To the Chairman and Members of the Brentford District Council Annual Report, 1894. Gentlemen, I beg to present my annual report upon the health and sanitary condition of the Brentford Urban Sanitary District for the year 1894. Population—For the middle of the year 1894, I estimate the population of Brentford at 14,302, which is an increase of 168 over 1893, and of the several ecclesiastical districts into which it is divided my estimate is as follows—St George's with St. James' 4767. St. Paul's 7488. New Brentford 2047. Births—The number of births during the year has been 474, of which 239 were males and 235 females. The birth rate is 33.1 per thousand which is 2.4 lower than last year and 5.7 lower than the average of the last 10 years. It will be seen on referring to the table on page 3 that the birth rate is steadily decreasing. Deaths—The number of deaths during the year has been 221, 117 males and 104 females, in St. George's 77, in St. Paul's 108, in New Brentford 36. The death rate is 15.4 per thousand, which is 3.2 lower than last year and 2.9 lower than the average of the last 10 years and is the lowest death rate for 10 years. This year as in previous years the mortality was very high in July. The principal causes of death have been from— Bronchitis 27 Phthisis 25 Heart Disease 12 There have been 17 Inquests held. Death resulted from natural causes in 8 of these, 3 died from suffocation, 2 from scalds and burns, 2 from drowning and 2 were run over. 5 newly born infants were returned as non-certified. The following table epitomises the ages at which the deaths occurred: Deaths under 1 year 77 ,, from 1 year and under 5 36) 113 under 5 years „ „ 5 years „ 15 11 „ „ 5„ „ 25 11 „ „ 25 „ „ 60 47 ,, over 60 „ 39 108 over 5 years. 5 of these deaths occurred in persons between 80 and 90 and 2 were over 90 years. The next table shows the distribution of the mortality in the 3 districts of the town during the last 10 years . 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 Total. St. George's 17.3 28 16.3 18.1 16.7 19.8 18.3 22.1 16.2 16.1 18.9 St. Paul's 17.5 21 16.2 17.4 18.8 18.1 17.2 20.3 18.9 14.4 17.9 New Brentford 16.1 16.5 17.3 20 14 22.5 22.2 21.3 22.8 17.5 19 2 Last year I pointed out the steady increase in the mortality of New Brentford, this year it again heads the list and in the average of the last 10 years it is also first. Infant Mortality—The rate of this mortality or the proportion of deaths under 1 year of age to every 1000 births is 162.4. This is a very marked improvement over last year and if it continues I shall feel that the town is progressing satisfactorily and that the many evil causes which produce a high infant mortality are being steadily diminished. The following table will show the rate for the last 9 years. 1886 1887 1888 1889 1890 1891 1892 1893 1894 Average for 9 years. 173 110.4 155.6 134.9 152.3 178.1 197.1 184.8 162.4 147.8 From this it will be seen that the infant death rate is very much above the average of the last 9 years. The following are the deaths from the principal zymotic diseases:— Small Pox—There has been no death from this disease for more than 10 years and this year there has been no case in the district. Measles—This disease has caused 11 deaths, 10 of which were in children under 5 years old 6 of these deaths were in June, 3 in July, and 2 in August. Scarlatina—I have to record but one death from this disease. This occurred in January in the Isolation Hospital. After having had Scarlet Fever continuously amongst us for more than 5 years, it is a great pleasure to be able to say that at last it has disappeared. Diphtheria and Membranous Croup—There have been 2 deaths from the former and 1 from the latter disease. Whooping Cough—There have been 6 deaths from this disease, 5 of which were in children under 5 years of age. 5 of these deaths occurred in the first quarter of the year. Typhoid Fever—Again it is most satisfactory to note the few cases of this dangerous disease, 5 cases only have been notified during the year and there have been 2 deaths Typhus Fever—This year there has not been a case of this disease. Diarrhœa—This disease has caused 11 deaths all under 5 years of age and principally in July. For several years Diarrhcea has caused many deaths amongst young children. This year the mortality is less owing to the cool summer. The number of deaths from these 8 diseases has been 34 and the zymotic death rate is 2.3, which is slightly below the average of the last 10 years. The following table shows the number of births and deaths and the various birth and death rates for the last 10 years: 3 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 Average of 10 years. Number of Births 480 520 507 437 504 512 494 492 503 474 492.3 Birth rate per 1000 385 41.2 39.7 33.8 38.5 38.7 35.9 35.2 35.5 31.1 36.8 Deaths from all causes 207 283 210 234 227 256 253 294 263 221 244.8 Death rate per 1000 16.6 22.4 16.4 18.1 17.3 19.3 18.3 21 18.6 15.4 18.3 Deaths from Small Pox 0 0 0 0 0 0 0 0 0 0 .0 ,, Measles 5 11 9 0 8 5 1 19 13 11 8.2 ,, Scarlet Fever 0 0 2 2 2 13 5 2 7 1 3.4 ,, Diphtheria 2 2 0 3 8 5 3 2 2 3 3 ,, Typhus Fever 0 0 0 0 0 0 0 0 1 0 0.1 ,, Whooping Cough 3 25 3 10 3 7 14 4 4 6 7.9 ,, Typhoid Fever 2 2 0 1 3 5 0 1 1 2 1.7 ,, Diarrhœa 13 12 10 10 6 21 14 18 30 11 14.5 ,, 8 chief zymotic diseases 25 52 24 26 30 56 37 48 58 38 39.4 Death rate of 8 chief zymotic diseases 2 4.1 1.8 2.08 2.29 4.2 2.6 3.4 4.1 2.3 2.8 Bakehouses and Slaughterhouses— These have been frequently visited, inspected and found generally clean and in good order. Lodging Houses—The common lodging houses have been constantly visited by night as well as by day. They are situated in Smith Hill has been closed as it was structurally unfit for the, purpose. There have been occasional cases of overcrowding but on the whole the business has been conducted decently and the houses have been clean and well looked after. Several public houses in the town are practically common lodging houses and some of them in case of fire can only be described as death traps on account of their low doors, winding staircases and intricate passages. Other Sanitary Work—This year as in previous years my energies have been directed to improving the dwellings of the working classes. Old and dilapidated cottages have been condemned. In some instances they have been permanently closed, in others they have been reopened after having been satisfactorily repaired. This policy will have to be continued for some years before all this class of property is brought into a proper sanitary state. In getting rid of this class of house which is let at a very low rental and generally inhabited by families earning low wages, it must not be lost sight of that the families thus turned out have to seek lodgings in larger and more modern houses and unless the strictest supervision is exercised overcrowding and its attendant evils will ensue to a very large extent. If all houses let in lodgings were registered the difficulties of the sanitary department would be very much lessened. I would again call the attention of the Council to the danger of allowing domestic animals to be housed in improperly drained and ill ventilated outbuildings. Much has been done in previous years to prevent this serious nuisance and it would be a pity to see the town gradually revert to a condition of things which existed some years ago. Isolation Hospital—I can again bear testimony to the excellent work done at this institution. From the beginning to the end of the year everything has worked smoothly and the results as seen by the accompanying table have been most satisfactory. Although the pressure in the hospital accomodation has not been so great as last year, still there have been many bad cases and it gives me great pleasure to again speak of Nurse Ward in terms of the warmest praise. The number of patients admitted during the year have been 38. Scarlet Fever Typhoid Fever Total 37 I 38 4 Remaining under treatment December 31st, 1893 39 Discharged cured 74 Died 1 Remaining under treatment December 31st, 1894 2 Infectious Diseases (Notification) Act—Under this Act I have received 94 certificates made up as follows : Scarlet Fever 45 Typhoid „ 5 Erysipelas 32 Diphtheria and Membranous Croup 11 Puerperal Fever 1 I have visited the various schools during the year and in 2 cases I have found children in the peeling stage of Scarlet Fever. I cannot close my remarks on this subject without thanking the Head Masters and Mistresses of the various schools for the very efficient help they have rendered me in keeping close watch over their scholars for any symptons of infectious disease. Mr Robinson, Sanitary Inspector, has supplied the following particulars— Summary of Nuisances, dealt with during the Year 1894. TABLE No. 1 Number of houses and premises inspected (including 237 house to house inspections) 731 ,, visits to the Courts and Alleys within the district (inspected at least once a week) 1740 ,, special complaints received or attended to 151 ,, nuisances discovered 686 ,, ,, outstanding December 31 st, 1893 15 701 ,, ,, abated 682 „ ,, outstanding December 31st, 1894 19 ,, preliminary notices issued 317 ,, formal notices issued 32 349 ,, reinspections made (about) 900 ,, summonses taken out 4 TABLE No. 2. Description of Nuisances dealt with. Number of defective and choked drains 212 ,, ,, w.c. cisterns (no water to closets) 138 ,, ,, w.c. connections 71 ,, ,, roofs, gutters and downspouts 49 ,, drinking water cisterns connected to w.c.'s 2 „ „ „ removed to other position 2 „ „ „ provided with covers 20 ,, new w.c. cisterns fixed (not previously in existence) 4 ,, dustbins provided or repaired 50 ,, accumulations of offensive matter, &c., removed 40 ,, nuisances from keeping of animals, poultry, &c. 4 5 Number of houses supplied with water 4 „ „ found dirty, cleansed and limewashed 47 ,, ,, found to be overcrowded 8 „ „ reported as unfit for human habitation 13 „ „ reopened after repairs 4 „ miscellaneous nuisances 25 ,, seizures of unsound food (fish) 1 „ dead bodies removed to mortuary 5 „ drains tested by smoke or water test 46 Common Lodging Houses—The whole of the common lodging houses within the district have been regularly and frequently inspected by day, and night inspections have also been made. The periodical cleansing and limewashing of the premises has been attended to and the houses generally found in a clean and satisfactory condition. One house has been condemned as unfit for the purposes of a common lodging house and two summonses have been taken out for keeping unregistered houses, convictions being obtained in each case. A printed copy of the byelaws for the regulation of common lodging houses has been posted up in each of the houses. Number of houses on register 8 ,, lodgers registered for 115 ,, visits by day 143 ??? ,, houses closed 1 ,, summonses taken out 2 ,, convictions 3 Amount of penalties and costs £2 2 0 Dairies, Milkshops, &c.—These have been frequently inspected and found in clean and satisfactory condition. Number of premises on register 17 ,, applications to register 2 ,, inspections made frequent Bakehouses, Slaughterhouses, &c.—During the year the 22 bakehouses within the District have been frequently inspected and the limewashing and cleansing of the premises has been attended to. The slaughterhouses (8 in number) have also been periodically visited, principally on killing days, and found complying with the Byelaws. Factories, Workshops, Schools—The factories, workshops, schools, &c., have received attention during the year, and during the inspections were found in a clean and satisfactory condition. Infectious Disease : Number of houses inspected on the occurence of infectious disease 90 „ „ disinfected 46 „ „ stripped and cleansed 17 „ articles of bedding, clothing, &c., disinfected in steam disinfecting apparatus 158 „ patients conveyed to Isolation Hospital 38 During the hot weather handbills were printed and distributed within the district with reference to Cholera, Diarrhoea, &c., and pointing out the means to be adopted to resist and prevent such diseases finding a footing in the neighbourhood. 6 Canal Boats Acts, 1877 & 1884—On the 1st of January, 1894, 2x0 canal boats were on the register at Brentford, and during the year 9 applications have been received to register canal boats as dwellings, of these 5 were new boats and 4 were re-registrations on account of change of ownership, and as each complied with the requirements of the Acts they were granted. 197 inspections have been made during the year and 31 contraventions of the Acts and Regulations have been met with. In 6 cases official complaint notes were forwarded to the owners and received attention and in 25 cases verbal cautions were given. The following is a list of the contraventions:— Boats not registered 3 ,. without certificates 14 ,, not properly marked 9 Certificate not identifying owner with boat 1 Cabin in dirty condition 1 ,, requiring painting 2 Boats without proper water cask 1 Total 31 No legal proceedings have been taken and not a single case of infectious disease ??? Mr. John Brydone, Her Majesty's Chief Inspector of Canal Boats, visited Brentford on Jan. 2nd, and expressed himself satisfied with the manner in which the boats had been looked after. I have again to report that during the inspections the boats were generally found in a clean and satisfactory condition, and the occupants civil and obliging at all times. I am Gentlemen, your obedient Servant, HENRY BOTT. Medical Officer of Health. Brentford, May 4th, 1895.