CHIS 2 CHISWICK PARISH. ANNUAL REPORT OF THE Medical Officer of Health. 1893. CHISWICK : PRINTED BY PLATRIER AND SONS, HIGH ROAD. \ 1894. CHISWICK PARISH. ANNUAL REPORT OF THE Medical Officer of Health. 1893. CHISWICK : PRINTED BY PLATRIER AND SONS, HIGH ROAD. 1894. SANITARY DEPARTMENT, March 1st, 1894. To the Chairman and Members of the Chiswick Local Board. Gentlemen, I beg to present my Fifteenth Annual Report upon the health and sanitary condition of the Chiswick Urban Sanitary District for the year 1893, together with the tables and statistics required by the Local Government Board. Population. The estimated population for the middle of the year I calculate to be about 23,382. Births. The number of births registered during the year was 675, of which 343 were males and 332 females. The birth rate was 28.86 per thousand (the lowest for the past 10 years). The birth rate for London was 31 per thousand. Deaths. The number of deaths was 338 (167 males, 171 females). The death rate was 14.45 per thousand, which is, I believe, the lowest recorded, with the exception of 1889 ; for London it was 2T3 I find that in 1875 the death rate was 24.9 per thousand, on an estimated population of 10,000. The natural increase of population (excess of of births over deaths was 337. The principal causes of death have been: 4 Diseases of the Respiratory Organs, Bronchitis, Pneumonia, and Pleurisy 66 Phthisis 26 Heart Disease 32 Diarrhœa 21 There were 19 Inquests held during the year. Deaths resulted from natural causes in 10 of these, 4 from accidental injuries, 2 from drowning, 2 from suicide, and 1 from suffocation. The following table epitomises the ages at which the deaths occurred: Deaths under 1 year 104 152 under 5 years of age. „ from 1 year and under 5 years 48 „ „ 5 years and under 15 „ 12 186 over 5 years of age. „ „ 15 „ „ 25 „ 8 „ „ 25 „ „ 65 „ 94 „ over 65 years 72 338 10 of these deaths occurred between the ages of 80 and 90, and 1 attained the age of 90. Infantile Mortality. The rate of this mortality or the proportion of deaths under one year of age in every thousand births was 154; in 1892, 169; and in 1891, 134. It will be seen from this that last year compares favorably with the one preceding, and it is a matter of vital importance to the welfare of the parish that the rate should be annually reduced. This can be primarily obtained by preventing overcrowding and condemning all houses which are found to be unfit for habitation. According to the statistics quoted in Ashby and Wright's work on " Diseases of Children," in this country out of every 1000 children born, on an average 149 die before the end of their first year of life, and 263 before the age of five years. During the next five years, from five to ten 5 years of age, 35 die, and 18 more between the ages of ten and fifteen years. So that out of the original 1000, 684 will be alive on their fifteenth birthday and 316 will be dead. From these figures it is clear that the mortality is greatest during the first year, and that it rapidly declines as childhood advances. There are, of course, many allowances to be made with regard to some of the statistics which have been produced, but the undeniable fact remains that the general mortality amongst infants and young children is terrific, and it is a subject to consider whether this loss of life is inevitable ? We must also bear in mind that wherever the death rate is high, disease will unavoidably leave its mark on those who survive, and the natural conclusion is that illness, and malnutrition in childhood, frequently leaves traces behind which are not wholly effaced by vigour in adults. The following are the diseases which proved most fatal to infants and young children : Diseases of the Respiratory Organs, viz.: Bronchitis, Pneumonia, and Pleurisy 34 Measles 5 Whooping Cough 9 Convulsions 7 Diarrhœa 20 Tuberculosis and Marasmus 9 Premature Birth 10 Tubercular Meningitis 9 Debility from Birth 12 Total 115 Zymotic Diseases. The following are the deaths from the principal zymotic diseases: 6 Whooping Cough 9 Measles 5 Scarlet Fever 2 Diphtheria 4. Croup (Membranous) 4 Enteric Fever 2 Continued Fever 1 Puerperal Fever 1 Diarrhœa 21 49 Zymotic death rate, 2.09 per thousand. Infectious Diseases Notification Aft. Under this Aft, I have received 239 certificates, viz.: Small Pox 25 Scarlet Fever 131 Diphtheria 15 Croup (Membranous) 6 Enteric Fever 6 Continued Fever 6 Puerperal Fever 2 Erysipelas 47 Cholera (English) 1 Total 239 An outbreak of small pox occurred at the latter end of April. The two first cases were reported at Turnham Green. I at once obtained the sanction of your Board to provide a nurse and all that was absolutely required by the patients, who were isolated as far as practicable, and every precaution taken to avoid the spreading of this very infectious disease. I used every effort to trace its origin but without success. A very severe case was shortly after notified from Chiswick New Town, and this being a densely populated part of the parish, with comparatively no 7 adequate means of isolation, an epidemic of the disease threatened, and matters assumed a serious aspect. Several other cases were shortly reported from the same locality, and as most of the patients were relatives and neighbours, I have every reason to believe that my instructions with regard to isolation were disregarded. Each house where a case existed was visited by the Sanitary Inspector several times during the day and late at night, and also by myself frequently. I had the patients removed into two adjoining houses, and placed them under the care of trained nurses; subsequently, I attended with your Clerk and late Chairman at the offices of the Metropolitan Asylums Board, and had an interview with one of the head officials, when we decided on communicating with the Authorities of the Small Pox Hospital at Highgate, and made arrangements for the removal of eight patients in ambulances provided by the former Board. This arrangement, although entailing considerable expense, doubtless had the desired effect of stamping out the disease. The total number of cases reported was 25 ; all recovered, with one exception, viz.: a militia recruit, who was sent home to Chiswick by the Military Authorities at Hounslow, and died at the Highgate Hospital a few days after admission. The death having occurred out of the district, was not recorded in the register or table. The houses from which these cases were reported were thoroughly disinfected by the Sanitary Inspector and cleansed (under my instructions) ; the bedding and clothing, which I considered required to be destroyed, were conveyed to the Pumping Station and 8 burnt, new articles being purchased by your Board to compensate the owners. At the earliest opportunity, I had the drainage of the houses in Wood Street (where the greater number of these cases occurred) thoroughly tested, and acting on the report of our Sanitary Inspector, I examined the drainage of several houses, and found large cesspools situated within a few feet of the dwellinghouses, containing a large amount of sewage matter, the overflow discharging into the public sewer. I need hardly add that this condition of affairs was at once remedied, and an excellent system of drainage substituted on the most modern principle. Scarlet Fever Has prevailed more or less during each month of the year, resulting in two deaths. The number of notifications indicate an increase of 79 on the year preceding. Immediately on the notification of any infectious disease, the houses where the cases occur are visited as soon as practicable by the Sanitary Inspector, when the usual enquiries are made and reported to me, and when necessary I personally attend the case to ensure all possible precautions being taken, and when the patients are convalescent, the house, or rooms, are properly disinfected by the Inspector, and my certificate is given when I consider the patients are able to resume their occupation or (in the case of children) to return to school, consequently the danger of spreading the disease is obviated. Diphtheria. This has caused four deaths : two in March, one in June, and one in September. There have been 15 9 cases notified, which is one less than in the previous year. Membranous Croup. Six cases were notified and four deaths; the first in May, the second in October, and the others in November and December. Whooping Cough Caused nine deaths; all young children, mostly under a year. Measles. There were five deaths from this complaint during the months of March, May, and June. For the preceding year there were 34 deaths. Enteric or Typhoid Fever. Six cases were notified and two deaths: one at Gunnersbury and one on the Glebe Estate. The former was imported; the drainage of the house where the latter occurred was found defective, and possibly accounted for the disease. Continued Fever A death was registered from this complaint. Puerperal Fever There were two cases notified and one death. Erysipelas. 47 notifications and no deaths. Diarrhœa This complaint has caused 21 deaths, and was prevalent during the months of July, August, and September, mostly in children under a year. 10 Phthisis. 26 deaths were registered from this disease. For the previous year there were 22 deaths. Cancer Was the immediate cause of eight deaths, the same number as the year preceding. Influenza. This complaint has been somewhat prevalent during the last three months of the year, although a certain number of cases occurred during the earlier months, more especially in February and March. Five deaths were registered from this complaint as the primary cause. Cholera. A case was reported in August, which I visited, and found to be simply choleraic diarrhoea; the patient recovered after a few days' treatment. It is a question with Medical Officers of Health as to the policy of including Erysipelas with the diseases for notification. I believe the principal reason for doing so has been its association with puerperal fever and vaccination. The following table gives the number of births and deaths, also the birth and death rates, together with the average for the past ten years. 11  1884 1885 1886 1887 1888 1889 1890 1891 1892 !893 Average of last 10 years Births during the year 711 649 709 683 688 678 639 654 679 675 676.5 Birth rate per thousand 40 35.32 37.37 34.84 34.10 32.64 29.89 29.48 29.80 28.86 33.23 Deaths from all causes 290 302 315 318 331 271 358 345 392 338 326 Death rate per thousand 16.25 16.43 16.60 16.24 16.40 13.04 16.75 15.55 17.20 14.45 15.89 Deaths from Small Pox 0 4 0 0 0 0 0 0 0 O .4 ,, Measles 3 21 5 2 8 3 16 8 34 5 10.5 ,, Scarlet Fever 0 5 0 2 2 8 2 0 1 2 2.2 ,, Diphtheria 1 9 1 2 1 0 3 0 3 4 2.4 ,, Whooping Cough 26 5 14 3 16 5 10 9 27 9 12.4 ,, Typhoid and other Fevers 0 3 2 3 1 1 0 7 3 4 2.4 ,, Diarrhœa 16 14 10 19 8 8 17 18 20 21 16.1 ,, Croup (Membranous and Diphtheritic) 1 1 1 0 1 1 1 1 1 4 .12 ,, Erysipelas 0 1 0 1 1 0 1 0 0 0 .4 ,, principal zymotic diseases 47 63 33 32 38 26 50 43 89 49 47 Death rate from do. 2.59 3.26 1.73 1.58 1.78 1.20 2.38 1.93 3.90 2.09 2.24 12 Isolation Hospital. The want of a Hospital of this description has long been felt, more especially during this year,owing to the sudden outbreak of small pox in the Spring, when we experienced great pressure, owing to the want of proper means of isolation, which was then made strikingly evident. As you are aware, representatives from the parishes of Chiswick, Acton, and Hanwell met on the 17th of August, in order to consider the advisability of a " Conjoint Scheme" whereby a hospital might be erected for the use of the three parishes. Subsequent meetings were held on the 5th and 28th of October. At an interview your Chairman and Clerk had with Dr. Thorne Thorne, at the Local Government Board, an intimation was given by the latter that it was a sine qua non small pox and fever cases should be treated separately, consequently it will be necessary to have two hospitals, one for each disease. Acting upon my advice, your Board has recently purchased an ambulance, the use of which will be considerably enhanced when the hospital is provided. Collection of House Refuse. I had occasion in several of my reports during the year, to refer to the unsatisfactory manner in which the dust was collected in our district, and suggested that the system should be reorganised, with additional powers and instructions to the Sanitary Inspector for its superintendence. I am pleased to observe that the Board has since taken the necessary steps to secure a more regular system of collection. Water Supply. It has not been found necessary to take samples 13 of water for analysis in this parish, as almost every house in the district is supplied with water from the Companies' mains. Two houses in Grove Park only derive their supply from wells. It is.however a matter of the utmost importance that a constant supply of water should be obtained for every house in the parish, and that the use of cisterns as a storage for drinking water should be abolished. Beyond an abundant supply of water, the advantages of a constant supply, as far as the public health is concerned, are few, if cisterns are to be retained, and for this reason alone I have refrained from pressing the subject of a constant supply, unless the Board had power to compel the several owners to fix a " draw-off tap" to the main. The improper position of drinking water cisterns is constantly brought to our notice, and in addition to this, they are very seldom cleansed. With the Board's permission, I ordered the distribution of about 500 circulars in various parts of the parish during the Summer months, urging the necessity of periodical cleansing of cisterns. I have frequently inspected houses where the cleansing of drinking water cisterns is overlooked. Early in the year I inspected the houses in Hunt Street, where I found the cisterns situated beneath the floors in a filthy condition; and on the Glebe Estate, where the small cisterns are placed on the first floor landing or in anterooms, it has been proved that the water is taken therefrom by dirty receptacles. From these facts, I have no hesitation in saying that if the water used for drinking purposes could be taken direct from the main, the sickness in our parish would be greatly reduced. I find that the Water Companies will allow 14 the water to be obtained in the manner above described, if the fittings are in accordance with their regulations, and that cisterns are only needed to supply the small flushing apparatus to the water closets. London Water Supply. According to the monthly reports, the Thames derived water has been found to be well filtered, clear and bright for each month of the year. It is an invariable rule that when the quantity of organic matter present in the water is above the average, its mainly vegetable character is proportionally more decided. The singularly small rainfall which has characterised most of the months of the year 1893, has been continued to the end. With the exception of the months of February and July, when the fall was above the average, and October, when the mean fall was slightly exceeded, each month has been conspicuously deficient in rain ; there being a deficiency over the whole year of no less than 8.46 inches of rain. Inspection of the Parish. Early in the Summer, in consequence of a case of scarlet fever which occurred on the Glebe Estate, I instructed our Sanitary Inspector to make a careful inspection of the drainage in that part of the district, and as a result of his investigation, I alluded to the condition of the drainage in one of my monthly reports "as being suspicious, if not alarming," and suggested that the test should be applied to the drains of every house. It was found that in Binns Road alone, without exception, every house drain required relaying throughout. The pipes were disjointed, leaking badly, and having a reversed fall, and in several 15 instances the sewage matter, instead of passing into the public sewer, found its way beneath the floors of the living rooms, creating a very serious nuisance. The same state of things was found in Glebe Street, Reckitt Road, Quick Road, Dale Street, Fraser Street, in fact all over the Glebe Estate. It is undoubtedly due to the original construction of the drains, for they were laid in many instances without being imbedded in concrete, and the joints were made of clay. It has been suggested that all house drains, however well-laid, are liable to become defective. The Board, having been convinced of the necessity of such an important work, gave me instructions to proceed with the work of drain testing by the Sanitary Inspector, who reports the result of his inspections from time to time. Nearly three hundred house drains have been relaid, provided with proper intercepting traps and ventilated, and each tested by the water test prior to their being passed. At the Board Schools on the Glebe, similar defects were also found in the drainage, as above described, which was a very serious matter, as the notifications from scarlet fever have been on the increase. The drains are now however put in a perfectly sanitary condition. The usual attention has been given to the dwellings of the working classes, which are frequently visited by the Sanitary Inspector, to encourage as far as possible an interest in the common rudiments of sanitation. It is, however, a very difficult matter to suppress the overcrowding and uncleanly habits so prevalent in some parts of the parish. 16 I have several times expressed my opinion in favour of the adoption of the Model Bye-laws for the registration of houses " Let in Lodgings." The annual cleansing of houses and premises (which the Bye-laws give power to enforce, both with regard to the owner and occupier) would greatly improve the houses of the working classes. In three instances, I had occasion to attend at the West London Police Court, in support of my certificate, issued under the Housing of the Working Classes Aft, and orders were obtained for the closing of three houses in Turnham Green. Magisterial orders have also been obtained for the abatement of overcrowding in a few cases, and one defendant, in default of the payment of a fine of 5l., was sent to prison for one month, for neglecting to comply with the Magistrate's order. This conviction greatly assisted our work in dealing with overcrowding. I also attended the Court in support of a summons issued by the Sanitary Inspector for unsound fruit, which he found exposed for sale in Wood Street, the defendant was fined 20/-, including costs. This had the desired effect in securing the sale of good fruit, only an occasional caution being given when required. Factory and Workshop Act, 1891. In compliance with the recent order issued by the Home Secretary under this Aft as applied to Sanitary Authorities, all outworkers in connection with the various trades referred to therein have been duly registered by the Sanitary Inspector, each workshop having been visited and its sanitary condition ascertained. The workshops will be visited from time to 17 time and reported on, and in the event of any outbreak of infectious disease, immediate precautions will be taken to prevent its spread. The Sale of Food and Drugs Acts Has been strenuously enforced during the past year, and proceedings have been taken against the vendors of inferior and adulterated food, and the quality of the milk has decidedly improved. Slaughterhouses, Bakehouses, Cowsheds, and Dairies. These have been periodically inspected by the Sanitary Inspector, and occasionally by myself, and have been found generally satisfactory. I would recommend that the following regulations should be printed and hung up in every bakehouse and slaughterhouse in the parish, to obviate any assumed ignorance on the part of the owners or occupiers: BAKEHOUSE REGULATIONS. Factory and Workshop Act, 1883. Section 15. It shall not be lawful to let or suffer to be occupied as a bakehouse or to occupy as a bakehouse, any room or place which was not so let or occupied before first day of June, 1883, unless the following regulations are complied with : (1) No watercloset, earthcloset, privy, or ashpit shall be within or communicate directly with the bakehouse ; (2) Any cistern for supplying water to the bakehouse shall be separate and distinct from any cistern for supplying water to a watercloset; (3) No drain or pipe for carrying off faecal or sewage matter shall have an opening within the bakehouse. Any person who lets or suffers to be occupied, or who occupies any room or place as a bakehouse in contravention of this section, shall be liable, on summary conviction, to a fine not exceeding forty shillings, and to a further fine not exceeding 18 five shillings for every day during which any room or place is so occupied after a conviction under this section. Section 16. Where a Court of Summary Jurisdiction is satisfied on the prosecution of an Inspector or Local Authority that any room or place used as a bakehouse (whether the same was or was not so used before the passing of this Act) is in such a state as to be on sanitary grounds unfit for use or occupation as a bakehouse, the occupier of the bakehouse shall be liable, on summary conviction, to a fine not exceeding forty shillings, and on a second or subsequent conviction, not exceeding five pounds. For the purposes of the 17th secftion of this Act, the Medical Officer of Health of the Local Authority shall have and exercise all such powers of entry, inspection, taking legal proceedings and otherwise, as an Inspector under the Factory and Workshop Act, 1878. Section 34 (1878 Act). Where a bakehouse is situate in any city, town, or place containing, according to the last published census for the time being, a population of more than five thousand persons, all the inside walls of the room of such bakehouse, and all the ceilings or tops of such rooms (whether such walls, ceilings, or tops be plastered or not) and all the passages and staircases of such bakehouse, shall either be painted with oil, or varnished, or be limewashed, or be partly painted or varnished, and partly limewashed : Where painted with oil or varnished, there shall be three coats of paint or varnish, and the paint or varnish shall be renewed once at least in every seven years, and shall be washed with hot water and soap once at least in every six months ; where limewased, the limewashing shall be renewed once at least in every six months. A bakehouse in which there is any contravention of this section shall be deemed not to be kept in conformity with this Aa. SLAUGHTERHOUSE REGULATIONS. 1. Every occupier of a slaughterhouse shall, at all reasonable times, afford free access to every part of the premises to the 19 Medical Officer of Health, the Inspector of Nuisances, or the Surveyor of the Sanitary Authority, or to any committee specially appointed by the Sanitary Authority in that behalf, for the purpose of inspecting such premises. 2. Ever}' occupier of a slaughterhouse shall cause every animal brought to such slaughterhouse for the purpose of being slaughtered, and confined in any pound, stall, pen, or lair upon the premises previously to being slaughtered, to be provided during such confinement with a sufficient quantity of wholesome water. 3. Every occupier of a slaughterhouse and every servant of such occupier and every other person employed upon the premises in the slaughtering of cattle shall, before proceeding to slaughter any bull, ox, cow, heifer, or steer, cause the head of such animal to be securely fastened so as to enable such animal to be felled with as little pain or suffering as practicable, and shall in the process of slaughtering any animal use such instruments and appliances and adopt such method of slaughtering and otherwise take such precautions as may be requisite to secure the infliction of as little pain or suffering as practicable. 4. Every occupier of a slaughterhouse shall cause the means of ventilation provided in or in connexion with such slaughterhouse to be kept at all times in proper order and efficient action ; and so that the ventilation shall be by direct communication with the external air. 5. Every occupier of a slaughterhouse shall cause the drainage provided in or in connexion with such slaughterhouse to be kept at all times in proper order and efficient action. 6. Every occupier of a slaughterhouse shall cause every part of the internal surface of the walls and every part of the floor or pavement of such slaughterhouse to be kept at all times in good order and repair,so as to prevent the absorption therein of any blood or liquid refuse or filth which may be spilled or splashed thereon, or any offensive or noxious matter which may be deposited thereon or brought in contact therewith. He shall cause every part of the internal surface above the floor or pavement of such slaughterhouse to be thoroughly washed with hot lime-wash at least four times in every year ; that is to say, at least once during the periods between the 20 first and tenth of March, the first and tenth of June, the first and tenth of September, and the first and tenth of December respectively. He shall cause every part of the floor or pavement of such slaughterhouse, and every part of the internal surface of every wall on which any blood or liquid refuse or filth may have been spilled or splashed, or with which any offensive or noxious matter may have been brought in contact during the process of slaughtering or dressing in such slaughterhouse to be thoroughly washed and cleansed within three hours after the completion of such slaughtering or dressing. 7. An occupier of a slaughterhouse shall not at any time keep any dog, or cause or suffer any dog to be kept in such slaughterhouse. He shall not at any time keep, or cause or suffer to be kept in such slaughter house any animal of which the flesh may be used for the food of man, unless such animal be so kept in preparation for the slaughtering thereof upon the premises. He shall not at any time keep any cattle, or cause or suffer any cattle to be kept in such slaughterhouse for a longer period than may be necessary for the purpose of preparing such cattle, whether by fasting or otherwise, for the process of slaughtering. If, at any time, he keep or suffer to be kept in such slaughterhouse any cattle for the purpose of preparation, whether by fasting or otherwise, for the process of slaughtering, he shall not cause or suffer such cattle to be confined elsewhere than in the pounds, stalls, pens, or lairs provided on the premises. 8. Every occupier of a slaughterhouse shall cause the hide or skin, fat, and offal of every animal slaughtered therein to be removed from such slaughterhouse within twenty-four hours after the completion of the slaughtering of such animal. 9. Every occupier of a slaughterhouse shall cause the means of water supply provided in or in connexion with such slaughterhouse to be kept at all times in proper order and efficient action, and shall provide for use on the premises a sufficient supply of water for the purpose of thoroughly washing and cleansing the floor or pavement, every part of the internal surface of every wall of such slaughterhouse, and every vessel or receptacle which may be used for the collection and removal 21 from such slaughterhouse of any blood, manure, garbage, filth, or other refuse products of the slaughtering of any cattle or the dressing of any carcase on the premises. 10. Every occupier of a slaughterhouse shall provide a sufficient number of vessels or receptacles, properly constructed of galvanized iron or other non-absorbent material, and furnished with closely-fitting covers, for the purpose of receiving and conveying from such slaughterhouse all blood, manure, garbage, filth, or other refuse products of the slaughtering of any cattle or the dressing of any carcase on the premises. He shall forthwith upon the completion of the slaughtering of any cattle or the dressing of any carcase in such slaughterhouse cause such blood, manure, garbage, filth, or other refuse produces to be collected and deposited in such vessels or receptacles, and shall cause all the contents of such vessels or receptacles to be removed from the premises at least once in every twenty-four hours. He shall cause every such vessel or receptacle to be thoroughly cleansed immediately after such vessel or receptacle shall have been used for such collection and removal, and shall cause every such vessel or receptacle when not in actual use to be kept thoroughly clean. 11. Every person who shall offend against any of the foregoing bye-laws for the registering and inspection of slaughterhouses, for preventing cruelty therein, for keeping the same in a cleanly and proper state, for removing filth at least once in every twenty-four hours, and for requiring such slaughterhouses to be provided with a sufficient supply of water, shall be liable for every such offence to a penalty of five pounds, and in the case of a continuing nuisance to a penalty of ten shillings for every day during which such nuisance shall be continued after the conviction for the first offence : Provided, nevertheless, that the justices or court before whom any complaint may be made or any proceedings may be taken in respecft of any such offence may, if they think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. 22 I consider that the general condition of the parish during the year has been very satisfactory. The only zymotic disease which has prevailed and increased was scarlet fever. The epidemic of small pox which occurred during the Spring and early part of the Summer, I have already alluded to. In conclusion, I append, as usual, the returns of the Sanitary Inspector. I am, Gentlemen, Your obedient servant, FREDC. C. DODSWORTH, Medical Officer of Health. Sanitary Inspector's Office, Vestry Hall, Chiswick. Report of Sanitary Inspector for the year ending 31st December, 1893. Number of complaints received during the year 82 ,, Houses, premises, &c., examined 1883 „ Notices served for abatement of nuisances 622 ,, Houses, premises, &c., repaired, cleansed, &c. 128 ,, Houses disinfected after illness of an infectious character 109 ,, Drains repaired, cleansed, and ventilated 418 „ House drains reconstructed and ventilated 298 „ Waste pipes from baths, sinks, and lavatories disconnected from drains 48 ,, Cesspools emptied and done away with, and new drainage provided connected with Public Sewer 6 ,, Water closets repaired, cleansed, &c. 332 23 Number of Water closets supplied with water separate from domestic supply 10 ,, New water closets provided 64 ,, Samples of water analysed taken from shallow wells supplying drinking water 0 ,, Houses supplied by Water Co., previously from shallow wells 4 ,, Cisterns repaired, cleansed and covered 22 ,, Dust bins, new, provided 138 ,, ,, ,, repaired, covered, etc. 80 ,, Dust complaints received and attended to 207 ,, Accumulations of dung and other refuse removed 12 ,, Animals removed,being improperly kept 20 ,, Cases of overcrowding abated 13 ,, Registered cowsheds, dairies, and milkshops regularly inspected 27 „ Licensed slaughter-houses regularly inspected 8 ,, Bake-houses regularly inspected 16 ,, Legal proceedings (i.e.) summonses for the abatement of nuisances 14 Your obedient servant, JOHN H. CLARKE, Sanitary Inspector. (A) TABLE OF DEATHS during the Year 1893, in the Urban Sanitary District of Chiswick; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Mortality from all causes, at subjoined ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pnuemonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Totals. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a.) (b.) (c.) (d.) (e.) (f.) (g.) (h.) (i.) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Chiswick Proper 26 5 4 2 2 7 6 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 2 .. .. 6 9 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 5 .. 2 7 17 Chiswick New Town 47 22 10 .. 2 11 2 Under 5 .. .. .. 1 .. .. .. .. .. .. .. 1 .. 10 .. .. .. 9 .. .. 11 32 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 5 2 .. 6 15 Turnham Green 83 24 6 4 2 17 30 Under 5 .. .. .. .. .. .. .. .. .. .. .. 1 4 3 .. .. 2 8 .. .. 12 30 5 upwds. .. 1 .. .. .. .. 1 .. 1 .. .. .. .. .. 1 .. 5 6 6 2 30 53 Turnham Green North 13 2 2 .. .. 4 5 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 3 4 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 4 1 2 9 Glebe Estate 57 24 12 2 1 13 5 Under 5 .. .. 1 1 .. .. .. .. .. .. .. 3 4 3 .. .. .. 5 .. .. 19 36 5 upwds. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. 2 3 6 1 7 2L Sulhamstead Estate 27 14 4 .. .. 6 3 Under 5 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 5 .. .. 10 18 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 2 2 .. 2 9 Gunnersbury 49 6 6 .. 1 19 17 Under 5 .. .. .. 1 .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 .. .. 7 12 5 upwds. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. 2 7 9 1 16 37 Grove Park 5 1 1 1 .. 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 2 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 3 Strand-on-the-Green 19 5 3 2 .. 7 2 Under 5 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 3 8 5 upwds. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 3 2 .. .. 5 11 Bedford Park 12 1 .. 1 .. 8 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 5 upwds. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 2 .. 4 11 Totals 338 104 48 12 8 94 72 Under 5 .. .. 2 4 .. .. .. .. .. .. .. 5 9 20 2 .. 4 34 .. .. 72 152 5 upwds. .. 2 2 .. .. 2 1 .. 1 .. .. .. .. 1 3 .. 22 32 32 7 81 186 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths occurring within the district among persons not belonging thereto. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 2 .. 3 (B) TABLE OF POPULATION, BIRTHS, AND OF NEW GASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the Year 1893, in the Urban Sanitary District of Chiswick ; classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. 21965. Estimated to middle of 1893. 23382. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Total. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a.) (4.) (c.) (d.) (e.) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Chiswick Proper 2180 Under 5 .. 3 .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 16 2 .. .. 1 .. .. .. .. 3 22 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chiswick New Town 2148 Under 5 .. 1 .. 3 .. .. .. .. .. .. .. 4 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 12 4 .. .. .. .. .. .. 1 .. 2 19 .. 7 .. .. .. .. .. .. .. .. .. .. .. .. Turnham Green 3490 Under 5 .. 1 1 .. .. .. 1 .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 2 28 2 .. .. 1 3 .. 1 .. 13 50 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. Turnham Green North 3180 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 2 8 1 .. .. .. •• .. .. .. 1 12 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glebe Estate 2750 Under 5 .. 3 2 1 .. .. .. .. .. .. 1 7 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 1 20 1 .. .. 2 1 .. .. 1 9 35 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sulhamstead Estate 1390 Under 5 1 2 .. 1 .. .. .. .. .. .. .. 4 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 6 8 .. •• .. .. 1 .. .. .. 10 25 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. Gunnersbury 4684 Under 5 .. 1 .. 1 .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 1 18 2 .. .. 1 .. .. .. .. 8 30 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Grove Park 780 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 4 .. .. .. .. .. .. .. .. .. 4 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Strand-on-the-Green 1340 Under 5 .. 1 1 .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 3 2 .. .. 1 .. .. .. .. .. 6 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bedford Park 1440 Under 5 .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 9 1 .. .. .. .. .. .. .. .. 10 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 23382 675 Under 5 1 13 4 3 .. .. 1 .. .. .. 1 26 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 24 118 11 3 .. 6 5 .. 2 1 46 213 .. 8 .. .. .. .. 1 .. .. .. .. .. .. .. State here whether " Notification of Infectious Disease" is compulsory in the District? Yes. Since when? January 1st, 1890. Besides the above-mentioned Diseases, insert in the columns with blank headings the names of any that are notifiable in the District, and fill the columns accordingly. State here the name of the Isolation Hospital used by the sick of the District. Mark (H) the Locality in which such Hospital is situated ; and if not within the District, state where it is situated. Chiswick has no Infectious Hospital.