BRO 1 Annual Report ON THE HEALTH OP THE BROMLEY RURAL SANITARY DISTRICT IN 1895. Census, 1881. No. of Acres 31,751 Inhabited Houses 3,901 Population 20,760 Census, 1891. No. of Acres 33,129 Inhabited Houses 5,025 Population 26,852 The population at the middle of 1895 was 29,498, estimated by the method adopted by the Registrar-General, and the rates in this Report are calculated on this basis. The number of registered births in the Bromley Rural District during the year 1895 amounted to 743, including 356 of males and 387 of females. The birth-rate per 1,000 persons estimated to be living in the District was 25.2 as against 25.5 in 1893 and 25.3 in 1894. The total deaths returned were 415, of which there were 218 of males and 197 of females, 69 of these occurred in the Workhouse, of some persons who did not belong to the District. The death-rate was 14 per thousand, i.e., considerably higher than in 1894, but lower than in the two- previous years 1893 1892, when it was 15.9 and 14.2 respectively. Owing to the excess of births over deaths there was an increase of population of 328 on the year. Twenty-six persons died from the seven principal zymotic diseases, a number considerably lower than in 1894, when 41 persons died from these causes. They included 2 from Scarlet Fever, 4 from Diphtheria, 3 from Measles, 5 from Whooping-cough, and 12 from Diarrhoea. The Zymotic DeathRate fell from 1.4 in [894 to 0.8. Table A shows the deaths from the seven principal Zymotic Diseases in each quarter of the year, and Table B in each of the last ten years. Under the provisions of the Infectious Disease Notification Act 133 cases were reported, as against 206 in 1893 and 198 in 1894. They included two cases of Small-pox, 57 of Scarlet Fever, 25 of Diphtheria, 2 of Membranous Croup, 14 of Enteric Fever, 2 of Puerperal Fever, and 31 of Erysipelas. 2 Small-pOX. There were only two cases reported, as against seven in 1894, and neither of them proved fatal. They occurred one in the Parish of Chislehurst, and the other in the Parish of North Cray. Scarlet Fever. Fifty-seven cases were reported, and they occurred one in the Parish of Chelsfield, 3 in Chislehurst, 21 in Farnborough, 13 in Foot's Cray, 2 in Keston, one in Knockholt, 7 in Mottingham, 5 in Orpington, one in St. Mary Cray, one in St. Paul's Cray, one in West Wickham, and one in the Workhouse. The greatest number, it will be seen, was reported from the Parish of Farnborough, where they occurred in the St. Joseph's Orphanage. Diphtheria. A considerable decrease of cases took place, compared with the number of cases and deaths during 1894, when there were 72 cases with 19 deaths. In 1895 only 25 cases were reported, and but 4 proved fatal. The greatest number of cases occurred in the Parishes of Orpington, 7 cases with 2 deaths; Hayes, 5 cases with no deaths; West Wickham, 3 cases and no deaths. The remaining two deaths occurred one in the Parish of Keston, and the other in the Parish of St. Mary Cray. Chelsfield had 1 case; Down 1; Farnborough 1; Foot's Cray 2; Keston 2; St. Mary Cray 2; and St. Paul's Cray 1. Diphtheria Notifications and Deaths in each Quarter of 1895. Cases. Deaths. Case Mortality, per cent. 1st Quarter 6 1 16.6 2nd Quarter 7 1 14.2 3rd Quarter 7 1 14.2 4th Quarter 5 1 20.0 25 4 16.0 Of the 25 cases, 12 were removed to the Hospital, giving a per centage of nearly 50. Enteric Fever. 14 cases with no deaths were reported, as against 20 cases with 6 deaths in 1894. They occurred, 1 in the Parish of Downe, 2 in Foot's Cray, 1 in Keston, 7 in Mottingham, 1 in Orpington, 1 in St. Mary Cray, and 1 in St. Paul's Cray. Measles. There were only three deaths from Measles, occurring one in the 3rd quarter and two in the 4th, in the Parishes of West Wickham and Downe. Whooping-Cough. This disease caused five deaths in the Parish of Chislehurst. Influenza. There were fourteen deaths from this disease, occurring twelve in the first quarter and two in the fourth. Complications from pulmonary diseases, such as bronchitis and pneumonia, were present in the majority of the fatal cases. Mr. Street's report on work carried out by him during the year, the usual tables of statistics, and the tables "A" and "B" required by the Local Government Board are appended. I have the honour to be, Gentlemen, Your obedient Servant, JAMES SCOTT TEW. March 30th, 1896. • ' 3 BROMLEY RURAL DISTRICT COUNCIL. Nuisances dealt with from December 31st, 1894, to December 31st, 1895. No of cases left from 1895 9 Total 9 Defective Drains and Cesspools full 98 Privies Dilapidated 15 Privies and Cesspits full 108 Pigsties dirty 2 Houses Disinfected 109 Dwelling Houses Repaired and Cleaned 73 No. of Hopper Houses 6 No. of Slaughter Houses 18 Overcrowded Dwellings 1 Smoke Nuisances 0 Cow Sheds 26 Milk Shops 15 Other Nuisances 42 Total 513 9 WILLIAM STREET, Inspector of Nuisances. 4 TABLE A. The number of Deaths from all causes and from the seven principal Zymotic Diseases with their Death Rates ; the principal causes of Death and the Infant Mortality in the Bromley Rural District in each Quarter of 1895. Quarters. Total Deaths. Death Rate per 1000. Deaths from 7 principal Zymotic Diseases. Zymotic Death Rate Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Measles. Whooping Cough. Diarrhoea. Phthisis. Influenza. Erysipelas. Rheumatic Fever. Puerperal Fever. Bronchitis, Pleurisy, and Pneumonia. Heart Disease. Injuries. Other Diseases. Deaths of Infants under 1 year per 1000 Births. 1st 139 18.8 2 0.2 ... ... 1 ... ... ... 1 9 12 ... ... ... 36 10 2 68 126 2nd 83 11.2 1 0.1 ... ... 1 ... ... ... ... 8 ... ... 1 ... 13 11 ... 49 49 3rd 93 12.6 13 1.6 ... ... 1 ... 1 1 10 7 ... ... ... 1 7 8 5 52 186 4th 100 13.5 10 1.3 ... 2 1 ... 2 4 1 8 2 ... ... ... 8 7 1 64 127 Totals 415 14.0 26 0.8 ... 2 4 ... 3 5 12 32 14 ... 1 1 64 36 8 233 121 TABLE B. Deaths from Zymotic Diseases during the past ten years and in 1895. Zymotic Diseases. 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 Average of ten Years. 1895 Small Pox 6 1 0.7 0 Scarlet Fever 1 2 1 3 2 0.9 2 Diphtheria 1 3 5 5 14 6 5 9 16 19 8.3 4 Fevers 2 3 1 2 1 2 1 6 1.8 0 Measles 2 4 7 1 8 8 2 7 1 4.0 3 Whooping Cough 1 4 2 9 5 15 14 2 10 7 6.9 5 Diarrhœa 11 18 19 8 9 2 1 6 9 6 8.9 12 Total 7 Zymotics 17 36 33 25 32 33 29 23 46 41 31.5 26 Other Zymotics 2 4 8 4 7 8 6 26 22 11 9.8 15 Totals 19 40 41 29 39 41 35 49 68 52 41.3 41 5 TABLE C. The number of Deaths from all causes and from the seven principal Zymotic Diseases in each Parish of the Bromley Rural District in 1894. The Parishes are arranged in the order of their general Death Rate during the year 1895. PARISHES. Census Population in 1891. Total Deaths. General Death Rate per 1000. Deaths from 7 Zymotic Diseases. Zymotic Death Rate. Chelsfield 1122 10 8.4 0 0.0 Foots Cray 3487 39 8.6 2 0.4 Mottingham 1037 10 8.7 0 0.0 Farnborough 1627 17 10.0 0 0.0 Chislehurst 6557 75 10.5 6 0.8 Hayes 804 9 10.7 1 1.1 West Wickham 1262 15 10.7 1 0.7 St. Mary Cray 1988 23 11.4 2 0.9 Downe 581 7 11.8 2 3. Keston 746 9 11.9 1 1.3 Orpington 4099 59 12.7 5 1.0 North Cray 549 9 18.0 1 2.0 Cudham 1103 21 19.6 1 0.8 Knockholt 872 19 21.2 0 0.0 St. Paul's Cray 1028 24 21.8 4 3. TABLE OF DEATHS during the year 1895, in the BROMLEY Burcd Sanitary District, classified according tc Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public 1nstitutions being shown as separate localities. Mortality from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under 5 years of age. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Typbus. FEVERS Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. 1nfluenza. 1njuries. All other Diseases. Total. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 60 and upwards. Enteric or Typhoid. Continued. Relapsing. Puerperal. Beckenham Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chelsfield 10 3 3 4 Under 5 ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... 3 3 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... 4 7 Chislehurst 75 21 8 2 3 23 18 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 1 ... 1 3 ... ... ... 19 29 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 7 9 ... ... 25 46 Cudham 21 5 3 11 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 2 4 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 3 10 17 Downe 7 3 2 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 1 ... ... ... ... 3 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 3 4 Farnborough 17 3 2 4 8 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 2 5 5upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... 1 ... 8 12 Foots Cray 39 6 3 3 16 11 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 ... 1 1 4 9 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 5 4 1 ... 17 30 Hayes 9 2 5 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 2 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 2 1 2 7 Keston 9 3 1 4 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ...::: ... ... ... ... ... ... ... 3 3 5 upwds ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 3 6 Knockholt 19 4 4 11 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 2 ... 9 15 Mottingham 10 2 4 1 1 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 3 6 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... 1 1 1 ... 1 ... 4 North Cray 9 4 2 2 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 4 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 2 5 Orpington 59 17 10 4 2 17 9 Under 5 ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... 2 5 1 ... ... 15 26 5 upwds ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... 4 6 4 2 2 13 33 St. Mary Cray 23 7 3 1 6 6 Under 5 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 3 ... ... ... 4 10 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 4 2 ... ... 6 13 St. Paul s Cray 24 9 3 1 1 6 4 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 3 ... ... ... 7 12 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 1 1 ... ... 6 12 West Wickham 15 2 1 2 1 4 5 Under 5 ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... 1 ... ... ... 2 3 5 upwds. ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 2 3 1 ... 4 12 Workhouse 69 2 4 2 29 32 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 5 6 5 upwds. ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 7 6 4 ... ... 45 63 Totals 415 90 44 9 17 137 118 Under 5 ... 1 2 ... ... ... ... ... ... ... ... 2 5 9 ... 5 25 1 2 1 76 129 5 upwds. ... 1 2 ... ... ... ... ... 1 ... ... 1 ... 3 1 27 39 35 12 7 157 286 TABLE OF populat1on, b1rths, and of new cases of 1nfect1ous s1ckness, com1ng to the knowledge of the Med1cal Off1cer of Health, dur1ng the year 189o, 1n the Rural San1tary D1str1ct of BROMLEY ; class1f1ed accord1ng to D1seases, Ages, and Local1t1es. Names op Local1t1es adopted for the purpose of these Stat1st1cs ; Publ1c 1nst1tut1ons be1ng shown as separate local1t1es. Populat1on at all Ages. Reg1stered B1rths. Aged under 5 or over 5. New Cases of S1ckness 1n each Local1ty, com1ng to the knowledge of the Med1cal Off1cer of Health. Number of such Cases Removed from the1r Homes 1n the several Local1t1es for Treatment 1n 1solat1on Hosp1tal. Census 1891. Est1mated to m1ddle of 1895. Smallpox. Scarlat1na. D1phther1a Membranous Croup. fevers. Cholera. Erys1pelas. Smallpox. Scarlat1na. D1phther1a. Membranous Croup. fevers. Cholera. Erys1pelas. Typhus. Ente11c or Typho1d. Cont1nued. Relaps1ng. Puerperal. Typhus. Enter1c or Typho1d. Cont1nued. Relaps1ng. Puerperal. Chelsf1eld 1122 1188 Under 5 5 upwards 1 1 1 1 Ch1slehurst 6557 7094 Under 5 1 5 upwards 1 2 3 1 Cudham 1103 1122 Under 5 5 upwards 2 Downe 581 592 Under 5 5 upwards 1 1 1 Farnborough (h) 1627 1700 Under 5 3 1 5 upwards 18 1 4 6 Foots Cray 3487 4514 Under 5 1 1 5 upwards 12 2 2 3 10 2 Hayes 804 839 Under 5 5 upwards 5 1 .5 Keston 746 752 Under 5 1 1 1 5 upwards 1 1 1 Knockholt 872 893 Under 5 1 5 upwards 1 Mott1ngham 1037 1137 Under 5 1 1 5 upwards 6 7 1 4 North Cray 549 500 Under 5 5 upwards 1 1 Orp1ngton 4099 4622 Under 5 2 1 1 5 upwards 5 5 1 13 2 3 St. Mary Cray 1988 2007 Under 5 1 1 5 upwards 1 1 1 St. Paul's Cray 1028 1142 Under 5 1 5 upwards 1 1 1 West W1ckham 1262 1396 Under 5 2 5 upwards 1 1 1 Workhouse Under 5 5 upwards 1 1 1 Total 26852 29498 743 Under 5 10 7 1 1 2 1 5 upwards 2 47 18 1 2 30 1 26 11 Bromley Rural District Council. ANNUAL REPORT FOR 1895. BY JAMES SCOTT TEW, M.D., D.P.H., MEDICAL OFFICER OF HEALTH. S. 9U9H k SON, PRINTFRS, BROMLEY.