Battersea Borough Council. Memorandum to 190 In re Londan B-I With the compliments of the Medical Officer of Health G. F. McCLEARY, M.B., D.P.H. Medical Officer of Health, Municipal Buildings, Lavender Hill, S.W. Telephone No. 68, BATTERSEA. BAT 8 Battersea Borough Council. REPORT UPON THE PUBLIC HEALTH & SANITARY CONDITION OF BATTERSEA During the Year 1900, BY W. H. KEMPSTER, M.D., MEDICAL OFFICER OF HEALTH. 1901. Battesea Borough Council. Chart indicating number of Births and Deaths registered weekly as occurring in Battersea during the year 1900. CONTENTS PAGE. List of Officers and Staff ... ... ... 6 Population ... ... ... ... 8 Births and Birth Rates ... ... ... 8 Deaths and Death Rates ... ... ... 9 Mortality Outlying Institutions ... ... ... 12 Weekly Summaries ... ... ... 14 Quarterly Summary ... ... ... 18 Comparative Statistics from the year 1856 ... 20 Local Government Board Table of Comparative Vital Statistics ... ... ... 21 Local Government Board Battersea Mortality Table ... ... ... ... 23 Coroner's Inquests ... ... ... 24 Infantile Mortality ... ... ... 26 Non-zymotic Diseases ... ... ... 28 Phthisis, or Consumption ... ... ... 29 Zymotic Diseases ... ... ... 32 Measles ... ... ... ... 35 Whooping Cough ... ... ... 40 Diarrhœa... ... ... ... 41 Influenza ... ... ... ... 42 PAGE. Notifiable Infectious Disease ... ... ... 43 Weekly Summaries ... ... ... 46 Local Government Board Table ... ... 48 Small Pox ... ... ... ... 51 Sickness and Mortality Table ... ... 52 Comparative Mortality Table ... ... 53 Table of Infectious Disease in Sanitary Districts ... 54 Scarlet Fever ... ... ... ... 56 Diphtheria ... ... ... ... ( 63 Enteric Fever ... ... ... ... 67 Typhus Fever... ... ... ... 71 Erysipelas ... ... .. ... 71 Puerperal Fever ... ... ... 74 Continued Fever ... ... ... 75 Cholera ... ... ... ... 75 Bubonic Plague ... ... ... 75 Disinfection Fumigation ... ... ... ... 81 Steam Disinfection ... ... ... 81 Infected Library Books ... ... ... 85 Destruction of Bedding, &c. ... ... 85 Flushing of Drains ... ... ... 85 Certificates of Disinfection ... ... 85 Mortuary Proposed New Mortuary ... ... ... 86 Bodies Received, &c. ... ... ... 87 Post Mortem Examinations ... ... 88 Unidentified Bodies ... ... ... 89 Bodies Received during each Month ... ... 89 Chalets ... ... ... ... ... 90 Water Supply Complaint to Railway and Canal Commission ... 91 Analyses of Companies' Water Supply Monthly ... 92 Unsound Food ... ... ... 92 Bakehouses ... ... ... ... 92 Cowhouses and Slaughter-houses ... ... 93 Vaccination Vaccination Return 1900 ... ... ... 94 Customs and Inland Revenue Acts... ... ... 95 Houses Let in Lodgings ... ... ... 96 Flooding... ... ... ... ... 97 Public Health Legislation during 1900 New Bye-laws, Suggested Amendments, &c. ... 97 Medical Examination of Officers and Employes ... 98 Charts. (1). Births, Deaths and Zymotic Mortality (2). Prevalence of Notifiable Infectious Disease Appendix. Sanitary Operations of the Year ... ... 100 Cases of notifiable infectious disease occurring in each street during the year ... ... ... 103 A list of the Officers and Staff of the public health Departement During tbe year 1900. OFFICERS. Medical Officer of Health. Public Analyst. W. H. Kempster, M.D. C. E. Cassal, F.I.C. Chief Sanitary Inspector. Isaac Young. Sanitary Inspectors. No i District ... ... ... John Herrin. „ 2 „ ... ... ... Alfred Chuter. „ 3 „ ... ... ... James Lawrence. „ 4 „ ... ... ... Arthur Edward Purnell. „ 5 „ ... ... ... John Thomas Baxter. „ 6 „ ... ... ... Horace Marrable. „ 7 „ ... ... ... Arthur Odell. „ 8 „ ... ... ... Hubert Harry May. Clerks. Senior Office Clerk ... ... Daniel Elwyn Richards. ... ... ... Isaiah George Brighting. Junior Clerks ... ... ... Bertrand William Sears. Thomas Frederick Dunning. STAFF. Disinfectors and Drain Testers. S. Terry. H. Hayllar. A. Nason. J. Smith. J. Bradshaw. G. Wheable. J. Holloway. G. Sewell. Mortuary Keeper. W. Shoesmith. To the Council of the Metropolitan Borough of Battersea. Gentlemen, I have the honor to present my Thirtieth and last Annual Report upon the Public Health and Sanitary Condition of Battersea. During the year under report, several important changes have taken place ; in May the Registration District of West Battersea was divided, and there are now three Registration Districts—East Battersea, North-West Battersea, and South- West Battersea; and by the Local Government Act, 1899, Battersea became a Metropolitan Borough, and several changes were made in the boundaries. In order, however, to render the statistics of the year of value for comparative and other purposes, the original Registrar's Districts and Parish Boundaries have continued to be adopted until the 29th December, 1900. By the recent changes in Local Government, duties which were formerly imposed upon the London County Council have been transferred to the Borough Council, viz., the registration of Dairies and Milkshops under the Dairies, Cowshed and Milkshops Order of 1885, and the supervision of Cowhouses, Slaughter-houses, and Offensive Trades. The Sale of Food and Drugs Act, 1899, also places upon the local authority the duty of the registration of wholesale dealers in Margarine and Margarine Cheese. The remarkable and highly satisfactory feature of the Public Health during the year has been the enormous diminution of notifiable infectious disease. In no year since notification became compulsory has such freedom from diseases of this class been attained, the reduction being most pronounced in regard to Diphtheria. The Census Enumeration which will be made on April Ist, 1901, would form a more correct basis for estimating the population of the year 1900 than would the Census figures of 1896 ; but as the result of the coming Census will not be obtainable probably until early in May, it is necessary as in previous years to rely upon an estimate based upon the assumption that the increase shown in the intercensal period (1891-1896) has since been maintained. The population as estimated for the year 1899 was 174,640, and if to this be added the average annual increase during the five years ending 1896, viz., 2,931, the population for 1900 would be 177,571, and upon this figure will be based the various birth, death and other rates. Births and Birth=Rate. Five thousand one hundred and sixty-one births were registered in Battersea during the year; of these, two thousand six hundred and eight were males and two thousand five hundred and fifty-three females. The birth-rate hereby shewn is equal to 29-0 per 1,000 of the population, and although higher than the Metropolis which was 28-6 per 1,000, is the lowest ever recorded in Battersea. The birth-rate for Battersea is, in fact, steadily declining each year, as the following rates for the last ten years will show. This reduction cannot be definitely explained, but is probably due to the fact that Battersea is not so largely populated by young married people of child-producing age as formerly. 1891 ... ... ... ... ... 34.6 1892 ... ... ... ... ... 32.3 1893 ... ... ... ... ... 33 .2 894 ... ... ... ... ... 3 1 .4 1895 ... ... ... ... ... 32.3 1896 ... ... ... ... ... 32.3 1897 ... ... ... ... ... 3 1.2 1898 ... ... ... ... ... 30.0 1899 ... ... ... ... ... 29.6 1900 ... ... ... ... ... 29.0 Average for 10 years ... ... 31.5 Birth-rate for London, 1900 ... 28.6 Deaths and Death-Rates. Two thousand nine hundred and fifty-one deaths were registered during the year. Of these, one thousand five hundred and seventeen were males and one thousand four hundred and thirty-four females, the distribution between the sexes being fairly equal. The registered death-rate was therefore equal to 16-6 per 1,000 of the population compared with 18.8 in the whole Metropolis, where the deaths registered numbered eighty-six thousand and seven. The following table classifies the deaths registered in Battersea in regard to locality and as to the number of "residents" and "non-residents" :— TABLE I. Locality. Deaths of "Residents." Deaths of "Non- Residents." Totals. East Battersea 1,042 7 1,049 West Battersea (excluding institutions) 10 1,304 1,294 Wandsworth and Clapham Union Infirmary 260 307 567 Bolingbroke Hospital 15 16 31 Totals 2,6 5 8 293 2,95 1 It will be seen from the above table that two hundred and ninety-three of the deaths registered related to "non-residents," and, therefore, to arrive at a correct figure as to the mortality of Battersea "residents," it is necessary to eliminate that number from the statistics and include those deaths of "residents" which have occurred during the year in other parts of the Metropolis outside Battersea, numbering three hundred and twenty and producing a corrected total of two thousand nine hundred and seventy-eight. The corrected death-rate is thus equal to 16-7 per 1,000 of the population. The localities in which the deaths of "residents" registered in other parts of the Metropolis occurred are here set out : — In Union Workhouses and Infirmaries 15 General and Special Hospitals 161 Metropoliton Asylums Board Hospitals 53 County and other Lunatic Asylums 7 1 Elsewhere (including River Thames, and other violent or sudden deaths in Streets, &c.) 20 Total 320 The following Table 11. classifies according to age, sex, cause of deaths, &c., those registered in the Metropolis outside Battersea. Zymotic Diseases contributed fifty-seven deaths most of these occurring in the hospitals of the Metropolitan Asylums Board. Deaths from violence numbered twenty-six compared with twenty-seven during the preceding year; and those from Phthisis and other Tubercular Diseases forty-three compared with forty-nine during 1899. TABLE II. Deaths of Battersea "Residents" Occurring Outside The Borough In Public Institutions And Elsewhere within The Metropolis. CAUSE OF DEATH. Totals. Sex. Age. Institutions, &c. 65 and upwards. Males. 1 to 5 years. All under 5. 5 to 15 years. 15 to 25 years 25 to 65 years. Union Workhouses, &c. General and Special Hospitals. Asylums Board Hospitals. County and other Lunatic Asylums. Under 1 year. Females Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlatina 11 5 6 ... 8 8 3 ... ... ... ... ... 11 ... Diphtheria 19 12 7 2 10 12 5 2 ... ... ... 1 18 ... Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric „ 15 11 4 ... ... ... 4 3 8 ... ... 1 14 ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... 1 ... ... ... ... ... ... 1 ... ... 1 ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 7 5 2 6 1 7 ... ... ... ... ... 7 ... ... Other Zymotics 4 4 ... ... ... ... ... 4 3 ... ... 1 ... ... Total Zymotics 57 34 23 8 19 27 12 5 9 4 3 10 43 1 Rheumatic Fever 2 ... 2 ... ... ... ... ... 2 ... ... 2 ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis and other Tubercular Diseases 43 28 15 1 1 12 3 6 22 ... 2 31 2 8 Respiratory 25 11 14 1 5 6 4 ... 10 5 1 12 4 6 Circulatory 35 21 14 ... 1 1 2 4 16 12 3 23 ... 5 Nervous 55 33 22 1 2 3 6 4 34 8 2 15 2 35 Cancer 29 13 16 ... ... ... 1 1 19 8 ... 2 5 ... 4 Violence 26 19 7 1 3 4 2 3 16 1 ... 15 ... ... All Other Diseases 48 21 27 7 1 8 4 4 20 12 4 28 2 12 Totals 320 180 140 19 42 61 34 27 148 50 15 161 53 71 In the foregoing table, twenty deaths will be found recorded as having occurred " elsewhere," the places where death occurred being here set out: — Devonshire Road, Hackney. St. John's Park, Holloway. Charing Cross. Hibernia Wharf, London Bridge. Cable Street, E. Buckingham Palace Road. York Road, Wandsworth. Chelsea Embankment. Grosvenor Road, Pimlico (2). Gasworks, Wandsworth. Wimbledon. St. Martin's-in-the-Fields. West Hainpstead. St. Anne's House. Vauxhall Bridge Road. River Thames (4). Tables III. and IV. show the number of births and deaths registered weekly in East and West Battersea respectively, and include the deaths of all persons whether "residents" or otherwise. The incidence of births and deaths at the various periods is also shown, the figures being grouped in quarters for that purpose, with additional particulars as to causes of death to be found in Table V. TABLE III. Births And Deaths Registered In East Battersea During The Fifty-Two Weeks of 1900. Week of Year. Week ending:- BIRTHS. DEATHS. Males. Females Total Males. Total. Females. 1 6th Jan 21 43 23 33 56 22 2 13th „ 30 28 58 19 11 30 20th „ 20 26 46 18 14 3 32 4 27th „ 19 25 44 16 11 27 5 3rd Feb. 19 22 41 10 10 20 6 10th „ 16 42 15 26 9 6 17th „ 26 24 50 15 14 29 7 8 24th „ 32 68 12 11 23 36 9 3rd March 19 20 39 11 8 19 10th „ 24 34 58 11 22 10 11 11 17th „ 20 13 22 29 49 9 12 24th „ 26 45 15 9 24 19 31st „ 11 7 18 13 35 66 31 L_ 1st Quarter 308 341 649 154 183 337 14 7th April 2 4 26 10 8 18 50 15 14th 21 36 57 12 9 21 16 21st „ 24 27 6 9 15 5 1 17 28th „ 13 9 2 9 18 47 22 18 24 50 5th May 26 8 9 17 19 12th 31 24 55 6 8 14 19th „ 9 3 12 20 33 29 62 21 26th 23 18 41 11 7 18 22 2nd June 28 26 54 10 3 13 14 29 7 17 23 9th 43 10 24 16th 28 49 21 6 14 20 25 23rd „ 20 29 8 5 13 49 26 30th „ 25 17 42 5 7 12 □ 2nd Quarter 112 100 212 319 331 650 Birth And Deaths In East Battersea, 1900 — continued. Week of Year. Week ending:— BIRTHS. DEATHS. Males. Females. Total. Males. Females. Total. 27 7th July 20 22 42 10 3 13 28 14th „ 21 20 4 1 7 3 10 29 21st „ 24 22 46 6 8 14 30 28th „ 22 36 58 11 15 26 31 4th August 31 13 44 8 15 23 32 11th 12 15 27 14 9 23 33 18th 26 17 43 19 9 28 34 25th 27 20 47 11 21 32 35 1st Sept. 24 18 52 13 14 27 36 8th „ 24 23 47 14 4 18 37 15th „ 22 26 48 16 10 26 38 22nd „ 21 13 34 6 14 20 39 29th „ 20 27 47 9 7 16 I 3rd Quarter 294 282 576 144 132 276 40 6th Oct. 29 52 9 7 16 23 41 13th „ 18 19 37 8 3 11 42 20th „ 27 19 46 11 4 15 43 27th „ 23 17 40 7 12 19 44 3rd Nov. 20 18 38 11 6 17 45 10th „ 18 29 47 11 5 16 46 17th „ 20 20 40 8 6 14 47 24th „ 18 22 40 6 9 15 48 1st Dec. 21 17 38 9 10 19 49 8th „ 16 21 37 13 7 20 50 15th „ 28 26 54 10 10 20 51 22nd „ 24 19 43 9 10 19 52 29th „ 16 15 31 14 9 23 278 265 543 126 98 224 4th Quarter Whole Year 1,199 1,219 2,418 565 454 1,049 TABLE IV. Births and Deaths Registered in West Battersea during the Fifty-two Weeks of 1900. Week of Year. BIRTHS. DEATHS. Week ending:- Males. Females. Total. Males. Females. Total. 1 6th January 28 28 56 38 56 94 2 13th 24 26 50 29 46 75 3 20th 28 21 49 26 23 49 4 27th 30 36 66 33 17 50 5 3rd February 22 33 55 23 23 46 6 10th 25 27 52 13 11 24 7 17th 32 19 5 1 22 24 46 8 24th 31 31 62 26 18 44 9 3rd March 35 35 70 14 22 36 10 10th 39 32 71 15 16 31 11 17th 28 36 64 19 22 41 12 24th 23 14 37 16 20 36 13 31st 35 26 61 21 19 40 1st Quarter 380 364 744 295 317 612 14 7th April 22 23 45 21 11 32 15 14th „ 25 20 45 22 19 41 16 21st „ 19 23 42 17 19 36 17 28th „ 38 37 75 19 24 43 18 5th May 24 31 55 20 17 37 19 12th „ 27 22 49 25 21 46 20 19th „ 38 23 61 16 15 31 21 26th „ 22 22 44 12 18 30 22 2nd June 28 26 54 17 6 23 23 9th „ 31 23 54 18 12 30 24 16th „ 34 30 64 14 r2 26 25 23th „ 26 37 63 12 19 31 26 30th „ 17 13 30 15 11 26 2nd Quarter 35 1 330 681 228 204 432 Births and Deaths in West Battersea, 1900 — continued. Week of Year. Week ending:— DEATHS. BIRTHS. Males. Females. Total. Males. Females. Total. 27 7th July 21 24 45 13 12 25 28 14th „ 24 27 51 10 11 21 29 21st „ 23 23 46 11 14 25 30 28th „ 32 35 67 20 21 41 31 4th August 44 33 77 20 28 48 32 11th 17 22 39 28 16 44 33 18th 29 28 57 23 28 51 34 25th „ 24 27 51 16 23 39 35 1st Sept. 36 29 65 18 21 39 36 8th „ 27 27 54 18 7 25 37 15th „ 20 22 42 16 18 34 38 22nd „ 25 17 42 18 18 36 39 29th „ 29 20 49 14 12 26 I 3rd Quarter 35 1 334 685 225 229 454 40 26 26 52 13 25 6th October 12 4 1 13th 28 17 45 11 17 28 42 20th 23 29 52 15 13 28 43 27th 16 22 38 17 22 39 8 44 3rd Nov. 27 26 53 10 18 45 10th 24 34 58 14 19 33 46 17th 27 25 52 14 14 28 47 24th 27 24 51 13 14 27 18 48 1st Dec. 20 18 38 15 33 49 8th „ 17 23 40 24 16 40 50 15th „ 36 24 60 18 17 35 14 51 22nd „ 34 23 57 12 26 52 29th „ 22 15 37 26 18 44 327 306 633 204 200 404 4th Quarter c Whole Year 1,409 1,334 2,743 952 950 1,902 TABLE V. Quarterly And Annual Summaries Of Births And Deaths. Battersea. 1900. Deaths Small Pox Measles Scarlet Fever Diphtheria Whooping Cough Fever Diarrhœa Cholera Violence Inquests Public Institutions (including Non- Parishioners.) Deaths Births Under 1 Year Above 1st Quarter E 649 337 83 85 ... 16 1 5 3 1 ... 11 35 ... 1 ... 744 612 106 221 ... 24 1 1 21 4 1 27 51 188 ... 2nd Quarter E 650 212 71 40 2 2 11 2 3 11 25 ... ... ... 681 432 86 123 ... 14 ... 1 20 3 2 23 46 122 3rd Quarter E 576 276 34 5 19 2 60 2 11 27 ... 141 ... ... 4 W 68 5 454 155 110 ... 2 1 16 2 69 1 17 34 146 4th Quarter E 543 224 91 39 3 ... 14 3 7 ... ... 26 W 633 404 93 120 ... 15 ... 2 2 1 7 7 18 34 142 Whole Year E 2418 386 198 26 1 9 49 7 67 2 40 113 ... 1049 W 2743 1902 440 574 ... 55 1 5 59 10 79 1 85 165 598 Totals 5161 2951 826 772 ... 81 2 14 108 17 1 4 6 3 125 598 278 It will be seen that the greatest mortality occurred in the first quarter of the year when nine hundred and forty-nine of the deaths were registered. Th% highest weekly mortality was the first week of the year ending 6th January, 1900, when one hundred and fifty deaths occurred, principally from diseases of the respiratory organs. The last quarter of the year had the lowest mortality, six hundred and twenty-eight deaths being recorded, and the lowest weekly mortality was that for the week ending 14th July, when only thirty-one deaths occurred. ... ... ... ... ... ... ... ... The births and deaths registered during the four quarters of the year are here set out: — Births. Deaths. 1st Quarter 1,393 949 2nd „ 1,331 644 3 r d 1,261 730 4th 1,176 628 Totals 5. 161 2,951 By a coincidence the births registered during the first and last quarters, similarly to deaths, represent the highest and lowest records respectively. The following Tables VI., VII. and VIII., the first of which has been in use for many years, and the two others which are introduced for the first time, at the request of the Local Government Board, are excellent comparative records of mortality, &c., of present and past years, particularly No. VI., which contains a veritable sanitary history of Battersea since the year in which modern sanitation first came into existence, and when Battersea consisted of a congeries of small villages, between which extended market gardens, the inhabitants 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 seen that the year 1900 compares favourably with the forty-five years included in that table, having, with six exceptions, the lowest death-rate. TABLE VI. 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 16,872 562 33.3 380 22.5 100 182 1859 17,774 685 38.5 394 22.1 96 292 1860 18,676 680 36.4 399 21.3 62 281 1861 19,582 750. 38.3 505 25.7 112 245 1862 23.108 784 33.9 491 21.2 106 293 1863 26,635 1 .042 39. 1 522 19.5 86 520 1864 30,161 1,140 37.7 669 22.1 129 47 1 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 2,659 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 1387 19.5 238 1,478 1875 76,354 3,080 40.3 1724 22.5 307 1,356 1876 81,704 3,455 4 2.2 1,745 21.3 340 1,710 1877 87,094 3,481 39.9 1,725 19.8 280 1,756 1878 92,464 3,748 40.5 1,803 19.4 322 1,945 1879 97,834 4,001 40.8 1,980 20.2 355 2,021 1880 103,204 4,095 39.6 2,040 19.7 383 2,055 1881 108,342 4,452 41.8 2033 18.7 381 2,419 1882 112,661 4,504 39.9 2,214 19.6 353 2,190 1883 116,980 4,71 1 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 5,186 386 2,451 18.2 5 02 2,735 1888 138,565 5,061 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 18 9 2 154,121 4,990 32.3 2,692 17.4 473 2,298 1893 1 57,052 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 5358 32.3 2.941 17.7 608 2.419 1897 168,778 5,266 31 .2 2,620 15.5 391 2,646 1898 171,709 5,157 30.0 2,762 16.0 517 2,395 1899 174,640 5,179 29.6 2,8 5 8 16.3 377 2,321 1900 177,57 1 5 ,161 29.0 2,951 16.6 442 2,210 The years marked thus were census years. TABLE VII. BATTERSEA.—Comparative Vital Statistics. Year 1 Population estimated to middle of each Year. 2 Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths in Public Institutions. 9 Deaths of Residents registered beyond District. II Deaths At All Ages. Nett. Deaths of Non- Residents registered in District. 10 Rate per 1,000 Births registered. 6 Number. 7 Rate* 8 Number. 3 Rate 4 Number. 5 Number. 12 Rate* 13 1890 147,203 5,105 34.6 855 167 2,854 19.3 185 239 2,908 19.7 381 1891 151,190 5,237 34 . 6 736 140 2,619 17.3 395 196 274 2,697 17.8 1892 154,121 4,990 32.3 791 158 2,692 17.4 411 204 294 2,782 18.0 1893 157,052 5,225 33 .2 842 161 2,801 17.8 363 204 377 2,974 18.8 1894 159,984 5,024 31.4 718 142 2,404 15.4 354 204 377 2,577 16.1 1895 162,915 5,264 32.3 907 172 2,901 17.8 481 247 307 2,961 18.1 1896 165,847 5,358 32.3 937 174 2,941 17.7 507 266 319 2,994 18.0 1897 168,778 5,266 31.2 845 160 2,620 15.5 459 270 387 2,737 16.2 1898 171,709 5,157 30.0 840 162 2,762 16.0 495 258 388 2,892 16 . 8 1899 174,640 5,179 29.6 838 161 2,858 16.3 597 301 348 2,905 16 . 6 Averages for years 1890-99. 5,180 32.1 830 160 2,745 17.0 233 33 1 2,842 17 .6 161,343 444 1900 177,571 5,161 826 2,951 16.6 598 320 2,978 16.8 29 . 0 160 293 * Rates calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column 12 are the number in Column 7 corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term " Non-residents " is meant persons brought into the district on account of illness, and dying there; and by the term residents "is meant persons who have been taken out of the district on account of illness, and have died elsewhere. Area of District in acres (exclusive of area covered by water), 2,170 acres. Total population at all ages, 150,458; number of inhabited houses, 20,779; average number of persons per house, 7*2—at Census of 1891. Table VIII. is a new one introduced by direction of the Local Government Board to ensure uniformity; being used by all the Medical Officers of Health throughout the Kingdom. This gives the mortality for the whole of Battersea and shows the number of deaths occurring in the two registrars' districts and the local public institutions. A column has also been added showing the number of deaths in each class which were those of non-residents in Battersea. The classification of the causes of deaths are considerably altered in the new table, amongst the most important features being the sub-division of Respiratory Diseases; the classification of deaths from Alcoholism associated with Cirrhosis of Liver, and also of Venereal Diseases. In regard to the two latter causes of death it is exceedingly doubtful whether the mortality records ever correctly show the true extent to which these contribute to mortality, and until the law relating to the registration of deaths is so amended that the death certificate is forwarded to the registrar direct, instead of passing as at present through the hands of relatives, sentiment will continue to prevail and deaths from Venereal Diseases will continue to be recorded as from Blood Poisoning, &c., and deaths from Alcoholism will be recorded as from the diseases associating it, without reference to the primary cause. Table VIII. Battersea. Causes of, and Ages at, Death during the Year 1900. CAUSES OF DEATH. Deaths in Whole District at Subjoined Ages. Deaths in Localities at all Ages. Deaths in Public Institutions. Non-Residents. All Ages Under 1 year. 5 and under 15 years. 15 and under 25 years. 25 and under 65 years. 65 years and upwards. East Battersea. west Battersea. Wandsworth and Clapham Union Infirmary. Bolingbroke Hospital. 1 and under 5 years. Small-pox ... ... ... ... ... ... Measles 81 23 53 3 2 ... 26 49 6 6 3 Whooping Cough 2 ... 1 1 ... 1 1 ... ... ... ... Whooping Cough 108 54 51 3 ... ... 49 58 1 1 1 Diphtheria and Membranous Croup 14 2 7 4 1 9 5 ... 1 ... Croup 4 1 3 ... ... 2 2 ... Fever Typhus ... ... ... ... ... Enteric 17 ... ... 2 4 3 8 ... 7 10 ... ... Other Continued ... ... ... ... ... ... ... ... ... Epidemic Influenza 54 ... ... 2 3 34 15 18 34 ... 2 2 1 Cholera ... ... ... ... Plague ... ... ... ... ... Diarrhœa 149 126 18 1 3 69 77 2 1 4 ... Enteritis 82 60 10 1 1 9 1 26 40 16 16 9 Puerperal Fever 4 1 1 ... 2 1 1 1 1 ... Erysipelas 12 3 ... ... 6 3 2 3 7 1 Other Septic Diseases 1 1 ... ... 1 ... ... Phthisis 299 12 12 14 36 212 13 90 114 95 95 44 Other Tubercular Diseases 101 27 9 10 2 5 ... 26 24 3 ... Cancer, Malignant Disease 101 1 ... 72 28 27 43 28 3 31 16 Bronchitis 307 84 23 2 ... 110 88 118 143 46 ... 46 23 Pneumonia 279 59 70 10 11 109 20 122 127 30 30 16 Pleurisy 15 2 2 1 2 8 8 6 1 1 1 Other Diseases of Respiratory Organs 7 3 1 ... 2 1 3 4 ... ... ... ... ... Alcoholism Cirrhosis of Liver 10 ... ... 8 2 6 3 1 1 1 ... Venereal Disease 17 11 3 2 1 3 4 10 10 9 Premature Birth, &c 254 251 2 1 ... ... ... 11 4 132 8 ... 8 4 Diseases and Accidents of Parturition 16 3 13 ... 7 6 3 2 ... ... 3 ... Heart Diseases 250 2 3 13 11 140 81 26 91 100 1 101 41 Accidents 81 21 10 10 7 20 13 26 27 12 16 28 22 Suicides 14 ... ... 1 12 1 5 6 1 2 3 2 All other Causes 720 84 33 24 21 218 340 224 294 194 8 202 89 Totals 2951 826 313 103 106 995 608 1049 1304 567 31 598 293 ... ... ... ... ... ... ... ... 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... During the year, three hundred and thirty-nine cases of violent or other forms of sudden death were brought before the notice of the Coroner, and in two hundred and seventy-eight cases inquests were held. The verdicts of the respective juries were to the effect that one hundred and fifty-three of the deaths were due to natural causes and one hundred and twenty-five to violence. The latter included several deaths in which there was insufficient evidence to show whether the fatal injuries were self-inflicted or otherwise, and they are therefore recorded as " found dead." A brief summary is here given of the inquests held during the year : — Natural Causes 153 Violence:— Found Dead— Found drowned, &c. 26 Accidental— Suffocation in bed with parents 15 Falls, &c. 20 Run over in streets and on railway 13 Burns and Scalds 17 Drowning 4 Shot 1 Poisoning 1 Asphyxia 4 Want of attention at birth 2 Other injuries, &c. 4 81 Suicide— Poisoning 3 Cut throat 3 Hanging 3 Shot 3 Drowning 1 Fall 1 Run over on railway 1 14 Carried forward 153 Brought forward 153 Homicide — Run over 1 Suffocation 1 Want of food 1 Injuries 1 4 125 Total 278 Deaths from suffocation in bed with parents showed a slight decrease during the year, fifteen deaths being recorded from this cause compared with seventeen in 1899, eighteen in 1898, twenty-one in 1897, and twenty in 1896. Notwithstanding the reduction it remains a very serious matter that in five years ninety-one infants should die from suffocation due to the carelessness of parents. Drunkenness of parents no doubt, in many cases, is the contributing factor, and it is therefore of interest to compare the days upon which the deaths occurred and which are here set out. It must be remembered that the day refers to the morning on which the death of the children was discovered:— Sunday 1 Monday 1 Tuesday 1 Wednesday 1 Thursday 4 Friday 2 Saturday 2 Total 15 It will be seen that Sunday and Thursday show the largest number, and whether there is any connection in the circumstance that those mornings follow the night of "Early Closing" on Wednesday and the general half-holiday on Saturday is open to suspicion. Ages at Death Of the two thousand nine hundred and fifty-one deaths recorded during the year, eight hundred and twenty-six were of children under one year of age, three hundred and thirteen between one and five years, one hundred and three between five and fifteen years, one hundred and six between fifteen and twenty-five, nine hundred and ninety-five between twenty-five and sixty-five, and six hundred and eight were sixty-five years of age and upwards. Infantile Mortality. Premature birth, low vitality, and congenital defects of necessity contribute more or less to infantile mortality, and of the eight hundred and twenty-six deaths recorded among children under one year of age, two hundred and fifty-one were actually due to these causes. The diseases which principally contributed to the remainder of the infantile mortality were Diarrhoea, from which one hundred and twenty-six deaths occurred ; Bronchitis, eighty-four ; Pneumonia, fifty-nine ; Whooping Cough, fifty-four ; Tubercular Disease, thirty-nine; and Measles, twenty-three. The mortality at this period of life was equal to one hundred and sixty per thousand of the birth registered during the year. This shows a slight reduction upon the previous year and is exactly equal to the average of the last ten years. TABLE IX. Infantile Mortality. Year. Number of Deaths of Infants under 1 year of age. Rate per 1,000 Births Registered. 1890 855 167 1891 736 140 1892 791 158 1893 842 161 1894 718 142 1895 907 172 1896 937 174 1897 845 160 1898 840 162 1899 838 161 1900 826 160 Preceding Decennial Averages 831 160 At five years and under, one thousand one hundred and thirty-nine deaths were recorded; by a most remarkable coincidence this number exactly corresponds with that of the previous year and is, therefore, again well below the annual average. The following table compares the mortality at this age period during the past six years : — TABLE X. Year. No. of Deaths of Infants under 5 years of age. 1895 1,33 2 1896 1,432 1897 1,202 1898 1,222 1899 1,139 1900 1,139 Of the deaths recorded in Battersea at the other extreme of life, six hundred and eight were sixty-five years of age and upwards ; of these ninety-four were " non-residents," and by deducting this number and adding those of fifty " residents" occurring outside Battersea, a corrected total of five hundred and sixty-four is produced compared with five hundred and six during the previous year. The deaths at high ages continue to increase annually and indicate a great improvement in longevity. The annual average for the preceding five years was four hundred and thirty-four; two hundred and sixty-three of these deaths were recorded as from " old age." Causes of Non-Zymotic Mortality. Of the two thousand nine hundred and fifty-one deaths registered in Battersea, two thousand five hundred and nine were from diseases other than those included in the zymotic class. Diseases of the Respiratory System contributed the largest number to the mortality, namely, six hundred and eight, a very large proportion occurring during the first few weeks of the year and were doubtless associated with the outbreak of Influenza then prevailing. Phthisis and other Tubercular Diseases occupy the next place numerically, three hundred and fifty-two deaths being recorded. From Diseases of the Brain and Nerves, two hundred and seventy-three deaths took place ; from Premature Birth, low vitality, and other congenital defects, two hundred and fifty-four; Disease of the Heart, two hundred and fifty; of the Digestive Organs, one hundred and eighty-four; from Violence, one hundred and twenty-five; Age, two hundred and sixty-three; Diseases of the Urinary Organs, forty-two ; of the Organs of Generation, sixteen; Locomotory Diseases, two ; and all other Non-Zymotic Diseases, one hundred and forty. The following table compares the Non-Zymotic Mortality in Battersea during the past eleven years:— TABLE XI. Comparative Table of non-zymotic causes of Deaths recorded in Battersea during the past 11 years. 1891 1892 1893 1894 1896 1897 1900 1890 1895 1898 1899 Tubercular, including Phthisis 320 237 355 304 353 355 285 376 368 352 374 Of Brain, Nerves, &c. 261 195 259 213 211 334 211 2 4 1 181 241 273 Of the Heart, &c. 148 141 183 159 173 213 182 189 164 252 250 Of the Respiratory Organs, excluding Phthisis 618 572 635 653 47 1 623 531 439 608 540 383 Of Digestive Organs 118 122 112 127 197 114 154 202 168 194 184 Of Urinary Organs 34 49 72 60 57 56 88 69 75 70 42 Of Organs of Generation 15 16 15 14 12 7 22 14 16 16 12 Of Joints, Bones, &c. 4 7 2 3 6 - 5 6 2 6 2 Premature Birth Vitality, Malformation, &c. 206 238 256 295 273 332 298 286 288 297 254 Other Constitutional Diseases (including Cancer, Syphilis, &c.) and all other Diseases 70 91 148 160 140 245 153 150 146 134 153 263 A g e 71 74 122 103 118 128 207 150 317 259 125 Violence 77 60 81 102 70 102 117 118 122 96 Total 1850 2237 2026 2410 2339 2229 2245 2481 2509 1942 2219 The foregoing table shows very little variation in the proportionate distribution of the deaths from several causes except in the case of violence, which contributes the largest number recorded during the decennium. The larger number of deaths from Respiratory Diseases has already been referred to. It is, therefore, not necessary to enter into any minute discussion of the various diseases except with regard to those of the tubercular class, this being a subject occupying the particular attention of all sanitarians. Phthisis, or Consumption, and other Tubercular Diseases. In my report for the year 1899 (pages 62 to 78), I dealt very fully with this subject, giving the probable causes of the disease, its mode of treatment, and the means to be adopted for its elimination. The report also contained a summary of the recommendations of the Royal Commission appointed in 1896 to enquire as to what administrative procedures were available and would be desirable for controlling the danger to man through the use, as food, of the meat and milk of tuberculous animals; and what were the considerations which should govern the action of responsible authorities in condemning for the purpose of food supplies, animals, carcases, or meat exhibiting any stage of tuberculosis. The advantages and difficulties of compulsory notification were also discussed, and particulars given as to the experience of local authorities who had taken action in this matter. These included New York, where compulsory notification had been made law on condition that an inspector does not visit the house where the case is reported by a private medical practitioner, unless requested to do so by the practitioner ; Manchester, where pending the approval of the Local Government Board to Phthisis being included amongst the diseases notifiable under the Local Act, a voluntary system of notification was in force, medical practitioners receiving the same fees as for other cases ; Brighton, where a similar system of voluntary notification was in force; and Blackburn, where an unsuccessful application had been made to the Local Government Board for their consent to an order relative to the compulsory notification of Phthisis. It would doubtless be desirable to give a condensed summary of the action which has already been taken at Battersea in the matter. Early in the year 1899 a circular containing precautions against Consumption was delivered to every house in the district, endorsed by an urgent request that it might not be destroyed, but placed in such a position as to be readily referred to. The question of compulsory notification was in the meanwhile considered, and on the 25th January, 1899, the following recommendation was adopted by the Vestry: " That the necessary steps be taken with a view to ordering that Section 55 of the Public Health (London) Act, 1891, shall apply in this Parish to cases of Phthisis." On the 22nd February the subject was again brought forward for formal approval, but was held over until the 8th March, when the matter was again adjourned for a period of six months, being a subject for consideration at the meeting on the 13th September, when it was resolved that the matter be referred back to the Health Commitee for further consideration and report. Subsequently I submitted an exhaustive report on the subject of the probable causes of Tuberculosis, the advantages and difficulties of notification, and the action taken by some other authorities in regard to notification. Upon re-considering the subject, the Health Committee submitted the following report, which was adopted by the Vestry on the 8th November, 1899: " Your Committee are unable to recommend that any further steps be taken at present in the direction of compulsory notification, but they recommend that the handbill advising the public as to precautions to be taken to prevent the spread of the disease be re-issued throughout the Parish, that the Registrars of Deaths be requested to immediately notify all fatal cases of Phthisis to the Medical Officer of Health with a view to disinfection of the premises, and that the medical officers of local public institutions be asked to notify all cases admitted into such institutions." This system has now been in force for over a year, and has been found very effective, resulting in disinfection being carried out in a very large number of cases, inasmuch as of 201 deaths from Tubercular Diseases in private houses disinfection was allowed in 142 instances, representing over 71 per cent. In most of the cases disinfection not only included the fumigation of the premises, but also the steaming of the bedding or other similar articles. In another case disinfection was carried out upon a patient changing his residence. The mortality recorded in Battersea during the year from diseases of the Tubercular Class numbered three hundred and fifty-two; of these two hundred and ninety-nine were due to Phthisis or Consumption, and fifty-three to Tubercular Diseases of Bowels, Brain, &c. Of the number in question, however, forty-six were " non-residents," and this number must therefore be deducted, and the deaths of "residents" occurring outside the district, forty-three in number, included, representing a corrected total of three hundred and forty-nine. These figures compare very favourably with those of 1899 and preceding years, the corrected total for the year 1899 being three hundred and seventy-one. Statistics shew an enormous reduction compared with halfa-century ago. For instance, the Tubercular Mortality for England and Wales during the five years 1851-60 is shewn as being equal to 2679 per million per annum, whereas in the five years 1890-95 this has been reduced to 1463. Although the mortality from the disease has unquestionably been reduced there is some doubt but that the statistical effect is partly produced by improved diagnosis, cases of Pneumonia, &c. being formerly frequently certified as " Galloping Consumption," and thus classified with the tubercular deaths. Zymotic Sickness and Mortality. Zymotic Sickness and Mortality being more or less controllable by the observance of hygienic laws, this subject most readily appeals to those having the administration of sanitary districts. Compulsory notification is the only effective method of dealing with this class of disease, affording, as it does, the means of tracing the cause and ascertaining those areas which are principally affected, and also of enforcing isolation and disinfection. The subject of sickness and mortality from these diseases is therefore dealt with under the two distinct headings of " nonnotifiable infectious sickness and mortality " and " notifiable infectious sickness and mortality." The following table compares the mortality from these diseases during the past ten years, the death-rate being equal to 2.4 per 1000 of the population. TABLE XII. Comparative Table of Zymotic Mortality in Battersea during the past ten years. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 Small Pox ... ... ... ... ... ... ... ... ... ... Measles 37 90 90 1 5 1 99 185 7 6 119 103 81 Scarlet Fever 10 1 5 17 5 10 5 7 6 ... 2 Diphtheria 35 28 90 67 60 50 52 45 21 14 8 Enteric, &c., Fevers 19 14 13 15 11 8 8 10 17 Whooping Cough 104 100 115 77 52 137 82 71 52 108 Epidemic Diarrhœa 10 4 99 120 93 151 169 141 154 123 149 Other Zymotic Diseases 8 9 133 118 62 104 45 25 114 68 71 Total Deaths from Zymotic Diseases 398 468 491 602 517 442 564 473 391 377 Zymotic Death Rate 2·6 2·8 2·9 3·6 2·3 3·0 2·1 2·4 3·0 3·5 Death-rates from all Diseases 17·3 17·8 15·4 17·8 17·7 16·0 16.3 16·6 17·4 15·5 Further details of Zymotic Sickness and Mortality are dealt with under the headings of Non-Notifiable and Notifiable Infectious Diseases. Non-Notifiable Infectious Sickness and Mortality. The more important diseases under this heading are Measles, Whooping Cough, Diarrhoea, Influenza, and Chickenpox, the first four being the larger contributors to mortality. In the absence of such means as are afforded in the case of notifiable infectious diseases of recording the amount of sickness from these diseases, it is impossible to arrive at the relative proportion between the cases and the mortality therefrom. Valuable information is, however, afforded by the system adopted by the London School Board, whereby head-teachers bring to the notice of the Medical Officer of Health any cases of infectious disease occurring amongst the children where notice has not already been sent by the latter to the School Authorities, and as notices of all notifiable infectious cases arc sent to the schools, it follows that the sickness reported by the head-teachers relates to non-notifiable diseases. During the year, one thousand one hundred and fifty-one such notices were received, but there is reason to believe that this does not represent the total amount of sickness which occurred, many of the schools appearing to show greater or less activity in adopting the School Board's regulations in the matter. The notices received had reference to the following cases of sickness occurring either among the scholars or in houses occupied by such children :- Measles 446 Whooping Cough 256 Chicken-pox 198 Mumps 161 Other sickness, including Diarrhoea, &c. 90 Total 1,151 A summary of the notices received indicates that sickness was most prevalent during the third quarter of the year, which, in view of the summer holidays, really only represents about two months of school attendance. The disease which contributed most largely to that total was Measles. During the first quarter of the year only forty-nine notices were received, and it is in regard to this period of the year that I am inclined to assume that the system was not fully adopted; inasmuch as forty deaths actually occurred amongst children in Battersea during that period from Measles and Whooping Cough, the mortality from these two diseases together, considerably exceeding the number of notices received from the schools. For what such statistics are therefore worth, they are given here showing the number of cases of each class of sickness brought to notice during the four quarters of the year :— TABLE XIII. I Measles. Whooping Cough. Chickenpox Mumps. Other sickness, includiug Diarrhœa. Total. 1st Quarter 19 8 17 - 5 49 2nd 144 76 45 70 22 357 3rd 136 111 51 59 42 399 4th 147 61 85 32 21 346 Whole Year 446 256 161 90 1,151 198 Measles. During the year 1900, Measles again showed a reduced mortality compared with the two preceding years, the deaths registered in the district for the last three years being as follows:— 1898 119 1899 103 1900 81 The annual average for the last preceding ten years being 110. This reduction in the mortality is satisfactory in a measure, but, nevertheless, it cannot be regarded as other than a very grave matter that a disease of a preventibl character should be accountable for eighty-one deaths in a year. As, however, I have stated in previous reports it is not Measles per se that is so fatal but the complications resulting from want of care and attention in the convalescent stages of the disease. It is practically impossible in the absence of notification to ascertain the extent or locality of outbreaks nor to deal with the question of isolation. Judging, however, from the recorded mortality, Measles was most prevalent in the first quarter of the year when forty or nearly one-halt of the deaths occurred. Concerning notification, frequent efforts have been made by this, supported by other sanitary authorities, to render the same compulsory and in April last, with a view to further combined action, the views of the whole of the Local Authorities were sought and the replies are here summarised :— Summary of replies from Vestries and District Boards as to inclusion of Measles in the list of notifiable infectious diseases. Chelsea. —Vestry have suggested to the L.C.C. the desirability of Measles being declared a dangerous infectious disease. Fulham. —The Vestry some time since communicated with the L.C.C. on the matter, who, it is believed, have the question still under consideration. Lambeth. —Vestry of opinion that Measles should be placed within the category of " dangerous infectious diseases," but notification should not be made compulsory. St. Giles. —Board have been continually in correspondence with Local Government Board, and they think that if any further action is taken it should be by communicating with the L.C.C. rather than with the Board. St. Margaret and St. John, Westminster.—Vestry made considerable efforts some seven years ago in the direction suggested, but the result was not sufficiently encouraging to induce them to renew their active interest in the matter. Stoke Newington.-Concur. Bermondsey.—Of opinion that no practical public advantage would result from Measles being included as a dangerous infectious disease, while a large increase of hospital accommodation would be required. Camberwell.—Notification undesirable. Greenwich.—Ditto. Hampstead.—Not advisable at present time to classify Measles as a notifiable disease. Islington.—Cannot advise Vestry to approach the Local Government Board upon the subject. Lewisham.—Of opinion that Measles should not be included in list of notifiable diseases. Plumstead.—Not in favour. St. George, Hanover Square.—Cannot recommend that Measles be added to list of notifiable diseases. St. George the Martyr.—Vestry of opinion that no sanitary authority in London would be justified in embarking upon so great an expenditure as would be necessary for the compulsory notification of Measles. St. James, Westminster.—Do not concur. Wandsworth.—Of opinion that no advantage would arise from Measles being added to list. Whitechapel.—Not desirable. Hammersmith.—Under consideration. Clerkenwell, Hackney, Holborn, Kensington, Newington, Paddington, Poplar, Rotherhithe, St. George-in-the-East, St. Luke Middlesex, St. Marylebone, St. Saviour Southwark, St. Pancras and Shoreditch. —No action taken. Bethnal Green, Lee, Limehouse, Mile End, St. Martin in-the-Fields, Strand and Woolwich. —No reply received. In view of the lack of general support shown in the opinions expressed the subject was temporarily abandoned by this authority, but has subsequently been revived by the London County Council, who have recently asked for the views of this authority as to the desirability of extending to Measles, as apart from the provisions contained in Section 54 of the Public Health (London) Act, 1891, those contained in Sections 60, 61, 62, 63, 64, 65, 66, 68, 69, 70, 72, 73 and 74 of that Act, and in accordance with the instructions of the Health Committee, I submitted the following report which was directed to be forwarded to the London County Council:— Public Health Department, Municipal Buildings, Lavender Hill, S.W. 17th December, 1900. Gentlemen, In accordance with the instructions of the Health Committee at their last meeting I beg to report upon the letter from the London County Council asking for the views of this Sanitary Authority as to the desirability of extending to Measles the provisions contained in Sections 60, 61, 62, 63, 64, 65, 66, 68, 69, 70, 72, 73 and 74 of the Public Health (London) Act, 1891. The late Vestry on numerous occasions expressed their opinion as to the desirability of Measles being notifiable, and 1 now re-endorse that recommendation with a suggestion that the duty of notifying should be specially placed upon parents or guardians, as a very large number of cases of this disease are never seen by a medical practitioner. The question, however, which I am more especially directed to consider, is whether the system of notification shall be utilized purely for statistical purposes, or that the same provisions shall govern the notification of Measles in the matter of isolation, disinfection, &c., as already apply to the dangerous infectious diseases already included in Section 55 of the Public Health (London) Act, 1891. Measles occurs principally amongst children and contributes largely to the mortality returns. Measles however per se is not a dangerous infectious disease, the mortality too often resulting from want of proper care and nourishment during the convalescent stage of the disease, the real cause of death being Bronchitis or some similar disease as a sequel or complication of Measles. Notification therefore would doubtless reduce the mortality by reason of the means thereby afforded the officers of the authority of advising those in charge of the sick as to the necessary care to be taken. As to the application to Measles of the various sections referred to in the letter from the London County Council I am of opinion that although they could doubtless with advantage be enforced in many instances yet they would not be generally applicable, and should therefore be adoptive and enforced only at the discretion of the Medical Officer of Health. I therefore recommend that in the event of Measles being made a notifiable disease it should be subject to the following provision :— " That in the case of Measles, Section 60, 61, 62, 63, 64, 65, 66, 68, 69, 70, 72, 73 and 74 of the Public Health (London) Act, 1891, shall not apply except where in the opinion of the Medical Officer of Health the enforcement of the provisions of those sections would tend to prevent or check the spread of the disease, and that in such cases a notice be served requiring such precautions to be adopted as are contained in the foregoing sections." I am Gentlemen, Your Obedient Servant, W. H. Kempster, M.D., Medical Officer of Health. To the Health Committee, Battersea Borough Council. At present it is not officially known what action the London County Council propose to take in the matter. Whooping Cough. It has been shown that a considerable reduction in Measles mortality took place during the year, but this is not so satisfactory when the deaths recorded from Whooping Cough are taken into consideration with the fact that the two diseases are generally associated. During the year 1900 the mortality from Whooping-Cough, which in the preceding year was only fifty-two, increased more than two-fold, one hundred and eight deaths being recorded. The distribution of the deaths during the four quarters of the year was as follows : —During the first quarter, twenty-six; the second, thirty-one; the third, thirty-five; and the last quarter, sixteen. The following shows the mortality during the past six years and also the annual average during that period : — Deaths. 1895 52 1896 137 1897 82 1898 71 1899 52 1900 108 Annual average 83 The question as to the correct certification and classification of Diarrhoea deaths has of late occupied the attention of those responsible for statistics concerning sickness and mortality, and more particularly the Incorporated Society of Medical Officers of Health, and as a result of enquiries made by them from all available sources as to the classification generally adopted, it was found they were was so varied as to render the statistics of Diarrhoea deaths, and consequently of death-rates, in different localities misleading and altogether useless for comparison. As a result of their enquiries a memorandum on certification of " Diarrhoea" deaths has been issued by them to registered medical practitioners in England, Scotland, Ireland and Wales to the effect that in future the only authorised names to be used in certifying deaths from this disease are: epidemic enteritis, zymotic enteritis, or epidemic diarrhoea, and all other synonyms are to be entirely discarded. The new tables issued by the Local Government Board provide for the distinct separate classification of the Diarrhoea or zymotic enteritis deaths from those of the non-specific gastroenteritis, &c., deaths. Under the head of Diarrhoea and English Cholera one hundred and forty-nine deaths were recorded during the year, and although this is as nearly as possible equal to the average of the past six years, the mortality is higher than during 1899. The following shows the mortality recorded during each of the past six years:— Year. Deaths. 1895 1896 169 1897 141 1898 154 1899 123 1900 149 Annual average for the past six years 147 One hundred and thirty-two, or 88 per cent, of the deaths occurred during the third quarter of the year which embraces the months of July, August and September, being that portion of the year when, by reason of high temperature, milk and other food is subject to rapid decomposition. As usual a very large percentage of the deaths were those of children under five years of age, and this emphasises the necessity of those having care of young children ensuring cleanliness, particularly during the summer months, of all receptacles for food ; the boiling of milk and water ; and the withholding of any fruit or other article of food which is in the least degree decomposed; and the desirability of the constant flushing of house drains. So great an influence has a high temperature upon the germination of the Diarrhoea bacilli that it is found in practice that when the earth-temperature exceeds 56° Fahr. an outbreak of Diarrhoea maybe regarded as imminent. Influenza. This disease, which seems to have become quite endemic in this country, contributed fifty-four deaths to the total mortality. It is highly probable, however, that many more deaths were attributable to the disease and were recorded as from Bronchitis or Pneumonia, which are generally associated with or follow it. The disease is doubtless of a zymotic character and one in which strict isolation should be observed. The exact period of quarantine, however, has not yet been determined. In January the mortality was specially prevalent, and the usual handbill of precautions to be adopted against Influenza was re-issued, advising the public of the extremely infectious character of the disease, and pointing out that to those exposing themselves whilst in an infectious condition the spread and maintenance of the disease is chiefly due, the breath of those so affected being probably the principal medium of infection, and further that the early symptoms of Influenza are chiefly chills and shivering accompanied by great muscular weakness and Battersea Borough Council. Chart indicating the prevalence of notifiable infectious disease during each week of the year 1900. prostration, often amounting to inability to stand or move, with pains in the spine or other parts of the body ; and urging that persons thus affected should at once go to bed and there remain until convalescence is established, in order to avoid the danger of Pneumonia or Bronchitis, which are the chief complications to be feared as likely to lead to fatal results. The sick are also advised to resort early to medical aid in every case, for the determination of the real nature of the disease, and to avoid the more serious complications previously referred to. Infectious Disease Notification. Compulsory notification of certain infectious diseases has now been in force here for over eleven years, by the Infectious Disease (Notification) Act, 1889, and later by the Public Health (London) Act, 1891, which included the provisions contained in the former Act. The diseases at present notifiable are Smallpox, Scarlet Fever, Diphtheria and Membranous Croup, Cholera, Erysipelas and Typhus, Enteric, Continued, Relapsing and Puerperal Fevers, and by an order of the Local Government Board, dated 19th September, 1900, " Bubonic Plague " was also made notifiable. Hospital accommodation is provided by the Metropolitan Asylums Board for Smallpox, Scarlet Fever, Diphtheria and Membranous Croup, Enteric Fever, and the Plague; but for the other diseases the Union Infirmary is the only accommodation other than the General Hospitals. This arrangement necessitates application being made to the Relieving Officer for the removal of cases of Erysipelas and Puerperal Fever, and such an arrangement is very unsatisfactory, inasmuch as the person removed is in a very large measure pauperised. lam of opinion that either the Metropolitan Asylums Board should provide hospital accommodation for these cases, or that cases should be admitted to the Union Infirmary upon the order of the Medical Officer of Health of the Borough instead of upon the order of the Relieving Officer, and I would recommend that the Guardians be approached with a view to effecting the latter arrangement. During the year under report twelve hundred and thirtyone cases were notified, and included three hundred and six of Diphtheria and Membranous Croup, one hundred and sixty-five of Erysipelas, five hundred and forty-eight of Scarlet Fever, two hundred and five of Enteric, one of Continued Fever, and six of Puerperal Fever. The total notifications shew a most remarkable record, being the lowest recorded during any year since notification has been compulsory, as will be seen from the following figures relating to the last complete eleven years. The Infectious Disease (Notification) Act came into force very late in the year 1899, and therefore the figures for that year are of no value for comparative purposes, and are not included. Year. No. of Notifications received. 1890 1260 1891 1,383 1892 197 2 1893 2,798 1894 1,845 1895 1,657 1896 1,929 1897 2,569 1898 1,887 1899, 1,702 1900 1,231 Annual Average for preceding 10 years 1,900 The largest number of notifications received during any complete week of the year was thirty-seven, and this occurred on two occasions, namely, each in the second and third weeks of October. At the other extreme, twelve cases only occurred during the first week of September. Of the various diseases included in the notification statistics, Diphtheria shews the greatest reduction, representing three hundred, or nearly 50 per cent, less than the previous year. On the contrary, Enteric Fever shows an unsatisfactory increase. Each of these diseases, however, is dealt with more extensively in a later part of this report. Eight hundred and forty-nine of the cases were removed to hospital, representing 68·9 per cent, of the cases notified. This is a slightly lower proportion than that in the previous year, which was 70·5 per cent., but when compared with 22·8 per cent, in 1890 shews an exceedingly increased proportion of removals.The average annual percentage during the preceding ten years was 44 ·6. The following shews the percentage of notified cases removed to hospital during the eleven years, 1890-1900: — Percentage of Cases Year. removed to Hospital. 1890 22·8 1891 33·2 1892 43·3 1893 31·3 1894 43·0 1895 40·5 1896 46·8 1897 52·5 1898 62·9 1899 70·5 1900 68·9 Annual Average for preceding 10 years 44·6 Month Week of Year. Cases of Infectious Disease Notified. Small-Pox. Cholera. Diphtheria. Erysipelas. Scarlet Fever. Typhus Fever. Enteric Fever. Condoned and Relapsing. Puerperal Fever. Totals January 1 ... ... 5 2 3 ... 8 ... ... 18 9 4 ... ... 24 2 ... ... 7 4 ... ... ... 10 3 ... ... 3 1 3 4 14 ... 8 32 4 ... ... 5 10 ... 8 1 ... 4 ... 8 ... ... 30 5 ... ... 8 10 February ... 17 6 ... ... 3 1 7 ... 6 ... 31 7 ... ... 6 4 16 ... 5 ... ... 12 3 13 5 ... 33 8 ... ... ... ... ... ... 5 7 ... 6 ... 14 ... 16 ... 6 ... ... 21 March 9 8 2 1 2 1 5 10 14 6 ... 28 ... ... ... 11 6 11 ... ... 25 ... ... 5 ... 12 ... 9 ... 29 ... 5 29 ... ... ... 3 ... ... 13 9 9 ... 7 12 ... ... 22 April 14 ... ... 7 4 4 ... 3 ... 2 6 ... 24 15 ... ... 5 ... 16 ... 3 ... 17 ... ... 7 ... 17 6 1 ... ... 22 ... ... ... ... 4 ... 13 1 ... ... 18 May 18 ... ... 1 17 19 ... ... ... 3 13 ... ... ... 10 1 13 ... 4 ... 28 20 ... ... ... ... ... 20 21 ... 3 4 13 ... ... ... 15 4 ... ... 7 ... ... 2 2 ... 21 June 22 ... ... 2 7 12 ... 21 23 ... ... ... 1 8 ... ... 5 5 2 ... 15 24 ... ... ... 1 3 11 ... ... ... 20 25 ... ... 1 ... 3 2 14 ... 18 ... 26 ... ... ... ... 11 ... 1 ... 6 27 ... July 2 17 3 ... 6 3 3 ... 28 ... ... 21 ... 16 ... 2 ... 3 ... 14 29 ... ... 8 ... ... ... ... 3 3 30 ... ... ... 21 ... ... 7 3 ... 7 August 3 1 ... 4 15 ... ... 8 ... 1 2 16 32 ... ... ... ... 4 ... ... ... ... 1 5 3 4 23 33 ... 8 ... 7 6 ... 2 34 ... ... ... 12 3 3 4 ... ... 2 September 17 35 ... ... 8 ... 3 ... 6 ... 2 34 36 17 ... 4 ... 8 3 ... 32 37 ... ... ... ... 3 ... ... 7 7 15 33 38 ... ... 6 ... 1 18 ... ... 5 3 39 ... ... 13 ... 4 ... 2 9 4 ... 8 40 ... 37 ... 6 ... ... ... 5 6 20 37 ... ... Cases of Infectious Disease Notified during the Year 1900. Notifiable Disease. Cases Notified in Whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Ages—Years. East Battersea. We st Battersea. W and C. Union Infirmary. Emanuel School. West Battersea. W. and C. Union Infirmary. Emanuel School. Total. East Battersea. Under 1. 5 to 15. 15 to 25 25 to 65 65 and upward. 1 to 5. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 298 104 132 ... 4 30 28 111 108 ... 2 221 144 152 ... 2 Membranous Croup Erysipelas 6 8 2 ... ... 7 1 ... 1 ... ... 1 ... ... ... ... 165 5 2 11 110 16 ... 14 5 41 21 65 95 5 22 ... 5 548 149 314 Scarlet Fever 61 19 ... ... 220 ... 439 272 2 7 6 ... 219 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 76 Enteric Fever 205 13 67 1 108 47 91 ... ... 87 57 ... 144 ... ... Relapsing Fever 1000 ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... Puerperal Fever 6 ... ... ... 2 ... ... ... 6 4 3 ... 3 ... ... Plague ... ... ... ... ... ... ... ... ... ... ... _ 159 230 17 598 5 2 1,231 15 535 432 Totals 275 626 410 5 2 849 The cases removed to hospital included four hundred and thirty-nine of Scarlet Fever, two hundred and twenty-two of Diphtheria and Membranous Croup, one hundred and fortyfive of Enteric, three of Puerperal Fever, and forty-one of Erysipelas. The total mortality from notifiable diseases was ninetyseven, fifty-one occurring in hospital, and forty-six at the homes of the deceased. The average for the preceding three years was one hundred and seventy-one per annum. The excellent record for the year will be seen upon reference to Table XVII. Of the ninety-seven deaths, thirty-two were from Diphtheria, thirty-two from Enteric Fever, seventeen from Enteric Fever, thirteen from Scarlet Fever, and three from Puerperal Fever. As further evidence of the enormous reduction in the mortality it will be observed that the deaths from all notifiable diseases were only equal in number to the average annual mortality during the preceding three years from one disease, namely, Diphtheria. Various tables are inserted in this report to assist in indicating the prevalence of infectious disease during the various periods of the year, and this applies more particularly to Table XIV., which shews the number of notifications of each disease received during the fifty-two weeks of the year, and the same information is more graphically recorded in the chart facing page 43. It will there be seen that notifiable infectious disease was at its lowest in the first week of September, and at its highest in the second and third weeks of October. The month of November was marked by a continuous succession of rises and falls, and the months of April, May, June, July and August shewed the greatest general freedom. The largest number of cases occurred in the month of November, and the greatest freedom prevailed in .that of July. As indicating the incidence of infectious disease in the various sub-districts, Tables XVIII. and XV. are of great value. Table XVIII. distributes the cases amongst the various Sanitary Districts, and it is perhaps in this form that they are of the greatest value, and will be much more so if, as it is to be hoped, the arrangements of the census of 1901 will allow of reliable populations being attributed to each of these districts. Table XV., which replaces Table B. of former reports and which is inserted at the request of the Local Government Board, deals with notifications in areas of known populations, and this is therefore at present necessarily confined to the Registrar's Districts and Public Institutions. The following figures very briefly summarise the statistics referred to:— Distribution of Notifications amongst the Areas and Institutions of known Population. East Battersea 598 West Battersea (excluding Public Institutions) 626 Wandsworth and Clapham Union Infirmary 5 Bolingbroke Hospital — Royal Masonic School — Emanuel School 2 Total 1,231 The following places the Sanitary Districts in the order of incidence of infectious disease. District. Cases No. 8 83 „ 7 117 „ 6 135 „ 5 138 „ 4 140 „ 3 179 „ 2 218 „ 1 221 Total 1,231 A very remarkable feature will be observed in the above, namely, the relative position of the several Sanitary Districts in regard to prevalence of infectious disease exactly coincides with the numerical order of the Districts in question. I propose to deal now with each of the notifiable diseases. small Pox. Battersea has again to be congratulated upon absolute freedom from Small Pox, during a period which now considerably exceeds two years, the last case having been notified in the year 1898. One " reported" case, however, came to notice during the year. On 30th January a communication was received to the effect that a child at Russell Street was " covered with a rash resembling small pox." Enquiries were forthwith made TABLE XVI. Prevalence Of Notifiable Infectious Disease and Mortality therefrom No. of Cases notified No. of cases removed to hospital Deaths other than in hospital Deaths in hospital Total mortality ... ... ... ... Small Pox ... 2 Scarlet Fever 548 439 11 13 Diphtheria 10 298 221 19 29 Membranous Croup 8 1 3 ... 3 Typhus Fever ... ... ... ... ... Enteric Fever 17 205 144 15 32 ... Relapsing Fever ... ... ... 1 Puerperal Fever 3 ... 6 3 3 ... Cholera ... ... ... ... 4 1 11 Erysipelas 165 6 17 TOTALS. 1,231 97 849 4 6 51 TABLE XVII. Comparison of Notifiable Infectious Disease Mortality WITH THAT of Previous Years. Small Pox. Scarlet Fever. Diphtheria and Membranous Croup. Typhus Fever. Enteric Fever. Relapsing Fever, &c. Puerperal Fever. Cholera. Erysipelas. Total. 1897 ... 47 108 ... 18 ... 3 ... 11 187 15 ... 18 1898 ... 6 28 187 120 ... ... 7 17 ... 39 ... 1899 14 62 ... 140 ... 32 3 1900 ... 17 13 32 97 ... ... ... Average for preceding 3 years. ... 97 ... 2 4 ... 5 ... 15 171 30 — Cases Notified. Cases Removed to Hospital. Small Pox Diphtheria and Membranous Croup Relapsing Fever Puerperal Fever Erysipelas Small Pox Scarlatina Diphtheria and Membranous Croup Typhus Fever Enteric Fever Continued Fever Relapsing Fever Puerperal Fever Cholera Erysipelas Totals Enteric Fever Continued Fever Typhus Fever Sanitary Districts. Scarlatina Cholera Totals 88 64 ... 50 ... ... ... ... 19 221 ... 70 5 1 ... 40 ... ... ... ... 3 164 No. 1 ... 100 55 ... ... 83 2 ... 32 ... 1 ... 30 218 ... 44 ... 25 ... ... ... ... 10 162 32 ... ... „ 3 ... 8 4 35 ... 2 ... 26 179 ... 62 23 25 ... ... 10 ... ... 1 121 4 ... 17 ... 56 69 23 22 1 ... 1 140 ... 15 12 ... 1 7 ... 29 ... ... ... 91 66 „ 5 ... 35 ... ... ... ... 15 138 ... 61 22 ... ... ... 18 ... ... ... 1 102 6 ... 39 37 ... 30 ... ... ... ... 29 135 ... 37 30 ... 21 ... ... ... ... 9 97 7 ... 66 29 ... 9 ... ... ... ... 11 117 ... ... ... 2 47 14 ... 2 ... 1 ... 64 36 37 ... ... ... 83 ... ... ... 4 ... ... 6 23 23 ... 1 ... ... 1 48 „ 8 548 ... 205 1 ... 6 ... 165 1231 ... 439 222 ... 144 ... ... 3 ... 4 1 849 ... Battersea 306 and there being no doctor in attendance the child was examined by the Medical Officer of Health, and the case found to be one of chicken pox only. Many notices have been received during the year from Port Sanitary Authorities to the effect that troopers and other passengers had proceeded to this district after having been exposed to infection during the voyage from South Africa and elsewhere. In all such cases the persons were kept under close observation during the period of quarantine. As a further precautionary measure, all cases of chickenpox brought to notice by school teachers and others were visited, and if it were found that no doctor was in attendance such cases were examined by the Medical Officer of Health, it being found that outbreaks of small pox are frequently preceded by chicken pox, and in view of the possibility of a case of the former disease, in the absence of medical advice, being mistaken as the less dangerous disease. The following is a history of the prevalence of small pox in Battersea since compulsory notification has been adopted:— 1890 1 1891 0 1892 2 1893 108 1894 8 1895 20 1896 4 1897 1 1898 1 1899 8 1900 0 The last fatal case was that of an unvaccinated person occurring in October, 1895. During the year, five hundred and forty-eight cases were notified, shewing a great reduction upon previous years, the annual average being nine hundred and seventy-five. The following shews the number notified during each year from 1890 to 1900 : — 1890 505 1891 738 1892 1,171 1893 1,407 1894 837 1895 830 1896 1111 1897 1,621 1898 809 1899 721 1900 548 Annual average for preceding io years 975 The cases were fairly equally distributed throughout the year, being rather more prevalent in the month of October, when sixty-five cases were notified, the monthly average for the year being 42.1 cases. Age Distribution.—As usual, most of the cases occurred between the ages of five and fifteen years; five were under one year of age, one hundred and forty-nine between one and five years, three hundred and fourteen between five and fifteen years, sixty-one between fifteen and twenty-five, and nineteen were twenty-five years and upwards. Local Distribution. —The distribution of the cases in the East and West Divisions was most remarkably equal, two hundred and seventy-two occurring in the former, and two hundred and seventy-six in the latter. The sanitary districts at first sight do not appear to shew such equality in that respect, but it must be remembered that their sizes and populations greatly vary. The following table compares the incidence of Scarlet Fever in the eight Sanitary Districts during the past three years. It will be observed that District No. 6 shews the greatest improvement. TABLE XIX. Sanitary District. Number of Cases of Scarlet Fever Notified. 1898. 1899 1900 No. 1 69 88 71 123 100 „ 2 146 132 84 4 6 „ 3 130 69 8 9 „ 4 74 66 „ 5 123 „ 6 175 39 113 55 83 66 „ 7 5 1 36 „ 8 50 809 721 548 Totals Hospital Treatment. Four hundred and thirty-nine of the cases were removed to hospital, representing 80.1 per cent, of the cases notified, compared with 78-9 per cent, during the preceding year; as in former years, cases have occurred in houses where patients have returned from hospital, notwithstanding that thorough disinfection has been carried out, and to the further fact that between the date of disinfection and the date of the return of the patient, a period of many weeks, and in some cases of months, no further cases have occurred, yet within a few days of such return, other members of the family have contracted the disease. These circumstances forcibly suggest that in such cases the patients have been discharged from hospital whilst still in an infectious condition. The Metropolitan Asylums Board, in November, 1898, appointed a special Medical Officer to investigate all such cases occurring in the Metropolis for a period of six months, but his report has not been published. The following are cases which occurred during the year under report:— Case I. F. L., removed to hospital from Earlsfield, in 1899, discharged 10th January, 1900, and went to 86 Eland Road, Battersea. On the 22nd January, E. L., of that address, developed the disease. Case 2. R. P., removed to hospital from — Elsley Road, on the 15th November, 1899; returned 24th February, 1900. On the Ist March, A. P. developed the disease (R. P., after return, was reported to have had discharges from ears). Case 3. W. S., of — Tyneham Road, was removed to hospital on the 13th January, 1900, suffering of Diphtheria and returned 4th March. On the 9th March, the same patient developed Scarlet Fever, and was sent back to hospital. Case 4. A. S., of — Lockington Road, was removed to hospital on the 3rd February, and returned on the 14th April. On the 25th April, L. S., and on the 2nd May, W. S., were attacked; on the latter date also M. 8., living next door, and who had been playing with A. S., was attacked. Upon examination by the Medical Officer of Health, A. S. was found to be still in an infectious condition, with discharges from ear, and was sent back to hospital on the 30th April. Case 5. P. D., of — Motley Street, was removed to hospital on 23rd February, and returned on or about 23rd April. On the 4th May, E. S. was attacked. Case 6. E. M. and A. M., of — Salcott Road, were removed to hospital with Diphtheria on the 5th March, and whilst there were reported to have developed Scarlet Fever. They returned on the 9th May, and went to — Comyn Road, the family having changed their address. On the 24th May. E. I!., of Comyn Road, developed Scarlet Fever. Case 7. G. 8., of — Battersea Park Road, was removed to hospital on 29th January, and returned on or about 29th June. On the 5th July, S. B. was attacked. Case 8. R. W., of — Battersea Park Road, was removed to hospital on 2nd July, and returned on the 18th August. On the 30th August, S. W. was attacked. It is stated that the child had a rash on its chest when it returned, and that the scales from desquamation could be shaken from the clothes. Case 9. H. C., of — Sabine Road, was removed to hospital on 25th June, and returned on 22nd September. On the Ist October J. C. was attacked. Case 10. F. B. was removed to hospital from — Francis Street, Chelsea, on the 16th August, 1900, and was discharged on 28th September, and went to — Knowsley Road, where the parents then resided. On the 4th October, F. B. is stated to have been still desquamating. On the 3rd October,P.B., of the latter address, was attacked. Case 11. E.B., of — Sterndale Road, was removed to hospital on 18th July, and returned on or about Ist October. On the 6th October, F. E. was attacked. Case 12. J. J., of — Linford Street, was removed to hospital on 12th September, and returned on or about the 23rd October. On the 29th October, E. J., and the 6th November, G. T. were attacked. Case 13. F. Y., of — Elsley Road, was removed to hospital on the 25th September, and returned on the 4th December. On the 19th December, C. Y., who had slept with the above, was attacked. Case 14. C. G., of — Wickersley Road, was removed to hospital on the 9th October, and returned on the 12th December, and is reported to have then suffered from discharges from the ear. On the 23rd December, E. G., who had slept with the above case, was attacked. All the above cases are those in which Scarlet Fever has recurred in houses after patients have returned home, and the following cases therefore slightly differ, inasmuch as Diphtheria was developed in patients who only a few days previously were discharged from hospital after treatment for Scarlet Fever. Case 15. W. S., of — Tyneham Road, was removed to hospital on the 13th January, suffering from Scarlet Fever, and was discharged on the 4th March. On the 9th March, W. S. was sent back to hospital, suffering from Diphtheria. 9th November. On the 14th November, G. W. E. was returned to hospital, suffering from Diphtheria. These cases were from time to time brought to the notice of the Metropolitan Asylums Board, and the following are extracts from some of the reports of the Medical Superintendents of the hospitals upon the complaints forwarded. Grove Hospital. Case 9. " Desquamation was completed when H. C. was discharged, and the patient was free from all mucous discharges, and appeared quite well." Northern Hospital. Case 10. " When examined on September 26th, her mouth, nose, and ears were healthy; and on inspection immediately before she left the hospital, on September 28th, no morbid condition about her was discovered. I should be interested to learn whether anything suggestive of possible infectiousness was observed after she returned home." (In reply, attention was directed to the desquamation observed on the 4th October.) Gore Farm Hospital. Case 11. "On E. E.'s discharge, he showed no signs of being infectious. It is possible that the Scarlet Fever contracted by his brother may be due to some other cause than the discharge of E. E." Grove Hospital. Case 12. "The patient, J. J., was detained forty-three days in hospital, and was free from desquamation and all mucous discharges before he left the hospital." " The usual precautions were taken in discharging him." Gore Farm Hospital. Case 13. "F. Y. was as far as I could judge, free from infection on her discharge, nor do I see from the facts referred to any reason to suppose that the return case was directly connected with the child in question." Grove Hospital. Case 14. " She had a discharge from both ears while in hospital, which commenced from the right ear on the 13th, and from the left ear on the 14th October." " It had ceased before she was discharged, and must have recurred again. She was discharged in the ordinary way, and the usual precautions were observed." The reports of the Medical Superintendents are of value, as shewing the precautions adopted to prevent the recurrence of cases, but are not, in my opinion, sufficiently strong as a whole to remove the grave suspicion that further cases are contracted from insufficiently recovered, discharged cases. Personal Infection. Several groups and individual cases have been very clearly traceable to personal infection. On 5th April, a case of Scarlet Fever was notified from — orville Road, and although at once removed to hospital, four other members of the family were attacked, the first case not having been recognised until it was in the highly infective stage. On the 10th October, a case was notified from — Morrison Street. The patient was then in a state of desquamation, having been treated for some other ailment, and had attended business whilst in that state, whereby another engaged in the same office contracted the disease. On the ioth November, a case occurred at — Jedburgh Street, and upon investigation, it was found that the patient had been playing with a child suffering from the disease in an adjoining road. On the 23rd November, a case was notified from — Montholme Road, and it was found that the child was then desquamating, and had been attending Honeywell Road School whilst in that condition. The school was immediately disinfected by this Department, and doubtless owing to this prompt action only one further case occurred. Mortality. Deaths from Scarlet Fever during the year numbered thirteen. Eleven of these occurred at hospital, and two amongst the cases treated at home; the fatality rates being 2-5 and 1·8 per cent, respectively, or altogether, equal to 2-3 per cent, of the cases notified. The Scarlet Fever mortality rate was equal to o·o7 per 1,000 of the population, comparing most favourably with 0·13 per 1,000, being the rate for the thirty-three great towns during 1900. Diphtheria and Membranous Croup. It is difficult to refer in sufficient terms to the almost wonderful reduction which has been effected in the sickness and mortality from these diseases during the present year, the number of cases notified being only three hundred and six. Two hundred and ninety-eight were notified as Diphtheria, and eight as Membranous Croup, but these diseases are practically synonymous. In the year 1891 alone has there been such freedom from the disease. The annual average for the ten years preceding 1900 was 500. The following shews the number of cases notified during each of the years 1890-1900. 1890 349 1891 260 1892 366 1893 682 1894 504 1895 411 1896 426 1897 614 1898 791 1899 606 1900 306 Annual average 10 years 1890-9 500 Periodical Distribution. — The distribution of the disease during the year was remarkably equal, the monthly average being 23-5 cases. The extreme variations from the monthly average were the first four weeks of June, when only ten cases were notified, and the month ending the 10th March when 40 cases were notified. The weekly extremes were those ending May 12th and March 20th. In the former week no cases were notified, and in the latter fourteen. Age Distribution.—Children between the ages of five and fifteen years contributed the largest number to those attacked with Diphtheria. The following are the numbers for the various age periods: Under one year of age, four; from one to five, one hundred and ten ; from five to fifteen, one hundred and thirty-four; from fifteen to twenty-five, thirty; and from twenty-five to sixty-five years, twenty-eight. Local Distribution.—As in the case of Scarlet Fever, the cases of Diphtheria are almost exactly equally distributed between the two divisions of Battersea. In East Battersea one hundred and fifty-one cases occurred, and in West Battersea one hundred and fifty-three. The following table shews the distribution of the cases in the eight sanitary districts and comparison with the two previous years. TABLE XX. Sanitary District. No. of Cases of Diphtheria. 1898. 1899. 1900. No. 1 131 119 64 2 34 „ 2 55 132 „ 3 141 61 32 „ 4 55 17 67 55 62 „ 5 35 82 92 37 „ 6 34 29 „ 7 42 37 „ 8 5 1 39 791 306 606 Totals Each district shews a reduction upon the previous year, the largest being in the case of No. 2 District. It will be remembered that since 1898 extensive improvements have been carried out in that part of Battersea on the re-construction of sewers and street gullies and the provision of more efficient means of sewer ventilation and flushing. These were effected as the result of the recommendations of a Special Sub- Committee appointed to investigate the undue prevalence of Diphtheria in that locality, and it is most reasonable to assume that this improvement in the public health has thereby resulted. The following figures will show the marked reduction in the prevalence of Diphtheria in that district during the past three years. Cases of Diphtheria Notified Year. in No. 2 District. 1898 234 1899 132 1900 55 Hospital Treatment. — Two hundred and twenty-two cases were removed to hospital, being equal to per cent, of the cases notified, the proportion being slightly lower than during the previous year, which was 74 per cent. Under the heading of " Scarlet Fever" I have already dealt with two cases where Diphtheria was developed within a few days after they had been discharged from hospital for the treatment of Scarlet Fever. Personal Infection, &c.—It is frequently exceedingly difficult to trace the source of infection, but the few following cases are of interest, and shew little doubt in this matter. On the 26th January A. B., of Latchmere Road, was attacked with Diphtheria. It was subsequently ascertained that a few days previously he had visited a case at — Eversleigh Road. On the 29th October F. D. was attacked by Diphtheria after wearing a suit of clothes which, upon enquiry, were found to have been worn by a person who had died of Diphtheria at Yarmouth. Several cases occurred during the year in which the presence of Diphtheria was not ascertained until after the post-mortem examination. Exposure of an Infected, Person. —At their meeting held on the 20th March, the Health Committee considered the case of C. T., of — Kathleen Road, who, on the 13th March, was allowed to be exposed in a public place whilst suffering from Diphtheria, and the Committee gave the necessary instructions for proceedings to be taken in the matter. Upon a subsequent interview with the medical attendant, however, it was ascertained that, although the parents were not acting under his authority, yet he was of opinion that the patient had then recovered and was not infectious. The Committee therefore approved of a cautionary letter being addressed to the parents. Mortality.—The deaths from Diphtheria during the year numbered twenty-nine; nineteen of these occurred in hospital, and ten amongst the cases treated at home, the fatality rates being 8.5 and 11.9 per cent, respectively, or together, equal to 9.4 per cent, of the cases notified. Diphtheria mortality was equal to 0.16 per 1,000 of the population compared with the rate for the thirty-three great towns of 0.35 per 1,000 of the population. Enteric Fever. This disease again shewed an increase during the year, the number of cases notified exceeding that of any year since compulsory notification came into force, being two hundred and five compared with one hundred and eighteen, representing the annual average during the preceding ten years. Notwithstanding the increased prevalence the mortality was however lower than the preceding year. The following shews the number of cases notified in Battersea during the years 1890 - 1900 :- Year No. of Cases of Enteric Fever Notified. 1890 129 1891 111 1892 74 1893 12 9 1894 153 1895 135 1896 110 1897 95 1898 94 1899 157 1900 205 Annual average for 10 years 1890-9 118 Periodical Distribution. This disease usually prevails in the later months of the year, but during 1900 continued throughout each month, there being only four weeks when there was an entire absence of notifications. These were the fourth week of May, the second and fourth weeks of June, and the fourth week of July. The average weekly number of cases was 3-9, the largest number occurring in the third week of March when eleven cases were notified. The monthly average was 15-7 cases, the largest number occurring in any one period of four weeks being twenty-eight, in the month ending 17th March. Age Distribution. In Enteric Fever, we find the cases distributed among all the age periods, that from five to seven years claiming the largest number followed next by the age period of twenty-five to sixty-five years of age. The number at the various ages was as follows:—Under one year, one; from one to five years, thirteen ; from five to fifteen years, seventy-six ; from fifteen to twenty-five years, forty-seven ; from twenty-five to sixty-five years, sixty-seven ; and sixty-five years, one. Local Distribution. One hundred and eight of the cases occurred in East Battersea and ninety seven in West Battersea. The following tables shew the distribution of the cases in the eight sanitary districts during the past three years. The disease has been the most prevalent during each of the past two years in No. 1 Sanitary District. TABLE XXI. Sanitary District. Number of cases of Enteric Fever notified. 1898 1900 1899 No. 1 14 33 50 16 32 „ 2 22 35 „ 3 12 11 12 23 „ 4 30 22 11 20 „ 5 30 23 „ 6 10 „ 7 9 14 11 „ 8 5 7 4 Totals. 94 157 205 Hospital Treatment. One hundred and forty-four cases were removed to hospital representing 70.2 per cent of the cases notified compared with 79.6 during the preceding year. General Remarks. It is difficult to account for the great increase in prevalence of Enteric Fever during the past two years. In some quarters it is suggested that this may in a measure be due to the large number of invalids continuously returning from South Africa retaining infection in their persons and clothing, and this seems highly probable and may account for some of the cases where no other cause was traceable. Although not imported from abroad many cases have been clearly found to have been contracted outside Battersea, particularly during the period of the summer holidays. Many persons after spending a few weeks in different parts of England returned to Battersea to be stricken down with Enteric Fever within a few days. In each of these cases the Medical Officers of Health were communicated with. In a few other cases, patients had consumed shell-fish, but it could not be proved that this had been the cause of the illness. Other cases were clearly traceable to personal infection, four occurring in one house where an unrecognised case had been kept at home occupying the same room as other members of the family, and even when two of the further cases had occurred considerable difficulty was experienced in persuading the parents to allow the cases to be removed. The Medical Officer of Health, however visited and insisted upon removal and this was speedily effected. The fourth case occurring a few days later was also removed. A group of cases occurred in Lintord Street which was doubtless also the result of personal infection, the class of people occupying the houses being such as are always in and out of their neighbours' houses. Notwithstanding that in every case prompt removal to hospital was carried out, immediately followed by disinfection, eleven cases occurred during the year, and taking into consideration the number of houses in the street this shewed the worst record in Battersea. Of the eleven cases, one was of quite an isolated character, occurring in March, but the remaining ten, the first of which occurred on the 30th July, were clearly grouped, following one another in regular succession during three months, the last case occurring on the 3rd November. During the three succeeding months which brings us down to the time of writing, no further case occurred. In the course of an enquiry made by Dr. Hamer, Assistant Medical Officer of Health to the London County Council, in November concerning the undue prevalence of Enteric Fever in the Metropolis generally, those cases occurring in Battersea were also investigated by him, but he was unable to find that any common cause existed here. Mortality. The deaths from Enteric Fever during the year numbered thirty-two; fifteen of these occurred amongst those cases treated at hospital, and seventeen of those kept at home. The fatality rates respectively were 10.4 and 27.8 per cent., a record very favourable in support of hospital treatment. The Enteric mortality rate was equal to 0.18 per 1,000 of the population compared with 0.20, representing the mortality rate for the thirty-three great towns. Typhus Fever. No notifications of this disease were again received during the year. In fact, the disease is now very rare in England, and yearly becomes more so, in view of the greater vigilance and enforcement of the various powers for improving sanitary conditions. This disease is one dependent upon poor living, filth and overcrowding, and under conditions suitable for its propagation, is of a highly infectious and fatal character. Erysipelas. This disease covers so many forms and degrees of inflammatory affections, that very little room is afforded for discussion. One hundred and sixty-five cases were notified during the year, most of them following wounds and abrasions, and therefore were what is known as Traumatic Erysipelas. The following shews the number of cases occurring during each year since the commencement of the system of notification, from which it will be seen that the record of this year is most satisfactory in being not only far below the annual average, but the lowest recorded in any year:— Year. Number of cases of Erysipelas notified. 1890 250 1891 240 1892 333 1893 439 1894 325 1895 244 1896 263 1897 225 1898 178 1899 204 1900 165 Annual average for 10 preceding years 270 Age Distribution.—The age period from twenty-five to sixtyfive was as usual, the most largely affected, considerably more than one half of the cases occurring at those ages. The following was the age distribution of the whole of the cases notified Under one year of age, five; from one to five years, two; from five to fifteen years, eleven; from fifteen to twenty-five years, twenty-one ; from twenty-five to sixty-five, one hundred and ten; and above sixty-five years, sixteen. Local Distribution.—Sixty-five cases occurred in East Battersea, ninety-five in West Battersea and five were developed in the Wandsworth and Clapham Union Infirmary. The following table shews the distribution of the cases in the eight Sanitary Districts, and for the purposes of comparison those of the two preceding years :— TABLE XXII. Sanitary District. Number of cases of Erysipelas notified. 1898. 1899. 1900. No.1 34 34 19 30 „ 2 41 39 „ 3 29 40 26 „ 4 21 29 27 16 „ 5 15 24 „ 6 15 24 29 „ 7 8 11 11 9 „ 8 6 8 Totals 178 204 163 Hospital Treatment. —Forty-one cases were removed to hospitals, namely, the Union Infirmary or general hospitals, but principally the former. Those cases thus removed represented 25.2 per cent, of the cases notified. Mortality.—The deaths recorded during the year numbered seventeen; of these six occurred in hospital and eleven at home, representing 14.6 and 8.8 per cent, respectively, or together 10.3 per cent, of the cases notified. The Erysipelas mortality rate was equal to 0.09 per 1,000 of the population. This most fatal disease also shews a very satisfactory record during the year, being the lowest since the passing of the Notification Act of 1889. Six cases were recorded compared with an annual average of 12.5 cases during the preceding ten years, the number recorded during each of those years being here shewn. Year. Number of cases of Puerperal Fever notified 1890 18 1891 12 1892 16 1893 18 1894 10 1895 10 1896 10 1897 7 1898 10 1899 14 1900 6 Annual average for 10 preceding years 12 Local Distribution, &c.—ln so small a number of cases local distribution is simplified. The cases occurred on the following dates and in the following places :— 11th June Rollo Street.—(Fatal.) 11th july Duffield Street. 13th „ Grove Mansions. —(Fatal.) 11th September Home Road. —(Fatal.) 12th „ Albany Mansions.—(Fatal.) 24th „ Shelgate Road. In each case enquiries were made as to the nurses attending upon the patients, and these were duly cautioned by letter against attending any midwifery cases for at least six weeks. An important case occurred in an adjoining district, where one of the nurses who had attended the fatal case at Rollo Street, Battersea, attended upon another woman in her confinement notwithstanding that she had been duly cautioned by letter against doing so. This second case also terminated fatally and, as the result of the Coroner's inquiry, the woman was charged with manslaughter. Hospital Treatment and Mortality. —Three of the cases notified were removed to hospital, where one died, and the remainder treated at home were all fatal. The proportion of Puerperal Fever cases to the number of births occurring during the year was equal to 0.11 per cent. Continued Fever. One notification of Continued Fever was received in January from Totteridge Road. The patient was treated at home and eventually recovered. This disease is a kind of Low Fever and is of doubtful cause and origin. Cholera. The term Cholera, as understood in regard to notification, relates only to Asiatic Cholera, of which there have been no cases, nor any great danger of invasion for many years. English Cholera, which is certainly of a specific character, frequently occurs during the summer months and has done so in Battersea during the past year, but this is only a synonym of Diarrhoea or Epidemic Enteritis. Bubonic Plague. During the year under report this country has been seriously threatened by plague, a number of imported cases occurring in August and on subsequent occasions. The first cases were discovered in Glasgow, which may be regarded as the chief centre of infection. The strictest quarantine and isolation were enforced, which has fortunately resulted in the disease being kept under control. The Port and other Sanitary Authorities immediately notified the Health Department when any persons were proceeding to this district after having subjected themselves to possible contagion, and all such persons were kept under the strictest observation by the Health Officers for the full period of incubation. On the 1st September the Metropolitan Asylums Board issued a circular notifying that the Superintendents of the Board's Ambulance Stations had received instructions to remove forthwith to the South Eastern Hospital any person duly certified to be suffering from plague, and by an Order of the Local Government Board, dated 19th September, 1900, " Plague " was made compulsorily notifiable, and the following are the more important terms of the Order in question :— "In the District of every Sanitary Authority which is situate without the Administrative County of London the persons mentioned in Section 3 of the Infectious Disease (Notification) Act, 1889, and the Sanitary Authority shall, under this Order, have the same powers and duties in relation to the notification of cases of Plague as they would have under that Act if Plague were an infectious disease to which that Act applied. "In the District of every Sanitary Authority in the Administrative County of London, and in the District of the Port Sanitary Authority of the Port of London, the persons mentioned in Section 55 of the Public Health (London) Act, 1891 (including the Managers of the Metropolitan Asylums District), and the Sanitary Authority shall, under this Order, have the same powers and duties in relation to the notification of cases of Plague as they would have under that Section if Plague were an infectious disease to which that Section applied. " The Sanitary Authority shall forthwith cause . circular letters to be sent to all legally qualified medical Practitioners in the District, informing them of their duties under this Regulation. " It will be the duty of every Medical Officer of Health to report forthwith to us any case of Plague which may be notified to him, or which may otherwise come or be brought to his knowledge, and which may occur in the District or area assigned to his charge." In accordance with this Order the following circular was forwarded to every Medical Practitioner in the District.— Public Health Department, IMPORTANT. . Municipal Buildings, Lavender Hill, S.W. TELEPHONE No 68. 27th September, 1900. Notification of Bubonic Plague, Dear Sir, I am directed to draw your attention to an Order issued by the Local Government Board, dated 19th inst., relative to the notification of cases of the Plague. Under this Order, Medical Practitioners and Sanitary Authorities have the same powers and duties in relation to the notification of cases of Plague as they would under Section 55 of the Public Health (London) Act, 1891, if Plague were an infectious disease to which that Section applies. I have also to inform you that the Metropolitan Asylums Hoard have instructed their Boards Ambulance Stations to remove forthwith to the South Eastern Hospital any person duly certified to be suffering from Bubonic Plague. If, therefore, you have any case of suspected Plague please forward immediately the usual notification, and steps will be taken for the removal of the patient to hospital for observation, the result of which you will be duly informed. I am, Dear Sir, Yours faithfully, W. H. Kempster, M.D., Medical Officer of Health On the 9th October, 1900, the London County Council communicated the arrangements made by them for facilitating diagnosis in respect of any suspected cases of Plague, and that the services of Mr. James Cantlie, M.B., F.R.C.S., formerly Medical Officer in one of the Plague Hospitals of Hong Kong, had been employed for that purpose, and requesting that any suspected cases of the disease might be immediately brought to the notice of the Council's Medical Officer of Health. The London County Council further stated that they were prepared to provide refuges for the accommodation of persons who have been in contact or living with persons attacked by Plague. On the same date the Local Government Board issued memoranda prepared by their Medical Officer, containing suggestions likely to be of assistance to Sanitary Authorities and their officers in guarding against the Plague or dealing with any cases which may occur, and also containing details of the arrangements under which Medical Officers of Health might send to the offices of the Local Government Board for bacteriological examination material from suspected cases. The memoranda in question were classified under two headings: (1) Administrative Considerations ; (2) Symptoms of Plague ; and the more important points therein are here summarised :— Administrative Considerations. Plague has, for the space of nearly two centuries, receded from Europe, but has in recent years once more trended westward, and has re-appeared in Great Britain. Sanitary authorities need be on the alert to detect the presence of the disease and prevent its becoming epidemic. Plague will not readily fasten on that section of our population which is properly housed, cleanly, and generally, in a sanitary sense, well-to-do ; that rather it will especially affect insanitary areas such as are peopled by the poorest class, and where overcrowding of persons in houses and dirt and squallor of dwellings and of inhabitants tend to prevail. The following facts respecting Plague deserve to be borne in mind :— (1) Plague has an incubation period of 3 to 5 (in exceptional cases of perhaps 8 to 10) days. (2) Plague is wont, especially in its earlier manifestations, to assume a mild form, or even to present anomalous symptoms, tending to confound it with other and more innocent diseases. (3) Plague in all its forms must needs be regarded as personally infective. (4) Plague affects rats as well as the human subject. It may, indeed, be found causing mortality among those lower animals antecedent to its definite invasion of the population. There can be no doubt that the rat and the man are, as regards Plague, reciprocally infective. The memoranda further refers to the diminution of Typhus due to improved sanitary conditions, and compares its close resemblance to Plague, and also suggests the general measures which should be adopted in dealing with an outbreak, including prompt isolation, disinfection, and the quarantine of persons who have been exposed to infection ; the abatement as speedily as possible of all insanitary conditions in the locality ; and in the case of death the prompt disposal of the bodies. Symptoms of Plague. The memoranda gives also the symptoms of several forms of Plague, the more common usually beginning some three to five days after exposure to infection. Such attack may develop gradually, but, as commonly met with, there is a sudden onset with much fever, as indicated by a high temperature, rapid pulse, headache, hot skin, and thirst. The eyes are injected as if inflamed; the expression, at first anxious and frightened, becomes subsequently vacant and dull; the utterance is thick, and the gait unsteady as in one under the influence of drink. There is at times a distinct tendency to faint. The tongue is at first covered with a moist white fur, except at the edges, which are red, but later on it becomes dry and of a mahogany colour. Further information is contained in a report prepared by Mr. James Cantlie, and issued by the London County Council in October on " The Signs and Symptoms of Plague." On the 15th October a communication was received from the Town Clerk of the City of London to the effect that the Port of London Sanitary Authority would be glad to receive notification of cases of Plague occurring in the vicinity of the docks and river, and would be prepared to pay the usual fee to medical practitioners for certificates, although such cases might not actually occur within the district of the Port of London. On the 21st October a communication was received from Dr. Shirley F. Murphy, asking that inasmuch as unusual mortality amongst rats had been observed in some localities in which the inhabitants have subsequently suffered from Plague, the Health Committee of the Council may be immediately informed if at any time such mortality among rats is observed in the district. It will thus be seen that elaborate arrangements have been made throughout the country and Metropolis for combating the disease, and which, together with the generally improved sanitary conditions now existing, has undoubtedly prevented the disease from so far becoming epidemic. Disinfection. Disinfection by fumigation was carried out in 1,404 instances during the year. In the majority of cases, sulphurous acid gas was the agency employed ; in other cases, however, where the sulphur fumes would be liable to injure metal work or delicate fabrics, formalin was used. Disinfectants were also gratuitously supplied in 5,631 instances, either at the houses or upon application at the Disinfectant Stores, Town Hall Road. The disinfectants distributed, consisted of 2-1b. packets of carbolic powder and i-pint bottles of Sanitas fluid. Steam disinfection was carried out during the year in four hundred and ninety-two instances; the articles weighing 39 tons, 10 cwt., 3 qrs., 27 1bs. The amount paid to the contractor (Mr. W. G. Lacy) during the year amounted to £732 9s. 9d. The present practice is to disinfect by steam after all cases of enteric fever, after fatal cases of all notifiable diseases and phthisis, the latter subject to permission, and in all cases where patients are treated at their homes. When the Council's Disinfectant Station is erected it is proposed to disinfect by steam after every case of infectious disease notified. At the time of writing my last report, the recommendation to provide a disinfecting station had been referred back to the Health Committee, who appointed a Sub-Committee of View, to consider details and cost, and on the Ist May, 1900, the following report was submitted by them to the Health Committee :— "Your Sub-Committee have had before them a return, prepared by the Medical Officer of Health, shewing the methods adopted for disinfection by heat in thirty-five Metropolitan districts. " In twenty-five instances steam disinfection is carried out under the direct control of the sanitary authorities; in one case, disinfection is carried out by dry heat, in another, the Vestry was constructing a station, in three cases the authorities make use of apparatus provided for adjoining parishes; in one case, that provided at a local hospital, and in four instances, exclusive of Battersea, steam disinfection is carried out by contract." Your Sub-Committee have visited three of the stations, viz.: at Camberwell, Lambeth, and Newington. At Camberwell, a Goddard, Massey and Warner machine is provided. This system your Sub-Committee found would be totally impracticable for the requirements of this Parish. At Newington, where in 1899, the Parish had a population of 123,183, a Manlove Alliott (Washington Lyon) machine, vacuum arrangement is provided. (This machine is manufactured in three sizes). By the courtesy of Dr. Millsom, the Medical Officer of Health, the working of the apparatus was fully and practically demonstrated. Steam disinfection is there carried out after all cases of infectious disease, and it is found that the apparatus is capable of effectually dealing with the whole of the articles. The process of disinfection occupies from 40 to 50 minutes, the temperature reached during the operation being 240° f. under a 10 1b. pressure in the steam jacket. The temperature is subsequently reduced to 160° f. for the purpose of creating a vacuum, and finally raised to 260° f. under a 20 lb. pressure. An incinerator for the destruction when necessary of infected articles is also provided, distinct from the dustdestructor, which immediately adjoins. The Parish Mortuary and Coroner's Court is situated on the same site, and it is found a matter of great convenience that they should be in so close proximity. At Lambeth, with a population of 304,073, in 1899, two stations are provided, at one of these the machinery is of an old type, and at the other a modern machine, an " Equifex," manufactured by Messrs. Defries, is provided. Your Sub- Committee have viewed the latter, and were shown the process of disinfection carried out by the machine, which differs from the Manlove Alliott, the goods being saturated with steam, supplied by means of a steam sparge pipe in place of the steam jacket arrangement provided in that machine. The goods were readily dried upon being shaken for a moment in the air. This building likewise immediately adjoining the Mortuary. In both the latter machines, automatic indicators were provided, shewing the temperature and time of exposure to the disinfection process, forming a permanent record of each operation. By the arrangement of the apparatus as at Lambeth, the services of one permanent attendant only at the station are rendered necessary, but such a principle is probably applicable to other machines of the same class. Your Sub-Committee, however, although pleased with both the two latter forms of machines, are inclined to prefer the " Equifex." Your Sub- Committee beg to recommend : — 1. That the Vestry take immediate steps to provide the necessary means of carrying out steam disinfection without the intervention of a Contractor. 2. That in the event of the foregoing recommendation being adopted, your Sub-Committee recommend that one of the two following sites be selected for the purpose. (a) Adjoining proposed mortuary in Sheepcote Lane. (b) On one of the Vestry's wharves, Lombard Road. 3. That the Surveyor be requested to prepare plans and specifications, and estimates of the cost of buildings, machine, incinerator, &c. On the 30th June, 1900, the Health Committee further considered the subject, and submitted the following report, which was adopted at the meeting of the Vestry on the 11th July. Your Committee now recommend :— (a) That immediate steps be taken to provide the necessary means of carrying out steam disinfection without the intervention of a Contractor. (b) That a disinfection chamber, with duplex machinery, be erected on land between the proposed mortuary and the western wall of the Vestry's Depôt, Sheepcote Lane, in accordance with the plan prepared by the Surveyor, and that it be referred to your Committee to prepare the necessary detail drawings, specification, &C. At a meeting of the Health Committee, held on the 27th November, the Surveyor submitted the following estimate of the cost of the works :— Building £2,369 0 0 Two Steam Disinfectors 736 0 0 Two Vans 100 0 0 Bags, &c. 25 0 0 £3,230 0 0 and that Committee submitted the following report, which was adopted by the Borough Council, on the 28th November. Your Committee have considered detail drawings, specification, and bills of quantities for the erection of a disinfecting station; on land adjoining Latchmere Road Baths, and they recommend that the buildings be erected in accordance therewith, subject to a loan being obtained for the purpose. Disinfection For some years past a practice has been adopted and whereby all books borrowed from the Public Lending destruction . of Library Libraries by persons from houses in which infectious disease exists, are forwarded to this Department, and unless they are such as are practically not replaceable, in which case they are thoroughly disinfected, they are destroyed and replaced. During the past year ninety-four such books were received, of which seventy-eight were destroyed and replaced, and the remaining sixteen disinfected, and returned to the Library Department. Destruction In no case during the y ear was found necessary of Bedding, or desirable to destroy bedding, &c. This practice is adopted when the cost of disinfection would exceed the value of the article infected. Unavoidable damage to clothing and bedding occurred in two instances, and in these cases the articles were replaced by direction of the Health Committee. The cost during the year amounting to £1 12s. 6d. Flushing of After all cases of Enteric Fever and Diphtheria and House in other cases, when considered necessary, the Drains, &c. drains of the houses were flushed by the staff with disinfectants, and this was carried out in 764 instances. During the year 1,192 certificates were granted, the of majority of these being supplied to the Head Disinfection. Teachers of Schoo l s to whom it is a pract ice to forward them when there are school-children occupying the house which has been disinfected. The remainder of the certificates were supplied where such were required by employers before allowing employes to return to their duties. In my report for the year 1899, I dealt at some length with the question of the recognised necessity for increased mortuary accommodation and gave details of the scheme for the erection of a Mortuary on the ground adjoining Latchmere Road Baths at an estimated cost of Applications were then being made to the Local Government Board and London County Council respectively for the following loans which have now been granted subject to the usual conditions. Local Government Board £985 for Post-Mortem Room. „ „ „ £2723 for Coroner's Court. London County Council Total £4,795 The work of erection will now, therefore, be speedily put in hand. During the year 1900 the existing Mortuary has been in greater requisition than during the previous year. Two hundred and ninety-one bodies having been received. One hundred and eighty-nine were the bodies of males and one hundred and two those of females. The following return shews the number of admissions and other particulars relating to the Mortuary during the past thirteen years :— TABLE XXIII. Number of bodies received in the Mortuary. Number of bodies upon which postmortem examinations were held. Number of bodies upon which Coroner's inquests were held. 134 106 134 1888 140 1889 118 140 194 1890 148 199 169 1891 176 139 187 1892 163 193 237 1893 243 200 1894 208 224 197 232 1895 259 210 278 1896 293 242 2 73 1897 289 246 267 1898 238 294 260 1899 274 221 1900 273 291 234 The largest number of bodies received during any one day of the year was on the 15th day of March when six were admitted. Two hundred and thirty-four post-mortem examinations were carried out during the year and two hundred and seventythree inquests held; the latter at the Coroner's Court in Althorpe Grove. In connection with the new Mortuary a Coroner's Court is to be provided, and great benefits will accrue to coroner, jury, and witnesses, when the same is ready for use. The London County Council will contribute per annum as a rental for the use of the same. Eighteen bodies were admitted to the Mortuary for sanitary reasons in view of the limited accommodation at the homes of the deceased's relatives. &c. Of the bodies admitted to the Mortuary during the year three were those of persons who had died of infectious disease and were isolated in the infectious chamber. In my report upon the previous year I suggested the possibility of the existing Mortuary being retained for special purposes after the new one is erected, and this would be particularly useful and desirable for receiving bodies recovered from the river which during the year under report numbered fifteen. The unidentified bodies received during the year numbered eight, and these were subsequently interred at the expense of the Guardians. The following particulars relate to the bodies in question : — TABLE XXIV. Particulars of unidentified bodies admitted to the Mortuary during the year 1900. Date body was admitted to Mortuary. Sex. Age. Cause of death. Where found. 1900. 19th January. Newly born Not stated, probably " drowning " River Thames M M 2nd February 35-40 years do. Drowning do. Do. About 20 years 11th May F do. Newly born 20th „ Suffocation F Drowning do. M About 40 years 23rd June do. Suffocation by pressure F Newly born 26th „ M Newly born Wandsworth Common Want of food and exposure 17th October. F Newly born Asphyxia Amies Street 26th Dec. The bodies admitted to the Mortuary during each month of the year numbered, in January, thirty-nine ; in June, twenty-nine; in February, March, September and December, each twentyseven ; in April, twenty-six; in August, twenty; in October, nineteen; in May, eighteen ; in July,seventeen ; and in November, fifteen. The number received during each month are also here shewn in their calender order :— January 39 February 27 March 27 April 26 May 18 June 29 July 17 August 20 September 27 October 19 November 15 December 27 Total 291 The arrangements for the care and cleansing of the Mortuary have been altered during the year, and are now carried out by the Coroner's Officer and his wife. The Coroner's Officer, as the title implies, is an officer under the control of and paid by the Coroner, and, in addition to other duties, on his behalf is responsible for cleansing the bodies of those admitted when circumstances require, the fees paid by the Coroner for this work being refunded by the Borough Council. The wife of the Coroner's Officer is the Mortuary Keeper under the Borough Council, and is responsible for the cleanly condition of the Mortuary, the cleansing of towels and for keeping the Register of bodies admitted, which latter is submitted to the Health Committee at each meeting. Châlets. Five of these now exist in Battersea, the last having been opened during the year under report in York Road, at the corner of Plough Road. At the time of writing the erection of another was being considered, the probable site being in Bridge Road, near Battersea Park Road. The following are those now in use and under the control of the Health Committee :— (1) Lavender Hill, at junction with Falcon Road. (2) Battersea Park Road, at corner of Cabul Road. (3) Victoria Road, by Victoria Suspension Bridge. (4) Victoria Circus (opened 1899). (5) York Road, corner of Plough Road (opened 1900). Each of the chalets are provided with accommodation for both sexes, and have lavatories attached. There are also eight public urinals maintained by the Borough Council at:— Town Hall Road. Nine Elms Lane (near steam-boat pier). Do. (by Rifleman Public-house). Battersea Park Road (near S. E. & C.& D. Railway Station). Do. (near L. B. & S. C. Railway Station). Forfar Road. Church Dock, Church Road. Wye Street. Vicarage Boad. Urinal accommodation, accessible to the general public, is also provided at one hundred and twenty public houses. The number of public conveniences in Battersea is therefore one hundred and thirty-three, and these are all kept under the close and constant supervision of the Sanitary staff. Water Supply. At the time of writing my previous report, a complaint was being laid before the Railway and Canal Commission, with reference to the quality of the water supplied in Battersea, by the Southwark and Vauxhall and the Lambeth Water Companies, more particularly as shewn by samples taken in November, 1899, which, according to the Analyst's report, " represented waters insufficiently purified for public supply and for drinking purposes." The complaint came on for hearing on the 22nd and 24th January, 1901, strong expert evidence being produced on both sides. The Court were satisfied that the complaint at the time it was presented was fully justifiable, but that in view of the extensive work which the two Water Companies had since carried out, and had in contemplation, there was no alternative but to dismiss the cases, but without costs. There is every reason to be satisfied with the result of the action, which has doubtless had the effect of compelling the Water Companies to carry out those necessary works. Samples have been taken monthly during the year, from the supplies of both the Water Companies, and in no case has the Analyst found it necessary to recommend that objection should be taken to quality of the supplies of either Company, at the point where the samples were obtained. Food Supply. The sources of food supply have received careful and constant supervision during the year, and particularly on Saturdays. In four instances it was found necessary to seize articles exposed for sale, in a state unfit for human food, and these were subsequently conveyed before the Magistrate at the Police Court for condemnation and subsequent destruction. The articles seized consisted of apples, damsons, ham and pork, and in each of the cases proceedings were taken for the recovery of penalties. It is the practice that when retail vendors become aware that articles of food purchased are unfit for human food, they attend with the same at the Public Health Department, when, if the condition of the articles justifies it, and there appears to have been no attempt to sell the same, a certificate is granted, which enables the retailer to claim the return of the money paid to the wholesale dealer. Fifteen such certificates were granted during the year, relating to the following articles :— Herrings, haddocks, kippers, mixed fish, crabs, mussels, conger eels, rabbits, potatoes, tomatoes, strawberries, black currants and plums. Under the Sale of Food and Drugs Acts, five hundred samples are taken annually, and during the year under report, milk again received special attention, representing more than 33 per cent, of the total number of samples taken. In consequence of the number of cases of arsenical poisoning occurring in some parts of the country as the result of drinking poisoned beer, it was considered desirable to procure samples in Battersea, and eighteen such were taken, which upon analyses, were found to be free from arsenic or other foreign poisonous matter. Bakehouses. The usual half-yearly inspections of bakehouses were carried out in the months of April and September. There are at present one hundred and ten such premises in Battersea. At the April inspection ninety-nine of these were in use, and the necessary limewhiting, &c., had been carried out, except in seventeen instances, in which the Health Committee directed statutory notices to be served. In September, the same number were in use, and it was necessary to serve fourteen statutory notices. At the last inspection those in use consisted of forty-one bakehouses above ground, ten semi-basement, and forty-eight entirely beneath the floor level. Cowhouses and Slaughterhouses. The usual annual inspection was carried out by a Sub-Committee of the Health Committee, previous to the meeting of the Licensing Committee of the London County Council, when it was found that with few exceptions, the same were in good and clean condition. No objection was offered by the Health Committee to the renewal of the licenses, but they directed that the attention of the Licensing Committee should be called to defects existing at three of the premises. Application for the renewal of the license in respect of No. 43 Usk Road, was not made, and the same consequently lapsed, reducing the number of cowhouses to five, the slaughterhouses numbering nine. The following premises have been licensed for the year 1900-1 :— Slaughter-houses (9). Cow-houses (5). 205 St. John's Hill. 14 Belle View Road. 163 Alderney Dairy, Wiseton 351 York Road. Road. 189 43 Usk Road. 49 Hope Dairy, Hope Street. 139 Bridge Road West. 62 High Street. 345 Battersea Park Road. 235 96 Falcon Road. Vaccination. The Vaccination Act, 1898, came into operation on the Ist day of January, 1899, is fully dealt with in the report for that year. During the year under report the number of children successfully vaccinated was two thousand three hundred and seventy-eight, the births registered during the same period numbering five thousand one hundred and sixty-one. The proportion of children vaccinated to the number of births registered was equal to 46 per cent. Five others were insusceptible of vaccination ; five hundred and forty-six died unvaccinated ; in three hundred and eight cases vaccination was postponed by medical certificates ; fifty-two removed to other districts, the vaccination officers of which were duly apprised ; in ninety-one cases the privilege of conscientious objection was taken advantage of, and the remainder were neither duly entered in the Vaccination Register nor accounted in the Report Book on the 31st January, 1901. The following table, furnished by the Vaccination Officer, gives details of vaccination during the year 1900 :— TABLE XXV. Battersea Vaccination Returns, January to December, 1900. Registration Sub-District. Number of Births retured in the Birth List sheets-1900. Nos. of those births duly entered by the 31st January, 1901,in Cols. 10, 11, and 13, of the Vaccination Register. (Birth List Sheets), viz:- No. of Births which on, the 31st January, 1901, remained unentered in the Vaccination Register on account. Number of those Births remaining on 31st January, 1901, 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. 11, Insusceptible of vaccination. Had Smallpox. Col 13, Dead unvaccinated. Conscientious Objection Certificates received. Postponement by Medical Certificate. Removed to Districts the vaccination officers of which have been apprised. Removed to places unknown. East Battersea West Battersea (North and South) 2435 1219 4 ... 252 49 585 815 126 24 176 2734 1159 1 ... 294 42 182 28 213 Totals 5169 2378 5 ... 546 91 1400 308 52 389 Customs and Inland Revenue Acts. In the year 1891 this Act first came into operation, its object undoubtedly being to encourage the erection of tenement dwellings. Houses certified by the Medical Officer of Health under these Acts are subject to abatement of house duty. By. the Act of 1890 the rental qualification was per annum and under, but the 1891 Act raised this to Ninety-three certificates have been granted during the year 1900, after personal inspection by the Medical Officer of Health, and the following shews the number granted annually since the Act came into force. Year. Certificates granted by the Medical Officer of Health 1890 243 1891 113 1892 165 1893 201 1894 9 1 1895 91 1896 120 1897 27 1898 82 1899 68 1900 93 The following requirements are taken into consideration when dealing with applications:— (1) That it be satisfactorily shewn that the house in question comes within the Sections of the Acts. (2) That a definite minimum height and superficial area for living and sleeping rooms, as defined by the London Building Act, 1894, exists. (3) That there is a sufficient and available supply of water on each floor. (4) That there is at least one water closet properly supplied with water for every twelve occupants (or less) on each floor. (5) That the drainage of the premises is in accordance with the regulations recognised by the Authority in whose jurisdiction the house is situated. (6) That accommodation for clothes-washing is provided sufficient for the number of persons inhabiting the house. Houses Let in Lodging's. The houses registered under the bye-laws with respect to houses let in lodgings or occupied by members of more than one family have been regularly inspected during the year. Forty-nine such premises are now upon the register, and should at any time the inspectorial staff of the Department be so increased as to permit of the necessary time being specially devoted to this class of property, the number upon the register might possibly be increased. There is, however, considerable difficulty in selecting the class of property which should come within the scope of these bye-laws, the definition of " a house let in lodgings " being so exceedingly wide as to permit of the inclusion of by far the greater proportion of the houses in Battersea. It is found that the occupiers of the class of houses already registered are of such a destructive character that defects even when remedied are not by any means of a permanent character. Flooding. There has been no very serious flooding of houses during the year as the result of the heavy rainfall, although there was a little of a temporary nature on Saturday, 25th August, when for about half-an-hour the rainfall was so heavy that rain-water pipes, gullies, &c., even in the highest parts of Battersea, were quite insufficient to carry the water away during the continuance of the storm. Public Health Legislation of the Year. New Bye-Laws, Orders Of Local Government Board, See. Bye-laws. Under the provisions of the Public Health (London) Act, the local Sanitary Authority has certain powers to make bye-laws Certain of these the Authority is compelled to frame and enforce, whereas others may be made at the discretion of the Sanitary Authority, and one of the latter is for " regulating the decency of persons using the public lavatories and sanitary conveniences provided and maintained by the Sanitary Authority." Such bye-laws have been framed during the year under report and the Council have received the approval of the Local Government Board relative thereto. Drainage Bye-laws. The London County Council has again had under consideration the draft bye-laws for regulating the construction of drains, &c. throughout the whole metropolis, and are applying to the Local Government Board for their approval. Carbolic Acid—Poisons Order. By an Order dated 26th July, 1900, and issued by the Lords of the Privy Council, it is henceforth required that liquid preparations of Carbolic Acid and its homologues containing more than three per cent, of those substances, except any preparation prepared for use as sheep-wash, or for any other purpose in connection with agriculture or horticulture and contained in a closed vessel, distinctly labelled with the word " Poisonous," the name and address of the seller and a notice of the agricultural or horticultural purpose for which the preparation has been prepared, shall be deemed poisons within the meaning of the Pharmacy Act, 1868, and shall be deemed poisons in the second part of Schedule A. of the said Pharmacy Act, 1868. L.C.C. re Proposed Amendment of Bye-laws re Offensive Matter. During the year the L.C.C. have had under consideration the amendment of their bye-laws relative to the removal of offensive matter and have invited suggestions, and upon the recommendation of the Health Committee, the London County Council was informed that this Authority were of opinion that the most suitable times for the removal of offensive matter by road, are between 4 a.m. and 10 a.m. from March to October, and between 6 a.m. and 11 a.m. from November to February, and that they were opposed to the removal of any such matter during the evening, and that the bye-laws should apply to the removal of horsedung-manure mixed with either straw or moss litter. Medical Examination of Officers and Employes. Two hundred and forty-one medical examinations have been carried out during the year. The persons examined included four candidates for appointments, two hundred and nineteen applicants for admission into the Sick and Accident Society, of whom it was necessary to recommend the non-acceptance of three; seventeen members of the Society who were receiving sick or accident allowance and of whose unfitness for work the Society desired to have further medical evidence ; and one person claiming damages for alleged injuries received whilst following his employment. Appendix. The Appendix contains a summary of the Sanitary Operations of the Year and also a return shewing the number of cases of each of the notifiable infectious diseases occurring in each street, &c., in Battersea during the year 1900. W. H. KEMPSTER, M.D., Medical Officer of Health, Summary of Sanitary Operations of the Year. Total Sanitary Operations 76,098 Inspections. House-to-house, &c. 37,590 Bake-houses 540 Urinals 468 Complaints 2,855 Gipsy vans 101 Notices Served. Intimations, &c. 3,330 Notices under Sec. 4 1,040 „ „ 62 and 65 1,257 Drainage Work. Drains Tested by Smoke 1,250 „ Water 7,408 Drains Laid to New Houses 524 Drains Relaid to Old Houses 867 Drains Cleansed or Repaired 759 Soil-Pipes and Drains Ventilated 1,013 Sink and Rainwater Pipes Disconnected or Repaired 333 Water Closets Cleansed, Repaired or Reconstructed 285 Yards Drained and Paved 470 Mews and Stables Drained and Paved 30 Cesspools abolished 1 Water Supply. Houses Supplied with Water or Fittings Repaired 166 Water Closets Supplied with Water or Supply Disconnected from Drinking Water Cistern 714 Cisterns Covered, Cleansed or Repaired 498 Certificates of Water Supply granted in respect of New Houses 521 Food. Samples taken under the Sale of Food and Drugs Acts 500 Seizures effected in respect of Unsound Food :— Meat 2 Fruit 2 — 4 Food Condemned and Certificates granted : — Fish 8 Meat 1 Fruit 5 - 14 Other Sanitary Defects Remedied or Work Carried out. Urinals Altered, Repaired or Water laid on 69 Structural Improvements effected in Bakehouses or cleansing, &c, carried out 32 Overcrowding Abated 78 Premises Cleaned or Repaired 1,111 Accumulations of Manure, &c., Removed or Proper Receptacles Provided 90 Dust Receptacles Provided 881 Leaky House Roots and Gutters Repaired 326 Keeping of Animals in Unfit State Discontinued 19 Sanitary Conveniences Provided and other Improvements effected in Factories and Workshops 78 Occupation of Underground Rooms illegally used for sleeping purposes, Discontinued 8 Smoke Nuisances Reported and attended to 546 Disinfection. Premises Disinfected by Fumigation 1,404 Cases after which Steam Disinfection was carried out 492 Houses Supplied with Disinfectants 5,621 House Drains Flushed with Disinfectants after Infectious Disease 764 Infected Bedding and Goods Destroyed and Replaced 2 Infected Library Books Disinfected, or Destroyed and Replaced 94 Public Conveyances Disinfected Certificates of Disinfection Granted 1,192 Summary Proceedings. Proceedings Ordered to be taken if necessary 2,196 Summonses Issued 337 Magisterial Orders obtained 312 Note.—This Table does not include a large number of Sanitary Improvements voluntarily effected by owners, &c., for instance in the case of Bakehouses, cleansing, &c., is shewn to have been carried out in thirty-two instances, whereas that number represents those cases only in which it was necessary to serve notices, the whole of the Bakehouses in the Parish having been cleansed at least twice during the year, representing more than 200 operations. Similar remarks apply to many other items. TABLE XXVI. Return shewing the number of cases of each of the notifiable infectious diseases occurring in each street in Battersea during the year 1900. Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Abercrombie Street ... ... ... ... ... ... 1 5 7 1 ... ... ... ... ... ... ... ... ... ... ... ... Abysinnia Road ... ... ... Acanthus Road ... ... ... ... 1 ... 1 ... Acre Street ... ... 1 ... ... ... 1 1 1 ... 4 Ægis Grove ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... Afghan Road ... ... ... 1 1 ... ... ... ... ... ... Albert Road 2 ... ... 1 3 ... ... ... ... ... ... ... ... Alexandra Avenue ... ... ... ... ... ... ... ... ... ... Alfred Place ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Alfred Street 1 ... 1 ... ... ... ... 1 Aliwal Road 6 2 2 ... ... ... ... ... ... 1 ... ... ... ... Almeric Road 1 ... ... ... ... ... 1 Altenburg Gardens ... 2 1 ... ... 1 ... ... 1 ... Althorpe Road 1 ... ... ... ... 3 ... ... ... ... ... ... ... ... Althorp Grove ... ... ... ... ... ... ... ... ... Amies Street 1 ... ... 1 ... 31 ... ... 6 5 1 Carried forward ... 12 7 ... ... Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases ... 12 7 5 ... ... 1 Brought forward ... ... 6 31 ... ... Amner Road ... ... ... ... ... ... ... ... ... ... ... ... Andoe Road ... ... ... ... ... ... ... ... ... ... Anerley Street ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Anhalt Road 2 3 ... ... ... ... 3 ... ... ... ... ... Arden Street 3 ... ... ... ... ... ... ... ... ... ... ... Arliss Road 1 1 2 ... ... ... ... ... Arthur Street ... ... 3 6 1 ... 2 ... Ascalon Street 1 ... ... ... ... 1 ... 4 ... 1 ... ... ... ... ... Ashbury Road ... 1 3 5 ... ... ... ... ... ... ... Ashness Road ... ... ... ... ... ... ... ... Ashton's Buildings ... ... ... ... 1 1 2 ... ... ... ... ... ... ... ... ... Ashurst Street ... ... ... ... ... ... ... Atherton Street 2 2 ... ... ... 4 1 ... ... ... ... ... ... ... ... Auckland Road ... 1 ... ... ... ... ... 1 ... 4 Austin Road ... 8 3 ... ... ... ... 4 ... 2 1 ... Balfern Street 8 1 ... ... ... ... Balham Park Road 1 ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... Ballingdon Road ... ... ... ... ... ... ... Banbury Street ... ... ... ... ... 1 1 ... ... ... Barmore Street ... ... ... ... ... ... ... 28 ... 12 79 Carried forward 2 5 1 13 ... ... ... Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera Erysipelas. All notifiable diseases. Street, Road, or Place. Enteric Fever. ... 28 25 ... 12 ... ... 1 13 Brought forward ... 79 2 ... ... 1 ... ... ... Basnett Road 1 4 ... ... ... ... 16 12 ... ... Battersea Park Road 4 ... ... 37 5 ... ... ... ... ... ... ... 5 ... Battersea Rise ... 5 ... ... ... ... 1 ... ... ... ... Beauchamp Road ... 1 Beaufoy Road ... 2 1 ... ... ... 1 ... ... ... 4 Beechmore Road ... ... ... ... ... ... ... ... ... ... ... Belfour Street ... ... ... ... ... ... ... ... ... 1 1 Belleville Road ... ... ... ... ... ... ... ... ... ... ... Bellevue Road ... ... ... ... ... ... ... ... ... ... ... 3 ... Benfield Street 1 ... ... ... ... ... ... 1 5 ... ... ... ... Benham Street ... ... ... ... ... ... ... Bennerley Road ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Berber Road ... Berkeley Street ... ... ... ... ... ... ... ... ... ... Bewick Street ... ... ... ... ... ... ... ... ... ... ... Birley Street ... ... ... ... ... ... ... ... ... ... ... Blenkarne Road ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Blondel Street ... 1 ... ... ... 2 ... ... 1 ... ... Bolan Street ... 3 ... 3 ... ... 1 ... ... ... ... ... Bolingbroke Grove 4 ... 21 145 Carried forward 22 ... 60 ... 1 4 1 ... ... Street, Road, or Place. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Erysipelas. All notifiable diseases. Small Pox Cholera. Brought forward ... 60 4 1 ... 22 ... ... 21 145 1 ... Bolingbroke Road ... ... ... ... ... ... ... ... ... ... ... Boundaries Road ... ... ... ... ... ... ... ... ... ... ... Bourne's Place ... ... ... ... ... ... ... ... ... ... ... Bout flower Road 1 ... ... ... 1 ... ... ... ... ... ... 3 Bramfield Road ... 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... Bramwell Street ... ... ... ... ... ... Brassey Square ... ... 3 ... ... ... ... ... ... 4 1 ... ... Brewery Cottages ... ... ... ... ... ... ... ... ... 1 ... 13 ... ... ... ... 4 Bridge Road 7 1 ... 1 ... 1 Bridge Road West ... ... ... ... ... ... 4 2 Brighton Terrace ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Britannia Place ... 1 ... ... ... ... 1 Broadlands Terrace 1 ... ... ... ... ... ... ... ... ... Brodrick Road 1 1 ... ... ... ... ... ... 2 ... ... 9 ... ... ... ... ... ... Broomwood Road 7 2 ... ... ... 2 ... 2 ... ... ... ... Brougham Street ... ... ... Broughton Street 2 ... 5 ... 1 ... ... ... ... ... 2 Broxash Road ... ... ... ... ... ... ... ... ... ... ... Brussells Road ... ... ... ... ... ... ... ... ... ... ... Brynmaer Road ... ... ... ... ... 5 ... ... ... 5 ... 1 Carried forward ... 51 ... 84 ... 3 1 ... 195 28 ... Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever Continued Fever Relapsing Fever. Puerperal Fever Cholera. Erysipelas. All notifiable diseases. Brought forward ... ... 195 84 5 1 ... 31 1 ... 28 ... ... 5 Bullen Street ... ... 2 2 ... ... 1 ... ... 1 ... ... Burland Road ... ... 1 ... ... ... ... Cabul Road ... ... 6 ... ... ... ... 5 1 ... ... ... 1 Cairns Road ... ... ... ... ... ... ... 1 ... Cambridge Road ... ... ... ... ... ... ... ... ... ... ... Candahar Road ... 4 ... ... ... ... 2 ... ... ... 2 ... ... 1 Canterbury Place ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carlton Grove ... ... ... 2 ... ... 10 Carpenter Street ... 3 4 ... ... 1 ... 6 Castle Street ... ... 1 1 ... ... ... 5 ... ... ... 1 ... 1 Ceylon Street ... ... ... ... ... ... ... ... ... 3 1 Chalmers Street ... ... ... ... 1 1 ... ... 8 ... ... Chatham Road ... 1 ... ... ... 7 ... Chatham Street ... 16 6 5 ... 4 ... ... ... ... 1 Chatto Road ... 3 ... ... ... ... ... 1 4 ... ... ... ... ... ... Cherwell Street ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chesney Street ... ... ... ... ... Chivalry Road ... ... ... ... ... ... ... ... ... ... Church Lane ... ... ... ... ... ... ... ... ... ... ... 2 Church Road 1 ... ... ... ... ... ... 3 ... ... 42 Carried forward ... 116 ... ... 67 ... 1 38 26 4 Street, Road, or Place. Small Pox. Scrrlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Brought forward 264 116 4 2 ... ... 1 ... 38 67 ... Clapham Common North Side ... 1 ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... Clapham Common West Side ... ... ... ... ... ... ... ... ... ... ... Colestown Street ... ... ... ... 1 ... ... ... Cologne Road ... 2 ... ... ... ... 3 ... ... ... 2 Comyn Road ... 1 ... ... ... ... 1 1 Corunna Place ... ... ... ... 1 ... ... ... ... ... 2 Corunna Road ... ... ... ... ... ... ... 1 1 ... 1 Corunna Terrace ... ... ... ... ... ... ... 1 ... ... Cottage Place ... ... ... ... ... ... ... 1 ... ... 1 Creek Street ... ... ... ... ... ... ... 1 1 ... ... ... ... Crescent Place ... ... ... ... ... ... ... ... ... Crichton Street ... ... ... ... ... ... ... ... ... ... ... Cringle Street ... ... ... ... ... ... ... ... ... ... ... Culmstock Street ... ... ... ... ... ... ... ... ... ... ... Culvert Road ... ... ... ... ... ... 2 2 9 ... 13 ... ... ... ... ... ... Cupar Road ... ... ... ... ... Currie Road ... ... ... ... ... ... ... ... ... ... ... Currie Street ... ... 1 ... ... ... ... ... ... ... 1 Darien Road ... ... ... ... ... ... ... 2 1 ... 3 Darley Road 1 ... 2 ... 7 ... 1 3 ... ... ... Carried forward ... 46 2 ... 82 43 128 301 ... ... Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever Cholera. Erysipelas. All notifable diseases. Brought forward 128 82 ... 4 6 ... ... 2 ... 301 43 ... Dashwood Road ... 2 2 ... ... ... ... ... 4 ... Dents Road ... ... ... ... ... ... ... ... ... ... ... ... Dermot Road ... ... ... ... ... ... ... ... ... ... 1 Devereux Road ... ... ... ... ... ... ... 1 ... ... Dickens Street ... ... ... ... ... ... ... ... ... ... ... ... Doddington Grove ... ... ... ... ... ... ... ... 2 2 ... Dorothy Road ... 1 ... ... ... ... 2 ... 4 1 Duffield Street ... ... ... ... ... ... ... ... ... 1 1 Dulka Road ... ... 2 ... ... ... ... 2 ... ... ... ... Eccles Road ... ... ... ... ... 3 1 ... ... 2 Eckstein Road ... ... ... ... ... ... ... 3 1 2 ... Edna Street ... ... ... ... ... ... ... ... ... ... ... Eland Road ... ... ... ... ... ... ... ... 3 2 1 Elcho Street ... ... 3 ... ... ... ... 6 3 ... ... ... ... Elsley Road ... 2 ... ... 15 10 1 ... 2 ... ... 4 Elspeth Road ... ... ... ... ... 1 1 2 Emanuel School ... ... 3 ... ... ... ... ... 3 ... ... Emu Road ... ... ... ... ... ... ... 1 1 ... ... Estcourt Road ... ... 1 ... ... ... 1 ... ... ... ... Este Road ... ... ... ... ... ... 2 1 ... ... 1 150 Carried forward 97 ... 53 ... 3 ... 356 53 ... Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Street, Road, or Place. Brought forward ... 150 97 ... 53 ... ... 3 ... 356 53 ... ... Ethelburga Street ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... ... Etruria Street ... 3 ... ... ... ... ... ... Everett Street ... ... ... ... ... Eversleigh Road ... 7 ... 1 ... ... ... ... ... 3 3 ... ... ... ... Falcon Grove ... ... ... 2 1 ... 1 ... ... ... ... ... 6 ... Falcon Road ... 2 1 3 ... ... ... ... 1 Falcon Terrace ... ... ... 1 ... ... Field's Place ... ... ... ... ... ... 1 ... ... ... 1 Fontarabia Road ... 1 ... ... ... ... ... ... 3 1 1 Foote's Row ... ... ... ... 1 ... ... ... ... ... 1 1 Ford's Place ... ... ... ... ... ... ... 1 ... ... Forfar Road ... ... ... ... ... ... ... ... ... ... ... Forthbridge Road ... ... ... ... ... ... ... ... ... 5 5 1 ... ... ... Foxmore Street ... ... ... ... ... 1 ... Francis Street ... ... ... 1 ... ... ... ... 1 1 3 1 ... ... ... ... Freeland Street ... ... ... ... ... 1 ... ... ... ... ... Freke Road ... 4 ... ... 4 ... ... 1 ... ... ... Frere Street ... ... ... ... ... 1 ... ... ... ... ... ... ... Froude Street ... ... ... ... Gambetta Street ... ... ... ... ... 1 1 2 ... ... ... ... 60 Carried forward ... 59 ... 3 398 168 108 ... ... Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Brought forward ... 108 ... 59 ... ... ... 393 168 60 3 ... ... ... ... ... ... ... ... ... Garden Place ... ... ... ... ... ... Garfield Road 1 ... ... ... 1 2 ... 1 ... ... ... 1 ... ... ... Gayville Road ... 3 1 ... ... ... ... ... ... ... ... Gideon Road ... ... ... 1 ... ... 1 ... 5 ... ... ... Gladstone Street 2 9 3 1 ... ... ... Gladstone Terrace ... 1 ... ... ... 5 ... ... ... ... ... Glycena Road ... ... ... ... ... ... ... ... ... 4 1 ... ... ... ... ... Gonsalva Road 5 ... ... ... ... ... ... Gorst Road ... ... ... ... ... ... ... ... ... ... Goslings Yard ... ... ... ... ... ... ... 1 2 ... ... ... Goulden Street ... ... ... 5 2 ... ... ... ... ... ... ... Gowrie Road ... ... ... ... ... ... ... ... ... Granard Road ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... Grandison Road 3 ... ... ... ... Granfield Street ... ... ... ... ... 2 2 ... ... ... ... Grant Road 6 3 1 ... 1 ... 1 ... ... Grayshott Road ... ... ... ... ... ... 3 1 4 ... Green Lane ... ... ... ... 1 3 ... ... ... ... ... ... ... Gwynne Road ... 1 ... 7 4 ... 2 ... ... Hafer Road ... ... ... ... ... ... ... ... ... 70 ... ... ... 453 116 ... ... 3 Carried forward 194 70 Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Brought forward ... 194 ... 70 ... ... ... 70 453 116 3 ... ... 2 ... 4 ... ... ... ... Haines Street ... 2 1 ... Hanbury Road ... ... ... ... ... ... ... 1 ... ... Harbut Road ... ... ... ... ... 5 4 ... ... 1 1 ... Harley Street ... ... ... ... 1 ... ... ... ... ... Harroway Road ... ... ... ... ... ... ... ... ... ... Hart Street ... ... ... ... ... ... ... ... ... ... ... Hauberk Road ... ... ... ... ... ... ... ... ... ... ... Havelock Terrace ... ... ... 1 ... ... ... ... 1 ... ... Heaver Road ... 1 ... ... ... 1 ... ... 2 ... ... ... Henley Street ... 3 ... ... ... ... 4 ... ... 1 Henning Street ... ... ... ... ... ... ... ... ... ... ... Henry Street ... 2 ... ... ... ... ... 4 ... ... 2 Hermitage Gardens ... ... ... ... ... ... ... ... ... ... ... Heslop Road ... ... ... ... ... ... ... ... ... ... ... Hibbert Street ... ... ... ... ... ... ... ... 1 ... 1 High Street ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... Hillier Road ... ... ... 2 2 Holden Street ... ... ... ... ... 1 ... ... ... ... 1 Holman Road ... ... ... ... ... ... ... ... ... ... ... Home Road 2 ... ... ... ... ... ... 1 ... 3 ... Carried forward ... 72 211 123 ... ... 483 ... 4 73 Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever Enteric Fever Continued Fever Relapsing Fever Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. 211 123 ... 72 ... ... Brought forword ... 73 483 4 ... 5 ... Honeywell Road ... 4 ... ... ... ... ... ... 9 ... ... Hope Street ... ... ... ... ... ... ... ... ... Howie Street ... 1 ... ... ... ... ... ... 1 ... 2 Hyde Lane ... ... 1 4 5 ... ... ... ... ... ... Ilminster Gardens ... ... 1 ... ... ... 1 ... ... ... ... Infirmary (W. & C. Union) ... ... 5 ... ... ... ... ... ... ... 5 10 ... 6 3 ... ... Ingelow Road 1 ... ... ... ... ... 1 ... ... Ingrave Street ... ... 6 1 2 ... 10 ... 5 ... ... ... ... ... ... ... Inworth Street ... 5 John Street (New Road) John Street (York Road) Juer Street ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... 1 ... 2 ... ... ... ... 1 4 Jedburgh Street ... 1 1 ... ... ... ... ... ... ... 2 ... Kamballa Road 2 1 ... 1 ... ... ... ... ... ... ... Kassala Road ... ... ... ... ... ... ... ... ... ... Kathleen Road ... 3 ... ... ... ... ... ... ... 1 4 Keildon Road ... ... 2 ... ... ... 2 ... ... ... ... Kelmscott Road 6 2 ... ... ... ... ... ... ... ... 8 4 ... ... ... ... ... 4 Kennard Street ... ... ... ... ... 2 ... 2 1 ... ... ... ... Kerrison Road ... 5 Carried forward ... 4 146 84 ... ... 85 562 ... 2 43 ... Street, Road, or Place. Small Pox Scarlet Fever. Diphtheria Typhus Fever. Enteric Fever. Continued Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Relapsing Fever Brought forward ... 243 146 ... 84 ... ... 4 ... 562 85 Kersley Mews ... ... ... ... ... ... ... ... ... ... ... Kersley Street ... 4 ... ... ... ... ... ... ... 5 1 ... ... Khyber Road ... 1 ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 2 Kilton Street 1 ... ... 1 ... ... ... ... 7 Kingsley Street 3 3 ... ... Kirtling Street ... ... ... ... ... ... ... ... ... ... ... ... ... ... Knowsley Road 4 ... ... ... ... 6 2 ... Knox Road ... ... ... ... ... ... ... ... ... ... ... Kyrle Road 3 1 ... ... ... ... 5 ... ... ... 1 ... ... Landseer Street ... 3 1 2 ... ... 7 ... 1 Latchmere Grove ... 4 ... ... 1 ... ... ... ... ... 5 Latchmere Road ... 3 5 ... 5 ... ... ... ... 1 14 Latchmere Street ... 1 ... ... ... ... ... ... ... ... 1 Lavender Gardens ... 1 ... ... ... ... ... ... ... ... 1 Lavender Hill ... 6 6 ... 2 ... ... ... ... ... 14 Lavender Road ... 3 ... ... 1 ... ... ... ... 2 6 Lavender Sweep ... 2 ... ... ... ... ... ... ... ... 2 Lavender Terrace ... ... ... ... 1 ... ... ... ... 2 3 5 ... Leathwaite Road ... 2 ... 8 ... ... ... ... 1 Limburg Road 1 2 ... ... 3 ... ... ... ... ... ... Carried forward 288 170 ... ... ... 94 652 ... 96 ... 4 Small Pox Diphtheria. Typhus Fever. Enteric Fever Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas All notifiable diseases. Scarlet Fever. Street, Road, or Place. Brought forward ... 288 170 ... 96 ... ... ... 652 4 94 ... ... ... ... ... ... ... 3 Linda Street 2 1 ... Lindore Road ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 ... ... ... ... ... 14 Linford Street 3 ... ... ... ... ... ... ... Lithgow Street ... ... ... ... ... ... Little Europa Place ... ... ... 4 ... 5 ... ... 1 Livingstone Road ... 6 ... ... ... 4 ... ... ... 1 1 ... ... 5 ... Lockington Road ... 5 ... ... ... ... ... ... ... ... ... ... ... 3 Lombard Dwellings ... 3 ... ... Lombard Road ... 1 ... ... ... ... ... ... ... ... 1 Longbeach Road ... ... ... ... ... ... ... ... ... ... ... Longhedge Street ... 1 4 ... ... ... ... ... ... 1 6 Lothair Street ... ... ... ... ... ... ... ... ... ... ... Louvaine Road ... ... ... ... ... ... ... ... ... ... ... Lubeck Street ... 2 ... ... ... ... ... ... ... ... 2 Lurline Gardens ... ... ... ... ... ... ... ... ... 2 2 Macduff Road ... ... ... ... ... ... ... ... ... ... ... Mallinson Road ... 4 ... ... 1 ... ... ... ... ... 5 Mantua Street ... ... ... ... 1 ... ... ... ... ... 1 Marjorie Grove ... 2 ... ... ... ... ... ... ... 1 3 Marmion Road ... 4 ... ... 1 ... ... ... ... ... 5 Carried forward ... 3 1 5 176 ... 118 ... ... 4 ... 100 7 1 3 Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever Continued Fever. Relapsing Fever Puerperal Fever Cholera Erysipelas All notifiable diseases. Brought forward 315 176 ... 118 ... ... 4 ... 100 713 Marney Road ... 7 3 ... ... ... ... ... ... ... 10 Mayford Road ... ... ... ... ... ... ... ... ... ... ... Maysoule Road ... 2 5 ... 1 ... ... ... ... 2 10 Meath Street ... ... ... ... ... ... ... ... ... ... ... Mendip Road ... ... ... ... 2 ... ... ... ... ... 2 Meteor Street ... ... ... ... ... ... ... ... ... ... ... Meyrick Road ... 7 1 ... 3 ... ... ... ... 2 13 Middleton Road ... 1 ... ... ... ... ... ... ... ... 1 Millgrove Street ... ... ... ... ... ... ... ... ... 1 1 Montefiore Street ... 5 ... ... ... ... ... ... ... ... 5 Montholme Road ... 2 3 ... ... ... ... ... ... ... 5 Morella Road ... 1 ... ... ... ... ... ... ... ... 1 Morrison Street ... 2 1 ... 2 ... ... ... ... ... 5 Mossbury Road ... 1 1 ... ... ... ... ... ... ... 2 Motley Street ... 4 ... ... ... ... ... ... ... 1 5 Mundella Road ... ... 1 ... 3 ... ... ... ... ... 4 Musjid Road ... 2 ... ... 2 ... ... ... ... ... 4 Mysore Road ... ... ... ... ... ... ... ... ... 3 3 Nepaul Road ... ... 1 ... 1 ... ... ... ... ... 2 New Bridge Terrace ... ... 1 ... ... ... ... ... ... ... 1 New Road ... 1 1 ... 3 ... ... ... ... 3 8 Carried forward 350 194 ... 135 ... ... 4 ... 112 795 Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Street, Road, or Place. ... 350 194 ... 135 ... ... 4 ... 112 795 Brought forward ... ... ... ... ... ... Newcomen Road ... ... ... ... ... ... ... 2 1 1 ... ... ... ... ... ... Newman Street ... ... Nightingale Lane ... ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... Nine Elms Lane ... ... ... ... Northcote Road ... ... ... 6 1 3 2 ... ... Nottingham Road ... ... ... ... ... ... ... ... ... ... ... Oberstein Road ... ... ... ... ... ... ... ... ... 1 1 Octavia Street ... 1 1 ... ... ... ... ... ... ... 2 Old Park Avenue ... ... 1 ... ... ... ... ... ... ... 1 Orbel Street ... 1 ... ... ... ... ... ... ... ... 1 Orkney Street ... 3 1 ... ... ... ... ... ... ... 5 Orville Road ... 9 ... ... 3 ... ... ... ... 1 13 Oulton Street ... ... ... ... ... ... ... ... ... ... ... Ouseley Road ... ... ... ... ... ... ... ... ... ... ... Pagden Street ... 2 ... ... ... ... ... ... ... ... 2 Palmerston Street ... 3 ... ... ... ... ... ... ... ... 3 Park Grove ... ... ... ... ... ... ... ... ... 1 1 Park Road (Bridge Road) ... 3 ... ... ... ... ... ... ... ... 3 Park Road (St. John's Hill) ... ... ... ... ... ... ... ... ... ... ... Parkham Street ... ... 1 ... 1 ... ... ... ... ... 2 Carried forward ... 376 202 ... 14 1 ... ... 4 ... 116 839 Street, Road, or Place. Scarlet Fever. Diphtheria. Enteric Continued Fever. Relapsing Fever. Puerperal Fever Cholera Erysipelas. All notifiable diseases. Small Pox. Typhus Fever. Brought forward ... 376 202 ... 14 1 ... ... 4 ... 116 839 Parkside Street ... 1 1 ... 1 ... ... ... ... ... 3 Parma Crescent ... ... ... ... ... ... ... ... ... ... ... Patience Road ... ... ... ... ... ... ... ... ... ... ... Patmore Street ... 1 ... ... ... ... ... ... ... ... ... Pearson Street ... 2 ... ... ... ... ... ... ... ... 2 Petworth Street ... ... 1 ... ... ... ... ... ... ... 1 Peveril Street ... 5 1 ... ... ... ... ... ... ... 6 Plough Road ... 3 ... ... 1 ... ... ... ... 2 6 Plough Terrace ... ... ... ... ... ... ... ... ... ... ... Ponton Road ... 1 ... ... 1 ... ... ... ... 1 3 Ponton Street ... ... ... ... ... ... ... ... ... ... ... Porson Street ... ... ... ... 1 ... ... ... ... ... 2 Portslade Road ... 2 2 ... ... ... ... ... ... ... 4 Pountney Road ... ... ... ... ... ... ... ... ... ... ... Power Street ... ... 1 ... ... ... ... ... ... ... 1 Poyntz Road ... ... 2 ... 3 ... ... ... ... 1 6 Prairie Street ... 2 ... ... ... ... ... ... ... ... 2 Prested Road ... ... ... ... ... ... ... ... ... ... ... Prince of Wales Rd. ... 2 ... ... ... ... ... ... ... ... 2 Cyril Mansions ... ... ... ... ... ... ... ... ... ... ... Carried forward ... 396 210 ... 148 ... ... 4 ... 120 878 Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever Cholera. Erysipelas. All notifiable diseases. Street, Road, or Place. Brought forward ... 396 210 ... 148 ... ... 4 ... 120 878 Norfolk Mansions ... ... ... ... ... ... ... ... ... ... ... Overstrand ... 1 ... ... 1 ... ... ... ... ... 2 Primrose ... ... ... ... ... ... ... ... ... ... ... Clifton Gardens ... ... ... ... ... ... ... ... ... 1 1 Princes Terrace ... ... ... ... ... ... ... ... ... ... ... Queen's Road ... 7 6 ... 2 ... ... ... ... 1 16 Queen's Square ... 1 ... ... ... ... ... ... ... 1 2 Radstock Street ... 1 ... ... ... ... ... ... ... ... 1 Ramsden Road ... ... ... ... ... ... ... ... ... ... ... Randall Street ... ... 1 ... ... ... ... ... ... 2 3 Raywood Street ... 1 1 ... ... ... ... ... ... ... 2 Ravenslea Road ... ... ... ... ... ... ... ... ... ... ... Robertson Street ... 9 3 ... 1 ... ... ... ... 1 14 Rollo Street ... 2 7 ... 1 ... ... 1 ... 2 13 Rosenau Crescent ... 1 ... ... ... ... ... ... ... ... 1 Rosenau Road ... 1 1 ... ... ... ... ... ... ... 2 Rosemeath Road ... ... ... ... ... ... ... ... ... ... ... Roundel Street ... ... ... ... ... ... ... ... ... ... ... Rowena Crescent ... 4 1 ... ... ... ... ... ... ... 5 Rusham Road ... ... ... ... ... ... ... ... ... ... ... Carried forward ... 424 230 ... 153 ... ... 5 ... 128 940 Small Pox Scarlet Fever. Diphtheria Typhus Fever Continued Fever. Relapsing Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Enteric Fever. Street, Road, or Place. Brought forward ... 4 2 4 230 ... 153 ... ... 5 ... 128 940 Rushill Mews ... ... ... ... ... ... ... ... ... ... ... Rushill Road ... 1 1 ... ... ... ... ... ... ... 2 Ruskin Street ... 1 1 ... ... ... ... ... ... 1 3 Russell Street ... 2 ... ... 1 ... ... ... ... 1 4 Sabine Road ... 3 1 ... 1 ... ... ... ... ... 6 St. Andrew's Street ... ... ... ... 1 ... ... ... ... 1 2 St. Ann's Road ... ... ... ... ... ... ... ... ... ... ... St. George's Street ... ... ... ... ... ... ... ... ... ... ... St. James' Grove ... ... ... ... ... ... ... ... ... ... ... St. James' Road ... ... ... ... ... ... ... ... ... ... ... St. John's Hill ... ... 1 ... ... ... ... ... ... ... 1 St. John's Hill Grove ... 1 ... ... ... ... ... ... ... ... 1 St. John's Road ... ... ... ... ... ... ... ... ... ... 1 St. Peter's Place ... ... ... ... ... ... ... ... ... ... ... St. Phillip Street ... 3 3 ... 1 ... ... ... ... ... 8 Salcott Road ... 2 4 ... ... ... ... ... ... ... 7 Sangora Road ... ... ... ... 1 ... ... ... ... ... 1 Sarsfeld Road ... 1 1 ... ... ... ... ... ... ... 2 Savona Place ... ... 2 ... ... ... ... ... ... ... 2 Savona Street ... 1 1 ... 2 ... ... ... ... 2 6 Carried forward ... 440 2 45 ... 160 ... ... 5 ... 136 986 Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever Enteric Fever. Continued Fever Relapsing Fever. Puerperal Fever. Cholera. Erysipelas All notifiable diseases Brought forward 440 245 ... 55 ... 136 ... ... ... 160 986 Seldon Street ... ... ... ... ... ... ... ... ... ... ... Severus Road ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... ... 2 Sewell Road ... ... ... ... ... 3 ... ... Seymour Street ... ... ... ... ... ... ... ... ... ... ... ... Shaftesbury Park Chambers ... ... ... ... ... 1 ... 1 ... ... ... ... Sheepcote Lane ... ... 2 ... ... ... 2 Shelgate Road ... ... 1 ... ... ... 1 1 1 ... 4 Shellwood Road ... ... ... ... ... ... ... ... ... ... ... ... Shillington Street ... 1 ... 2 ... ... ... 3 ... 6 ... ... Shirley Grove ... ... ... ... ... ... 1 ... 1 ... 1 ... ... Silverthorne Road ... ... 1 ... ... ... 2 1 ... ... ... ... 1 Simpson Street ... ... ... 1 3 ... ... Sisters Avenue ... 1 ... ... ... ... ... 1 4 Sleaford Street ... ... ... ... ... ... ... ... ... ... ... ... Somerset Street ... ... ... ... 1 ... ... ... 1 2 Soudan Road ... ... ... ... ... ... ... 1 ... ... 1 Southolm Street ... ... ... ... ... ... ... 4 1 ... 5 Speke Road ... ... 3 ... ... 5 ... ... ... 1 9 Spencer Road ... ... ... ... ... ... ... ... ... ... ... Spencer Street ... 1 ... 2 ... ... 5 ... ... ... 8 258 172 ... 142 ... 6 Carried forward ... 460 ... ... 1038 Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Brought forward 172 ... ... 6 ... 142 2 5 8 ... 1038 ... 4 60 ... ... ... ... ... 2 Spicer Street ... 2 ... ... ... ... ... ... 1 Stainforth Road ... ... 6 ... 5 1 ... ... ... ... ... ... 2 Stanley Street ... ... ... ... 2 ... Stanmer Street ... 1 2 ... 4 ... 8 ... ... 1 Starch Factory Road ... ... ... ... ... 2 ... ... ... ... 2 ... ... ... ... ... 5 3 ... ... Sterndale Road ... 1 ... ... ... ... ... ... ... Stewarts Lane West ... ... ... ... Stewarts Road ... 6 ... ... ... ... 7 ... 1 14 ... 2 6 ... ... 4 ... ... ... Stockdale Road ... ... ... ... ... ... Stockwood Street ... ... ... ... ... ... ... ... ... ... ... Stonells Road ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stormont Road ... 2 2 ... ... ... ... ... ... ... ... ... ... Strath Terrace 1 ... ... ... ... 1 Strathblaine Road ... ... ... ... ... ... ... 1 ... ... ... Sudbrook Road ... ... ... ... ... ... ... ... Sugden Road 1 ... 3 ... ... ... ... ... ... ... 4 ... ... ... ... Surrey Lane ... ... ... ... ... 1 1 Surrey Lane South ... ... ... ... ... 1 ... ... 1 ... 2 ... ... ... ... ... ... Taybridge Road ... ... ... ... ... Tennyson Street 2 ... ... ... 3 6 1 ... ... ... ... Carried forward ... 490 ... 179 ... 6 1099 ... 2 7 8 146 ... Small Pox. Scarlet Fever Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. Street, Road, or Place. Brought forward 490 278 ... 179 ... ... 6 ... 146 1099 Thackeray Street ... ... ... ... ... ... ... ... ... ... ... Theatre Street ... ... ... ... ... ... ... ... ... ... ... Thessaly Square ... ... ... ... ... ... ... ... ... ... ... Thibet Street ... ... ... ... ... ... ... ... ... ... ... Thirsk Road ... 2 ... ... 1 ... ... ... ... ... 3 Thurleigh Road ... 1 ... ... 1 ... ... ... ... ... 2 Tidbury Street ... ... 1 ... 1 ... ... ... ... ... 2 Tidemore Street ... 2 ... ... ... ... ... ... ... ... 2 Tipthorpe Road ... ... ... ... ... ... ... ... ... ... ... Totteridge Road ... 4 ... ... ... 1 ... ... ... ... 5 Town Hall Road ... ... ... ... ... ... ... ... ... ... ... Tritton Street ... ... 4 ... ... ... ... ... ... ... ... Tregarvon Road ... 2 ... ... ... ... ... ... ... ... 2 Trollope Street ... 1 ... ... 1 ... ... ... ... ... 2 Trott Street ... 1 1 ... ... ... ... ... ... ... 2 Tweed Street ... 2 1 ... ... ... ... ... ... ... 3 Tyneham Road ... 5 1 ... ... ... ... ... ... 1 7 Upper Tooting Park ... ... ... ... ... ... ... ... ... ... ... Ursula Street ... 1 ... ... ... ... ... ... ... ... ... Urswicke Road ... ... ... ... ... ... ... ... ... 1 1 1132 1 Carried forward ... 148 511 283 ... 6 ... 183 Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. 28 3 ... 183 6 ... 148 Brought forward 511 1 ... ... 7 1 1 ... ... ... ... Usk Road ... 2 3 ... ... ... ... ... ... ... ... ... Vardens Road ... ... ... ... ... 1 Verona Street ... ... ... 1 ... ... ... ... ... Vicarage Road ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Victoria Crescent ... ... ... 2 ... ... ... ... ... 1 ... Victoria Dwellings ... ... 3 3 ... 1 Victoria Road ... ... ... ... ... ... 4 ... Wadhurst Road ... 1 4 ... ... ... ... ... ... 5 ... 2 2 ... ... ... ... ... ... ... Wakehurst Road ... ... ... ... ... ... ... ... ... Wandsworth Common (North Side) ... ... ... ... 5 ... 2 Warriner Gardens ... 3 ... ... ... ... ... ... ... Warriner Mews ... ... ... ... ... ... ... ... ... ... Warsill Street ... 3 ... ... ... ... ... ... ... 1 4 Watford Villas ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Wayford Street ... ... ... ... ... ... 2 ... ... ... 2 Wayland Road .... ... 1 ... ... ... 1 1 ... 1 Webbs Road ... ... ... ... ... ... ... ... Wellington Road ... ... ... ... ... ... ... ... 2 2 ... 2 ... ... ... ... ... Weston Street ... ... 2 ... ... Wexford Road ... ... ... ... ... ... ... ... ... ... Carried forward ... ... 189 1 ... 6 159 ... 526 291 Street, Road, or Place. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. All notifiable diseases. 189 1172 ... 1 ... 6 ... 159 526 Brought forward 291 ... ... ... 10 8 ... Wickersley Road ... ... ... 1 1 ... ... 3 ... ... 4 William Street ... ... ... 1 ... ... 1 ... 1 ... Wilson Street ... ... ... ... ... 2 1 3 Winsham Street ... ... ... 2 ... ... ... ... ... ... ... ... ... Winders Road ... ... ... ... ... ... ... ... ... ... Winifred Grove ... ... ... ... ... ... ... ... 4 ... ... ... Winstanley Road ... 1 ... ... 1 4 10 2 Winstead Street 1 ... ... 1 ... ... ... ... ... 4 ... ... ... ... ... ... ... Wiseton Road ... ... ... ... ... ... ... ... ... ... ... Wix Lane ... ... ... ... 6 ... ... 6 Woodgate Street ... ... ... ... ... ... ... 2 ... ... ... ... ... Worfield Street 1 ... 1 ... ... ... ... ... ... ... ... Wroughton Road ... ... ... ... ... 9 ... ... ... 4 Wycliffe Road 2 ... 2 1 ... ... ... ... ... ... ... ... ... Wye Street 1 ... ... 1 ... 1 ... ... ... ... ... ... ... ... Yelverton Road 1 ... ... ... ... ... ... ... ... ... ... York Place ... ... York Road ... 1 ... ... 2 7 ... 4 ... ... Totals 548 306 ... 205 6 ... 65 1231 1 ...