BRO 6 RURAL DISTRICT COUNCIL OF BROMLEY. ANNUAL REPORT ON THE HEALTH OF THE Bromlen Rual Samtarn District, FOR THE YEAR 1904, BY JAMES SCOTT TEW, M.D., D.P.H. BROMLEY, KENT: S. Bush & Son, 41 & 42, High Street. 1905. BROMLEY RURAL DISTRICT. AREA AND POPULATION. No. of Registration District. Area in Statute acre. Inhabited Houses. Population. Land and Inland Water. Inland Water only. 1881 1891 1901 1881 1891 1901 41 28,839 40 2770 3237 3655 14303 16818 18808 The above figures omit Chislehurst and Foots Cray, the former of which was constituted an Urban District on April ist, 1900, and the latter on April 1st, 1902. Sub Registration Districts. Area in Situate acres. Inhabited Houses. Population. Land and Inland Water. Inland Water only. 1881 1891 1901 1881 1891 1901 BECKENHAM R 3942 3 319 409 447 1657 2066 2166 Hayes 1282 .. 143 160 118 694 804 838 West Wickham 2660 3 176 249 259 963 1262 1328 ORPINGTON 21117 21 2038 2336 2607 10458 12138 13442 Chelsfield 3378 .. 193 232 330 947 1122 1522 Cndham 5925 1 217 217 230 1029 11C3 1111 Downe 1652 .. 117 127 139 555 581 610 Farnborough 1429 .. 137 258 285 1451 1627 2262 Keston 1487 8 151 150 171 731 746 832 Knockholt 1701 1 171 191 217 789 872 952 Orpington 3517 7 581 760 830 3050 4099 4259 St. Mary Cray 2028 4 371 401 405 1906 1988 1894 4- CHISLEHURST 3780 16 413 492 601 2188 2614 3200 Mottiugham 642 .. 130 172 219 779 1037 1332 N. Cray 1484 10 130 117 143 S35 549 661 St. Paul's Cray 1654 6 153 203 239 774 1028 1207 Total for whole District. 28839 40 2770 3237 3665 14303 16818 18808 Annual Report on the Health OF THIi BROMLEY RURAL SANITARY DISTRICT, For the Year I904. POPULATION The population of the Bromley Rural District estimated to the middle of 1904 was 19,504, showing an increase of 696 since the census of 1901, and 217 on the estimated population of 1903. The number of registered births amounted to 483, including 256 of males and 227 of females, and giving a Birth-rate of 24.7 per 1,000 of population as compared with 26.4 in the previous year, and 21 .0 in 1902. Three hundred and fourteen deaths were registered, consisting of 155 of males and 159 of females. To these must be added 3 deaths of residents which occurred outside the District, 2 at the Bromley and Beckenham Joint Hospital, and 1 at the Cottage Hospital, Eltham. Of the total 317 deaths 71 were those of non-residents. The Death-rate was 12.6 per 1,000 of the population as compared with 12.3 in 1903, and 112 in 1902. The principal Epidemic Diseases include Small-pox, Measles, Scarlet Fever. Diphtheria. Whooping Cough, Fever (including the three principal forms, Typhus, Enteric or Typhoid Fever, and Pyrexia of uncertain origin), and Diarrhoea. Of the total 246 deaths, 22 were caused by one or other of these diseases, viz., 3 by Diphtheria, 9 by Whooping-cough, and 10 by Diarrhoea. The Epidemic Disease Death-rate was 1.1 per 1,000 of the population as compared with .7 in 1903, and 1.7 in 1902. 5 The Infant Mortality, i.e., the number of deaths of infants under one year of age per each 1,000 registered births was 132, as compared with 93 in 1903, and 107 in 1902. During the year 1904 the birth-rate throughout England and Wales taken as a whole was 27.9 (which is the lowest rate on record), the general death-rate 16.2, and the epidemic disease death-rate 194 per 1,000 of population. The rate of mortality among infants under 1 year of age per 1,000 registered births was 146. All the above rates for this District are somewhat higher than last year, but compare favourably with those of the country generally, the death-rate, epidemic disease death-rate, and the infant mortality being respectively 3.6, 0.84, and 14 below those for England and Wales. NOTIFIABLE DISEASES. Under the provisions of the Infectious Disease (Notification) Acts, 1889 and 1899, 79 cases were notified as against 100 in the previous year. They consisted of 29 cases of Diphtheria, 1 of Membranous Croup, 19 of Erysipelas, 24 of Scarlet Fever, 4 of Enteric Fever, and 2 of Puerperal Fever. Small Pox. — It is satisfactory to note that no cases of this disease occurred during the year. • A Local Government Board Inquiry was held at the offices of Bromley and Beckenham Joint Hospital Board on February 17th, 1904, by K. J. Reece, Esq., M.D , respecting a petition presented to the Local Government Board to issue a Provisional Order to empower the Joint Board to put in force the powers of the Land Clauses Acts with a view of acquiring a site for a Small-pox Hospital. Diphtheria.—Twenty-nine cases were reported as compared with 25 in 1903, and occurred as follows:.— January 3 cases March 1 case May 2 cases September 2 ,, October 3 ,, . November 15 „ December 3 „ Total 29 cases 6 The several parishes contributed as follows :— West Wickham I case Chelsfield 2 cases Farnborough 3 „ Knockholt 2 „ Orpington 7 „ St. Mary Cray 14 ,, Total 29 cases Two of the cases died in Hospital—1 in March from Farnborough. aged 1 year; and 1 in December from St. Mary Cray, aged 7 years. The cases and deaths occurred at the following age-periods:— 1—5 5—15 15—25 25-65 years. years. years. years. 11 14 3 1 =29 cases 11 =2 deaths Membranous Croup —One fatal case of this form of Diphtheria occurred in June at Orpington—a child aged 3 months. Twelve of these cases of Diphtheria were in the families of persons at Crocken Hill, in the Parish of St. Mary Cray, during the months of November and December. Crocken Hill is on the extreme east of this District, the greater part of the village being in the Dartford Rural District, where Diphtheria was also prevalent at that time and previously. • Erysipelas was responsible for 19 non-fatal cases as compared with 20 cases in 1903, and were reported as follows: — February 2 cases March 1 case April 2 cases June 2 ,, July 1 case September 2 cases October 1 case November 3 cases December 5 ,, Total 19 cases The casts occurred at the following age-periods:— 1—5 5—15 15-25 25—65 65 £ upwards years. years. years. years. years. 1 2 1 11 4 =19 cases. 7 Scarlet Fever fell from 50 cases in 1903 to 24 in 1904, as follows:— January 4 cases March 5 „ April 2 „ May 1 case July 1 „ September 2 cases November 6 ,, December 3 ,, Total 24 cases Locally they occurred as follows:— Hayes 2 cases Chelsfield 9 „ Farnborough 5 „ Orpington 4 „ St. Mary Cray 1 case Mottingham 1 „ North Cray 1 „ St. Pauls Cray 1 ,, Total 24 cases The cases occurred at the following age-periods:— 1—5 5—15 25—65 years. years. jears. 3 20 1 — 24 cases The disease was cf a mild type and no deaths resnlttd. Enteric (01 Typhoid) Fever. Four non-fatal cases occurred —the same number as in 1903—at the following age periods:— 1—5 15—25 25—65 years. years. years. 1 1 2=4 cases One occurred at Mottingham in January and 1 in February; One at the Union Workhouse, Farnborough in July; and one at St. Mary Cray in August. I made several communications to your Council during the year respecting matters referred to in a Report made to a Local Committee at Mottingham by Dr. Simpson. While I did not think that the facts bore out the conclusions arrived at, viz., that the 8 cases of typhoid occurring in Mottingham during several years past to an extent somewhat above the average were caused by the consumption of specifically infected milk, yet I specially considered that report and advised your Council to carry out as far as possible any suggestions which were practicable and likely to improve the conditions of the milk supplies, soil and water. Your Council had already settled for the better disposal of the storm water and a considerable improvement has been made in this respect during the past year ; the Mottingham pond was thoroughly cleaned out in September at a cost £37 10s., part of the expense (£15) being borne by the Rev. Canon St. John on behalf of Mottingham House ; improvements have been made at the dairy farms and a number of drains examined and reconstructed. This work will be further continued during the ensuing year. I am glad to report that there has been 110 case of Typhoid Fever at Mottingham since February, 1904. Puerperal Fever-—Two non-fatal cases occurred as compared with 1 in 1903, and arose 1 in January at Hayes, and 1 in July at St. Paul's Cray. NON-NOTIFIABLE DISEASES. No deaths resulted from Measles during the whole of the year. Whooping-cough caused 9 deaths—1 in February at Cudham, 1 in May at Keston, 2 in October at Orpington, 3 in November at Orpington, and 2 in December at Orpington. The patients' ages varied from 27 days to 5 years. Diarrhoea was responsible for 10 deaths—1 in May at Keston, 3 in August (i at St. Mary Cray, 1 at Chelsfield, and 1 St. Paul's Cray), 3 in September (1 at Cudham and 2 at Orpington), 1 in October at Hayes, 1 in November at St. Mary Cray, and 1 in December at Farnborough. Nine of the patients were infants under 1 year of age and 1 an adult female. Influenza caused 3 deaths—1 in January at Downe, 1 in February at Orpington, and 1 in December at Farnborough, two of the patients being infants and one an adult male. HOSPITAL ISOLATION. Fifty cases of infectious disease were treated at the Bromley and Beckenham Joint Hospital, and 2 at the Union Infirmary, Farnborough, consisting of 26 cases of Diphtheria, 22 cases of Scarlet Fever, 1 of Erysipelas, 2 of Enteric Fever, and 1 of Puerperal Fever. 9 They were admitted as follows:— In January 7 cases (3 Diphtheria, 4 Scarlet Fever). ,, February 1 case (Enteric Fever). „ March 4 cases (1 Diphtheria, 3 Scarlet Fever). „ April 2 „ (Scarlet Fever). „ May 2 ,, (1 Diphtheria, 1 Scarlet Fever). ,, July 3 ,, (1 Scarlet Fever, 1 Enteric Fever, and 1 Puerperal Fever). ,, September 4 ,, (2 Diphtheria, 2 Scarlet Fever). ,. October 3 ,, (Diphtheria). ,, November 19 ,, (13 Diphtheria, 6 Scarlet Fever). „ December 7 ,, (3 Diphtheria, 3 Scarlet Fever, and 1 Erysipelas). Total 52 cases Of the total number of cases of infectious disease, 65 per cent. were removed to Hospital. Of those treated 19 were males and 33 females, the ages varying from 1 to 35 years. INSPECTIONS. The district, which now includes 13 parishes, is divided into two parts for the purposes of inspection, viz.:— No. 1 District (Mr. Nightingale) includes the parishes of:— Population at census of 1901. Orpington 4259 St. Mary Cray 1894 Mottingham 1332 North Cray 661 St. Paul's Cray 1207 9353 No. 2 District (Mr. Dunlop) includes the parishes of:— Population at census of 1901. Hayes 838 WestWickham 1328 Chelsfield 1522 Cudham 1111 Downe 610 Farnborough 2262 Keston 832 Knockholt 952 9455 10 In addition to visits of inspection to houses in which cases of infectious disease have occurred, I have accompanied the Sanitary Inspectors at one time or other in each branch of the sanitary work during the past year, particularly in reference to matters connected with dairies and cowsheds throughout the district, and to drainage in Mottingham, Knockholt, Keston, and St. Mary Cray. The Common Lodging House (one only), the condition of the Slaughterhouses, and the Dairies, Cowsheds and Milkshops are dealt with in detail in the Sanitary Inspectors' Reports appended, many of which I have also personally inspected. FACTORY AND WORKSHOPS' ACT, 1901. In No. i District there are on the register 12 factories and 54 workshops; in No. 2 District 3 factories and 72 workshops ; making a total of 15 factories and 126 workshops in the whole of the Rural District of Bromley. A considerable amount of work has been done under the Act during the past year, details of which are appended in the reports of the Sanitary Inspector for each part of the District and in the specially provided table. ELEMENTARY SCHOOL CLOSURES. It was found necessary to recommend the closure of the following elementary schools for the periods and on account of the prevalence of the infectious disease set opposite each:— National School, Cudham, February 8th to February 26th, Whooping-cough. National School, Downe, April nth to May 13th, Measles. Fairchild's School, Warlingham, May 9th to May 27th, Measles. 'I he School, Keston, May 16th to June 6lh, Whooping-cough. Infants' School, Hayes, June 13th to July 8th, Whoopingcough. National School, Knockholt, November 14th to November 18th, Diphtheria. National School, Knockholt, December 1st to December 9th, Diphtheria. TUBERCULOSIS. I asked your Council to consider the question of the Notification of Pulmonary Phthisis in the District, advocating the adoption of a voluntary system, and this being agreed to, I addressed the following circular letter to each registered medical practitioner in the District;— "The Rural District Council of Bromley, being desirous " of, as far as possible, preventing the spread of Tuberculosis, 11 "propose to ask your co-operation in the adoption of a limited " system of voluntary notification of this disease. " It is proposed to ask you to notify cases of well-developed "Pulmonary Phthisis (preferably confirmed by bacteriological " examination), in which, in your opinion, the disease is likely " to be conveyed to others by expectoration or otherwise; and " where such measures as the circulation of primed recommen" dations, disinfection of the premises at intervals, cleansing, or "other sanitary measures, can be carried out or enforced with " advantage by the Council, with a view of effecting an im" provement in the surroundings of the patients and the " protection of those coming in close contact with them. " The Council propose to adopt from January ist, 1905, a " system of voluntary notification of such cases, and to pay a "fee of 2s. 6d. for non pauper cases, and is. for pauper cases "—chronic cases to be notified annually only. "If in case of death a written intimation to the Sanitary " Inspector of the District by the medical attendant or rela" tives. or other person in charge, stating that disinfection of " the sick room or other parts of the house is desired, such " disinfection will be carried out gratis by the Council's •' officers. " For several reasons a compulsory system of notification " of this disease appears to be undesirable at the present time. " but the Council nope that something useful may be effected " by the above means." REPORTS DURING YEAR. I have made 19 reports to your Council during the year on various matters which have included several on the drains, watercourses, dairies, etc., at Mottingham ; dairies and cowsheds at North Cray ; condition of Lawrence Yard, St. Mary Cray ; Perry Hall drainage, Orpington ; slaughter-houses and cowsheds, West Wickham ; piggeries, Ramsden, &c. CONDITION OF DISTRICT AT END OF YEAR. A considerable diminution in the number of cases of infectious disease took place in December and at the end of the year the health of the District was in a satisfactory condition. The reports of the work carried out by the Sanitary Inspectors, the tables of vital statistics required by the Local Government Board, and the table provided by the Secretary of State for recording action taken under the Factory and Workshops Act, 1901, are appended. I have the honour to be, Gentlemen, Your obedient Servant, March 20th, 1905. JAMES SCOTT TEW. Table 1.—For Whole District. Year. Population estimated to Middle of each Year. Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths of Non-Residents registered in District. Deaths of Residents registered beyond District. Nett Deaths at all Ages belonging to the District. Number. Rate.* Number. Rate per 1,000 Births Registered. Number. Rate.* Deaths in Public Institutions. Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1898 31,513 688 21.8 89 129 391 12.4 85 34 10 367 11.6 1899 32,220 759 23.3 106 142 444 13.7 106 39 21 426 13.2 1900 32,923 850 25.8 89 125 465 14.1 139 39 13 439 13.3 1901 24,625 642 26.0 59 91 325 13.1 100 55 8 278 11.2 1902 25,225 530 21.0 57 107 333 13.2 92 56 8 285 11.2 1903 19,287 511 26.4 48 93 289 14.9 108 51 238 12.3 Averages for Years 1898-1903. 27,632 663 24.0 74 114 374 13.5 105 45 12 338 12.1 1904 19,504 483 24.7 64 132 314 16.0 118 71 3 246 12.6 'Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.—The deaths to be 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 to be included in Column 12 are the number in Column 7, corrected by the substraction 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 sickness or infirmity, and dying in public institutions there ; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The " Public Institntions " to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmary, such as hospitals, workhouses and lunatic asylums. Area of District in acres (exclusive of area covered by water), 29,557. At Census of 1901:—Total population at all ages, 24,625. Number of inhabited houses, 4,819. Average number of persons per house, 5. Table 2. Names of Localities. Bromley Rural. Beckenham Sub-Registered District. Orpington Sub-Registered District. Chislehurst Sub-Registered District. Year. Population estimated to middle of oach year. Births Registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths uuder 1 year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b a. d. 1900 32,923 850 439 89 1,617 21 17 6 4,390 43 20 5 1901 24,225 642 278 59 2,166 40 11 1 13,442 356 151 28 9,017 246 116 30 1902 25,225 530 285 57 2,174 49 24 3 13.597 355 178 41 9,454 126 83 13 1903 19,287 511 238 48 2,189 53 23 7 13,749 369 177 30 3,349 89 38 11 Averages of Years 1900-1903. 25,515 633 310 63 2,036 40 18 4 13,596 360 168 33 6,552 126 64 14 1904 19,504 483 246 64 2,199 43 27 4 13,888 347 176 52 3,417 93 43 8 Notes.—(a) The separate localities adopted for this table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groupa of parishes, or registration sub-districts. Block 1, may, if desired, be used for the whole district; and blocks 2, 3, etc., for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (b) Deaths of residents occurring in public institutions beyond the district are to be included in sub-columns c of this table, and those of non-residents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms "resident" and 44 non-resident.") (c) Deaths of residents occuring in public institutions, whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. (d) Care should be taken that the gross totals of the several columns iu this Table respectively equal the corresponding totals for the whole districts in Tables I. and IV. : thus the totals of sub-columns a, b, and c should agree with the figures for the year in the colums 2, 3, and 12, respectively, of Table I.; the gross total of the sub-columns c should agree with the total of column 2 in Table IV., and the gross total of sub-colums d with the total of column 3 in Table IV. Table 3.—Cases of infectious Disease Notified during The Year 1904. Notifiable Disease. Cases Notified in Whole District. Total cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At Ages+—Years. At all Ages. Under 1. 1 to 5. 5 to 15 15 to 25. 25 to 65. 65 and upwards Beckenham. Orping< ton. Chislehurst. Beckenham. Orpington. Chisle- | hurst. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 29 .. 11 14 3 .. 1 28 .. .. 25 .. Membranous croup 1 .. 1 .. .. .. .. .. 1 .. .. .. .. Erysipelas 19 .. 1 2 1 11 4 .. 17 .. .. 1 .. Scarlet Fever 24 .. 3 20 .. l .. 2 19 3 .. 19 3 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 4 .. 1 .. 2 .. .. 2 2 .. 1 1 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Lever .. .. .. .. .............. .. .. .. .. .. .. .. .. Puerperal Fever 2 .. .. .. 1 1 .. 1 .. 1 .. .. 1 Plague * .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 79 .. 17 36 6 16 4 4 67 8 1 46 5 Notes. —The localities adopted for this table should be the same as those in Table II. and IV. State in space below the name of the isolation hospital, if any, to which residents in the district, suffering from infectious disease, are usually sent. Mark (H) the locality in which it is situated, or if not within the district, state where it is situated', and in what district. Mark (W) the locality in which a workhouse is situated. * This space may be used for record of other disease the notification (compulsory or voluntary) of which is in force in the district. † These age columns for notifications should be filled up in all cases where the Medical Officer of Health, by inquiry or otherwise has obtained the necessary information. Bromley and Beckenham Joint Isolation Hospital, Bromley Common, Bromley Urban District. Table 4.—Causes of, and Ages at, Death during 1904. Causes of Death. Deaths in whole District at subjoined Ages. Deaths in Localities (at all ages). Total Deaths whether of residents or non - residents in Public Institutions in the District. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Beckenham. ()rpington. Chislehurst. Small-Pox .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 3 .. 2 .. .. .. 1 .. 3 .. .. Whooping-cough 9 6 2 1 .. .. .. .. 9 .. .. Diphtheria, Membranous Croup 3 1 1 1 .. .. .. .. 3 .. .. Croup .. .. .. .. .. .. .. .. .. .. .. Diarrhoea, Dysentry 10 9 .. .. .. 1 .. 1 8 1 1 Epidemic or Zymotic Enteritis 8 5 3 .. .. .. .. 2 5 1 .. Enteritis 7 4 2 .. 1 .. .. .. 5 2 .. Other continued fevers .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. Other septic diseases i .. .. .. .. 1 ... 1 ... ... 2 Tuberculosis of Meninges 4 1 3 ... ... ... ... ... 4 ... 1 Tuberculosis of Lungs 14 ... 1 2 2 8 1 2 3 9 Other forms of Tuberculosis 2 1 ... 1 ... ... ... ... 1 1 1 Alcholism 1 ... ... ... ... 1 ... ... 1 ... 3 Cancer 21 ... 1 ... ... 13 7 ... 17 4 12 Premature Birth 7 7 ... ... ... ... ... ... 7 ... ... Developmental Diseases 14 14 ... ... ... ... ... 1 12 1 2 Old Age 32 ... ... ... ... ......... 32 5 18 9 49 Meningitis 2 ... ... 1 1 ... ... ... 1 1 ... Inflammation and Softening of Brain 2 1 ... ... ... ... 1 ... 2 ... 3 Organic Diseases of Heart 27 ... ... ... 1 15 11 1 23 3 5 Acute Bronchitis 7 4 1 ... ... 1 1 3 2 2 1 Chronic Bronchitis 6 1 ... ... ... 2 3 1 4 1 3 Lobar (Croupous) Pneumonia 7 3 3 ... ... ... 1 1 5 1 ... Lobular (Broncho-) Pneumonia 6 ... 1 1 ... 2 2 1 5 ... 3 Diseases of Stomach ... ... ... ... ... ... ... ... ... ... ... Obstruction of Intestines 3 ... ... ... ... 3 ... 1 1 1 i Cirrhosis of Livr 2 ... ... ... ... 2 ... ... 1 1 ... Nephritis and Bright's Disease 8 ... ... ... ... 4 4 2 5 1 3 Tumours and other Affections of Female Genital Organs 2 ... ... 1 ... 1 ... 1 ... 1 1 Accidents & Diseases of Parturition 4 1 ... ... 1 2 ... ... 2 2 ... Deaths by Accident or Negligence 7 ... 1 1 3 2 ... 1 2 4 3 Deaths by Suicide 4 ... ... ... ... 4 ... 2 2 ... ... Deaths fromlll-defined causes ... ... ... ... ... ... ... ... ... ... 1 All other causes 23 6 1 1 ... 10 5 1 19 3 14 All causes 246 64 22 10 9 72 69 27 176 43 118 Annual Report of Medical Offieer of Health for 1904, for the Rural District of Bromley. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sa,nitary Inspectors or Inspectors of Nuisances. Premises. Inspections. Number of Written Notices. Prosecutions. Factories 3 Nil. (Including Factory Laundries.) Workshops 190 16 „ (Including Workshop Laundries.) Workplaces Homeworkers' Premises 4 „ Total 197 16 Nil. 2-DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecution. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts—* Want of Cleanliness 61 61 Nil. Nil. Want of Ventilation Overcrowding Want of drainage to floors 3 3 „ „ Other nuisances insufficient ‡Sanitary accommodation unsuitable or defective not separate for sexes Offences tender the Factory and Workshop Act— Illegal occupation of underground bakehouse (S. 101) Breach of special sanitary requirements for bakehouses (SS. 97 to 100) Failure as regard lists of outworkers (S. 107)... Giving out work to be done J unwholesome (S. 108)... in premises which are | infected (S. 110) Allowing wearing apparel to be made in premises infected by scarlet fever or smallpox (S. 109) ... Other offeDces Total 64 64 Nil. Nil. •Including those specified in Sections 2, 3, 7 and 8, of the Factory Act as remediable under the Public Health Acts. JFor districts not in London state here whether Section 22 of the Public Health Acts Amendment Act, 1890, has been adopted by the District Council ; and if so what standard of sufficiency and suitability of sanitary accomnii dation for persons employed in factories and workshops has been enforced. 3.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspectors of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 2 Action taken in matters referred by H.M. Inspectors as remediable under the. Public Health Acts, but not under the Factory Acts (S. 5) Notified by H.M. Inspectors Reports (of action taken) sent to H.M. Inspectors Other Underground Bakehouses (S. 101) :— In use during 1903 Certificates granted in 1903 in 1904 In use at the end of 1904 Homework :— Number of Lists of Outworkers" (S. 107) :— Lists. Outworkers Lists received Addresses of outworkers forwarded to other Authorities 1 received from other Authorities Homework in unwholesome or infected premises :— Wearing Apparel; Other. Notices prohibiting homework in unwholesome premises (S. 108) Cases of infectious disease notified in homeworkers' premises Orders prohibiting homework in infected premises Workshops on the Register (S. 131) at the end of 1904 Important classes of Workshops, such as workshop bak houses may be enumerated here. Total number of workshops on Register 126 126 * The Lists should be received twice in the year. The year's figures required in the Table are then obtained by adding together the two half-yearly totals. 18 BROMLI:Y RURAL DISTRICT COUNCIL No. 1 District. Sanitary Inspkciok's Office, Orpington, February 24th, 1905. To the Chaitman and Members of BROMLEY RURAL DISTRICT COUNCIL. GENTLEMEN,— I have the honour to-present to you my Annual Report for the year 1904. The number of visits paid to the respective parishes in my district are as follows:—Orpington 190, St. Mary Cray 149, St. Paul's Ciay 55, North Cray 34, Mottingham, 114. Complaints.—Fifty-three complaints were received and investigated, the majority of which related to the removal of house refuse in the Parish of Orpington. I regret to say that the collection of house refuse in this parish whs not carried out at all satisfactorily. Infectious Disease. — During the year forty-two cases of Infectious Disease were notified, viz.:—Diphtheria 21, Erysipelas 8, Puerperal Fever 1,Scarlet Fever8.TyphoidFever3> Membranous Croup 1, being a decrease of 10, as compared with the previous year. The locality of the cases was as follows :—Orpington 17, St. Mary Cray 17, St. Paul's Cray 3, North Cray 1, Mottingham 4. An outbreak of Diphtheria occurred among the scholars at Crocken Hill School in November, and twelve children from the Stones Cross district contracted the disease. Disinfection.—Twenty-nine rooms were either fumigated with sulphur di-oxide, or sprayed with formaldehyde, the clothing and washing articles being soaked in a 2 per cent, solution of formaldehyde or izal fluid. 19 Drain Testing--—Tile drains of 51 houses have been examined and tested either with smoke or water, and in most instances found defective. Out of this number it was found necessary to entirely reconstruct the drainage of 26 houses. All new work in connection with the above was submitted to a severe water test before being covered in. Overcrowding".—Two cases of overcrowing were discovered and abated without notice. Fruit Pickers' Shelters. — The temporary shelters were visited frequently during the fruit and hop-picking season. Two cases of overcrowding were found by me, and abated after verbal notice. The majority of the people who occupy these shelters have no respect for cleanliness, but fortunately only one case of infectious disease occurred among them during the season. Common Lodging House.—Twenty-one visits were made to the common lodging house at Ford Croft, and I have at all times found the house clean and well ordered. Slaughter Houses.—There are eight of these in my district, all of which are registered, and six are licensed from year to year. The one occupied by Mr. F. Strouts is so structurally defective that it is almost impossible to put the building in a sanitary condition. Arrangements have recently been made between owner and occupier for the erection of a new slaughter house, and plans are beiog prepared for that purpose. Thirty-five visits were made to the respective slaughter houses and I found the bye-laws were complied with. Factory and Workshops Act, 1901. A new register under this Act is now compiled. It contains entries of 11 factories and 54 workshops. There are 12 Bakehouses in the District which were visited periodically, and although many of them are not modern in construction, special attention has been given with regard to cleanliness. One complaint of neglect or default was received from the Factory Inspector. This referred to dirty walls, etc., of a Wheelwright's Shop and Blacksmith's Forge. The necessary limewashing was carried out by the occupier after written notice to do SO. Dairies, Cowshed, and Milkshops. A large amount of work has been done in this direction, especially at Mottingham in which parish a considerable quantity of milk is produced. During the year 100 visits were paid to the different cowsheds, 26 of such visits being in company with your Medical Officer of Health. The regulations with respect to drainage, cleanliness, ventilation, and water supply were strictly enforced. 20 Insanitary Dwellings. In my report for 1903 I referred to the houses in Lawrence Yard, St. Mary Cray Several of the houses have been vacant during the greater part of the year, but those that are occupied remain in the same or even a worse condition than before, although notice has been served on the owners to carry out necessary requirements. River Cray. I have made periodical visits to various parts of the river in your District, and have found the stream fairly satisfactory. SUMMARY OF WORK DONE. Number of complants received 53 Number of nuisances discovered 127 Number of statutory notices served 22 Number of nuisances abated without notice 102 Number of letters, reports, and school notices sent 546 Houses at which drains were tested 51 Houses at which drains weie defective 50 Number of sectional tests new work 81 New w.c. pans provided 41 New dust bins provided 53 New cesspools made 1 Foul accumulations removed 10 Houses cleansed and repaired 35 Number of back yards paved 9 Houses supplied with water from main 1 Overcrowding cases abated 2 Cowsheds, slaughter-houses, and bakehouses cleansed 30 Water laid on to w.c.s 8 Number of workshops visited 54 I have the honour to be, Gentlemen, Your Obedient Servant, HENRY NIGHTINGALE. (Assoc. & Cert. Royal San lust.), Sanitary Inspector. 21 BROMLEY RURAL DISTRICT COUNCIL No 2 District Office of Sanitary Inspector, Farnborouoh, R.S.O., Kent. March yd, 1905. To the Chairman and Members of BROMLEY RURAL DISTRICT COUNCIL. GENTLEMEN,— I have the honour to present to you my Annual Report for the year 1904. The number of visits made in the several parishes is as follows:—Chelsfield 60, Cudham 45, Downe 44, Farnborough 112, Hayes 42, Keston 66, Knockholt 40, and West Wickham 118. Complaints-—Fifty-four complaints were received and investigated ; of these 32 related to cesspools, and 22 to defective drainage. Water Supply.—Thirteen houses were found to be without an available supply of wholesome water, and these (together with thirty others) outstanding in my last report have been connected with the Company's water main. Infectious Disease.—Thirty-seven cases of infectious disease were dealt with, viz., Scarlet Fever 16, Erysipelas 11, Diphtheria 8, Enteric Fever 1, Puerperal Fever 1. It was found necessary to disinfect 26 rooms; the fumigation was carried out with formalin, the clothing, &c., being disinfected with a solution of perchloride of mercury. Upon investigating a fatal case of Diphtheria at Farnborough, it was proved that the patient (a child) contracted the disease from a cat. 22 Drainage and Drain Testing.—The drainage of eighty-two nouses has been examined and tested. With the exception of four, it was found necessary to reconstruct same. The work in connection therewith has been carried out under my supervision. Dairies, Cowsheds, and Milkshops' Order of 1885.—There are 12 persons carrying on the trade of cow-keepers, and who are registered under the above Order. The cowsheds were limewashed twice during the year, and at "Woodlands" and "Coney Hall" Farms, West Wickham, new systems of drainage, &c., have been carried out in accordance with the regulations. Bakehouses.—There are 16 registered Bakehouses ; they have all been limewashed twice during the year as required by Section 99 of the Factory and Workshops' Act, 1901. The occupier of one has been called upon to cleanse the premises twice during the year in addition to the limewashing above mentioned as the premises were found dirty and generally unsatisfactory. Slaughter-houses.—There are six licensed slaughter-houses, and the general cleansing, &c., has been duly carried out in accordance with the Bye-laws. Fruit-Pickers' Shelters.— Thirty-four visits were paid to the different fruit-pickers' shelters during the fruit-picking season, and the Bye-laws were duly complied with. I have to again report that several of the " shelters " at Court Lodge Farm, Chelsfield, were allowed to be occupied during the winter months, and that the owners would not close them until they were absolutely compelled to do so. Notice has been served requiring the owners to carry out the necessary cleansing and limewasking before allowing the " shelters " to be re-inhabited and such notice will be strictly enforced. Factories and Workshops. — Special attention has been given to premises of this character during the year to see that the provisions of the 1901 Act are observed. Seventy-two Workshops and three Factories have beeir inspected, and where limewashing and cleansing was required it was carried out after verbal or written notice. Two new wash-houses have been built at "Cedar" and " Allems " Laundries, Farnborough. No Complaint was received from the Home Office. The list of domestic Factories or Workshops is being added to as they come under notice to be forwarded to the District Factory Inspector from time to time as required by the Home Office. 23 The Register contains entries of Factory and Workshops as follows:— Parish. Factories Workshops. Chelsfield — 9 Cudham — 4 Downe — 5 Farnborough 3 16 Hayes — 9 Keston — 9 Knockholt — 11 West Wickham — 9 Totals 3 72 SUMMARY OF WORK DONE. Number of complaints received and investigated 50 Nuisances discovered and abated 224 Preliminary notices served and complied with 24 Statutory notices served and complied with 10 Number of nuisances abated without notice 190 Number of letters written, reports made and school notices sent 662 CHARACTER OF WORK DONE. Number of houses cleansed and repaired 44 Houses supplied with water from the Company's main 43 Houses where drains were examined and tested 82 Houses at which drains were found to be defective 78 Houses at which drains were trapped ... 40 Inspections made in course of work (new drains) 164 Overcrowding cases abated 2 Number of water closets provided 20 Number of earth closets provided 24 Number of dust bins provided 32 N umber of cesspools cleansed 200 Number of new cesspools provided (watertight) 18 Number of privies cleansed 36 Urinals cleansed and lime-washed 28 Offensive accumulations removed 24 Infected houses fumigated and cleansed 26 24 In conclusion I beg to state that a large amount of sanitary improvement work has been carried on throughout the District during the year with very little friction, owners of properties being advised to effect improvements rather than being compelled. I may state that it was only found necessary to serve statutory notices for the abatement of nuisances or remedying sanitary defects in 10 cases, the greater part of the work being carried out after personal interview or letter to the persons concerned. I have the honour to be, Gentlemen, Your Obedient Servant, ANDREW DUNLOP, (Assoc. and Cert. San. Inst.) Inspector of Nuisances.