CHIS 6 CHISWICK PARISH. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. 1897. CHISWICK: Printed by Platrier and Sons, High Road. 1898. CHISWICK PARISH. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. 1897. CHISWICK: Printed by Platrier and Sons, High Road. 1898. Chiswick Urban District Council Sanitary Department. THE NINETEENTH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. Mr. Chairman and Gentlemen, I beg to submit for your consideration my Annual Report for the year 1897 upon the general sanitary condition of your District, with an account of the steps taken in the administration of the laws for the protection and improvement of the public health of the Parish, together with other matters pertaining to the Sanitary Department of your service for the past year. The following are briefly the main features that characterise the year. The vital statistics show a rise in the birth rate, being about the average for the past 10 years. The death rate was one of the lowest on record, whilst the rate from zymotic disease was considerably less than that of the previous year. The year was on the whole ,a healthy one—the 4 amount of zymotic disease having been insignificant Cases of scarlet fever were reported during each month; the total number, however, was about a third of that of the preceding year. The deaths of infants under one year were less than those of the previous year. The growth of the population of the District continued, and was evidenced by the excess of births over deaths, amounting to 441. Building operations progressed with tolerable activity, both dwelling-houses and shops. The number of the former amounted to 126, and the latter to 23, which is satisfactory evidence of the growth of the District, and of the increase of the population. The year having been dry and moderately warm, was on the whole favourable to a low death rate, but the high temperature in the summer produced as usual an excessive fatality from infantile diarrhoea, and consequently had a tendency to raise the mortality in children under one year. Population. I have estimated the population for the middle of the year at 25,972. Births. The number of births during the year was 789— 399 males, 390 females. The birth rate was 30.37 per thousand; for London it was 30,and for England and Wales, 29.7. 5 Deaths. During the year 348 were registered—166 males, 182 females. The annual rate of mortality amounted to 13.30 per thousand; whilst for London it was 17.7, and for England and Wales, 17.4. The deaths, tabulated in the usual Forms, as required by the Local Government Board, are to be found at the end of this Report. Diseases of the respiratory organs (excluding phthisis) caused 53 deaths, an increase of five on the previous year. Diseases of the circulatory organs resulted in 38 deaths, showing an increase of 16 on that of the preceding year. Phthisis and Tuberculosis. 31 deaths were registered from this disease, an increase of one on the year 1896. The following Table epitomises the ages at which the deaths occurred: Deaths under a year 105 „ from 1 year and under 5 years 47 152 under 5 years of age. „ „ 5 years and under 15 „ 14 „ „ 15 „ „ 25 „ 10 „ „ 25 „ „ 65 „ 101 „ „ 65 and upwards71 196 over 5 years of age. Thirty deaths were registered between the ages of 70 and 80, and 17 between 80 and 90. Infantile Mortality. The rate of this mortality, or the proportion of 6 deaths under one year in every thousand births, was 133; for London it was 158. The following diseases proved most fatal to young children under five years of age: Bronchitis, Pneumonia, and Pleurisy 26 Diarrhœa 30 Tubercular Diseases 6 Convulsions 16 Total 78 Zymotic Diseases. The following are the deaths from the principal zymotic diseases: Scarlet Fever 5 Diphtheria 11 Membranous Croup 4 Typhoid or Enteric Fever 2 Measles 1 (a child under 5 years) Diarrhœa 34 (30 children under 5 yrs. [4 adults) Total 57 The zymotic death rate was 223 per thousand, against 3.05 for 1896; for London it was 2.58, and for England and Wales, 2.15 (less the 100 chief towns, 1.62). The following Table gives the average births, deaths, and death rates; also the deaths from diseases of the zymotic class for the past ten years: 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 Average of last 10 years. Births during the year 688 678 639 654 679 675 708 692 724 789 692.6 Birth rate per thousand 34.10 32.64 29.89 29.48 29.80 28.86 29.52 28.15 28.55 30.37 30.13 Deaths from all causes 331 271 358 345 392 338 313 382 360 348 343.8 Death rate per thousand 16.40 13.04 16.75 15.55 17.20 14.45 13.05 15.37 14.29 13.39 14.94 Deaths from Small Pox 0 0 0 0 0 0 0 0 0 0 0 „ Measles 8 3 16 8 34 5 12 11 10 1 10.8 „ Scarlet Fever 2 8 2 0 1 2 3 3 3 5 2.9 „ Diphtheria 1 0 3 0 3 4 4 5 8 11 3.9 „ Whooping Cough 16 5 10 9 27 9 3 1 28 0 10.8 „ Typhoid and other Fevers 1 1 0 7 3 4 6 0 1 2 2.5 „ Diarrhœa 8 8 17 18 20 21 9 26 22 34 18.3 „ Croup (Membranous and Diptheritic) 1 1 1 1 1 4 1 1 4 4 1.9 „ Erysipelas 1 0 1 0 0 0 2 0 1 0 5 „ principal zymotic diseases 38 26 50 43 89 49 40 50 77 57 51.9 Death rate from ditto 1.78 1.20 2.38 1.93 3.90 2.09 1.66 2.4 3.05 2.23 2.22 8 Infectious Diseases (Notification) Act, 1889. Under the above I have received the following notifications: Small Pox 0 Scarlet Fever 72 Diphtheria 43 Membranous Croup 3 Typhoid or Enteric Fever 15 Continued Fever 4 Erysipelas 39 Total 176 Those for the year 1896 numbered 320, and for 1895, 118. Scarlet Fever. The diminution of the prevalence of this most infectious disease in the District is satisfactory, although a certain number of cases occurred during each month of the year; five deaths were registered, and 72 notifications. Diphtheria. Forty-three notifications and 11 deaths. This disease, which was formerly met with in rural districts chiefly, has of late shown an increasing tendency to become an urban disease. The Registrar-General, referring to the increased mortality from this disease in recent years, states: "That a part of it may be attributed with much probability to a number of deaths which would formerly have been referred to croup being now ascribed to diphtheria." 9 Membranous Croup. Three notifications and four deaths within the year. Enteric or Typhoid Fever. Fifteen notifications and two deaths, one of which was imported. Continued Fever. Four notifications, no deaths. Erysipelas. Thirty-nine notifications, no deaths. Diarrhœa. From this complaint there were 34 deaths, 30 children, four adults. It was most prevalent during the months of July, August, and September. The question why diarrhoea is so prevalent and fatal to infants and young children in hot summers, has been for some time under consideration by the Medical Department of the Local Government Board. Absence of rainfall, a mean temperature of 60 degrees or over, a polluted atmosphere, together with artificial and injudicious feeding, are the chief causes of the malady. Measles. This complaint is not required to be notified to the SanitaryAuthority under the provisions of the Infectious Diseases Notification Aft, 1889. It becomes a question as to whether any great advantage would accrue from its addiLion to the list, unless hospitals were provided for the reception of those cases which could not be properly isolated at home. It is an undoubted fact 10 that the disease is frequently spread through the agency of schools. The duration of an epidemic has frequently been shortened by the closure of schools, both public and private. The School Board do not allow children living in infected houses to attend their schools, a fact probably unknown to many parents. This Parish was particularly free from this complaint during the year; one death only was recorded. Influenza. This complaint was somewhat prevalent during the first quarter of the year, resulting in three deaths, which were mostly associated with pulmonary affections. Cancer. Malignant disease was accountable for 11 deaths, which is a decrease of nine on that of the previous year. Cancer is stated by some to be on the increase generally, possibly however some portion of the apparent increase in deaths classified to this cause may be due to more accurate diagnosis. Deaths from this disease are usually more numerous proportionally to population and are probably more prevalent amongst well-to-do people than the poorer classes. The parts of the body most commonly affected are the internal organs, in women the uterus and breast; the disease being for the most part one of later life. Inquests. Eight sudden deaths necessitated public enquiries. The causes of death were: 11 Accidentally run over on the Main Road 2 A child suffocated accidentally in bed 1 Neglect at birth 3 Drowning 1 Pneumonia 1 Water Supply. The results of the bacteriological examinations for the year continue to show the thorough efficiency of the filtration; also the excellent character of the supply from the two Companies serving this District, the West Middlesex and Grand Junction. I have the satisfaction of remarking that the District has now a constant supply to each house. The importance of this cannot be overrated. A draw-Off tap has been supplied to 300 houses, which enables the occupiers to obtain the drinking water direct from the main, instead of through cisterns which are too frequently both dirty and uncovered. Housing of the Working Classes Act, 1890., The proceedings under this Aft applied to two houses in Essex Place (Nos. 31 and 33), which I condemned as being uninhabitable in their present condition, both are at the present unoccupied. Isolation Hospital. The temporary hospital which was opened for the reception of Patients in January, 1896, was closed in February, 1897, owing to the diminution of the number of cases. It is a matter of congratulation that your Council have at last succeeded in securing a site for a Fever 12 Hospital, which has been so difficult to obtain and much needed for so large and growing a parish as Chiswick. I attended the West London Police Court in October with regard to several serious sanitary defects existing in houses in Windmill Road, Wood Street, Mona Terrace, and Dorchester Grove; in consequence of the summonses not having been complied with, the Magistrate, with one exception, imposed a fine of 40/- and costs. I also attended in November in reference to defective drainage at 429, High Road, Chiswick. In this case the landlord was fined £5, he having also neglected to comply with the summons; and again in December I attended and gave evidence concerning two houses in Upham Park Road, where the following sanitary defects were found, viz.: no disconnecting trap between the house drains and sewer, in addition to other insanitary arrangements. Bakeries. The bakeries have been kept in good order, and as by degrees new ones are being built, with modern appliances, the health of the workmen will improve, and bakers will not in future be a short-lived class. Slaughter houses. These have been kept in a fairly satisfactory condition. The time however must come when private slaughter houses will be abolished, and abattoirs, or public slaughter houses take their place. Thorough 13 inspection of the meat cannot be satisfactorily carried out under existing circumstances, which is considered of primary importance by all sanitarians. General Inspection of the District. I have made the usual personal inspections, and reported on the same when found necessary to your Council. The system by which the Parish is regularly and systematically inspected by your Sanitary Officials has been carried out with the usual activity evidence of which will be shown in the report of the Sanitary Inspector herewith appended. House Refuse Removal. The general cleansing of ashpits and other refuse receptacles was efficiently carried out by the Surveyor's staff. The novel collection of dust by the motor carts or wagons will, it is to be hoped, prove an economical success. The contemplated erection of a refuse destructor being both a ready and efficient method of disposing of this refuse by incineration, will in all probability be carried out during the coming year. Recreation Ground in Chiswick Lane. Negotiations are now pending for the purchase by your Council of the Homefields. This much-needed playground will shortly be added to the attractions of the district, and will have a tendency to improve the physique of the young people, and in addition will, I hope, give a moral tone, which will be an adequate return for the investment. 14 Public Baths. Public Baths are much needed, and would prove a great acquisition, and be much appreciated by the residents generally, more especially by the poor and middle classes. Meteorological Report. The total rainfall was 19.95. The most rain fell during the months of March and August. The details of the rainfall are indicated in the following Table: January 1.35 July .55 February 2.34 August 3.35 March 3.21 September 2.16 April 1.43 October .50 May .75 November .83 June 1.89 December 1.59 Before closing this Report, I wish to place on record my indebtedness to our Sanitary Inspector for his zealous and able help. A large amount of additional work has devolved upon him during the past year. The rapid manner in which he has removed infectious cases to the temporary Infectious Hospital and carried out the process, of disinfection of the patients' houses and clothes, is worthy of the highest commendation. I append his Report, and remain, Gentlemen, Your obedient servant, FREDC. C. DODSWORTH, Medical Officer of Health. 15 Sanitary Inspector's Office, Vestry Hall, Chiswick. Report of Sanitary Inspector for the year ending 31st December, 1897. Number of complaints received during the year 117 „ Houses, premises, &c., visited and examined 2254 „ Notices served for abatement of nuisances 659 „ Houses, premises, &c., repaired, cleansed, &c. 63 „ Houses disinfected after illness of an infectious character 44 „ Drains repaired, cleansed, and ventilated 105 „ House drains reconstructed and ventilated 110 „ Waste pipes from baths, sinks, and lavatories disconnected from drains 0 „ Cesspools emptied and done away with, and drainage provided connected with Public Sewer 2 „ Waterclosetsrepaired,cleansed,&c. 196 Water closets supplied with water . separate from domestic supply 4 „ New water closets provided 14 Samples of water analysed taken from shallow wells supplying drinking water 0 „ Houses supplied by Water Co., „ previously from shallow wells 1 „ Cisterns repaired, cleansed and covered 9 16 Number of Dust bins, new, provided 189 „ „ „ repaired, covered, etc. 12 „ Dust complaints received and attended to 279 „ Accumulations of dung and other refuse removed 47 „ Animals removed,being improperly kept 16 „ Cases of overcrowding abated 20 „ Registered cowsheds, dairies, and milkshops regularly inspected 36 „ Licensed slaughter-houses regularly inspected 9 „ Bake-houses regularly inspected 18 „ 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 1897, 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. Diarrhœa 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 55 18 4 5 1 16 11 1 Under 5 .. 1 1 .. .. .. .. .. .. .. .. .. .. 5 .. .. 1 3 .. .. 13 24 5 upwds. .. .. 1 .. .. .. .. .. .. .. .. .. .. 2 .. .. 2 4 6 .. 16 31 Chiswick New Town 46 19 10 .. .. 13 4 Under 5 .. .. 2 .. .. .. .. .. .. .. .. .. .. 8 .. .. 2 3 .. .. 15 30 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 6 2 .. 4 16 Turnham Green 71 21 8 4 3 20 15 Under 5 .. 2 1 .. .. .. .. .. .. .. .. .. .. 7 .. .. 1 6 .. .. 12 29 5 upwds. .. 1 2 .. .. 1 .. .. .. .. .. .. .. 1 .. .. 6 5 8 .. 18 42 Turnham Green North 10 2 .. 1 .. 4 3 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 2 5 upwds. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 .. 2 .. 2 8 Glebe Estate 47 17 11 1 1 9 8 Under 5 .. .. 1 .. .. .. .. .. .. .. .. .. .. 4 .. .. 2 6 .. .. 12 25 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 3 8 1 8 22 Sulhamstead Estate 24 7 5 .. .. 12 .. Under 5 .. .. 1 1 .. .. .. .. .. .. .. .. 1 .. .. .. 5 1 .. 3 12 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 .. 2 .. 7 12 Gunnersbury 63 14 8 1 3 14 23 Under 5 .. .. 2 3 .. .. .. .. .. .. .. 1 .. 3 .. .. .. 2 .. .. 10 21 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 5 7 4 1 24 42 Grove Park 7 .. .. .. 1 3 3 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 2 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 .. 2 5 Strand-on-the-Green 13 5 1 1 .. 5 1 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 4 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 1 .. 4 9 Bedford Park 12 2 .. 1 1 5 3 1 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 3 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 .. 6 9 Totals 348 105 47 14 10 101 71 Under 5 .. 3 8 4 .. .. .. .. .. .. .. 1 .. 30 .. .. 6 25 2 .. 73 152 5 upwds. .. 2 3 .. .. 2 .. .. .. .. .. .. .. 4 3 .. 25 28 36 2 91 196 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. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Area and Population of the District or Division to which this Return relates. Area in Acres, 1,245. Population (1891) 21,965. Death Genera], 13.39 per 1,000 Population, estimated to middle of 1897. Rates Infant (under one year of age) 133 per 1,000 Births Registered. (B) TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the Year 1897, 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 1897. 25972. 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.) (b.) (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 2964 Under 5 .. 6 3 2 .. .. .. .. .. .. .. .. 11 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 6 8 .. .. 2 .. .. .. .. 7 .. 23 .. .. .. .. .. .. .. .. .. .. .. .. .. Chiswick New Town 2273 Under 5 .. 3 3 .. .. .. .. .. .. .. .. .. 6 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 1 .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. Turnham Green 3655 Under 5 .. 2 4 .. .. .. .. .. .. .. 2 .. 8 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 11 10 .. .. 2 1 .. .. .. 12 .. 36 .. .. .. .. .. .. .. .. .. .. .. .. .. Turnham Green North 3830 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 3 1 .. .. 1 1 .. .. .. 5 .. 11 .. 1 .. .. .. .. .. .. .. .. .. .. .. Glebe Estate 2845 Under 5 .. 2 1 .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 3 .. .. 3 .. .. .. .. 4 .. 11 .. .. .. .. .. .. .. .. .. .. .. .. .. Sulhamstead Estate 1455 Under 5 .. 5 1 1 .. .. 2 .. .. .. .. .. 9 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 4 1 .. .. 1 .. .. .. .. 1 .. 7 .. .. .. .. .. .. .. .. .. .. .. .. .. Gunnersbury 5180 Under 5 .. 5 2 .. .. .. .. .. .. .. .. .. 7 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 18 4 .. .. 3 .. .. .. .. 3 .. 28 .. .. .. .. .. .. .. .. .. .. .. .. .. Grove Park 880 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 .. .. .. 1 .. .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. .. .. .. .. .. Strand-on-the-Green 1390 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 3 .. .. .. 1 .. .. .. .. 3 .. 7 .. 1 .. .. .. .. .. .. .. .. .. .. .. Bedford Park 1500 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 1 .. .. 1 .. .. .. .. 2 .. 5 .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 21965 25972 789 Under 5 .. 23 14 3 .. .. 2 .. .. .. 2 .. 44 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 49 29 .. .. 15 2 .. .. .. 37 .. 132 .. 3 .. .. .. .. .. .. .. .. .. .. .. 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.