CHIS 7 CHISWICK PA RISH. ANNUAL REPORT OF THE Medical Officer of heath. 1898. chlswick: Printed by platrier & sons, high road. 1599. Chiswick Urban District Council Sanitary Department. THE TWENTIETH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. Mr. Chairman and Gentlemen, It becomes my duty to place before you my annual record of matters pertaining to the public health of your District for the year 1898, together with a report of the proceedings taken by your officials of the Public Health Department, with a view to maintain and improve the sanitary conditions of our Parish. The record for the year, though not quite so favourable as that for 1897, still marks a progressive improvement, and as compared with the average of the past ten years is in many respects very satisfactory. The amount of zymotic disease was about the average. Measles was more or less prevalent during the first six months of the year, and a mild form of scarlet fever during most months. The vital statistics indicate a rise in the birth rate, which is slightly above the average of the past ten years. 4 The death rate exceeded that of the previous year 1897, as also the zymotic death rate. The deaths of infants under a year also show an increase on 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 406. Building operations have continued, both dwelling houses and shops : the former amounting to 228 and the latter to 9, indicating the growth of the District. The year was one of continuous sunshine, with dry and warm weather. This on the whole was favourable to a low death rate, but the continuous high temperature during the summer months caused an excessive mortality in children under one year, due to summer diarrhoea and gastro enteritis. Population. I have estimated the population for the middle of the year at 26,772. Births. The number of births during the year was 856— 415 males, 441 females. The birth rate was 31.97 per 1,000; for London it was 29.5, and for England and Wales, 29.4. Deaths. During the year 450 were registered—201 males, 219 females, and two non-residents not included in the death rate. The annual rate of mortality amounted to 16.80 per 1,000; whilst for London it was 18.7, and for England and Wales, 17.6. 5 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 (exclusive of phthisis) caused 80 deaths, an increase of 27 on the previous year. Diseases of the circulatory organs resulted in 40 deaths, showing an increase of two on that of the preceding year. Phthisis and Tuberculosis. 34 deaths were registered from this disease, an increase of three on the year 1897. Quoting from the "Harben Lectures," Sir Thorne Thorne, states "That there is abundant statistical evidence at any rate since 1857, when civil registration of deaths was instituted of a general and progressive reduction in the mortality from all forms of tuberculosis, and at all ages with one very important exception." The exception he referred to being that of children under a year, who are specially liable to a form of this disease known as tabes mesenterica. The reduction in the mortality from tuberculosis generally, has partly resulted from improved social conditions, such as ventilation of houses and factories, also demolition of insanitary dwellings. Dampness of sites which is a frequent cause of this form of disease has been considerably reduced since the construction of sewers and drains. On the other hand, the explanation of the increase in tabes mesenterica is doubtless due to the bacillus which is frequently found in the milk supply. Cows 6 are very liable to tubercular disease, induced by their confinement in close and ill-ventilated sheds, infection from the mucus discharge being readily conveyed from one to another. Phthisis is now recognised as an infectious and consequently a preventable disease. The infection is usually spread through either drinking the milk of tuberculous cows, or by the inhalation of dried expectoration. Dampness of subsoil, together with illventilated houses, have a tendency to lower the vitality, and render the dwellers in them less able to resist the contagion. All such houses should be reported to the Sanitary Authority. The rooms used by phthisical patients should be thoroughly disinfected, under the supervision of our Sanitary Inspector. A patient suffering from this disease should sleep alone, should not expectorate on the floor or about the room, the sputa should be collected in a small vessel containing a disinfectant, and afterwards burnt. The following Table epitomises the ages at which the deaths occurred: Deaths under a yearz 132 203 under 5 ,, from 1 year and under 5 years 711 years of age. „ „ 5 years and under 15 ,, 121 „ ,, 15 „ ,, 25 ,, 141 247 over 5 ,, ,, 25 ,, ,, 65 ,, 126 years of age. ,, „ 65 and upwards 95 Two non-residents excluded. Forty-four deaths were registered between the ages of 70 and 80, 22 between 80 and 90, two at 94, and one at 97. Infantile Mortality. The rate of this mortality, or the proportion of deaths under one year to every thousand births, was 154, against 133 for the previous year; for London it was 167, and for England and Wales 161. 7 The following diseases proved most fatal to young children under five years of age: Bronchitis and Pneumonia 39 Convulsions 19 Tubercular Diseases 13 Diarrhœa 40 In addition to the above there were 9 premature births. Zymotic Diseases. The following are the deaths from the principal zymotic diseases: Diphtheria 2 Enteric Fever 4 Puerperal Fever 1 Erysipelas 3 Measles 31 (29 children under 5yrs) Whooping Cough 7 Diarrhoea and Dysentery 45 (40 children under 5 yrs) Total 93 The zymotic death rate was 3.47 per thousand, against 2.23 for 1897; for London it was 2.62, and for England and Wales, 2.22. The following Table gives the average births, birth rates, deaths, and death rates; also the deaths from diseases of the zymotic class, together with the average for the past ten years. 8  1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 Average of last 10 years. Births during the year 678 639 654 679 675 708 692 724 789 856 709.4 Birth rate per thousand 32.64 29.89 29.48 29.80 28.86 29.52 28.15 28.55 30.37 31.97 29.92 Deaths from all causes 271 358 345 392 338 313 382 360 348 452 355.9 Death rate per thousand 13.04 16.75 15.55 17.20 14.45 13.05 15.37 14.29 13.39 16.80 14.98 Deaths from Small Pox 0 0 0 0 0 0 0 0 0 0 0 „ Measles 3 16 8 34 5 12 11 10 1 31 13.1 „ Scarlet Fever 8 2 0 1 2 3 3 3 5 0 2.7 „ Diphtheria 0 3 0 3 4 4 5 8 11 2 3.8 ,, Whooping Cough 5 10 9 27 9 3 1 28 0 7 9.9 ,, Typhoid and other Fevers 1 0 7 3 4 6 0 1 2 4 2.8 „ Diarrhoea 8 17 18 20 21 9 26 22 34 45 22 „ Croup (Membranous and Diphtheritic) 1 1 1 1 4 1 1 4 4 0 1.8 ,, Erysipelas 0 1 0 0 0 2 0 1 0 3 0.7 ,, principal zymotic diseases 26 50 43 89 49 40 50 77 57 93 57.4 Death rate from ditto 1.20 2.38 1.93 3.90 2.09 1.66 2.4 3.05 2.23 3.47 2.39 9 Infectious Diseases (Notification) A 61, 1889. Under the above I have received the following notifications: Scarlet Fever 70 Diphtheria 27 Typhoid or Enteric Fever 14 Continued Fever 2 Puerperal Fever 2 Erysipelas 52 Total 167 For the year 1897 they numbered 176, for 1896 320, and for 1895 118. Scarlet Fever Was more or less prevalent daring each month. The cases were of a very mild type; there were 70 notifications and no deaths. An outbreak of this complaint occurred in October at Strand-on-theGreen, which was the result of several children attending the Board School when they were in the peeling or desquamating stage, thus conveying it to others, the attacks having been of such a mild character had been overlooked by the parents. Diphtheria. Two deaths and 27 notifications, against 11 deaths and 72 notifications for the year 1897, indicate a satisfactory decrease. Typhoid or Enteric Fever. Four deaths and 14 notifications, against t\vo deaths and 15 notifications for 1897. V Continued Fever. No deaths, two notifications. 10 Puerperal Fever. One death, two notifications. Erysipelas. Three deaths, 52 notifications. Diarrhœa. This complaint caused 45 deaths. It was as usual most prevalent during August and September, more especially with children under five years of age. Absence of rainfall, with a high temperature of 60 degrees or over, a polluted atmosphere with artificial and injudicious feeding, are the chief causes of this malady. Measles. From this complaint there were 31 deaths. It is not included in the diseases which are required to be notified. It was very prevalent during the first five months of the year, and it is to be regretted that comparatively little care is taken by parents among the poorer classes to prevent the spread of it, considering it is as inevitable as teething. It must, however, be allowed that it is difficult to prevent measles from spreading, it being infectious from an early stage, if not from the commencement of an attack. The circumstances in which many of the poor live in this parish and elsewhere, two or more families occupying one house and using a common staircase, almost preclude the possibility of isolation. Again more care might be taken in order to protect the patients against secondary affections of the lungs, etc., which are as a rule the immediate causes ot death. I have no doubt that many lives might be saved if it were practicable to isolate the little 11 sufferers in hospital, especially such as live in overcrowded rooms, tainted with foul air, and under conditions which preclude the necessary care in the nursing and management of measles. Influenza. Was prevalent during the first and last quarter of the year, resulting in five deaths, most of which were associated with pulmonary diseases. Cancer. Malignant disease was accountable for 27 deaths, which is an increase of 16 on that of the previous year. It is generally admitted that this disease is on the increase in this country; possibly, however, some portion of the apparent increase in deaths classified to this cause may be due to more accurate diagnosis. Inquests. Eighteen inquests were held on parishioners and others. The causes of death may be classified as follows: Deaths caused by disease 5 Accidental suffocation 4 Accidents 4 Suicide 2 (non-residents) Drowning 1 Neglect at birth 2 Water Supply. The two Companies which supply this District are the West Middlesex and Grand Junction. The result of the daily bacteriological examinations continue to indicate the thorough efficiency of the filtration ; also the excellent character of the supply. 12 The fact that each house in the District has a constant supply, is an advantage which is duly appreciated by all. A separate supply direct from the main has been provided for the inmates of 330 houses. Housing of the Working Classes Aft, 1890. The proceedings under this Act applied to twelve houses in William Street, all of which have since been thoroughly repaired; also six in Devonshire Street which are now being put in order. I attended the West London Police Court on several occasions during the year in regard to the above ; also concerning a house in Burnaby Gardens where the drainage was found defective. The owner was fined 20/- with costs. Isolation Hospital. The site for either a temporary or permanent hospital has at last been secured; the latter would be an immense advantage to this Parish. The prompt removal of all cases of infectious disease to an institution of this kind is the best and surest means of avoiding an epidemic, especially in a large, growing Parish like Chiswick. Slaughter houses. Seven in number : all have been kept in a fairly satisfactory condition. It is to be desired in the interests of public health that private slaughter houses may at no distant date give place to public abattoirs, such as are to be seen in large towns and also on the Continent. It is, however, satisfactory to know that comparatively little slaughtering goes on in this Parish, the wants of which are mostly provided for by the dead meat trade. 13 Bakeries. Sixteen in number, all of which have been kept in good order. Cowsheds. Four in number. The several premises have been inspected by the Sanitary Officials during the year, and found to be in a generally satisfactory condition. There has been a reduction in the number of cowsheds both in this Parish and in London generally. A large proportion of the milk consumed in Chiswick is brought from the country by rail principally. Condensed Separated Milk. Several of the large London Parishes have recently discussed the subject of the sale of this milk, which is sold in tins, and found to be deficient in fat, and, as a result, highly injurious to the health of those children who are fed on it. If this milk is given as the entire food, the amount of fat necessary to the normal diet can be obtained only by using an enormous quantity. I need not refer any further to this matter, as it has already been brought before your notice. The Recent Vaccination Act. The relaxation of the laws in relation to this, I fear, in the future are likely to be followed by serious results, bearing in mind the two latest epidemics, that of Gloucester in 1896, followed by Middlesbrough in 1898. It has been estimated that in London one now dies from small-pox, where before vaccination 17 died. In England generally 1 for 20, and in Scotland 1 for 25. On the other hand, in 14 those countries where vaccination has not been generally adopted, small-pox has continued its ravages. The decline of this disease has, in every country, followed the introduction of vaccination, those countries in which vaccination has been most carefully and thoroughly carried out, showing the greatest decline of small-pox, and because there is not any other influence to which this decline can be reasonably attributed. Medical Officers of Health whose duty and interest it is to promote sanitation in every way, are in fact equally unanimous as other medical men are in recommending and using vaccination as the only reliable protection against the ravages of small-pox. It has been alleged that the diminution of small-pox is due to improved sanitation generally. If this were so, all other infectious diseases ought to have decreased in the same way. However, they have not. Some, such as typhoid or enteric, and typhus, which are spread by contaminated water or milk, or in the latter by overcrowding, have decidedly decreased in proportion as these sanitary defects have been removed, whilst others which resemble small-pox in being spread by personal infection, such as measles and whooping cough, in which isolation is equally difficult as in the case of small-pox, have not decreased in the same degree that the latter has, whilst diphtheria has really increased. More than 1,100 Medical Officers of Health have recently signed a declaration in which they express their belief that "sanitation," apart from vaccination, cannot be relied on to prevent or stamp out epidemics of small-pox, and that the only trustworthy protection at present known against small-pox is efficient vaccination in infancy, and 15 sequent re-vaccination, and that the only effective way of stamping out epidemics lies in the free use of these agencies. They support this belief by actively promoting vaccination and re-vaccination whenever an outbreak of small-pox occurs in any of their Districts. With the view of removing all reasonable fear of the communication of any serious disease by vaccination the Royal Commissioners recommended, and the Government have now adopted the use of calf lymph, so carefully prepared that no ground exists for suspecting the possibility of conveying any disease. I regret to say that vaccination in this District is being much neglected since the Act came into force, especially by the poorer class of inhabitants. General Inspection of the District. The system by which the Parish is regularly inspected by your Sanitary Officials has been carried out with the usual activity. I have made personal inspections, and when necessary have reported on the same to your Council. House Refuse Removal. The weekly collection of dust refuse has been efficiently carried out by the staff of your Surveyor. The motor wagons have so far proved a success, and have caused a certain amount of interest amongst several members of other Sanitary Authorities. The erection of a refuse destructor has not as yet been added to the District: it is both a ready and efficient method of disposing of house refuse generally by incineration, and will, I believe, be carried out during the year. 16 Public Baths Are much in request, and when built will supply a great want, and be truly appreciated by the poor and middle classes who have not the advantage of baths in their houses which are now so general. Artisans' Dwellings, Built on the improved sanitary principle, would be a decided benefit to the labouring class by whom they would be duly appreciated, there being a great demand for this class of property. Recreation Ground in Chiswick Lane. The purchase of the Homefields having been arranged, we have every reason to anticipate that it will be shortly enclosed and laid out as a pleasure ground, adding to the attractions of the District. Meteorological Report. The total rainfall for the year was 14'93. The largest amount fell during the months of October, November, and December. The details are indicated in the following Table January .69 July .55 February 1.25 August 1.04 March 1.20 September .30 April .88 October 2.86 May 1.52 November 1.83 June .89 December 1.92 Before closing this Report, I have to acknowledge the zeal and efficiency of our Sanitary Inspector, whose Report I append, and remain, Gentlemen, Your obedient servant, FREDc- C. DODSWORTH, Medical Officer of Health. (A) TABLE OF DEATHS during the Year 1898, 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, Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. 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. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhcea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pnuemonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Totals. 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 93 30 13 4 1 23 22 Under 5 .. .. .. .. .. .. .. .. .. .. .. 4 4 13 .. 2 5 2 .. .. 13 43 5 upwds. .. .. .. .. .. 1 .. .. .. .. .. 2 .. 2 .. 5 5 6 .. .. 29 50 Chiswick New Town 68 28 18 .. 3 16 3 Under 5 .. .. .. .. .. .. .. .. .. .. .. 12 .. 2 .. .. 9 .. .. 1 20 46 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 4 4 2 .. .. 11 22 Turnham Green 30 5 5 2 .. 6 12 Under 5 .. .. .. .. .. 1 .. .. .. .. .. 2 .. 1 .. 3 .. .. .. .. 3 10 5 upwds. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 5 .. .. 9 20 Turnham Green North 86 32 16 3 2 21 12 Under 5 .. .. .. .. .. .. .. .. .. .. .. 9 .. 10 .. 1 10 .. .. .. 18 48 5 upwds. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 6 7 7 .. .. 16 38 Glebe Estate 52 18 8 3 .. 16 7 Under 5 .. .. .. .. .. .. .. .. .. .. .. 2 .. 7 .. .. 7 1 .. .. 9 26 5 upwds. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 3 6 6 .. .. 8 26 Sulhamstead Estate 18 8 1 .. 2 4 3 Under 5 .. .. 1 .. .. .. .. .. .. .. .. .. .. 5 .. .. 1 .. .. .. 2 9 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 .. .. .. 6 9 Gunnersbury 68 10 4 •• 3 29 22 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 3 .. .. .. 7 14 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7 10 7 .. .. 30 54 Grove Park 5 1 .. .. .. 3 1 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 .. .. 1 4 Strand-on-the-Green 19 .. 5 .. 1 5 8 Under 5 .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. 1 .. .. .. 1 5 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 .. .. .. 10 14 Bedford Park 11 .. 1 .. 2 3 5 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 1 .. .. 6 10 Totals 450 132 71 12 14 126 95 Under 5 .. .. 1 .. .. 1 .. .. .. .. 2 29 7 40 .. 6 37 4 .. 3 73 203 5 upwds. .. .. 1 .. .. 3 .. .. 1 .. 1 2 .. 5 .. 28 43 36 .. 1 126 247 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. 2 .. .. .. .. 2 .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 (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 1898, 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. 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 1898. 26772. Registered Births. 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 3174 Under 5 .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 3 5 .. .. 2 .. .. .. .. 6 .. 16 .. .. .. .. .. .. .. .. .. .. .. .. .. Chiswick New Town 2325 Under 5 .. 3 .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 3 1 .. .. 1 .. .. .. .. 5 .. 10 .. .. .. .. .. .. .. .. .. .. .. .. .. Turnham Green 3705 Under 5 .. 3 2 .. .. .. .. .. .. .. 2 .. 7 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 4 2 .. .. 4 .. .. .. .. 12 .. 22 .. 1 .. .. .. .. .. .. .. .. .. .. .. Turnham Green North 3930 Under 5 .. 3 1 .. .. .. .. .. .. .. 1 .. 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 4 .. .. .. 2 .. .. .. .. 7 .. 13 .. 1 .. .. .. .. .. .. .. .. .. .. .. Glebe Estate 2933 Under 5 .. 1 1 .. .. .. .. .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 8 5 .. .. 2 .. .. .. .. 8 .. 26 .. .. .. .. .. .. .. .. .. .. .. .. .. Sulhamstead Estate 1490 Under 5 .. 2 2 .. .. .. .. .. .. .. 1 .. 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 .. .. .. .. .. .. .. .. 3 .. 4 .. .. .. .. .. .. .. .. .. .. .. .. .. Gunnersbury 5220 Under 5 .. 8 1 .. .. .. .. .. .. .. 1 .. 10 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 16 5 .. .. .. .. .. .. .. 4 .. 25 .. .. .. .. .. .. .. .. .. .. .. .. .. Grove Park 1005 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 .. .. .. 1 .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. Strand-on-the-Green 1440 Under 5 .. 2 .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 7 .. .. .. .. .. .. .. .. 1 .. 9 .. .. .. .. .. .. .. .. .. .. .. .. .. Bedford Park 1550 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 1 .. .. 2 .. .. .. .. 1 .. 5 .. .. .. .. .. 2 .. .. .. .. .. .. .. Totals 21965 26772 856 Under 5 .. 22 8 .. .. .. .. .. .. .. 5 .. 35 .. 1 .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 48 19 .. .. 14 2 .. 2 .. 47 .. 132 .. 2 .. .. .. 2 .. .. .. .. .. .. .. 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. 17 Sanitary Inspector's Office, Vestry Hall, Chiswick. Report of Sanitary Inspector for the year ending 31st December, 1898. Number of complaints received during the year 84 ,, Houses, premises, &c., visited and examined 2888 „ Notices served for abatement of nuisances 653 ,, Houses, premises, &c., repaired, cleansed, &c. 81 ,, Houses disinfected after illness of an infectious character 99 ,, Drains repaired, cleansed, and ventilated ... 142 ,, House drains reconstructed and ventilated 51 „ Waste pipes from baths, sinks, and lavatories disconnected from drains 25 „ Cesspools emptied and done away with, and new drainage provided connected with Public Sewer 1 ,, Waterclosetsrepaired,cleansed,&c. 51 ,, Water closets supplied with water separate from domestic supply 2 ,, New water closets provided 20 ,, Samples of water analysed taken from shallow wells supplying drinking water 0 „ Houses supplied by Water Co., previously from shallow wells 0 ,, Cisterns repaired, cleansed and covered 32 18 Number of Draw-off taps provided for direct domestic water supply from main instead of cisterns 336 „ Dust bins, new, provided 88 „ „ ,, repaired, covered, etc. 15 ,, Dust complaints received and attended to 250 ,, Accumulations of dung and other refuse removed 20 ,, Animals removed,being improperly kept 8 ,, Cases of overcrowding abated 4 „ Registered cowsheds, dairies, and milkshops regularly inspected 13 ,, Licensed slaughter-houses regularly inspected 7 ,, Bake-houses regularly inspected 16 ,, Legal proceedings (i.e.) summonses for the abatement of nuisances 8 Your obedient servant, JOHN H. CLARKE, (Mem. San. Inst.) Sanitary Inspector. 19 SANITARY DEPARTMENT. SALE OF FOOD AND DRUGS ACTS, 1875-9. Inspector's Report for the year ending 31st December, 1898. Gentlemen, During the past year I have submitted 55 samples of food to the Public Analyst for analysis, as follows:— New Milk 44 Butter 5 Sweets 1 Lard 5 55 Four samples of milk were adulterated with water to the extent of 6, 10, 11, and 25 per cent, respectively. Your Council ordered proceedings tobe taken in each case : an old offender was fined £10 : 12 : 6 ; in the case of first conviction of a small vendor, a fine of 20/- was inflicted; a third defendant produced the warranty required by statute, and the case was dismissed ; the fourth case was that of a servant in the employment of a large dairy firm, whom I caught in the act of adulterating the milk from a public urinal; the defendant pleaded guilty, and the Magistrate having characterized the case as an exceptionally bad one, imposed a fine of £3, or the alternative of one month's hard labour. The total amount received from fines and costs during the year amounted to £14 : 12 : 6. 20 Two other samples of milk were reported to be of inferior quality, but there did not appear to be sufficient grounds to justify legal proceedings. I am pleased to say that of the ten samples of butter and lard, only two of the latter were reported as being suspicious. It will be observed that the number of samples is comparatively small as compared with previous years. This is due to the fact that the quality of food sold in the District has maintained an exceptionally good standard, rendering expenditure in the analysis of food unnecessary; further, the Medical Officer desires a systematic inspection of dairies, etc., in order that the best possible attention should be devoted to the food supply. I am, Gentlemen, Your obedient servant, JOHN H. CLARKE, Inspector.