonment with or without hard labour. Existing legislation provides only for a penalty not exceeding £20, and in many cases fines of only a few shillings have been inflicted. Sec. 4 provides that after a first offence the Court may order a notice of the conviction to be affixed to the premises in such manner and for such period as may be determined. By Sec. 10 it is proposed to render it an offence to be in possession of an adulterated article with intent to sell. Sec. 11 provides for the prohibition of importation of adulterated articles. Sec. 19 provides that a warranty given by a person not resident in Great Britain or Ireland shall not be a good defence. Sec. 24 would empower an Inspector to seize or procure any sample of food at the place of delivery, and for that purpose to break open any parcel. Sec. 26 provides that the sample shall be divided into four parts, instead of, as at present, into three, provided the vendor requires it. One of the samples would be delivered to the vendor, one to the Public Analyst, and the other two retained by the F 82 Inspector, who, under Sec. 20, would, in a case where it was the purpose of the defendant to rely upon a warranty, forthwith forward one to the warrantor. Sec. 30 provides that every local authority adopting the Act shall procure at least one sample per annum for every thousand inhabitants. Sec. 31 would be a very valuable section in that the period within which a summons must be served is, in a case where a warranty is produced, not limited to twenty-eight days, thereby enabling the Sanitary Authority to proceed against the wholesale vendor. Sec. 38 provides for the appointment of a Board of Reference. Common Lodging Homes Acts, 1851. 1853. Stoving of Vermin infected bedding. In reply to a letter dated 12th June, 1897, from the Medical Officer of Health of the London County Council, asking whether opportunity would be given to keepers of common Lodging Houses to free the bedding of their houses from Vermin by means of the Vestry's disinfecting apparatus, I have arranged that in any case where in my opinion such would be desirable this shall be carried out by the Vestry's contractor. At present, no application has, however, been made. Removal of Manure. During the year the Public Health Committee of the London County Council .have had under consideration the subject of nuisances arising from accumulations of manure in London districts, and in connection therewith Section 36 of the Public Health (London) Act, 1891, which provides for a sanitary authority to employ or contract with scavengers to collect or remove the Manure and other refuse matter from any stables or cowhouses within their district, the occupiers of which signify their consent in writing to such removal. 83 TABLE XVII. Summary of Sanitary Operations during 1897. 1892 1893 1894 1895 1896 1897 Total Sanitary operations 38,779 54,577 53,791 55,806 69,432 67,200 Number of House Inspections 23,587 25,091 24,747 30,051 38,781 42,486 Bakehouses Inspections 215 296 313 460 532 545 Bakehouses Nuisances abated ... 18 19 49 57 29 Urinals—Inspections 251 260 318 483 468 367 Do. altered, repaired, or water laid on ... 120 119 31 40 58 Intimations Served, 54 & 55 Vic. cap. 76(3) 3,691 4,420 4,289 4,256 3,461 3,030 Notices Served under Sec. 4 921 1,211 1,076 1,198 909 611 Notices Served under Sec. 62 and 65 1,588 2,572 1,605 1,709 1,952 2,246 Complaints Received and attended to ... 4,089 3,253 3,877 3,302 3,254 Number of Houses Disinfected 1,227 2,069 1,449 1,454 1,698 2,009 Houses Supplied with Disinfectants 3,026 5,275 3,175 3,616 6,748 7,846 Overcrowding Abated 34 38 56 33 60 65 Premises Cleansed and Repaired 189 280 328 138 235 319 Drains Tested By Smoke 700 1,491 1,272 1,331 1,188 914 „ Water 178 491 794 997 2,829 3,080 Drains Cleansed and Repaired 1,107 1,564 1,106 1,205 941 799 Drains Relaid 220 917 742 742 762 636 Soil Pipes ventilated ... ... 135 796 846 764 Sink and Rain Water Pipes disconnected 1,360 562 1,012 634 565 318 Water Closets Cleansed and Repaired 237 314 426 236 282 327 Cesspools Abolished 1 4 6 8 ... 5 Mews and Stables Drained and Paved 86 30 11 8 17 10 Yards Drained and Paved 161 253 938 555 735 765 Accumulations of Manure Removed or proper receptacles provided 41 70 56 61 56 93 Dust Receptacles Provided 738 772 1,221 688 587 714 Dust Complaints forwarded to the Surveyor ... 271 214 377 209 205 Leaky House-roofs and Gutters Repaired 185 84 240 134 180 182 Houses Supplied with Water 151 130 93 252 121 122 Water Closets Supplied with Water, or supply disconnected from drinking water cistern 860 731 1,113 1,054 911 1,029 Cisterns Covered. Cleansed and Repaired 409 469 624 816 687 637 Keeping of Animals in unfit state discontinued 5 16 11 16 25 26 Smoke Nuisances dealt with 10 26 21 11 12 36 Certificates of Disinfection Granted 1,044 1,659 1,551 1,538 1,740 2,176 Water Supply Certificates Granted (Sec. 48) 16 118 141 282 288 236 Proceedings Ordered by Vestry and Sanitary Committee 444 1,211 1,100 1,243 959 1,536 Summonses Issued 14 73 52 63 65 48 Magisterial Orders Obtained and Enforced 14 70 42 59 55 40 Sanitary Conveniences provided or improvements affected to Factories and Workshops, Sec. 38 4 8 19 14 38 40 Underground sleeping rooms disused ... ... ... 12 19 42 Gipsy vans inspected ... ... ... 64 56 30 Drains laid to New Houses ... ... ... ... 266 244 Samples taken under the Sale of Food and Drugs Act 101 103 101 227 300* 300* •This is for the Analytical year ending March. 84 At present, however, no power appears to be given to sanitary authorities to charge for this service. It will be generally conceded that there would be a great advantage to the sanitary authority having the power to remove and charge an agreed sum for the service. Table xvii shews the sanitary work of the Public Health Department for the last six years. The total number of sanitary operations during 1897 was 67,200. These were slightly less numerous than in 1896 owing to the inspectorial staff being short handed for a month or two at the end of the year. It will, however, be apparent that the more serious work, such as the inspection of premises was in excess of any previous year. The total number of house inspections during the year 1897 was forty-two thousand four hundred and eighty-six. It must not be imagined that this is identical with the number of separate houses inspected, as many in a bad and insanitary condition required re-inspection on many occasions. The number of intimations served under sec. 3 of the Public Health (London) Act was three thousand and thirty, under sec. 4, six hundred and eleven, and the notices served under secs. 62 and 65 were two thousand two hundred and forty-six. Complaints to the number of three thousand two hundred and fifty-four were received and attended to. The number of houses disinfected was two thousand and ninety, while disinfectants were distributed in seven thousand eight hundred and forty-six instances, and certificates of disinfection, two thousand one hundred and seventysix issued, and three hundred and nine premises were cleansed and repaired, and overcrowding abated in sixty-five cases. Drains were tested by water in three thousand and eighty instances, and by smoke in nine hundred and fourteen. There were seven hundred and ninety-nine drains cleansed and repaired, while six hundred and thirty-six were relaid. There were two hundred and forty-four drains laid to new houses under the 85 drain inspector, which office has now ceased to exist, as each district sanitary inspector for the future takes charge of all the drains, both old and new in his district. Soil pipes were ventilated in seven hundred and sixty-four cases, sink and rain water pipes disconnected in three hundred and eighteen instances. Three hundred and twenty water closets were cleansed and repaired, and five cesspools discovered and abolished, One thousand and twenty-nine closets were supplied with water or the supply disconnected from the drinking water cistern. Six hundred and thirty-seven cisterns were covered, cleansed or repaired. One hundred and twenty-two houses were supplied with water, and two hundred and thirty-six certificates of proper and sufficient supply of water and fittings issued. The Health Committee and the Vestry ordered proceedings in one thousand five hundred and thirty-six instances. Summonses were issued in forty-eight instances to enforce the same, and in forty magisterial orders were obtained. Mews and stables were drained and paved in ten instances, and ninety-three accumulations of manure removed or proper receptacles provided. Animals were found to be kept in an unfit state in twenty-six cases. Sanitary conveniences were provided or improvements effected to Factories or Workshops in forty cases. Dust receptacles were provided in seven hundred and fourteen instances, and two hundred and five complaints forwarded to Surveyor. Leaky house roofs and gutters were repaired in one hundred and eighty-two cases. Underground sleeping rooms were disused in forty-two cases, and gipsy vans inspected in thirty. 86 Details of proceedings at Police Court. During the year 1897, 48 summonses were issued respecting the Health Department, particulars of Court. which are here set out:— Summonses issued. Withdrawn. Dismissed. Magisterial Orders obtained. Under the Sale of Food and Drugs Act 22 - 2 20 Under the Public Health (London) Act:— Non-compliance with notices 17 4 - 13 Contravention of bye-laws 2 1 - 1 Permitting the occupation of new houses without obtaining certificate of Water supply 5 - - 5 Smoke nuisances 1 1 - - Under the Factory and Workshops Act:— Occupation of Bakehouse not in use on 1st January, 1896 1 - - 1* 48 6 2 40 * In this case the decision of the magistrate has since been reversed in the High Court. Of the two summonses dismissed under the Sale of Food and Drugs Act, one was upon production of a warranty, and the other owing to the summons not having been properly served. The six summonses under the Public Health (London) Act, 1891 withdrawn, were on account of the Vestry's requirements having been carried out and the costs paid by the defendants. The following articles of food have been condemned during the year, and certificates granted for same :— 1¼ cwt. of herrings 9 cod fish 5 boxes of oranges ¾ cwt. of skate 264 crabs 1 duck 1 box of halibut 2 boxes of tomatoes 1 box of cod 4 boxes of kippers 2 barrels of herrings 1 box of hake 3 trunks of haddocks 87 A practice has been adopted that when retail vendors become aware that articles of food purchased of wholesale dealers are unsound and unfit for human consumption, they attend with the same at the Public Health Offices, and if satisfied that no attempt has been made to sell the articles, they are condemned by the Vestry's Officers, and cremated at the Dust Destructor, and a certificate is given in support of any claim upon the wholesale firm who originally sold the same. This no doubt prevents a large amount of unsound food being offered for sale. The whole of the butchers, fishmongers, fruiterers, and other tradesmen's premises have been kept under close and frequent supervision both on week days and Sundays, and in no case has it been found necessary to effect a seizure of any article of food. Bakehouses The half-yearly inspection of bakehouses was carried out in May and September. At the May inspection there were 108 in active use, and with seventeen exceptions the cleansing and lime-washing had been carried out, in which cases intimations were served, followed in two instances by statutory notices by order of the Health Committee, which were subsequently complied with. At the September inspection it was found necessary to serve fourteen notices, which were duly complied with. At that time the bakehouses in occupation numbered 104. Cowhouses and Slaughterhouses. In October last, a Sub-Committee of the Health Committee visited the whole of the Cow-houses and Slaughter-houses in the Parish for which applications had been made for the renewal of licenses. There were 18 such applications, of which 8 were in respect of cow-houses, and 10 for slaughter-houses, in respect of one existing cow-house, application was not made, and the license consequently lapsed. 88 Opposition was made on behalf of the Vestry to the renewal of two slaughter-house licenses; in one case, upon the grounds that the conditions of the license that pigs only be slaughtered had not been complied with inasmuch as cattle had been dealt with, and further, that the London County Council's bye-laws had not been observed at the time the Sub-Committee visited the premises. In this instance, the Council refused to renew the license. In the second case, the license was renewed subject to not more than forty pigs being slaughtered in one day, and such portion only of the premises that is licensed being used for the conduct of the business. There are therefore now only 8 cow-houses and 9 slaughterhouses licensed in the parish which is, no doubt, a step in the direction of the provision of public abattoirs. Public-house Urinals. The urinals were inspected in three hundred and sixty-seven instances, and in fifty-eight were altered, repaired or had water laid on. In July, in consequence of numerous complaints as to the insufficient flushing of the urinals, and the consequent nuisance arising therefrom, the following notice was served, with good effect, upon the occupiers of all premisesin which urinals were situate and accessible to the public: The Vestry of the Parish of St. Mary, Battersea. To the Occupier of. The Vestry, as the Sanitary Authority, request that you will be good enough to arrange that the urinal to which the public have access, situate at your premises, may be regularly flushed with disinfectants during hot weather in order to avoid nuisance. By Order. Municipal Buildings, Lavender Hill. 89 Water Supply. The usually quarterly samples were taken during the year from the mains of the Lambeth and of the Southwark ahd Vauxhall Water Companies. A prominent feature in the work of the Public Health Department is the largely increased number of special inspections made by the Chief Sanitary Inspector, and the District Sanitary Inspectors, the results of which are reported to the Health Committee at the next subsequent meeting. In order to facilitate reference to the minutes if necessary the dates upon which such reports have been made during the year 1897 are appended. January 5th.—At this meeting a report was submitted with reference to the condition of the drainage of the Latchmere Street Board School, as to its generally defective condition, which is quoted in my last Annual Report; that the London School Board, who had been served with notice, had requested that the matter might stand in abeyance for a time, that plans were subsequently submitted to the Health Committeefor the remodelling of the system of drainage, and that the works, which are of an extensive character, are, at the time of writing completed. In connection with the drainage of the large schools in the parish, it may be stated that nearly all of them have been redrained since the Public Health (London) Act came into operation, and consequently they are now in a satisfactory condition in that respect. January 19th.—At this meeting an exhaustive report was submitted relative to the drainage, water closets, and other sanitary conveniences in connection with the Wandsworth and Clapham Union Infirmary, St. John's Hill, and in respect of which a preliminary report had been furnished by the Chief Inspector at the meeting of the Health Committee on the 15th September, 1896, at which time the Committee gave him instructions to make a fuller examination of the general sanitary condition of the Infirmary, and report to them thereon. 90 That the whole of the drains, with the exception of Blocks B and E, were in a defective condition, and that generally the various water closets, etc., were of an obsolete pattern, and in many cases insufficiently supplied with water. Further, that from time to time, alterations had apparently been made in connection with the drainage, etc., intercepting traps, and other appliances fixed without proper regard being had to the general system of drainage. The Committee directed that a copy of the Report should be furnished to the Guardians with the request that the matter should receive their early attention. Considerable delay occurring, the Committee ordered a notice to be served upon the Guardians to carry out the necessary works. This notice was served upon the 23rd February, and subsequently a criticism by Mr. Aldwinckle, the Architect to the Guardians, dated June 10th, 1897, upon the report of the Chief Sanitary Inspector and an examination which he had made of the matters complained of by the Health Committee, was laid before them. The following are a few of the most important extracts from the Architect's report, and will shew the conclusions he arrived at. "In this report I do not deal with the drainage and sanitary arrangements in Blocks "B" and "E" as these are considered satisfactory in Mr. Young's Report, and also because I personally know them to be correct, as they were all re-modelled under my direction ten years ago. "I may remark at the outset, that while Mr. Young's Report deals in very considerable detail with the internal sanitary arrangements, his condemnation of the old drainage is very general in its nature, and is apparently based upon examination at very few points. I have, however, considered it necessary to examine and test the whole of the main lines of this old drainage, as well as many of the branch drains. 91 "Generally speaking, these old drains are laid in the manner usual thirty or forty years ago, viz., with clay joints, and upon the natural ground, without any concrete bed. These clay joints perish or fall out, leaving open joints, through which the sewage escapes into the adjoining subsoil. In all cases where the drains are near the surface of the ground, such a condition of things is distinctly insanitary. "Soil-Pipes to W.C's.—The W.C. soil-pipes in the three turrets are of lead, built into the walls, and without any means of access for repairs; those in the two northern turrets are trapped at the foot, either directly or by means of a trapped inspection chamber, and all three rise through the roof of the turret with open ends. I have tested with the smoke test the soil-pipes in the northwest and north-east turrets, and found them perfectly sound. In the same turrets I have tested the soil-pipes for syphonage, putting in each case, two pails of water down one of the upper closets, but did not succeed in unsealing the traps of any of the lower ones. This is accounted for by the fact that these closets stand in a range of three on each floor, two going into one branch, and the third into a second branch, the two branches uniting before joining the vertical soil-pipe. I am informed that the soil-pipe in the south-west turret has no trap at the foot, but I have not opened the roadway at this point. In all other respects this soil-pipe is similar to those in the other two turrets." "In all other cases, except the range of four closets on the landing in the Female Pavilion, and the two single closets for the Matron and the Assistant Medical Officer, the soil-pipes are trapped at the foot; they are all of lead, except those to the W.C's adjoining the four day rooms ; these latter are of cast-iron of light rain-water section, with lead branches from W.C. to soil-pipe. I cannot defend the continued use of these iron soilpipes inside the building (see my remarks later on as to the iron waste-pipes trom slop-sinks in main turrets). All soil-pipes throughout have top ventilation." 92 "Waste-pipes from Slop-Closets or Slop-Sinks.—These are in all cases inside the buildings, and have top ventilation ; they are all of cast-iron, of light rain water pipe section, with ordinary red lead joints. This class of pipe does not admit of a reliable and air-tight joint being made, as they are not intended to be used for the purposes of internal foul wastes. Very careful smoke tests were made with these pipes in the two northern turrets; the general results were much better than one would have anticipated; but a serious defect was found in the cistern chamber of the north-west tower, caused by defective joints in positions where access for repair was practically impossible. As indicating the superiority of lead over iron pipes for internal wastes, I may point out that similar defects were not detected in the cistern-room of the north-eastern turret, and upon examination it was found that, in that case, the pipe running through the cistern-room was of lead. I cannot but feel that these internal iron pipes are not only insanitary but dangerous, and I should recommend their being replaced by strong iron pipes placed externally with proper arrangements for anti-syphonage." "Water Supply to W.C's &c.—With a few exceptions, the whole of the W. C's and slop-sinks are supplied direct from the drinking water cisterns; this is an unsatisfactory and, indeed, dangerous arrangement, and should be altered." "Anti-Syphonage.—At present, no provision is made in any way to guard against syphonage and consequent unsealing of traps. Such provision is undoubtedly necessary in the case of W.C.'s or slop-sinks standing singly one above another, the only exception being, as previously described, where there are ranges of three or four closets together upon the same floor, where I found it quite impossible to unseal the traps of the lower W.C.'s." "Soil-Pipes and W.C.'s.—The soil-pipes are of cast iron, fixed externally, trapped at foot, and top ventilated, with fresh air inlet and Mica flap. With two exceptions, these W.C.'s are the "Household " pattern with flushing cisterns." 93 "Generally.—From the details contained in the foregoing report, it will be seen that a good deal of the old drainage is in an insanitary condition, and that many of the internal sanitary arrangements are more or less faulty; but this does not justify the recommendation contained in Mr. Young's Report, which is to the effect that "anything short of an entire re-construction of the drainage, waste and soil-pipes, and most of the sanitary fittings, will not meet the case." I may point out that the notice from the Vestry, under the Public Health (London) Act, 1891, does not go as far as Mr. Young's very comprehensive recommendations. The exact terms of the notice are "to abate the same by executing such works as may be necessary to put the drains in sound and water-tight condition, providing means of inspection and ventilation thereto, and further to take the necessary steps to prevent syphonage of traps of slop-closets, &c., and provide proper and sufficient supply of water to water closets, also to remedy defective soil-pipes and slop-closet waste pipes." "I think that the terms of this notice will be fairly met if the defects which I have described in the drainage and other sanitary arrangements are remedied. So far as the old drainage is concerned, its defective condition is so serious that I am sure the Guardians would have this rc-constructed without any pressure from the Vestry, now that they have been made aware of the facts, nor will this be either a very extensive, or very costly undertaking." It will be seen from the report of the Architect that he apparently did not agree with the Chief Inspector's general condemnation of the drains, as it was made upon examination of the system at very few points. It is a fact he did not for the purpose of examination and testing break open the ground, etc., (which would have been both costly and unnecessary) in order to ascertain the condition of the drains which is shewn by the Architect's own findings and recommendations not to have 94 been necessary, as the conclusions he arrived at were exactly similar to those of the Chief Inspector, and Health Committee, that nothing short of an entire reconstruction ot the drainage, etc., would meet the case, and that those recommendations have been found to be perfectly justified and verified in the following report of the Special Committee of the Guardians appointed with reference to this question. The Architect subsequently accepted various suggestions with reference to the remodelling of the system of drainage, which were embodied in the plans submitted to and approved by the Vestry, and the works are at date of reporting being carried out, and when completed will make the Infirmary one of the best drained institutions of the parish. Report of Special Committee of the Guardians with Reference to Infirmary Drainage. Your Committee recommend— (1.) That the whole of the Drainage of the Infirmary, with the exception of that in connection with Blocks "B" and "C," and also with the exception of the main Western Drain along roadway, having been found, after careful testing, to be very defective and insanitary, the same be removed and replaced by a new system of Drainage upon modern sanitary principles, and that the Architect be instructed to prepare a sketch Plan, showing such new system of Drainage, for submission to the Vestry of Battersea. (2.) That all internal soil and waste pipes be removed and replaced by cast galvanized iron pipes placed externally, such pipes to have, in all cases, top ventilation placed well above roof gutters—soil pipes from water closets only to be of lead. (3.) That in all cases where the water supply to the water closets and slop sinks is taken direct from the drinking water cisterns, the same to be disconnected, and proper water waste preventing cisterns be provided. 95 (4.) That all the "D" traps be removed from soil pipes, and replaced by proper drawn lead syphon traps. (5.) That all gullies that are not of glazed earthenware with trap in the same piece, be removed and replaced with proper gullies. (6.) That all the Jennings' valve water closets be removed and replaced by those of a modern type, on the bracket or Corbel principle, with waste preventing flushing cisterns. (7.) That the defective water closets and slop sinks in the old Block Wards be removed and replaced with others of modern type. (8.) That the iron baths (all in a defective condition,) be removed and replaced by glazed fire-clay baths. (9.) That the Ward Scullery sinks, some of which are of slate, some of galvanized iron, and some of wood (lead lined), all being in a defective condition, be removed and replaced by glazed fire-clay sinks. (10.) That the Housemaid's sinks, which are in fair condition be retained. (11.) That the lavatories, which are Jennings' "Tilt-up," and in good condition, be retained. (12.) That anti-syphonage pipes be provided to all soil pipes, except where the water closets are in ranges of three or more upon each floor. (13.) The main western drain, running down west roadway will be retained, but the Ventilation will be improved, as suggested by the Architect, and three new manholes will be provided. 96 February 2nd.—At this meeting he reported with reference to the special annual inspection of Urinals attached to the various licensed houses in the parish, stating that except in 58 cases they were found to be in cleanly condition, the walls suitably protected with impervious material, and with water supply and properly trapped drains. The total number of houses at which drink is consumed upon the premises was 158. February 15th.—At this meeting he reported with reference to the Stone Works, New Road, that at these premises some 50 men were employed without proper and sufficient water closet and urinal accommodation, and that the drains serving the same were in defective condition. The Committee directed the necessary notices to be served, and subsequently suitable water closet and urinal accommodation was provided, and the drains partially re-constructed. He also submitted report with reference to Firewood Cutting premises at the rear of the "Halfway House," Battersea Park Road, that some 15 men, 14 women and 1 boy were employed in chopping wood, etc., for whom no water closet accommodation was provided. In this case also the Committee directed that notice should be served, which was subsequently complied with by suitable water closet accommodation being provided for each of the sexes. March 2nd.—At this meeting a report was submitted with reference to the complaint which had been made relative to the deposits of manure and fish offal upon the Latchmere allotments and the ground adjoining the railway embankment, Sheepcote Lane, to the effect that he had found such deposits were made by street vendors, etc., without the consent of the persons occupying the ground. The Committee directed that the matter be brought under the notice of the Board of Overseers, the Commissioners of Police, and the Railway Company, and the nuisance was found to have considerably abated upon subsequent inspection being made. 97 March 16th.—At this meeting the Chief Sanitary Inspector submitted reports relative to the alleged overcrowding of the Lodging Houses in Surrey Lane, to the effect that the premises in question were registered by the London County Council, and that in no case was any overcrowding found to exist, having regard to the amount of cubic air space required for each person by the Common Lodging Houses Act. That No. 65 Surrey Lane was let to male lodgers only, having six bedrooms, and was occupied upon the date of inspection by 31 men, being registered for this number. No. 41 for women and couples, having five bedrooms, was found to be used by 14 persons, for which number it is registered. No. 39 principally used by women lodgers, having seven bedrooms, was found to be occupied by 36 lodgers, for which number it was registered. No. 37 had eight bedrooms, and was principally used by couples and children, was registered for 39 lodgers, and was found to be occupied by this number. The latter premises are provided with two kitchens or day rooms, where the lodgers can sit and prepare their food, the regulations relating to the management of this class of lodging house, requiring that the bedrooms shall not be allowed to be used during the day. The premises are provided with separate water closet accommodation for the sexes, and are also supplied with washing basins, and upon the date of inspection to which the report had reference, the whole of the bedrooms were found to be empty, and the walls, ceilings, floors and bedding, etc. found to be in fairly cleanly condition, excepting the walls and ceilings of the day rooms, which were subsequently cleansed and limewhited. The above four houses are registered to accommodate 120 lodgers, and were found to be occupied by this number. Free access has always been given to the Vestry's officers to these premises whenever application has been made. Also with reference to No. 111 Bridge Road West, which G 98 was formerly registered as a lodging-house, but subsequently disused for this purpose, that it was found in the early part of December, 1896, a portion of the premises were again occupied by a number of casual lodgers, that he had directed the London County Council's attention to the matter, who, stated that they did not regard the premises as a common lodging-house. They were consequently kept under observation for some time by the Officers of the Health Department, and it was found early in the present month that the front rooms of the ground and first floors were let out night after night for the purpose of a common lodging-house. Upon inspection on the nth March, 1897, it was found that in the ground floor front room there were nine beds, and in the first floor front room, six beds. In the ground floor front room the only ventilation was by two small openings, 9" x 6", and although the bedding provided was fairly clean, the rooms were not provided with proper sanitary conveniences. The kitchen or day room was entirely underground, without light or ventilation. The Committee directed that the matter be brought again to the notice of the London County Council, with a request that the premises in question should be registered as a common lodging-house. At this meeting a report was submitted with reference to the alleged over-crowding at certain houses in Winstanley Road, which had been inspected a few months previously during the ordinary house to house inspection of the road, when no overcrowding was found to exist. That upon a further inspection of the premises being made, several of the rooms were found to be fully occupied, but in no case was over-crowding discovered. Many of the rooms were in dirty condition, arising principally from the habits of the occupants and notices were served upon the owners with a view to remedying the insanitary condition, which were subsequently complied with. 99 April 6th.—At this meeting a report was submitted relative to the water closet accommodation at Messrs. Stimpson's Works, Candahar Road, that on the date of inspection some fifty men were found to be employed, for whom there was only one water closet. The water supply to same was by means of a spindle valve, and the urinal accommodation was dirty, and not properly supplied with water. That there was in addition to the above one water closet for the office staff, apparently little used. The Committee gave directions that the necessary alterations should be made to provide one water closet for every twenty-five persons employed upon the works, with proper urinal accommodation in addition. The alterations were subsequently made to meet the Committee's requirements. April 20th.—The Chief Sanitary Inspector submitted a special report relative to the defective condition of the drains of No. 11 Newman Street, in respect of which notice had been served, and the owner of the property had at the previous meeting of the Committee attended, and stated that he had found no defect therein ; that acting under the Committee's directions, and after giving 24 hours notice to the occupier, the drains had been opened up and tested by smoke in the presence of the owner, the smoke freely escaping from two or three points in the course of the drain; that subsequently the drains were tested by water, when it was found impossible to fill the same in consequence of their defective condition, and that the owner had now consented to comply with the requirements of the Vestry and reconstruct the drains in accordance with their requirements, and further to pay the cost the Vestry had incurred in opening up. Also that acting upon a complaint made by the Factory Inspector, a tailor's workshop, which had been recently opened at 19 York Road, had been inspected, that persons of both sexes were found to be employed, and that the water closet ventilated directly into the workshop. The portion of the 100 premises used as a workshop had been made by roofing in a part of the yard and enclosing the water closet. Notice was served, and the use of the building for a workshop discontinued. June 1st.—At this meeting he reported relative to the complaint which had been made with reference to Messrs. Ransome's Dock, and in respect of which it was stated the stench proceeding therefrom had been the cause of illness of certain persons employed upon buildings in course of erection near the dock in question; that the dock had been kept under constant observation, and upon a recent inspection there were found to be decaying carcases of three animals upon the surface of the water, from which most offensive smells emanated, that he had subsequently seen Messrs. Ransome's manager with a view to the dock being cleansed, and the removal of the offensive carcases, etc. from the water. The dock was emptied on the following Sunday morning, and although there was a considerable quantity of mud at the bottom, no nuisance arose therefrom. The dock has been kept under close observation since the date of the complaint, and no further nuisance had been detected. He also submitted report with reference to Messrs. Ransome's Engineering Works to the effect that some 105 men were employed, for which the sanitary conveniences consisted of an iron trough 10+12 feet in length, in most offensive condition, and without proper water supply, that two further iron trough closets were provided, having lever plug outlets, and supplied with water by means of a 3/4 inch ball valve. It was understood that the troughs were emptied only once per day. The conveniences for the office staff were found to be in good condition and of more recent construction. The Committee gave directions that proper and sufficient water closet accommodation should be provided, and the works were subsequently carried out, and a portion of the drains relaid 101 in accordance with the Vestry's requirements, the buildings in which they were situated thoroughly cleansed and limewhited. Also that at Messrs. Bowley's premises some 18 men were found to be employed, for whom a water closet was provided with defective water supply and an untrapped urinal, with the surface surrounding the same in badly paved condition, allowing pools of stagnant water to collect. These defects existed in the works north side of Wellington Road, on the south side it was found there were certain other conveniences. Further, that one of the processes of manufacture herein conducted was the grinding of white lead in oil, that at some time or other suitable facilities for washing were provided for the workmen employed, but that on the date of his inspection these were out of order, and the workmen had in consequence for months past been utilising a large tank for the purpose of washing their hands, and this, upon the date of inspection, had the appearance of having been very infrequently emptied. A portion of the yard of these works was used as a urinal, and was in a most offensive condition, without proper paving or drainage. The Committee gave directions that the necessary steps should be taken to see that the various matters were attended to. Notice was consequently served, and the works carried out. Also with reference to the Albion Wharf, Wellington Road, that for the use of the persons employed, namely, two workmen, and two on the office staff, there were two of Moule's earth closets, which were, upon the date of inspection, found to be in good and cleanly condition. The Committee, having regard to the whole of the circumstances of the case, decided not to require further accommodation to be provided. Also that at the Imperial Oil Company's Works, Wellington Road, some ten men were employed in addition to the office staff, and that the water closet accommodation was in a satisfactory 102 condition, except that the walls of the enclosures required cleansing and lime-whiting. He further reported that upon inspecting the premises of the London Road Car Co., in Wellington Road, in which some 240 horses were stabled, the stables were found to be in good and cleanly condition, and properly lighted, ventilated and paved; the litter used in connection with the premises being peat. The number of workmen constantly employed was found to be about sixteen, and sufficient water closet accommodation was provided. Since the date of the Report the Committee have had plans before them in connection with these premises for the erection of a new granary, proper receptacles for manure, and suitable water closet accommodation, and at the time of reporting these have now been constructed, and the premises may be said to be in good condition. Also with reference to a complaint which had been received as to the alleged insanitary condition of the house No. 72 High Street, the ground floor front room of which was used as a hair-dresser's shop, that upon inspection he had found that the family consisted of husband, wife. and five children, aged respectively, the girls, twelve, nine, seven, and four years, and a boy of five years. That the kitchen on the ground floor and the two rooms on the first floor were in an indescribably filthy condition, the windows broken, the walls and ceilings dirty and dilapidated, excremental and other filth being upon the walls, and what articles of furniture there were, the floors, and bedding; that the latter for the children consisted simply of sacks of rubbish—in all respects resembling stable manure; beneath the bedstead the enclosure was filled with straw, shavings, and other material, largely impregnated with filth ; that the parent's bedroom was in somewhat similar condition, the drains were blocked, and about a cartload of house refuse in the yard. He further stated the the N.S.P.C.C. were taking proceedings against 103 the parents, and that notice relating to the several matters was served upon the occupier, and eventually complied with. Also that No. 6 Winifred Grove had been allowed to be occupied without the owner having first obtained the certificate required under Section 48 Public Health (London) Act, that the house was far from completion, without suitable doors or windows to several of the rooms, waterclosets, or sanitary conveniences. The occupier being a tailor named Dobkins, of 11, Broadhinton Road, Clapham, who had working with him, in the first floor front room, his wife, two men, a lad sixteen years of age, one woman, and a girl fourteen years of age—in all seven persons—in a cubic air space of 1,814 feet. Notice was immediately served upon the occupier of the room, and the number of workers therein reduced. The Committee subsequently directed proceedings to be taken against the builder, who was fined 10/- and 12/- costs. June 15th.—At this meeting, he reported relative to the alleged nuisance from black smoke being emitted from the shaft in connection with certain laundry works, that although the premises had been kept under constant observation during the period preceding the date of report, no serious nnisance had been observed, that he had inspected the premises, and found the fuel used was about ⅔ coke and ⅓ small coal, that the furnaces were fitted with special smoke preventing apparatus and force draughts, capable of preventing smoke within twentyeight seconds of their application to the fuel in the furnaces, and that the apparatus was entirely under the control of the stokers, whose fault it was should any nuisance be created. The Committee gave directions that the shaft should be kept under constant observation, and a further report submitted at its next meeting. He also, pursuant to the instructions of the Committee, 104 submitted report with reference to the alleged offensive smells proceeding from the Vestry's Dust Destructor, Sheepcote Lane, that although the same had been kept under frequent observation, no nuisance had been discovered to arise therefrom, and further that no complaints had ever been received with reference to the shaft, that he had found, upon visiting the Destructor, that the refuse was being burnt as soon as received, and that no nuisance arising from the deposits could be discovered to exist. Also relative to the sorting and sifting of house refuse at Mill Pond Bridge Wharf, Nine Elms Lane, that it was found upon inspection that a large number of men and women were engaged in the same, from which some effluvia was given off, that he had found upon personally visiting the premises subsequently, that some ten women and six men were engaged sorting and sifting the refuse, in addition to which four men were employed in filling the barges, that there was about one barge load of soft core which was very offensive, and a similar quantity of hard core, not so offensive, upon the wharf. The manager was cautioned, and notice was served upon the proprietors to forthwith discontinue the sorting and sifting, and to remove the whole of the refuse deposited upon the wharf at least once in every twenty-four hours, and on the 12th inst. it was found the refuse was being rapidly removed, and within three days the whole of the soft core had been removed, and nearly the whole of the hard core, and the sorting and sifting discontinued, the refuse being deposited in the barges as received. The nuisance appeared to be caused owing to the Bank Holiday, and that the work-people did not resume their work on the following day as expected, and that the barges could not be obtained as had been arranged. July 6th.—At this meeting the Chief Sanitary Inspector reported with reference to several complaints that had been 105 received relative to the non-supply of water by the Southwark and Vauxhall Water Company, principally affecting the district on the south side of Lavender Hill, and which was similarly affected during the preceding summer. The principal complaint appeared to be in connection with Grove Mansions, North Side, Clapham Common, which were without water for two whole days andparts of several others. Enquiries were made at a number of premises principally in Plough Road, St. John's Hill Grove, Beauchamp Road, Leathwaite Road, and Grandison Road, where the houses are provided with suitable cisterns, and in many instances have in addition, draw off taps in the cellars, from which it was found that upon certain occasions no water could be obtained, thereby proving that not only was there no pressure in the Company's mains, but as a fact, the water must have been turned off. All the houses visited appeared to be provided with fittings for a constant supply of water, but in spite of this fact the Company had failed to give such constant supply, and the Committee directed that the Local Government Board and the London County Council should be communicated with upon the matter. Also with reference to 151A Usk Road, that there was no water closet accommodation for the use of the persons employed —namely, four men. It was also found that urinal accommodation was necessary, in consequence of a portion of the premises being used, but not adapted, for this purpose. The Committee gave directions that suitable water closet accommodaton with pedestal seat should be provided. July 30th—.At this meeting he reported with reference to the alleged offensive condition of the Creek at Messrs. Price's 106 premises, York Road, that after the Creek Pumping Station had been working for the purpose of passing storm water into the river from the Creek and main low level sewers, a considerable amount of sewage matter which necessarily passed out with such storm water, became largely mixed with the mud, &c. at the bottom of the Creek, and caused the same to become offensive. That no great nuisance was created when the pumping takes place at low water, but that when the tide was sufficiently high to give three or more feet depth of water in the Creek, the material pumped out did not find its way rapidly into the river, and consequently was deposited as already stated, at the bottom of the Creek, and that he had upon making a subsequent examination, found the mud was of an offensive character, and largely charged with gases which were being constantly disengaged. The length of the Creek to the River wall is about 48o feet, and from the river wall to low water mark about 120 feet The greatest width of the Creek is about 36 feet, and the least width about 25 feet. The top end is not concreted nor paved in any way, and is worse than any portion of the river bank in the parish. He recommended that the storm overflow should have a covered culvert laid down through the Creek, and discharge into the river at low water mark, or that the bottom of the Creek should be concreted and suitably sloped as to be thoroughly scoured during the ebb of the tide. He also reported, pursuant to the directions of the Committee, relative to the nuisance alleged to arise from the emission of black smoke from certain laundry premises, and which had been kept under constant observation for the previous five weeks. That although a matter of about 100 hours had been spent in observing the shaft in question, black smoke was found to be emitted only upon three occasions, for one, three and four minutes respectively, and that there was not sufficient 107 evidence, having regard to the opinion of the Solicitor on the matter, to justify proceedings being taken against the proprietors. Also that upon testing the drains of "G" and "H" Blocks, Victoria Dwellings, they were found to be in defective condition, and that most of the w.c.'s were trapless valve closets, in many instances the valves being defective, allowing the water to escape. They discharged into soil pipes which are trapped at the foot. Some of the closets had from time to time been removed, and pans of the wash-down type fixed, with traps above the floor line, without any regard to the liability to syphonage by providing suitable antisyphonage pipes. That upon the water closet handles being raised, it was found that most offensive effluvia were given off, that the water closets were badly supplied with water, and the soil pipes were of lead with soldered seams and situated within the building. The Committee gave the necessary directions for the matter to be brought before the notice of the owners with a view to an entire reconstruction taking place. This was subsequently carried out, and necessitated the relaying of the branch drains and certain portions of the main drain, with suitable means of inspection, abolishing the dip-stone trap arrangements in connection with the old intercepting chambers in the courtyard, the provision of suitable self-cleansing interceptors and air inlets, and further new water closets and soil-pipes, about 40 in number to the blocks of buildings in question. September 14th.—At this meeting he reported having received information from the Coroner's officer, that on the afternoon of the 2nd September an inquest would be held upon the bodies of two persons who had died at No. 86 Longhedge Street; that the rooms occupied by the family were in dirty condition, and it had been suggested he should attend the inquest. That he had visited the premises in question and 108 found that upon the first floor, the rooms occupied by the family named were in a cleanly condition, but that the bedding used by the family was dirty and verminous, that the occupier had agreed to the rooms being disinfected, and portions of the bedding destroyed, which was subsequently carried out. Further that he had inspected the following workshops laundries, etc.: At 19 Bridge Road West, the flooring of passages used as ironing places were in dangerous condition, and there was want of proper ventilation to the water closet in basement. The washhouse was overcrowded, seven persons being employed in a cubic space of 970 feet. At 74 Bridge Road West, it was found that the floor of front ironing-room and washhouse were dangerous, but that the workrooms were in other respects in good condition. At 12 Straithblaine Road, two rooms on the second floor were occupied by a tailor employing 4 men and 2 women. The work-rooms were in cleanly condition and well ventilated. At 84 Queen's Road, no overcrowding existed, but it had been the practice at times to engage additional hands in the same workroom, and under these circumstances it would be overcrowded. The proprietor agreed to discontinue the practice or to utilise another room for the purpose. Also with reference to the sanitary conveniences provided in connection with the London and South Western Railway Co.'s platform, Clapham Junction, and also those of the London Brighton and South Coast Railway Co. The sanitary conveniences of the latter are situated upon 109 Nos. 8 and 9 platforms, and were all found to be in good and cleanly condition upon the date of inspection. The water closets being of the wash-down type, provided with water waste preventers, and the urinals suitably supplied with water. The conveniences of the London and South Western Railway Co. are situated upon platforms Nos. 2, 3, 4, 5 and 6, and in most instances consisted of foul container closets, inadequately supplied with water. The urinals were found in most instances to be cleanly and properly supplied with water. The Committee gave directions that the London and South Western Railway Co. should be approached with a view to abolishing the whole of the water closets in question, and provide those of a wash-down type, with suitable syphonic action flushing cisterns. After some correspondence had taken place as to the power of the Vestry to require these works to be carried out, the Company provided new water closets, &c. Also with reference to a complaint that had been made as to the manufacture of ice cream at certain premises in the Winstanley Road, which were deemed unfit for the purpose, that a careful examination of the freezers and other vessels used in connection with the business had been made, and the same were found to be in cleanly condition, that from delivery notes and bills the milk and ice were found to be supplied by respectable firms. The premises in which the manufacture of the ices was carried on, were not in such cleanly condition as is desirable where the manufacture of food or drink is conducted, and he suggested that the attention of the London County Council and Local Government Board should be drawn to the necessity of stringent regulations being made in this and similar matters, as he was not aware that the Vestry had any powers to prohibit the manufacture of these articles upon the premises which were the subject of the report. 110 These Bodies were accordingly communicated with upon the matter. October 5th.—At this meeting, he reported that at a certain house in Livingstone Road, two rooms were in an over-crowded condition, in addition to which a number of cats were kept therein. That the premises first came under notice in April, 1896, when complaint was made that numerous cats were being kept in the basement rooms. Upon inspection at that time, it was found the occupier had some 6 cats upon the premises, in consequence of which notice was served, and in due course the cats were reduced to two in number. That from time to time the premises had been visited since this, and on the 14th August, having received complaint that there were some 12 cats, one dog, three single men lodgers, a mother and daughter in two rooms, he had visited the premises and found the actual occupants were three persons, comprising mother, daughter and a nephew, and also two cats and one dog. That upon visiting the premises on the 24th September, it was found that both rooms were still used for sleeping purposes, and occupied by the same persons who had occupied them upon the previous occasions, excepting that there were no dogs. The rooms were found to be in cleanly condition, and have been occupied by the same person for the past ten years, and there was not the slightest foundation for the statement which had been made concerning the premises. He also, as directed by the Committee, submitted a report relative to the noises, &c., in the A 1 Biscuit Co's. Works, Queens Road, and also as to the Sanitary conditions there. The Committee gave directions that the necessary notice should be served with regard to certain matters, and this was subsequently complied with. He also submitted report relative to a complaint of offensive effluvia proceeding from the works of the Military Equipmen Co., Queens Road, that upon inspection of the same it was found 111 that the nuisance arose from the roasting of barley and coffee, principally the first mentioned, which is carried on in a revolving drum fixed obliquely, the bottom of which is perforated. Barley is placed in the drum at about three bushels at a time, and naked gas jets are applied thereto, the barley being burnt almost to a cinder. When sufficiently charred it is removed on to the concrete floor of the building, from which volumes of smoke of a pungent character are given out, and as the building in which the manufacture is conducted was not provided with suitable openings for ventilation, the fumes and smoke given off escaped through the broken windows of the building. That it was necessary for the workmen in charge of the roasting to wear suitable protectors over the eyes and nose, and if the roasting was to be continued the building should be adapted for the purpose by suitable shafts being provided in order that the products of combustion may be given off in a proper manner outside the building. Certain defects were found in the Sanitary arrangements, and the Committee directed that notices should be served, which were subsequently complied with, the roasting of barley being discontinued. Also with reference to an inspection of Messrs. Auborn & Heaviside's Works, John Street, York Road, at which premises some seven men and twenty-nine females were employed, that the sanitary conveniences and the work-rooms were in good condition and properly ventilated, except that the walls and ceiling of the boiling room required lime-whiting. The Committee gave directions that notices should be served, and the necessary works were eventually carried out to comply with the same. He also submitted report relative to the complaints which had been made alleging offensive smells to arise from certain chemical works, and which were believed to proceed from the manufacture of Cyanide of Potassium, that upon inspection of 112 the premises on the 21st September, and whilst the process of manufacture was stated to be in full operation, no nuisance could be observed. That on the 23rd September, in company with the District Inspector, he had kept observation of the premises from 7.30 in the evening, until 1.45 the next morning. That twice during this period slight emissions of vapour were noticed to proceed from the works, and were found to be slighty irritating to the nose and throat. That on the 27th September, he again, in company with the District Inspector, kept observation from 8.15 until 11 o'clock at night, during which time no nuisance was discovered. Numerous buildings in the vicinity of the works had been coated with a substance resembling Prussian blue, and which was believed to arise from the manufacture of Cyanide of Potasium at the works in question. Since the date of this report the premises have been under constant observation, and further reports have been submitted to the Health Committee on the matter, which tend to shew that certain alterations have been made with a view to minimising the nuisance. October 19th.—At this meeting he reported with reference to certain drainage work which had been carried out by the owner of No. 1, Broomwood Road, contrary to the regulations of the Vestry, and as specified in a notice served upon him on the 17th August, that the requirements had been disregarded and a portion of the drain repaired, when as a matter of fact it was necessary to relay the entire drain. The Committee gave directions, that subject to the opinion of the Solicitor, proceedings should be taken to enforce compliance with the Vestry's requirements, and eventually the case came before the Magistrates at the South Western Police Court, and an order was made that the works should be carried out. November 2nd.—At this meeting he reported as to having attended the Annual Meeting of the Public Health Committee 113 of the London County Council with reference to the licensing of slaughter-houses and cow-houses, that there were before such Committee eight applications' for the renewal of cowhouse licenses, and ten for slaughter-houses, all of which were renewed, except as to 82, Usk Road. The license for this slaughter-house was objected to by the Council's officer on the ground that a condition attached to the license had been disregarded, in that cattle had been slaughtered, when the license was granted only for the slaughtering of pigs. The fact was also submitted to the Licensing Committee, that when a Sub-Committee of the Health Committee of the Vestry visited the premises, the Bye-Laws of the London County Council relative to the conduct of the business of a slaughterer of cattle were being contravened, and also that a very large number of pigs were slaughtered on the premises in question. The Committee of the Council thereupon decided not to renew the license. 351 York Road. In this case objection was made to the renewal of the license by the Council's officer on the ground that portions of the premises not controlled by the license had been used for the purpose of the business of a slaughterer of cattle, and the Committee also took into consideration the question the Health Committee had raised, that in their opinion not more than 40 pigs were to be slaughtered in one day. The Licensing Committee renewed the license upon the condition that not more than 40 pigs should be slaughtered in one day, and that only the licensed portions of the premises were to be used for the conduct of the business in future. He also submitted report with reference to a complaint of offensive smells which were alleged to emanate from the ventilating shaft in connection with the drainage of a paper mill, that although the drains had been tested, no defect, had been discovered therein, and that it would appear to arise from the misuse of the sanitary conveniences by the workpeople employed, in that h 114 portions of the premises were used as urinals which were not intended or adapted for the purpose when the water-closets were laid down some time previously by an order of the Health Committee. That the number of men and boys employed on the date of inspection was sixty-seven, for these, four water-closets were provided, with flapseats and they were in good working order. The Committee directed that the walls should be suitably protected with impervious material and water supply laid on, in order that the portion of the premises then used as a urinal might be made suitable for the purpose, and the works were subsequently carried out. Also with reference to an offensive business which was carried on at certain premises in High Street, that the shop was used for frying fish, but the nuisance complained of was found to arise from the scraping and drying of skate skins, which is effected by allowing the skins to become somewhat putrid in order that the particles of flesh adhering thereto may be more easily removed. The skins are then stretched on boards and exposed in the open air. The business in some respects may be said to resemble gut scraping, and is equally offensive. That the matter had come under notice in July and that upon preliminary notice being served, the business was discontined for a time. It had however recommenced, and statutory notice had been served. The Committee now directed that the necessary proceedings should be taken for enforcing same if in the opinion of the Solicitor, such a course was practicable. The matter was placed in the hands of the Solicitor and the nuisance subsequently discontinued without recourse to summary proceedings. November 16th.—He also submitted report relative to the sanitary convenience provided for the use of the workmen at No. 385 Battersea Park Road, that it was without light or ventilation, and further that no urinal accommodation was provided. That 115 some fifteen men were employed upon the works, and suggested that certain alterations should be made. The Committee gave directions for notice to be served, which was subsequently complied with. Similar remarks also apply to No. 351 Battersea Park Road, except that here the sanitary conveniences for the workmen were in good condition, but the urinal had no proper and sufficient water supply. Also with reference to premises in Chatham Road, at which some ten persons were employed, that the water closet accommodation provided there was found to be in offensive condition, and in other respects was not satisfactory. The Committee gave directions that water closet and urinal in addition should be provided, and the necessary notice was served and subsequently complied with. Similar remarks apply to the Castle Ironworks at which some five persons were employed. The necessary notices were served and the works carried out. November 30th.—He also submitted report with reference to complaints which had been made relative to the Dust, &c., given off from the furnace shaft of the Salvation Army Depot, Wellington Road, that upon inspection it was found that owing to the faulty construction of the furnace, and the nature of the fuel used, which consisted of the lighter portions of paper and other rubbish brought to the works, vast quantities of dust were given out of the chimney shaft. That some hundred and ninety to two hundred men were employed, the principal work carried on being wood-chopping, tin plate work and paper sorting, that the workmen are fed and housed upon the premises, and that with the exception of the water closets being in dirty condition, the dormitories, workshops, &c., were in fairly good condition. 116 Formerly the men received at these premises were similar in all respects to casuals in a workhouse, but it is now the practice only to receive men transferred from the other centres, at which the Salvation Army carry on their social work. There are the necessary means provided for washing and bathing purposes, &c. Drainage work The number of inspections made by the Drain in connection with New Inspector have been 8139 in addition to which Buildings, &c. frequent visits were made by the Chief Sanitary Inspector. The drains tested numbered 1217 which comprise both sectional testings of the work while in progress and and final testings which are made prior to the occupation of the dwellings. The number of premises in respect of which the whole of the works have been completed in a satisfactory manner and as required by the Bye-laws of the London County Council under Sec. 39 (1) Public Health (London) Act, 1891 and the regulations of the Vestry, was 244, whilst the houses for which certificates have been given with reference to the water supply under Sec, 48 Public Health (London) Act, 1891, numbered 236. In connection with the latter, attention should be directed to the fact that the certificate in question (which has exclusive reference to the water supply of new houses) is frequently represented by builders to persons purchasing houses, and also desiring to know if the drainage, &c., has been properly carried out, as a certificate of the Sanitary Authority with reference to the whole sanitary condition of the premises, and in order to prevent this, it has been found neeessary to endorse the certificates granted to the effect that it has only reference to the water supply. It may be stated that there is an increasing willingness on the part of builders to conform to the Vestry's requirements, and much less difficulty is now experienced in this respect than formally. The Bye-laws of the London County Council regarding the construction of w.c.s are in some respects impracticable, and 117 in others not sufficiently stringent. It stated in the remarks with reference to new drainage works in my last annual report, that our present drainage regulations were insufficient in various details, but as the London County Council had framed draft Bye-laws under Section 202 of the Metropolis Management Act 1855 it was not suggested ours should be amended. Twelve months have however, elapsed, and we are unfortunately still without a code of Bye-laws made by a central authority and applicable to the whole Metropolis. The Chief Inspector informs me that it is frequently remarked by builders that in other parishes they are allowed to do such and such a thing, why cannot they do the same here? It therefore at times becomes somewhat difficult to enforce regulations of the Vestry, as not seeming to have the same weight as a Bye-law made under a special section of an Act of Parliament and ratified by the Local Government Board. The Vestry has therefore deemed it necessary (pending a uniform code of Bye-laws being made by the London County Council) to revise the drainage regulations in very many particulars, and in the preparation of these, have noted several of the more salient points in the draft Bye-laws of the London County Council, and included them in such Regulations, so that should Bye-laws by the London County Council be made in respect to drainage, it is thought they will, in many respects, be similar to the Regulations adopted by the Vestry on the 13th April last. There is one other point to which attention should be directed, and that is the vexed question of repairs to combined systems of drainage. Probably nearly two-thirds of the properties in the Parish are drained by combined operations, and whilst a very large number have already been re-constructed by the owners of the same, the Vestry has been compelled by the legal decisions given on the point, to repair, and where the Vestry have been satisfied they were liable, they have given directions for so much of the combined systems as were 118 sewers to be relaid, and the works have been carried out. It is however regrettable that the Vestry should be made responsible for work in connection with private property in which it has not the slightest pecuniary benefit, and in many instances is entirely helpless, as cases have been decided to the effect that a drain laid down under the approval of the Sanitary Authority, may become a sewer through the act of some person making a surreptitious connection thereto from an adjoining property, and it can only be said that it would be well to amend such law, in order that the burden of repair of private property should fall upon the shoulders of those who own the same, and not upon the Vestries and District Boards. Several local authorities have found it necessary to appoint a special staff of workmen to re-construct these systems of drainage, so great has the Work become. Medical During the past eighteen months, one hundred and Examination . of Vestry ninety-two employes have been medically examined, Employes. and certificates of the state of health given. During 1897 one hundred and eleven were examined. The results are entered in a register for future reference. Mortuary. During the year under report two hundred and eighty-nine bodies were received into the Mortuary, six for sanitary reasons, these latter deaths having arisen generally from infectious disease. On two hundred and eightytwo of the bodies deposited in the Mortuary, inquests were held. In conclusion I beg to refer again to the extremely low death rate for the year 1897 shewn in this report, as an indication that the sanitation of the Parish is satisfactory, which condition I hope will be maintained, the more especially as the Vestry has determined to strengthen the sanitary staff by increasing the district inspectors to eight in number, the parish being re-divided into a like number of districts; in addition to the appointment of 119 a female inspector to supervise places where women and girls are employed. I have to express my thanks to all my colleagues for their ready and able assistance during the year under report. To the Health Committee and the members of the Vestry generally, I beg to tender my high appreciation of the kind support with which I have always been favoured; indeed, without such support the duties of a Medical Officer of Health, are becoming so numerous, being added to year by year, that it would be impossible to carry them out successfully. W. H. KEMPSTER, M.D., Medical Officer of Health. 120 APPENDIX. LIST OF STREETS AND PLACES CONTAINED IN EACH OF THE EIGHT SANITARY DISTRICTS OF BATTERSEA. District No. 1. Boundaries:—North, River Thames; South, Parish Boundary; East, Parish Boundary: West, L.B. & S.C.Ry. Southward to L. & S.W.Ry. (the latter Westward and Beaufoy Road). Inspector Mr. J. Herrin. Ægis Grove Acre Street Arden Street Ascalon Street Battersea Park Road (From L.C. & D.Ry. bridge to Nine Elms.) Belfour Street Bewick Street Brandon Street Brewery Cottages Broughton Street Ceylon Street Cherwell Street Corunna Place Corunna Road Corunna Terrace Crichton Street Cringle Street Currie Street Dashwood Road Dickens Street Emu Road Etruria Street Everett Street Foot's Row Froude Street Gambetta Street Gonsalva Road Haines Street Haward Street Ingelow Road John Street Kirtling Street Linford Street Montefiore Street Motley Street Mundella Road Mundella Terrace New Road Nine Elms Lane Patmore Street Ponton Road Ponton Street Porson Street Portslade Road Power Street Prairie Street Queens Road (South of L. & S.W.Ry. Station.) Queens Square Robertson Street Ruskin Street St. Andrews Street St. Phillips Street Savona Place Savona Street Seldon Street Seymour Street Silverthorne Road Sleaford Street Stanley Street Sterndale Road Stewarts Road Stockdale Road Tennyson Street Thackeray Street Thessaly Square Tidemore Street Tidbury Street Trollope Street Tweed Street Wadhurst Road William Street Woodgate Street District No. 2. 121 Boundaries:—North, River Thames; South, W.L.E. and L. & S.W. Railways; East, L.B. &S.C. Railway; West, Albert Bridge Road (Southward to Cambridge Road), Cambridge Road, Bridge Road (from Cambridge Road, Southward) and Battersea Park Road (Westward to W.L.E. Railway Bridge). Inspector Mr. A. Chuter. Abercrombie Street Albert Road (East Side and West Side from Cambridge Road to Battersea Park Road) Alexandra Avenue Alfred Street Anerley Street Arthur Street Atherton Street Austin Road Battersea Park Battersea Park Road Beechmore Road Berkley Street Brighton Terrace Blondel Street Brougham Street Brynmaer Road Cambridge Road Carlton Grove Carpenter Street Chatham Street Chesney Street Culvert Place Culvert Road Cupar Road Doddington Grove Forfar Road Foxmore Street Frere Street Gaines' Cottages Gladstone Street Gladstone Terrace Havelock Terrace Henley Street Kassala Road Kennard Street Kersley Mews Kersley Street Hilton Street Landseer Street Landseer Terrace Latchmere Road (From W.L.E. Railway to Battersea Park Road). Latchmere Street Lockington Road Longhedge Street Lurline Gardens Macduff Road Meath Street Millgrove Street Orkney Street Oulton Street Pagden Street Palmerston Street Palmerston Terrace Park Grove Parkside Street Prince of Wales Road (From Albert Road to Victoria Road) Queen's Road (From Battersea Park Road to Queen's Road Station) Raywood Street Rollo Street Russell Street St. George's Street St. James' Grove Sheepcote Lane Soudan Road Southolm Street Stewart's Lane West Victoria Circus Victoria Road Warriner Gardens Warriner Mews Warsill Street 122 District No. 3. Boundaries:—North, River Thames; South, W. L. E. Ry.; East, District No. 2 ; West, River Thames. Inspector Mr. I. Lawrence. Albert Road (West side) (From River Thames to Cam- bridge Road.) Alfred Place Althorpe Grove Anhalt Road Ashton's Buildings Ashurst Street Balfern Street Banbury Street Battersea Park Road (North side from Princes Head to Bridge Road.) Bolan Street Bolingbroke Road Bourne's Place Bridge Road Bridge Road West Bullen Street Cambridge Road (North side) Castle Street Church Lane Church Road Colestown Street Cottage Place Crescent Place Edna Street Elcho Street Ethelbruga Street Ford's Place Francis Street Freeland Street Goulden Street Granfield Street Green Lane Harley Street Hart Street Henning Street Henry Street High Street Home Road Howie Street Hyde Lane Inworth Street Juer Street Little Europa Place Miles Cottages Octavia Street Orbell Street Orville Road Park Road Parkham Street Petworth Street Peveril Street Phoenix Wharf Lane Prince of Wales Road (From Albert Road to Bridge Road.) Radstock Street Randall Street Rosenau Crescent Rosenau Road Somerset Street Spencer Street Spicer Street Stanmer Street Surrey Lane Surrey Lane South Trott Street Ursula Street Vicarage Road Watford Villas Wellington Road Winstead Street Worfield Street 123 District No. 4. Boundaries:—North, W.L.E. Railway; South, York Place, Winstanley Road, and L. & S.W. Railway; East, outer circle of W.L.E, Railway ; West, River Thames. Inspector Mr. A. E. Purnell. Afghan Road Andoe Road Barmore Street Battersea Park Road (From High Street to W.L.E. Railway Bridge). Benfield Street Buckton Street Cabul Road Candahar Road Creek Street Currie Road Darien Road (From Winstanley Road to Lavender Road.) Duffield Road Este Road Falcon Grove Falcon Road (From Prince's Head to Railway Bridges.) Falcon Terrace Grant Road (From Winstanley Road to Lavender Road.) Gwynne Road Harroway Road Heaver Road Holman Road Ingrave Street Kamballa Road Kerrison Road Khyber Road Knox Road (From Winstanley Road to Lavender Road.) Latchmere Grove Lavender Road Lavender Terrace Lithgow Street Livingstone Road (From Winstanley Road to Lavender Road.) Lombard Road Lubeck Street Mantua Street Meyrick Road Musjid Road Natal Road Nepaul Road Newcomen Road (From Winstanley Road to Lavender Road.) Newman Street Patience Road Pearson Street Rowena Crescent Shillington Street Simpson Street Speke Road (From Winstanley Road to Lavender Road.) Stainforth Road Thibet Street Totteridge Road Urswicke Road Verona Street Wayford Street Winders Road Winstanley Road (North side) Wye Street Yelverton Road York Road (From Prince's Head to Junction with Plough Road.) 124 District No. 5. Boundaries: North, District 2; South, Lavender Hill; East, Beaufoy Road and Parish Boundary; West, District 4 and Falcon Road. Inspector Mr. J. T. Baxter. Acanthus Road Amies Street Arliss Road Ashbury Road Basnett Road Beaufoy Road Birley Street Brassey Square Dorothy Road Eland Road Elsley Road Eversleigh Road Falcon Road (From Railway Bridge to Lavender Hill.) Gideon Road Glycena Road Grayshott Road Hanbury Road Holden Street Kathleen Road Kingsley Street Knowsley Road Latchmere Road (From W.L.E. Railway Bridge to Lavender Hill). Lavender Hill (North side) Morrison Street Mossbury Road Pountney Road Poyntz Road Sabine Road Shellwood Road Shirley Grove Theatre Street Tipthorpe Road Town Hall Road Tyneham Road Wickersley Road Wycliffe Road District No. 6. Boundaries:—North, District 4; South, Bramfield Road, a line continued westward across Wandsworth Common to Parish Boundary; East, Falcon Road, St. John's Road, and Northcote Road ; West, River Thames and Parish Boundary. Inspector Mr. H. Marrable. Abysinia Road Aliwal Road Auckland Road Battersea Rise (From Northcote Road Westward.) Benham Street Belleville Road (From Northcote Road to Wandsworth Common.) Bennerley Road (From Northcote Road to Wandsworth Common.) Bolingbroke Grove (From Battersea Rise to Bramfield Road.) Boutflower Road Bramfield Road (North side) (From Northcote Road to Wandsworth Common.) 125 District No. 6—continued. Britannia Place Brussels Road Cairns Road Canterbury Place Chivalry Road Clapham Junction Cologne Road Comyn Road Darien Road (From Plough Road to Winstanley Road.) Eckstein Road Emma Street Field's Place Grant Road (From Plough Road to Winstanlsy Road.) Harbut Road Hibbert Street Hope Street John Street, York Road Kelmscott Road (From Northcote Road to Wandsworth Common ) Knox Road (From Darien Road to Winstanley Road). Linda Street Livingstone Road (From Plough Road to Winstanley Road.) Lothair Street Louvaine Road Mallinson Road (From Northcote Road to Wandsworth Common.) Maysoule Road Mendip Road Middleton Road Newcomen Road (From Plough Road to Winstanley Road.) Northcote Road (West side) (From Battersea Rise to Bramfield Road.) Oberstein Road Park Road, Wandsworth Common Plough Road Plough Terrace Prested Road St. John's Hill St. John's Hill Grove St. John's Road (West side) St. Peter's Place Salcott Road (From Northcote Road to Wandsworth Common.) Sangora Road Severus Road Sewell Road Shelgate Road (From Cemetery to Northcote Road ) Speke Road (From Plough Road to Winstanley Road.) Spencer Road Starch Factory Road Stockwood Street Strathblaine Road Strath Terrace Tritton Street Usk Road Vardens Road Wakehurst Road (From Northcote Road to Wandsworth Common.) Wandsworth Common (North side) Wayland Road Weston Street Wilson Street Windmill Road Winstanley Road (South side) York Place York Road (From junction with Plough Road to Parish Boundary). 126 District No. 7. Boundaries: North, Lavender Hill; South, Bramfield Road, Burland Road and a line eastward across Clapham Common known as "Bishop's Walk"; East, Parish Boundary; West, St. John's Road and Northcote Road. Inspector Mr. A. Odell. Almeric Road Altenburg Gardens Ashness Road Battersea Rise (From Northcote Road, Eastward.) Beauchamp Road Belleville Road (From Webbs Road to Northcote Road.) Bennerley Road (From Leathwaite Road to Northcote Road.) Berber Road Bramfield Road (North side) (From Northcote Road to Webbs Road.) Burland Road (North side) Clapham Common (North side) Clapham Common (West side) Eccles Road Elspeth Road Fontarabia Road Forthbridge Road Freke Road Garfield Road Gowrie Road Grandison Road (Clapham Common to Burland Road.) Green Lane Hafer Road Haubeck Road Ilminster Gardens Jedburgh Street Kelmscott Road Kieldon Road Lavender Gardens Lavender Hill (South Side) Lavender Sweep Leathwaite Road (From Clapham Common to Burland Road.) Limburg Road Lindore Road Longbeach Road Mallinson Road (From Leathwaite Road to Northcote Road.) Marjorie Grove Marmion Road Marney Road Meteor Street Mysore Road Northcote Road (Fast side from Battersea Rise to Bramfield Road.) Parma Crescent Rush Hill Road St. John's Road (East side) Salcott Road (From Leathwaite Road to Northcote Road.) Shelgate Road (From Leathwaite Road to Northcote Road.) Sisters Avenue Stormont Road Sugden Road Taybridge Road Thirsk Road Tregarvon Street Wakehurst Road (From Grandison Road to Northcote Road.) Webbs Road (From Battersea Rise to Bramfield Road.) Winifred Grove Wix Lane 127 District No. 8. Boundaries: North, Districts 6 & 7; South, Parish Boundary; East, Parish Boundary; West, Parish Boundary. Inspector Mr. H. H. May. Althorpe Road Anmer Street Balham Park Road Ballingdon Road Belleville Road Blenkarne Road Bolingbroke Grove Boundaries Road (From Bramfield Road to Nightingale Road) Bramfield Road (South Side) Broadlands Terrace Broderick Road Broomwood Road Broomwood Gardens Burland Road Chatham Road Chatto Road Clapham Common (West Side) Darlsy Road Dents Road Devereux Road Dulka Road Estcourt Road Gayville Road Gorst Road Granard Road Grandison Road (From Burland Road to Chatto Road) Hillier Road Honeywell Road Kyrle Road Leathwaite Road (From Bramfield Road to Chatto Road) Leveson Road Mayfield Road Montholme Road Morella Road Northcote Road (From Bramfield Road to Broomwood Road) Nottingham Road Nightingale Lane (North Side) Old Park Avenue Ouseley Road Ramsden Road Ravenslea Road Rusham Road St. James Road Sarsfeld Road Stonnell's Road Sudbrook Road Thurleigh Road Trinity Road Webbs Road (From Bramfield Road to Broomwood Road) Wexford Road Wiseton Road Wroughton Road Parish Boundaries: North, River Thames; South, District of the Wandsworth Board of Works; East, Parish of Lambeth, and District of the Wandsworth Board of Works; West, District of the Wandsworth Board of Works.