BRE 047 ANNUAL * REPORT of the Medical Officer of Health of the BRENTFORD URBAN DISTRICT COUNCIL, 1907. by HENRY BOTT, M.R.C.S., L.R.C.P, London, MEDICAL OFFICER OF HEALTH, and SUPERINTENDENT, ISOLATION HOSPITAL. THE URBAN DISTRICT COUNCIL OF BRENTFORD. SANITARY COMMITTEE, 1906-7. Chairman. J. B. MILBURN, Esq. The Chairman of the Council. W. J. GOMM, Esq., J.P. The wice=Cbairman of tbc Council. J. J. DOREY, Esq. Messrs. W. J. NOY, J. CLEMENTS, and W. H. WALTER, M.D. Medical Officer of Health and Superintendent, Isolation hospital HENRY BOTT, m.r.c.s., l.r.c.p., London. Sanitary inspector. H. COLEMAN, assoc., royal, san. inst. Brentford Urban District Council. ANNUAL REPORT OF THE MEDICAL OFFICER FOR THE YEAR 1907. To the Chairman and Members of the Brentford Urban District Council. Gentlemen, I beg to present my report upon the health and sanitary condition of the Brentford Urban Sanitary District for the year 1907. POPULATION I estimate the population of the whole district at the end of June to be 16,050, and of the several ecclesiastical districts into which it is divided I allot to St. James's with St. George's 4895, St. Paul's 9153 and to New Brentford 2002. Thus the population of Old Brentford is 14048 and New Brentford 2002. BIRTHS. The number of births has been 519, of which 263 were males and 256 females. The birth rate is 32.3 per thousand, which is 2.4 higher than last year's, which was the lowest for many years, but is 1.7 lower than the average of the last 10 years. DEATHS. The number of deaths occurring in Brentford during the year has been 234, of which 118 were males and 116 females. In St. George's 77, St. Paul's 124, and New Brentford 33. The death rate in the three districts respectively is St. George's 15.7, St. Paul's 13.5, and New Brentford 16.4. The Cottage Hospital is in New Brentford and 3 deaths occurred there, and the Isolation Hospital is in St. 4 George's district and 12 deaths took place there during the year. The death rate for the whole district is 13.9 per thousand which is .4 higher than last year, but 2.1 lower than the average of the last 10 years. CORRECTED DEATH RATE. The County Medical Officer has supplied me again this year with the names and places where inhabitants of Brentford died outside the district. I cannot allot them to their several districts as the addresses are incomplete, but 15 came from New Brentford and 60 from Old Brentford, making a total of 75 who died in the various institutions given below as against 55 last year. These when added to the 234 which occurred in Brentford give a total of 309, which presuming all the deaths which were registered in Brentford all inhabitants is a correct account of the total number of deaths which Brentford suffered during the year and gives a total death rate of 19.2 per thousand. For 1905 when the first correct return was made it was 17.6, and in 1906 it was 17. Brentford Workhouse Infirmary 58 Middlesex County Asylum, Wandsworth 7 West London Hospital, Hammersmith 5 Cancer Hospital 2 St. Thomas' Hospital 1 Charing Cross Hospital 1 River Thames, London 1 21 of these deaths were due to tubercular diseases, 11 to senile decay. 5 to cancer, and 10 to diseases of the lungs. INQUESTS. 16 inquests have been held, the same number as last year. Death resulted from Heart Disease in 6 cases, Suffocation in bed in 4, Suicide in 2, Drowning in 2, and Strangulated Hernia and Syncope 1 each. The following epitomises the ages at which death occurred. Deaths under 1 year 59 101 under 5 years „ from 1 to under 5 years 42 „ „ 5 „ 15 „ 22 133 over 5 years. „ „ 15 „ 25 „ 5 1 „ „ 25 „ 65 „ 65 „ over 65 years 41 11 of these deaths occurred in persons over 80 and 1 was over 90 years. The next table shows the distribution of the mortality of the 3 districts of the town during the last 10 years. 5  1898 1899 1900 1901 1902 1903 1904 '905 1906 1907 Average for 10 years St. George's 13.2 16.6 10.1 18.9 11 .7 I3.5 19.2 15.6 14.5 15.7 14.9 St. Paul's 18 19 5 17.5 15.4 16.4 11.9 13.2 11.0 12.4 13.5 14.8 New Brentford 20.7 22.3 24.3 20.7 20.7 15.8 21.3 19.9 16.4 16.4 19.8 INFANT MORTALITY. The rate of this mortality on the proportion of deaths under I year to every 1000 births is 113.6, which is the lowest recorded for many years (last year it was 140.7). If I could think that' this had been caused by greater care on the part of parents I should rejoice exceedingly, but it can be explained by the fact that in consequence of the wet, cool summer there was no Diarrhoea, and although there was an abundance of plums they did not decompose rapidly and so did no harm, still I hope the constant efforts which have been made for many years to teach parents how to feed and clothe their children have been productive of some good. I also hope to organize shortly a committee of ladies whose duty it will be to visit and advise mothers how to bring up their infants in the first year of life. Little however can be done for the class who leave their babies to the care of children little older than themselves whilst they go to the laundry or other work. The following table gives the rate and average infant mortality for the last 10 years. 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 Average for 10 years 198.8 187.1 138 193.8 176.6 125 161.4 115 140.7 113.6 155 The following are the deaths from the principal Zymotic diseases. SMALL POX.—None. MEASLES. There were a great number of cases from March to August, and 12 deaths were recorded. I am afraid the general public does not treat this disease seriously. They think all children must have it and take no precautions to check its spreading by isolation. Children suffering from Measles usually mix freely in the home with those who have not got it, and unless great care is exercised by the authorities they go to school and spread it there. The deaths are chiefly caused by lung complications and great care should be taken to keep the little sufferers warm in bed. 6 SCARLET FEVER. 5 deaths have been caused by Scarlet Fever. Last year I mentioned that we had an epidemic for 2 years and now I am happy to say that at last it has worn itself out, as there have been very few cases and only I death since last June. WHOOPING COUGH. During the first half of the year there were many cases of this disease and 8 deaths were caused by it. I can only repeat what I have said on many previous occasions, give up the old foolish plan of sending your children out in all weathers as a means of cure. It is exposure which causes the greatest number of deaths. DIPHTHERIA AND MEMBRANOUS CROUP. I am happy to say that there have not been nearly so many cases this year, and they have not been so virulent. 5 deaths have been registered, 4 of which occurred in April. I also think that the lower mortality is due to the fact that most parents recognize the necessity of at once sending for the doctor when a child has a sore throat. Antitoxin is thus used early and the results are invariably satisfactory. Antitoxin is still supplied by the Council free of cost to all Medical men for use in the district. TYPHUS FEYER.—None. ENTERIC FEYER. Again this year there has been only one death from this disease and I must congratulate the Council upon this fact for it is the greatest proof of the care and attention which is given to sanitation. DIARRHŒA. For the first time in the sanitary history of Brentford there has been no epidemic of Diarrhoea. In the past it has been a rare thing to have less than 20 deaths per annum. This year I have only 1 to record in July. It is most satisfactory and I hope it may continue for I think it conclusively proves that nearly all cases are preventable and are due to neglect of the simplest rules of diet. Last year there was no hot weather cousequently the milk did not go sour and feeding bottles did not require so much care. The number of deaths from these 8 zymotic diseases has been 33 and the zymotic death rate is two per thousand which is 1.7 lower than last year and 1.1 lower than the average of the last 10 years. The following tables shows the number of births and deaths and the various birth and death rates for the last 10 years. 7  1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 Average for 10 years. Number of births 523 497 500 516 532 536 545 530 476 519 517.4 Birth rate per 1000 34.9 32.8 32.6 33.9 34.7 34.8 34.8 33.6 29.9 32.3 33.4 Deaths from all causes 312 297 244 262 237 200 252 208 216 234 246.2 Death rate per 1000 20.8 19.6 15.9 17.2 15.4 12.9 16.1 13.1 13.5 13.9 15.8 Deaths from Small Pox 0 0 0 0 0 0 0 0 0 0 0 „ Measles 6 3 10 7 5 0 26 0 4 12 7.3 Scarlet Fever 1 3 1 1 0 0 0 4 7 5 2.2 „ Whooping Cough 26 4 0 7 0 7 3 2 3 8 6 „ Diphtheria 4 2 7 2 8 3 3 11 12 6 5.8 „ Typhus Fever 0 0 0 0 0 0 0 0 0 0 0 „ Enteric Fever 2 2 1 2 0 1 4 1 1 1 1.5 „ Diarrhoea 29 S3 23 38 22 13 34 16 32 1 26.1 „ 8 Zymotia diseases 68 6/ 42 57 35 24 70 34 59 33 48.9 Death rate of Zymotic diseases 45 4.4 2.7 3.7 2.2 i.5 4.4 2.1 3.7 2 3.1 OTHER SANITARY WORK. Early in the year the Local Government Board sent a Medical Inspector to examine the town. Dr. Manby made a long and thorough examination of the whole of the district and a report on his inspection was received in the summer. It was very carefully considered by the Council on several occasions and it was decided to press on the work of closing old and insanitary houses without delay. I, acting on this at once commenced, and I think good progress has been made, but the work has necessarily been slow for it could not be expected that owners of dilapidated, old and huddled together houses should see the necessity of demolition, closure or expensive alterations in the same light as it appeared to me. Several blocks of insanitary property have been dealt with under the Housing of the Working Classes Act during the past year, the most important being Running Horse yard. Nos. 1 & 3, Back Lane. The owner having given an undertaking not to relet the premises, the Council stayed proceedings. The houses cease to be inhabited. Nos. 34, 36 & 38 The Ham. The owners failed to comply with the Notice served upon them. Proceedings were taken, and the Court granted a closing order in each case with costs. The premises now remain unoccupied. 8 Nos. 15, 17 & 19 Back Lane. The owner being of opinion that it would not pay to reconstruct in accordance with the requirements of the Council, gave the tenants notice to quit, and demolished the premises. Plans were submitted to your authority and approved for the erection of two self-contained flats. Nos. 2 & 3 Troy Town Passage. The owners being of opinion that it would not pay to reconstruct in accordance with the requirements of the Council, gave the tenants notice to quit and demolished the premises. Nos. 1, 6 & 7 Troy Town Passage and No. 4 Back Lane. The owner failed to comply with the notices served upon him. Proceedings were taken and the Court adjourned the hearing of Summonses for one month, to enable the defendant to submit a specification for the consideration of the Council. Nos. 1, 2, 3 & 4 Cromwell Place, and Nos. 6 & 8 Back Lane. The owner failed to comply with the notices served upon him. Proceedings were taken and the Court adjourned the hearing of Summonses for one month, to enable the defendant to submit a specification for the consideration of the Council. Nos. 10 & 11 Back Lane. The houses are still in the same condition as when reported upon, excepting that they are now unoccupied. Nos. 19, 20, 21, 22, 23, 24 and 25 Running Horses Yard, and No. 25, Walnut Tree Road. After opposition from the owner of this property, an Order for their immediate closure was granted by the Court with costs. This order has a far more important bearing than the mere closing of this block of houses, by securing the permanent closure of one of the worst pieces of house property in the district. All the houses are unoccupied. In no instance have the people who have been turned out of their houses caused overcrowding, or have found any difficulty in finding proper accommodation. Nor have any been driven into the Workhouse as a result of the Council's action. BYE-LAWS. Bye-Laws governing houses let in lodgings, and new regulations with respect to dairies, cowsheds and milkshops adopted by the Council, have been approved by the Local Government Board, and will come into operation in February. Earlier in my report I stated that 21 deaths occurring outside the district were caused by Tubercular diseases, 24 deaths were registered from the same causes in the district, making 45 in all. This is very high, and I feel sure it can be reduced if special care is taken on the following points : 1. Always live and sleep in a room with the windows open. 2. Sleep alone. 3. Expectorate into a pot containing some disinfectant, or into a rag which must be burnt (Note the Council supply disinfectants free to the poor). 4. Do not spit on the floor, in the street, or in any public veyance. 9 5. Live as much as possible out of doors, and if travelling by tram ride outside when the weather permits. ISOLATION HOSPITAL. The following table shows the number of patients treated at the Brentford Isolation Hospital during the year 1907. Patients under treatment 31st Dec. 1906 24 Admitted during the year 1907. Scarlet Fever 96 Diphtheria 21 Enteric Fever 2 119 143 Discharged cured during the year 1907. Scarlet Fever 106 Diphtheria 15 Enteric Fever 1 122 Died during the year 1907. Scarlet Fever 6 Diphtheria 5 Enteric Fever 1 12 Patients under treatment 31st Dec. 1907. Scarlet Fever 8 Diphtheria 1 Enteric Fever 0 9 143 Two cases of diphtheria were received into the Ealing Isolation Hospital early in the year, as we were short of accommodation owing to alterations, and one case of supposed small pox was sent to the Small Pox Hospital at South Mymms. The work at the Hospital has not this year been as heavy as during the last two years. In 1906, 163 cases were admitted, but many of the cases were very severe, and required skilful and constant nursing. I am happy to say that the Matron and her staff have been unceasing in their devotion, and the nursing has left nothing to be desired, and the popularity of the Hospital is ever on the increase. Nurse Collins, who rendered valuable service during a time of considerable anxiety, has resigned during the year to get married. The Porter has carried out all his duties excellently, and the grounds are a model of tidiness. INFECTIOUS DISEASE (NOTIFICATION) ACT. Under this Act I have received 175 certificates as under: Small Pox Diphtheria Erysipelas Scarlet Fever Enteric Fever 1 52 14 105 3 Last year the number was 291. 10 SCARLET FEYER. There has been a decrease in the number of Scarlet Fever during the year, 105 cases being notified as compared with 160 cases in 1906. The following table shows the School Incidence: Ealing Road 15 St. Paul's 12 St. George's 11 Rothschild 6 St. Lawrence's 5 Private Schools 4 The Ham 2 Boston Road Temporary 1 Private Schools (outside) 1 Over School Age 17 Under ditto 28 Total 105 A sharp outbreak of Scarlet Fever occurred in North Road and Distillery Road, during the months of September and October, 19 cases being notified in the North Road alone. It threatened to become epidemic, but by careful supervision it was stamped out. The source or origin was traced to a family residing in the North Road, where the Sanitary Inspector discovered four children suffering from the disease. They were removed to the Hospital. Particular attention to disinfection, etc., was immediately given in all cases. The Council authorised proceedings to be taken against the parents, and they were fined 20/- DIPHTHERIA. During the year there has been a decided decrease in the number of cases of Diphtheria, 52 cases being notified, as compared with 106 in the previous year. with 106 in the previous year. The following table shows the School Incidence:— Rothschild 10 St. Paul's 8 Ealing Road 4 St. George's 3 St. John's 2 Private School 1 School outside district 1 Over School Age 7 Under School Age 16 Total 52 11 ENTERIC FEYER. There have been 3 cases of Enteric Fever notified during the year. Two cases were removed to the Hospital for treatment. The following table shows the number of Enteric cases notified during the past five years :— 1903 9 1904 3° 1905 6 1906 5 1907 8 CLOSURE OF SCHOOLS. In consequence of the prevalence of Measles and Mumps, two schools were closed during the year for the periods of two and three weeks. In each instance a copy of the Order and representation were sent to the Local Government Board and the Middlesex County Council. The following table shows the schools closed, period of closure, and nature of the disease : — School. Period. Disease. St. Paul's (Infants) Three weeks Measles. The Ham Two weeks Mumps. I wish again to express my thanks to the Masters and Mistresses of the various public elementary schools for the vigilance they have exercised during the past year. Several cases of infectious disease have been sent to me from the schools, and in more than one instance an outbreak of Scarlet Fever has been nipped in the bud. I earnestly hope that they will continue to assist me, and that they will advise me when any child comes to school habitually in rags and dirty, for it is in the homes of such poor little children that so much can be done by the sanitary authority. I once more desire to gratefully acknowledge the ever ready help which has been so constantly rendered by Sister Lucas and the nursing staff of the Cottage Hospital. Their constant visits to the poor and suffering have not only done much to smooth the passing of many a weary sufferer, but they have inculcated habits of cleanliness and order which were never understood before and which have made lasting impressions. The loss to the town of such a useful institution would be deplorable, therefore I beg to express a hope that all will subscribe according to their means. I am, Gentlemen, Your obedient servant, HENRY BOTT, M.O.H. 12 TABLE I. Vital Statistics of Whole District during 1907 and previous years. Year Population estimated to middle of each year. Births. Total Deaths Registered Total Deaths in Public Institutions in the District. Deaths of Non.iesidents Registered in Public Institutions in the District Deaths of Residents Registered in Public Institutions beyond the district Nett Deaths at all Ages belonging to the District. No. Rate* Under I Year of Age At all Ages No. Rate per 1000 Births registered No. Rate No. Rate * 1897 14806 576 38.9 83 144.0 231 15.6 1898 14974 523 34.9 104 198.8 312 20.8 1899 15142 497 32.8 93 187.1 297 19.6 No Public Institutions in District. 1900 15478 500 32.6 69 138.0 244 15.9 1901 15163 516 33.9 100 193.8 262 17.2 1902 1533° 532 34.7 94 176.6 237 15.4 1903 15474 536 34.6 67 1250 200 12.9 1904 15618 545 34.8 88 161.4 252 16.1 1905 15762 530 33.6 61 115.0 208 131 70 278 17.6 1906 15906 476 29.9 67 140.7 216 13.5 55 271 17.0 Averages for years 1897.1906 15365 523 34.0 82 1580 245 16.0 1907 16050 519 32.3 59 113.6 234 13.9 75 309 19.2 *Calculated per iooo of estimated population. Total population as per Census.—All ages, 15163. Number of inhabited houses, 3035. Average number of persons per house, 6. Area of District in acres (exclusive of area covered by water), 1080. Institutions outside the District receiving sick and infirm persons from the District.—Brentford Workhouse Infirmary, Isleworth. Middlesex County Asylum Wandsworth. West London Hospital. Charing Cross Hospital. Cancer Hospital, St. Thomas' Hospital. The Union Workhouse is not in the District. 13 TABLE II. Vital Statistics of separate Localities in 1907 and previous years. Names of Localities Whole District. Year Population estimated to middle of each year Births registered Deaths at all Ages Deaths under 1 year 1897 14806 576 23' 83 1898 14974 523 312 104 1899 15142 497 297 93 1900 15478 500 244 69 1901 15163 516 262 100 1902 15330 532 237 94 1903 15474 536 200 67 1904 15618 545 252 88 1905 15762 530 208 61 1906 15906 476 216 67 Averages of Years 1897 to 1906 15365 523 245 82 1907 16050 519 234 59 14 TABLE III. Cases of Infectious Disease notified during the Year 1907. 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. St. Lawrence's or New Brentford. St. Paul's St. George's Totals. St. Lawrence's or New Brentford. St. Paul's. St. George's. Total cases removed to Hospital. Under I I to 5 5 to 15 15 to 25 25 to 65 65 and upwards Small-pox 1 .. .. .. .. .. .. .. .. 1 1 .. .. 1 1 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including MembranousCroup 52 1 19 26 2 4 .. 43 3 6 52 1 19 3 23 Erysipelas 14 1 .. .. 2 10 1 2 7 5 14 .. .. .. .. Scarlet fever 105 •• 33 60 7 5 .. 10 55 40 105 7 54 35 96 Typhus fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric fever 3 .. .. .. 1 1 1 1 1 1 3 .. 1 1 2 Relapsing fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 175 2 52 86 13 20 2 16 106 53 175 8 74 40 122 Isolation Hospital—Claypond's Lane, Brentford. 15 TABLE IV. Causes of, and Ages at, Death during the Year 1907. Causes of death. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. All Ages Under 1 year I and under 5 5 and under 15 15 and under 25 25 and under 65 65 and wards Small-pox .. .. .. .. .. .. .. Measles 16 2 12 2 .. .. .. Scarlet Fever 6 .. 1 5 .. .. .. Whooping Cough 8 1 7 .. .. .. .. Diphtheria and Membranous 6 .. 4 2 .. .. .. Croup Croup .. .. .. .. .. .. .. Fever— Typhus .. .. .. .. .. .. .. Enteric 1 .. .. .. .. .. 1 Other continued .. .. .. .. .. .. .. Epidemic Influenza 3 .. 2 .. .. 1 .. Cholera .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. Diarrhoea 1 1 .. .. .. .. .. Enteritis .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Erysipelas 1 1 .. .. .. .. .. Other Septic Diseases .. .. .. .. .. .. .. Phthisis (Pulmonary Tuberculosis) 32 1 .. .. 2 27 2 Other Tubercular Diseases 13 2 2 5 .. 4 .. Cancer, Malignant Disease 17 .. .. .. .. 12 5 Bronchitis 30 9 5 .. .. 8 8 Pneumonia 25 6 5 .. .. 9 5 Pleurisy .. .. .. .. .. .. .. Other Diseases of Respiratory 6 .. .. .. 1 3 2 Organs Alcoholism-Cirrhosis of Liver 2 .. .. .. .. 1 1 Venereal Diseases 3 3 .. .. .. .. .. Premature Birth 16 16 .. .. .. .. .. Diseases and Accidents of Parturition 2 •• •• .. •• 2 .. Heart Diseases 29 .. 2 1 1 13 12 Accidents 6 .. .. 2 .. 4 .. Suicides 2 .. .. 1 .. 1 Senile Decay 16 .. .. .. .. .. 16 Suffocation in bed 4 4 .. .. .. .. .. All other causes 64 16 5 7 1 23 12 All causes 309 62 45 24 6 107 65 16 TABLE V. Infantile Mortality during the year 1907. Deaths from stated causes in weeks and months under one year of age. Cause of Death. | Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-I2 Months. Total Deaths under One Year. All causes. Certified 17 4 3 1 25 10 4 3 1 1 3 4 1 4 .. 2 58 Uncertified 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Common Infectious Diseases— Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria : including Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Diarrhœal Diseases— Diarrhoea, all forms .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 Enteritis, Muco-enteritis, Gastro-enteritis .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 .. .. 3 Gastritis, Gastro-intestinal Catarrh .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Wasting Diseases— Premature Birth 14 .. 1 15 1 .. .. .. .. .. .. .. .. .. .. 16 Congenital Defects 2 .. .. .. 2 .. .. .. .. .. .. .. .. 1 .. .. 3 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast-milk, Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Atrophy, Debilitv, Marasmus 2 1 .. .. 3 .. .. .. .. .. .. .. .. .. .. .. 3 Tuberculous Diseases — Tuberculous Meningitis .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Tuberculous Peritonitis: Tabes Mesenterica .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 Other Causes— Erysipelas .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Syphilis .. 1 .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 2 Rickets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 Convulsions .. 1 1 .. 2 2 .. 2 .. .. .. .. .. .. .. .. 6 Bronchitis .. .. 2 .. 2 3 1 .. .. .. 1 1 .. 1 .. .. 9 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Pneumonia .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 3 Suffocation, overlying .. 1 .. .. 1 1 1 .. .. .. 1 .. .. .. .. .. 4 Other Causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 18 4 3 1 26 10 4 3 1 1 3 4 1 4 0 2 59 Births in the year, legitimate and illegitimate 519 Deaths in the year of legitimate and illegitimate infants 59 Deaths from all causes at all ages .. 309 Population, estimated to middle of 1907 16050 17 Annual Report of the Medical Officer of Health for the year 190$,/on the Administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Laundries, Workplaces and Homework. 1.-INSPECTION. Including Inspections made by Sanitary Inspector. Premises. Number of Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) factories (Including Factory Laundries) 12 - Nil. workshops (Including Workshop Laundries) 83 9 Nil. Total 95 9 Nil. 2.—DEFECTS FOUND. Particulars. Number of Defects Number of Prosecutions. Found. Remedied. Referred to H.M. Inspect'r (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :— Want of cleanliness 2 2 .. .. Want of ventilation Overcrowding Want of drainage of floors 1 1 .. .. Other Nuisances 7 7 .. .. Sanitary accommodation — Insufficient Unsuitable or defective 1 1 .. .. Not separate for sexes Offences under the Factory and Workshop Act:— Illegal occupation of Underground Bakehouse (s. 101) Breach of special sanitary requirements for Bakehouses (ss. 97 to 100) Other Offences (Excluding offences relating to outwork which are included in Part III. of this Report) Total 11 11 .. .. 18 3.—HOME WORK. Nature of Work. Lists received from Employers. Addresses of Outworkers received from other Councils Inspections of Outworkers' Premises. Lists. Outworkers. Contractors. W 01 km en. Wearing Apparel. Making, &c. 3 1 2 6 8 4.-REGISTERED WORKSHOPS. Workshops on the Register (1) at the end of the Year. Number. (1) (2) Important Classes of Workshops, such as Workshop Bakehouses, may be enumerated here. Workshops Bakehouses, 80 Under ground 3 Ditto Above ground 12 Total number of workshops on Register 95 5.—OTHER MATTERS. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories : Failure to affix Abstract of the Factory and Workshop Act (s. 133) - Action taken in matters referred by H.M. Inspectors as Notified by H.M. Inspector - able under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Reports (of action taken) sent to H.M. Inspector. - Other - Underground Bakehouses (s. 101):. Certifictes granted during the year Nil. In use at the end of the year 2 19 Mr. Coleman, the Sanitary Inspector, submits the following report. ANNUAL REPORT OF THE SANITARY INSPECTOR FOR THE YEAR 1907. Public Health Department, Clifden House, Brentford, 15th Jan., 1908. To the Chairman and Members of the Sanitary Committee, Gentlemen, I have the honour of submitting to you my Annual Report of the work done in the Health Department during the year ending December 31st, 1907. INSPECTION OF DISTRICT. During the year a systematic inspection of the district has been made, in accordance with the General Orders of the Local Government Board, and the nuisances discovered during such inspections have been dealt with in the manner provided by the Public Health Act, and byelaws in force. In all, some 1955 visits were paid to premises in connection with the work of the department, and include visits to Dairies, Cowsheds, Milkshops, Canal Boats, Common Lodging Houses, ordinary inspections, visits to houses from which complaint of a nuisance had been received, visits to works in progress, and to houses in which cases of Infectious Disease had occurred. COMPLAINTS. Sixty-one complaints relating to nuisances in the district have been received. Each complaint was duly recorded in the Complaint Book, the premises visited, and all necessary steps were taken in respect thereof. NOTICES SERVED. As a result of these inspections 277 preliminary notices, and 94 statutory notices were served, of which the following is a summary:— Preliminary Notices 227 Notices under Sec. 94 Public Health Act 19 ,, ,, ,, 5 Infectious Disease (Prevention) Act 60 ,, ,, Housing of the Working Classes Act 15 Total 371 Wherever nuisances were found to exist preliminary notices were, served upon the person responsible calling attention to the matter, and pointing out the necessary remedial works. If these 20 notices were not complied with, reports were made to the Sanitary Committee, and the usual statutory notices were authorised to be served. I regret to record that, in one instance, it was found necessary to institute Police Court proceedings for a breach of the Council's Byelaws with regard to the prevention of Nuisances arising from the keeping of animals, which resulted in the defendant being fined £.2 and costs, (vide Table i.a.) The following table shows the number and nature of Nuisances dealt with during the year by notice. These do not include Nuisances abated or prevented at the verbal request of your Inspector. Nature of Nuisances dealt with. Number. Accumulation of offensive matter removed 12 „ manure removed 6 Animals so kept as to be a nuisance 6 Drains unstopped, cleansed and made efficient 40 „ reconstructed 31 „ trapped 1 Dustbins provided 43 Dustpits removed 6 Dungpits provided 4 Gutters and Down-spouts repaired or affixed 30 Yard areas paved and repaired 24 Roofs repaired and made water-tight 14 Effective means taken to prevent damp walls 2 Houses and rooms cleansed and repaired 69 House floors repaired and ventilated 4 Overcrowding 17 Sink wastepipes repaired, provided or trapped 11 ,, disconnected from drain 1 Sinks provided 3 Water cisterns cleansed 3 „ provided with covers 9 Water-closets provided 2 ,, abolished 3 ,, repaired, ventilated or limewashed 17 ,, pans and traps renewed 21 ,, pans cleansed 11 ,, flushing apparatus provided 10 „ „ repaired and provided with water 10 Windows of houses made to open 3 Ventilation shafts repaired 2 „ „ fixed 7 Other nuisances 9 Total 432 21 N.B.—This total does not include those nuisances existing in houses regarding which notices have been served under the provisions of the Housing of the Working Classes Acts. UNSOUND FOOD. There have been thirteen seizures of unsound food. In four instances the seizures were made in accordance with the Public Health Act, and the articles were submitted to a Justice of the Peace, and an order, in each case, was obtained to destroy the food, so as to prevent it being used for the food of man. This was done by burning at the Destructor. I am pleased to state that only two summonses were issued for food seized, condemned and destroyed. One was for exposing unsound meat for sale at a butcher's shop; the defendant was fined 20s. and costs. The other was for exposing for sale unsound tomatoes, which I seized from a barrow; the defendant in this case being fined ios. and costs, or fourteen days hard labour (Vide Table I, A.) The following Table shows the amount of food condemned during the year as being unfit for human food. No. of Seizure. Article. Quantity. 1 Whitings 2 Trunks. 1 Potatoes 2j Tons. 2 Tomatoes 208 lbs. 1 Rabbits 4 1 Pork 31 lbs. 1 Cauliflowers 108 1 Mackerels 109 1 Plums 100 lbs. 1 Kippers 2 Boxes. 1 Bananas 200 2 Haddock 2 Trunks. DAIRIES, COW SHEDS and MILK SHOPS. The above have been inspected as occasion required. In several instances it has been found necessary to warn occupiers of Cowsheds and Milk-shops for contravening the Regulations. Two Cowsheds were found to be occupied by more occupants than allowed under the Order. The Cows were found to be in a very dirty condition, their hind quarters being plastered with dung, no attempt being made to groom them. The premises referred to are now under new management, and are kept in a better sanitary condition. The interiors of the Cow-sheds have been lime-washed, cleansed and repaired, floor relaid with concrete, with suitable channels to carry off the liquid. A manure pit has also been built in connection with the premises. 22 Two applications for registration as purveyors of milk have been made during the year. In each case the premises were inspected, and their condition reported to the Sanitary Committee, and the applications were granted. One business carried on as Cowkeepers, Dairymen and Purveyors of Milk has been transferred. The dairy and cow-shed, situate in the Boston Fields, have been discontinued as such, and the premises are now used for other purposes. OFFENSIVE TRADES. The premises whereon offensive trades are conducted have been regularly inspected, and kept, as far as the nature of the business would allow, in a clean condition. During the year one application was received, and permission granted to carry on the trade of a tripe boiler. The premises have since been closed. SLAUGHTER HOUSES. There are six slaughter houses in use at the present time, all situated in, or adjacent to, the High Street. Only one of the above is subject to annual renewal, the remainder being perpetual licenses to the present occupiers. They have all been inspected during the year, and the Bye-laws enforced. CARAVANS The dwelling vans of showmen who visit the town for the purpose of attending the Fairs were inspected in order to ascertain their sanitary condition, and also for the purpose of detecting any Infectious Disease which might exist among the inmates. The condition of the vans was satisfactory, and no cases of Infectious Diseases were found among the occupants. COMMON LODGING HOUSES. There are seven common lodging houses in the District, all situated in, or adjacent to, the High Street. They contain thirty-one rooms for sleeping purposes, and afford accommodation for one hundred and seventy-eight lodgers nightly. They have been inspected both by day and night, and kept, as far as possible, in a clean condition. I am pleased to report that no cases of Infectious Disease have been notified at, or traced to, any of these houses. No. Situation of Premises. Rooms Registered. Accommodation for 1 Old Spring Gardens 3 12 Lodgers 2 „ „ 2 8 5 „ „ 2 8 „ 3 High Street 4 25 „ 4 „ 6 24 „ 6 „ 12 94 7 Market Place 2 7 „ 23 HOUSE DRAINAGE. The drains of thirty-one houses and premises have been entirely reconstructed, and brought up to date. The materials used in the construction of new drains are generally of stoneware, but in several instances I have induced owners to relay drains under houses with cast iron pipes, and in one instance the drains throughout the system were constructed of the latter material. The following is a list of premises the drains of which have been relaid under my supervision. Situation of Premises. Materials used in the Construction. 216, High Street Stoneware Pipes and Iron Pipes under building. 33, „ „ „ „ 34, „ „ „ „ 410, „ „ „ „ 4„, ,, ,, „ „ 13, Glenhurst Road „ „ 15, „„ „ „ „ 93, Ealing Road „ and Iron Pipes under building. 95, „ „ „ „ ditto 97, „ „ „ „ 99, „ „ „ „ 25. Windmill Road „ „ 27, „ „ „ „ 29, „ „ „ „ 31, „ „ „ „ 33, „ „ „„ 35, „ „ „ „ 37, „ „ „ „ 39, „ „ „ „ 41, „ „ „ „ 49, Enfield Road „ „ 51, „ „ „ „Iron Pipes under building. 53, „ „ „ „ditto 55, „ „ „ „ditto 57, „ „ „ „ ditto 13, New Road „ „ ditto 14, „ „ „ „ ditto Glenhurst House, Glenhurst Road „ „ ditto Inverness Lodge, Boston Road Iron Pipes throughout. St. Paul's Vicarage Stoneware Pipes. „ Church „ „ Stables, The Ham „ „ 24 BAKEHOUSES. There are fifteen bakehouses on the Register, classified as follows:—Underground bakehouses, 3; Other bakehouses, 12. One of the former is at present unoccupied. They have all been inspected, and a good standard of cleanliness has been found to exist. No certificates have been granted for the use and occupation of an underground bakehouse during the year. The following defects have been met with and remedied:— Cleansing and lime-washing 2 Defective drains 1 Defective W.C. 1 Defective eaves gutters 1 Accumulation of refuse 1 Dilapidated floor 1 Absence of ash-bins 3 Defective paving 1 CANAL BOATS. Brentford is the Registration Authority for the whole of the surrounding District. There are 307 boats on the Council's Register, one new boat having been registered. During the year 16 boats were examined, and with one exception the condition of the boats and their occupants was satisfactory. Five infringements of the Acts and Regulations were detected. They are as follows:— Boat not registered 1 Master without Certificate 2 Cabin dirty 1 No water vessel 1 No legal proceedings were taken in respect of any infringements. Three complaints notes were issued, all of which have been returned to me signed by some duly appointed inspector of Canal Boats. I am pleased to report that no cases of Infectious Disease have been notified upon any of the boats, and therefore it has not been necessary to detain any vessel for the purpose of cleansing and disinfection. INFECTIOUS DISEASES. The following table gives the nature and number of the diseases investigated and removed to Hospital, as compared with the previous year. 25 Nature of Disease. Investigated. Removed to Hospital. 1906 1907 1906 1907 Small Pox .. 1 .. 1 Diphtheria 106 52 26 23 Membranous Croup .. .. .. .. Enteric or Typhoid Fever 5 3 3 2 Erysipelas 19 14 1 .. Scarlet Fever 160 105 133 96 Typhus .. .. .. .. Puerperal 1 .. .. .. Totals 291 175 163 122 I regret to have to record that it was found necessary to institute legal proceedings in two instances connected with the prevention of Infectious Disease, viz., for removing a case of Diphtheria in a public conveyance without notifying to the driver as to the nature of the disease, a person was fined 40/-and costs; for failing to notify the Medical Officer of Health that his children were suffering from Scarlet Fever, a person was fined 20/- (Vide Table ia). Reference to Table 3c shows the precautions taken in order to prevent the spread of disease. DISINFECTION. One hundred and fourteen rooms have been disinfected upon the removal, recovery, or death of a patient, and all bedding and other articles likely to retain infection were removed to the Hospital for steam disinfection. Sixty notices were served on owners and occupiers of infected houses to strip and cleanse the interior walls of infected rooms. These notices have been complied with, and therefore in no instance has it been necessary for this Authority to proceed with the work. CONCLUSION. In concluding, I desire to express my keen appreciation of the support which every Member of the Urban District Council has extended to me in my efforts to carry out the difficult and dangerous duties imposed by the Public Health Acts. I am, Gentlemen, Your obedient Servant, H. COLEMAN {Assoc. Royal San. Inst., London). Sanitary and Workshop Inspector and Canal Boats Officer. 26 TABLE I A. PROSECUTIONS. The following particulars are extracted from the Register of Prosecutions. No. Nature of Offence. Fines. Costs. Total. Remarks. £ s d. £ s. d. £ s. d. 1 Exposing unsound food for sale 1 0 0 0 6 0 1 6 0 2 Failing to comply with Council's byelaws 2 . 0 0 1 8 0 3 8 0 3 Causing a person suffering from infectious disease to travel in a public conveyance without previously notifying driver 2 0 0 0 3 1 0 4 Exposing unsound fruit for for sale 0 10 0 1 1 0 1 11 0 or 14 days imprisonment 5 Failing to notify M. O. H. that children were suffering from infectious disease 1 0 0 0 0 6 3 houses unfit for human habitation .. 5 5 0 5 5 0 Order made to close each house. 7 Houses unfit for habitation Order made to close. 8 Ditto do. 9 Ditto do 10 11 Ditto Ditto 10 10 0 10 10 0 do. do. 12 Ditto do. 13 Ditto do. 14 Ditto do. 15 Ditto .. .. .. Case adj'd for one month. 16 Ditto .. .. .. do. 17 Ditto .. .. .. do. 18 Ditto .. .. .. do. 19 Ditto .. .. .. do. 20 Ditto .. .. .. do. 21 Ditto .. .. .. do. 22 Ditto .. .. .. do. 23 Ditto .. .. .. do. 24 Ditto .. .. .. do. 6 10 0 19 11 0 26 1 0 2 7 TABLE 2 B. Table showing number of cases of Infectious Disease notified in various Streets in the URBAN DISTRICT OF BRENTFORD during the year 1907—alphabetically arranged. Street or Road. Scarlet Fever Diphtheria Enteric Erysipelas Small-pox. Adelaide Road .. 3 .. .. .. Albany „ 12 .. .. 2 .. Avenue „ 3 1 .. .. .. Bangor „ 1 .. .. .. .. Boston „ 5 1 .. .. .. Boston Park Road .. 3 .. .. .. Braemar Road .. 1 .. .. .. Brentside .. 1 .. .. .. Brook Road 2 2 .. .. .. Catherine Wheel Yard .. 1 .. .. .. Clifden Road 2 1 .. .. .. Distillery Road 6 .. .. .. .. Ealing Road 6 1 .. .. .. Eastbourne Road 2 .. .. .. .. Enfield Road East .. 3 .. .. .. Enfield Road 1 1 .. .. .. George's Court 1 .. .. .. .. Glenhurst Road 1 2 .. .. .. Goat Wharf .. 2 .. .. .. Green Dragon Lane 2 .. .. .. .. Grosvenor Road 2 .. .. .. .. Grove Road 1 .. .. .. .. Hamilton Road .. 1 .. .. .. High Street 3 2 .. 3 1 Ivy Crescent 1 .. .. .. .. Ken ley Road i .. .. .. .. Kew Bridge Road .. 2 1 .. .. Lamb Passage 2 .. .. .. .. Lateward Road 5 3 .. 2 .. Layton Road 1 1 .. .. .. Mercury Road 2 1 1 .. .. Mafeking Avenue 3 1 .. .. .. Netley Road .. .. .. 1 .. Netley Road East 1 .. .. 1 .. New Road 2 2 .. .. .. North Road 19 1 .. 1 .. Old Spring Gardens .. 1 .. .. .. Orchard Road 3 2 .. 1 .. Paradise Place 1 .. .. .. .. Pottery Road 3 1 .. 2 .. Red Lion Yard 2 .. 1 1 .. Starnage Road East 1 2 .. .. .. „ „ West 1 .. .. .. .. Somerset Road 1 .. .. .. .. Sussex Place 1 1 .. .. .. The Ham 3 .. .. .. .. Town Meadow .. 2 .. .. .. Whitestile Road .. 3 .. .. .. Windmill Road 1 2 .. .. .. York Road 1 1 .. .. .. Totals 105 52 3 14 1 28 TABLE 3 c. INFECTIOUS DISEASE. Number of cases investigated and reported upon 175 „ re-visits to infected houses 107 „ rooms disinfected 114 „ wards „ 1 „ cabs „ 1 „ schools „ 2 „ books „ 8 „ reports to Head Masters and Mistresses 145 „ „ School Attendance Officer 80 „ „ Librarian 5 „ prosecutions under Infectious Disease Act 2 „ convictions 2 STEAM DISINFECTION. The following articles were removed from infected houses to the Isolation Hospital and subjected to steam disinfection: Number of beds and mattresses 107 „ pillows 165 „ bolsters 74 „ blankets 193 „ sheets 177 „ quilts, counterpanes, etc. 117 Total 1180