CHIS 9 Urban District of Chiswick. ANNUAL REPORT OF THE Medical Officer of Health. 1907. CHISWICK: PRINTED BY PLATRIER & SONS, HIGH ROAD. 1908. Urban District Council of Chiswick. PUBLIC HEALTH COMMITTEE. Dr. L. B. Diplock, J.P., Chairman. Councillor Cecil. E. Bovill, J.P. Councillor A. Jewell. „ G. Cursons, J.P. „ T. O'Brien. „ A. J. Fowkes. „ H. Roper. „ D. Harries. PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: Fredc. C. Dodsworth, M.R.C.S., L.R.C.P., &c. Chief Sanitary Inspector: John H. Clarke, M. R. San. I., &c. A ssistant Inspectors: J. W. Wood and P. Burr. Junior Clerk: W. Tillcock. Chiswick Urban District Council. Public Health Department, Town Hall, Chiswick, W. To the Chairman and Members of the Chiswick Urban District Council. Gentlemen, I have the honour to present to you my Thirtieth Annual Report on the health and sanitary conditions of this Parish. I wish to again acknowledge the help and support which have been accorded me both by the Chairman and members of the Public Health Committee, and I have also to tender my thanks to the members of my Staff for their assistance and support during the year. Whatever there is to record is due to a large extent to the thoroughness and efficiency with which their duties have been discharged, also to the zeal with which they have aided every effort to improve generally the sanitary conditions of the District. Vital Statistics. For the purposes of statistics, the population is estimated for the middle of the year. At the last census, taken on 1st April, 1901, our population was 29,809. Calculating that the rate of increase has been more than maintained, the population at the middle of 1907 may be approximately estimated at 35,970, and on these figures my statistics are based. 6 Births. The number registered during the year amounted to 915 (439 males, 476 females); of this number 24 were illegitimate. The birth rate was 25.43, compared with 25.15 for 1906 and 28.55 per thousand for 1905. That for London was 25.8 and the 76 great towns 27.5. The natural increase of population was 501 against 441 for the year 1906. Deaths. The total number of deaths in the District was 339 (148 males and 191 females) against 361 for 1906 and 437 for 1905. The number of deaths registered outside the District was 88; in addition there were 13 deaths of non-residents registered, eight of these occurring in St. Joseph's Hospital for Incurables. The death rate—calculated upon the total number of deaths of parishioners, viz., 339, plus the 88 who died beyond the District, but less the 13 non-residents registered in the District, making 414—was ll.50 of the total population. That of London was 14.6 and for the 76 principal towns 15.7. Infantile Death Rate, Being that of children under a year, was equal to 119T per thousand registered births, compared with 115.2 for 1906 and 107.7 for 1905. For London it was 115 and for the 76 principal towns 131. Senility or Old Age. 102 Persons attained the age of 65 and upwards; this number included 10 septuagenarians, 25 octogenarians, and five attained the age of 90 and upwards. 7 Infectious or Zymotic Diseases. From diseases of this class, there were 59 deaths, whilst for the year 1906 they amounted to 55; for last year they were as follows:— Measles 12 Scarlet Fever 7 Diphtheria 3 Whooping Cough 9 Enteric Fever 5 Diarrhœa 20 Enteritis 2 Puerperal Fever 1 The zymotic death rate was 1.64 per thousand, compared with l.62 for 1906, and for 1905, 1.7; that for London was 1.42 and for the 76 great towns 1.60. Infectious Diseases Notification Act. The following notifications have been received during the year:— Smallpox 0 Scarlet Fever 201 Diphtheria 30 Enteric Fever 30 Puerperal Fever 1 Erysipelas 34 Phthisis 2 Total 298 For 1906 there were 206, and for 1905 they numbered 238. Scarlet Fever Was again prevalent during the year, when the notifications indicated an increase of 80 on those for the preceding year, the cases being more prevalent 8 during the first and last quarters. At no time could it be said that the disease assumed an epidemic form, but throughout the year and in all parts of the District it prevailed to a greater degree than usual, and had it not been for the prompt isolation of the cases, I have reason to believe we should have experienced a sharp epidemic. Diphtheria. Thirty cases were notified during the year, an excess of two on those for 1906, whilst for 1905 they numbered 39. I consider that the exposure of young children to the emanations of sewage is a frequent cause of this complaint ; in many cases it is caught at school by exposure to infection from another child suffering from the same disease. There is little doubt that emanations from sewage do predispose to throat infections. In Great Britain, atmospheric humidity is considered most favourable to the general prevalence of this complaint, although it has been stated that it may become epidemic in those years in which the rainfall has been deficient. Enteric or Typhoid Fever. There were 30 notifications and five deaths; of the latter, two occurred in the Isolation Hospital. We had an unfortunate outbreak of this complaint, cases being notified during July, August and September. I instructed our Chief Sanitary Inspector to make a careful inspection of the drains at each house from which a case had been notified. On testing the drains at a mansion in Bedford Park, slight defects were discovered, and at a house in Elliott Road. 9 These are the two exceptions, otherwise the drains were perfect. The water supply was also satisfactory. Of 13 houses examined, 10 were supplied with water direct from the main. The cisterns at those houses which had not a constant supply were found to be clean and free from foreign matter. As regards the milk supply, 14 persons had their milk from a local dairy. I considered it desirable that a personal inspection should be made of the different farms from which the milk was supplied, and for this purpose arranged for your Chief Sanitary Inspector to visit certain farms in Berkshire and Wiltshire. I may say that the farms were above the average as regards sanitation, and in several the open shed system was adopted, and the result was satisfactorily indicated by the healthy condition of the cows. It was shown conclusively that no case of enteric fever had occurred at either farm for several years. Early in September, a visit was made by your Chief Sanitary Inspector to the Paddington Station with the view of inspecting the arrival of the milk in the early morning, and he reported the system adopted as being most unsatisfactory. Whilst on this subject, I must refer to the general construction of the lids of the churns, which are concave instead of convex, and have a natural tendency to collect dust and other impurities. They should undoubtedly be condemned and replaced by an improved cover which prevents any impurities getting to the milk, similar to those in use by several of our local dairies. 10 In my Report for November, I mentioned that Dr. Young, the County Medical Officer, came to Chiswick with the view of discussing this outbreak of enteric, and after looking carefully into all the details, all necessary and proper steps were taken. Enteritis. Two deaths were registered from this complaint, compared with five for 1906. Diseases of the pulmonary organs were responsible for 74 deaths, against 79 for the previous year. Diseases of the heart and circulatory organs accounted for 38 deaths; for 1906 they numbered 60. Influenza Was the immediate cause of four deaths, which occurred during the first quarter of the year. This complaint has been more or less prevalent during most months of the year. Cancer Caused 28 deaths, compared with 42 for 1906, and 28 for the years 1904 and 1905. I have arranged a Table giving the locality, age, and sex of those who have died from this complaint. 11 CANCER DEATHS (Distributed according to Locality, Age, and Sex). Wards. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. Totals. m. F. m. F. m. f. m. f. m. f. m. f. m. f. Bedford Park ... ... ... ... ... ... 2 ... ... ... ... ... 2 ... Chiswick Park ... ... ... ... ... ... ... ... ... 1 ... 2 3 Grove Park ... ... ... 1 ... ... ... 1 ... 2 ... ... ... 4 Gunnersbury ... ... 1 1 ... 1 2 1 ... 2 ... ... 3 5 Old Chiswick ... ... ... ... 1 ... 1 ... ... 1 ... ... 2 1 Turnham Green ... ... ... 1 ... ... ... 3 1 3 ... ... 1 7 ... ... 1 3 1 1 5 5 1 9 ... 2 8 20 12 Puerperal Fever. One case was notified which terminated fatally. The usual precautions were taken by the nurse engaged in the case, with the view of preventing the infection being conveyed to others. Phthisis. The notifications amounted to two only, and are voluntary. The deaths numbered 42. The following Table gives the particular locality in which they occurred, also the age and sex. 13 DEATHS FROM PHTHISIS (Distributed according to Locality, Age, and Sex). Wards. Under 8 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 Totals. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. Bedford Park ... ... ... ... ... ... 1 ... 1 1 ... ... ... 1 ... ... 2 2 Chiswick Park 3 1 2 5 2 1 3 2 ... ... ... 2 ... ... ... ... 10 11 Grove Park ... ... 1 ... ... ... ... 2 ... ... 1 ... ... ... ... ... 2 2 Gunnersbury ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 1 Old Chiswick ... 1 ... ... ... ... ... 1 1 1 1 ... ... ... ... ... 2 3 Turnham Green 1 1 1 1 1 ... ... ... 1 ... ... ... ... ... 4 2 Totals 3 2 4 7 3 2 5 5 2 2 4 2 ... 1 ... ... 21 21 14 Measles. This complaint was prevalent during the months of March, April, May, June and September, followed by 12 deaths, mostly due to lung complications. Whooping Cough. Nine deaths of children were due to this complaint, which prevailed in the spring, chiefly during the months of May and June. It is very fatal amongst young children. Diarrhœa Resulted in 20 deaths, against 32 for 190G. It was confined mostly to young children, and occurred as usual during the summer months, of July, August, and September. Inquests. Eighteen were held during the year; eight deaths were due to natural causes, nine to accidents, and one was a case of suicide. Dairies and Milk Shops. The total number registered in the district is 30. Each milk shop has been periodically inspected at frequent intervals during the year, and notices have been served in order to amend insanitary conditions, found as a result of inspection. Special attention has been given as to the steps taken in order to prevent contamination of the milk from dirt, dust, or flies. It is not generally recognised by milk sellers that during the summer months milk, when exposed for sale, is liable to be contaminated from both the dust and dirt of the shop, 15 and great surprise is frequently expressed on their attention being called to this fact. This also applies to the milk that stands in the churns in the dairies previous to its being strained, prior to its delivery, the prevailing idea being that the milkman's duty is discharged when he strains the milk through a muslin strainer, whereas by this means the grosser impurities are intercepted, but there remains the more dangerous contaminations, such as germs which are induced by this careless exposure of the milk. The provision made for the cleansing of those vessels and utensils used in the Dairies I propose referring to. In most instances either a steam apparatus or a special boiler is used for heating the water, also for cleansing or sterilizing purposes. It appears that the Lambeth Borough Council have established an Infants' Milk Depot, at which pure pasteurised or sterilized milk can be obtained at cost price, and by this means the milk is rendered free from the germs of disease, and since the Depot has been opened the general infantile death rate has been reduced from 134 per 1000 to 58 during the first six months. A similar system has been adopted in Liverpool with equally satisfactory results, where the infantile death rate has been reduced from 171 per 1000 to 96, the object being to combat the terrible loss of infant life from injudicious feeding, in addition to which it is a valuable preventitive against the possibility of tubercular disease being conveyed to the consumers of milk. The problem of Infantile Mortality is one receiving a large amount of attention at the present time, and it is generally admitted that this mortality is, to a 16 certain extent, preventible. It has been stated that from 85 to 99 per cent. of the children were at birth both fit and well, and it has been found that a child might be born healthy, although at the time its mother might be suffering from some disease. One great and important point is to educate people generally, and more particularly the poor, to the necessity of pasteurizing their milk before use, or sterilizing it, bringing it almost to the boiling point, but not allowing it to boil; this has the effect of destroying any germs which may exist. Samples of milk have been too frequently found which have contained the tubercle bacillus, and which are capable of being the cause of tuberculosis in the human being, when the cows may be suffering from the same complaint. When samples of milk are impure and dirty, it may be accounted for by the dirty condition of the cowsheds and premises where the cows are kept, and the milk stored. Whilst the general death rate has been so satisfactorily reduced since the passing of the "Public Health Act," that of infants has been about the same, and in some cases actually risen. The appointment of trained health visitors, to supervise and coordinate existing efforts to deal with the question of infantile mortality in connection with the Notification of Birth Act, will prove a necessity in all large and important parishes. Slaughter Houses. There are seven in the parish; all are systematically inspected, and are kept in accordance with the provisions of the Bye-laws relating to Slaughter Houses. I consider that the slaughtering of animals 17 for human food should be carried out under adequate inspection, which is only possible in a Central Abattoir, and I can but express a hope that future legislation will arrange for the abolition of the private slaughter houses. Bakehouses. There are 16 registered in the District. The powers conferred upon Local Authorities by the provisions of the Factory and Workshop Act, 1901, enabled them to improve the sanitary conditions of bakehouses generally, and a great amount of work has been done to premises of this character, since the year 1901. In the course of my visits of inspection, I have been struck with the general improvement as regards their sanitary condition. A difficulty that has to be contended with, is the loading of the bakehouses with sacks of flour; this is a most undesirable practice, which has a tendency to restrict the cubic area of the bakehouse, and the dust and dirt from the sacks causes a very undesirable admixture in the bread with which it is baked. Cowsheds. There are two in the parish at the present, which are satisfactory as regards cleanliness and ventilation. Mortuary. This has been much improved by a supply of hot water, a necessity which your Council readily recognised. Disinfection of Houses. I have made inspection of a number of dwelling houses, which were in such a filthy or unwholesome 18 condition that the health of the persons therein was affected or endangered thereby, or that the cleansing or purifying would tend to prevent or check infectious disease, and given the usual certificates requiring them to be cleansed or purified by the owners. New Buildings. The total number of houses passed for occupation by the Surveyor's Department, from January 1st, 1907, to 31st December, 1907, was 207. In addition to these, one large block of flats, containing eight tenements, also received approval. Buildings are still being rapidly pushed forward, and but little diminution, if any, is anticipated during the coming year. Sewerage. The sewerage of the District is partly on what is known as the separate system, and partly on the combined system. In the former case, the rain and surface water are kept separate, and discharged by means of a separate system into the nearest watercourses, and eventually into the river, whilst in the latter case, the whole of the rain and surface water is discharged with the sewage into the foul sewers. The ventilation of the sewers is effected by means of high columns placed in various parts of the District. I have not heard of any serious flooding during the past year, and I am strongly of opinion that freedom from this evil has been mainly due to the Council's action in providing new sewers through Duke's Avenue and Corney Road to the River, and 19 from Belmont Road through Bedford Park to the Metropolitan Sewer at Stamford Brook. I understand that the surface water drainage will, from time to time, be extended throughout the District, to the great advantage and benefit of the residents. Collection of House Refuse. The collection of house refuse is effected in Chiswick by the Surveyor's Department, and I am glad to say but very few complaints have been received in regard thereto, the disposal of the same being effected by means of a refuse destructor, adjoining the Sewage Works. I understand the Council are purchasing additional dust vans, which I am glad to learn are of the covered type, the open vans being in my opinion a far from sanitary method of collecting refuse. Workmen's Dwellings. The Council at present own two schemes of Workmen's Dwellings, viz., Loraine and Powell Roads. The former have been built with the intention of carrying out the principles laid down by Parliament, and I am glad to say are proving very beneficial, though it is not quite clear whether the tenants are all those for which the buildings were erected. In the latter case, the whole of the buildings on either side of Dalton Road were purchased, and extensive alterations and repairs effected, the name of the road being altered to, as far as possible, give the scheme a fresh start. Some little difficulty has been found in making this scheme properly pay 20 for itself, as the buildings were not erected for the express purpose of utilizing them as Municipal Dwellings, and the surroundings are hardly so ideal as those in the before-mentioned scheme at Loraine Road. Water Supply. There is, with few exceptions, a constant supply of water to all the houses in the District. I also append the total rainfall throughout the year—19.35 inches, which has been taken at the Sewage Works. I am glad to say a second gauge is now fixed at the Town Hall, which should prove of advantage in the future. Hospital Report for 1907. I have to record that the number of patients treated has exceeded that of the previous year. The following cases have been admitted:— Under 5 years 45 Between 5 and 17 years 99 Over 17 years 15 Total 159 Including six cases of Enteric Fever and six of Diphtheria. Nineteen cases were removed to Hospitals outside the District. There were nine deaths:— Scarlet Fever 6 Enteric Fever 2 Diphtheria 1 The asphalte paths recently made are a great improvement on the gravel, which were damp in wet weather. 21 One of the nurses has had to resign her duties owing to frequent attacks of rheumatism from which she suffered. The Matron and Nurses have been well occupied during the year, and we have found it necessary to procure extra nurses occasionally to meet any extra pressure. I am, Gentlemen, Your obedient Servant, FREDC- C. DODSWORTH, Medical Officer of Health. Fellow of the Society of Medical Officers of Health. Table showing Births and Birth Rates; Deaths and Death Rates; Deaths from Zymotic Diseases, also Death Rates during the past 10 Years. 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 Average of last 10 years. Births during the year 856 818 826 844 870 907 889 947 852 915 872.4 Birth rate per thousand 31.97 29.45 27.74 28.12 28.42 28.90 27.62 28.55 25.15 25.43 28.13 Deaths from all causes 452 408 392 352 394 328 424 437 441 414 360 Death rate per thousand 16.80 14.69 12.83 11.73 12.51 10.46 1317 12.96 10.65 11.50 12.73 Deaths from Small Pox 0 0 0 1 0 0 0 0 0 0 1 „ Measles 31 0 3 1 22 2 39 0 3 12 11 3 „ Scarlet Fever 0 1 4 1 1 0 5 3 0 7 2.2 „ Diphtheria 2 0 5 5 2 1 6 5 5 3 3.4 „ Whooping Cough 7 11 5 4 6 9 9 5 7 9 7.2 „ Enteric and other Fevers 4 1 4 0 5 2 0 1 1 5 2.3 „ Diarrhoea 45 54 12 22 13 9 15 36 32 20 25.8 „ Enteritis 0 0 0 22 13 19 18 6 5 2 8.5 „ Croup 0 0 0 0 1 .0 1 1 0 0 0.3 „ Erysipelas 3 0 1 2 3 4 4 1 2 0 2.0 „ Puerperal Fever 0 0 0 1 1 0 2 0 0 1 0.5 „ principal zymotic diseases 93 67 34 59 67 46 99 58 55 59 63.7 Death rate from ditto 3.47 2.4 1.14 1.6 21 1.4 3.07 1.7 1.62 1.64 201 TABLE 1. CHISWICK URBAN DISTRICT. Vital Statistics of Whole District during 1907 and previous years. Year. Population estimated to Middle of each Year. Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths in Public Institutions. Deaths of Nonresidents registered in District. Deaths of Residents registered beyond District. Deaths at all Ages. Nett. Number. Rate.* Number. Rate per 1,000 Births registered. Number. Rate* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1897 25,972 789 30.37 105 133 348 13.39 1898 26,772 856 31.97 132 154 452 16.80 1899 27,772 818 29.45 112 136 408 14.69 1900 29,772 826 27.74 144 174 392 12.83 1901 30,005 844 28.12 103 122 352 11.73 9 9 1902 30,609 870 28.82 112 128 394 12.51 11 11 1903 31,377 907 28.90 94 103.6 328 10.45 10 10 1904 32,177 889 27.62 111 124.8 424 13.11 8 8 46 462 14.35 1905 33,160 947 28.55 102 107.7 437 12.96 7 7 80 510 15.37 1906 33,873 852 25.15 98 115.2 361 10.65 17 12 92 441 13.01 Averages for years 1897.1906 30,148 869 28.66 111 129.8 389 12.91 1907 35,970 915 25.43 109 1191 339 9.42 12 13 88 414 11.50 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water) 1,245. Total population at all ages 29,809 Number of inhabited houses 5,235 Average number of persons per house 5 7 A Census of 1901. Institutions within the District receiving sick and infirm persons from outside the District—S. Joseph s Hospital. Institutions outside the District receiving sick and infirm persons from the District—West London and other Metropolitan Hospitals, Isleworth Workhouse Infirmary. The Union Workhouse is outside the District. TABLE II. CHISWICK URBAN DISTRICT. Vital Statistics of Separate Localities in 1907 and Previous Years. Names of Localities. 1. Whole District. 2. Bedford Park. 3. Chiswick Park. 4. Grove Park. 5. Gunnersbury. 6. Old Chiswick. 7. Turnham Green. 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. 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. 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. 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 c d a b c d a b c d a b c d 1897 25,972 789 ... 105 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1898 26,772 856 ... 132 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1899 27,772 818 ... 112 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1900 29,772 826 ... 144 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1901 30,005 844 ... 103 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1902 30,609 870 ... 112 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1903 31,377 907 ... 94 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1904 32,177 889 462 111 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1905 33,160 947 510 102 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1906 33,873 852 441 98 4,246 52 31 2 8,346 238 130 34 4,690 144 73 24 4,207 76 59 9 6,075 223 75 15 6,309 119 73 14 Averages of Years 1897 to 1906. 30,148 869 ... 111 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1907 35,970 915 414 109 4,173 57 29 4 8,697 270 124 44 5,151 120 63 13 4,303 90 46 5 7,348 220 79 25 6,298 158 73 18 TABLE III. CHISWICK URBAN DISTRICT. Cases of Infectious Disease notified during the Year 1907. Notifiable Diseases. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Bedford Park. Chiswick Park. Grove Park. Gunnersbury. Old Chiswick. Turnham Green. Totals. Bedford Park. Chiswick Park. Grove Park. Gunnersbury. Old Chiswick. Turnham Green. Totals. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria & Membranous Croup 30 ... 11 12 3 4 ... 1 14 8 2 3 2 30 ... 5 2 ... 2 ... 9 Erysipelas 34 ... ... 6 4 21 3 2 10 8 3 8 3 34 ... ... ... ... ... ... ... Scarlet fever 201 ... 69 119 9 4 ... 8 78 45 20 28 22 201 3 64 35 10 23 15 150 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 30 ... 1 6 6 16 1 7 7 5 3 3 5 30 4 5 4 1 1 3 18 Relapsing fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever 1 ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... 1 1 Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 2 ... ... ... ... 2 ... ... ... ... 1 1 ... 2 ... ... ... ... ... ... ... Totals 298 ... 81 143 22 48 4 18 109 66 29 43 33 298 7 74 41 11 26 19 178 Chiswick Council's Isolation Hospital, Clayponds Lane, Brentford, W. TABLE IV. CHISWICK URBAN DISTRICT. Causes of, and Ages at, Death during year 1907. Causes of Death. Deaths in whole District at subjoined ages. Deaths in or belonging to Localities (at all ages). Deaths in Public Institutions. All ages. Under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. Bedford Park. Chiswick Park. Grove Park. Gunnersbury. Old Chiswick. Turnham Green. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 12 4 7 1 ... ... ... ... 6 ... 1 3 2 ... Scarlet fever 7 ... 5 2 ... ... ... ... 2 2 1 ... 2 ... Whooping cough 9 8 1 ... ... ... ... 1 3 ... 1 3 1 ... Diphtheria & membranous croup 3 ... 2 1 ... ... ... ... 1 1 ... ... 1 ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 5 ... ... ... 1 4 ... 2 2 ... ... ... 1 ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza ... ... ... ... ... ... ... ... ... .. ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 20 19 ... ... 1 ... ... 1 7 7 2 2 1 ... Enteritis 2 ... 1 ... ... 1 ... ... 1 ... ... 1 ... ... Puerperal fever 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other septic diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 42 3 1 3 10 23 2 4 21 4 2 5 6 ... Other tubercular diseases 8 2 2 1 ... 3 ... 1 1 ... 1 3 2 ... Cancer, malignant disease 28 ... ... ... ... 15 13 2 3 4 8 3 8 1 Bronchitis 28 4 3 ... ... 5 16 1 10 3 3 6 5 ... Pneumonia 46 16 9 1 2 11 7 2 22 6 2 2 12 ... Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other diseases of respiratory organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... Alcoholism 3 ... ... ... ... 2 1 ... 1 ... 1 1 ... ... Cirrhosis of liver Venereal diseases 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... Premature birth 12 12 ... ... ... ... ... 1 1 4 ... 2 4 ... Diseases and accidents of parturition 2 ... ... ... ... 2 ... ... ... ... 1 1 ... ... Heart diseases 38 3 1 2 6 16 10 3 7 8 3 6 11 1 Accidents 9 3 ... 1 ... 2 3 1 2 ... ... 5 1 ... Suicides 1 ... ... ... ... 1 ... ... ... 1 ... ... ... ... Influenza 4 ... ... ... ... 3 1 ... ... ... 2 ... 2 1 Senile decay 17 ... ... ... ... ... 17 3 5 2 4 1 2 3 Nephritis 8 1 1 1 ... 4 1 1 1 1 ... 4 1 ... All other causes 108 34 4 8 6 31 25 6 28 20 14 30 10 6 All causes 414 109 38 21 26 124 96 29 124 63 46 79 73 12 TABLE V. CHISWICK URBAN DISTRICT. INFANTILE MORTALITY DURING THE YEAR 1907. Deaths from stated Causes in weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 1 month. 1-2 months. 2-3 months. 3-4 months. 4-5 months. 5-6 months. 6-7 months. 7-8 months. 8-9 months. 9-10 months.. 10-11 months. 11-12 months. Total Deaths under One Year. All Causes Certified 16 9 3 3 31 10 8 9 6 6 6 10 5 4 7 3 105 Uncertified ... 1 ... ... 1 ... 1 ... ... ... 1 ... ... 1 ... ... 4 Common Infectious Diseases. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... 1 1 4 Scarlet fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria: Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping cough ... ... ... ... ... ... 1 1 1 1 ... 1 2 ... ... 1 8 Diarrhœal Diseases. Diarrhœa, all forms ... ... ... 1 1 2 3 ... 2 ... 1 3 1 2 2 ... 17 Enteritis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Gastritis, Gastro-intestinal Catarrh ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 2 Wasting Diseases. Premature birth 8 2 1 1 12 ... ... ... ... ... ... ... ... ... ... ... 12 Congenital defects 1 ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... 3 Injury at birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of breast-milk ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... ... 2 Atrophy, debility, marasmus 2 1 ... ... 3 2 1 2 1 ... ... ... ... 1 1 ... 11 Tuberculous Diseases. Tuberculous meningitis ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Tuberculous peritonitis: Tabes mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other tuberculous diseases ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... 1 4 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 Convulsions 5 6 1 ... 12 1 ... 2 ... ... ... 1 ... ... 1 ... 17 Bronchitis ... ... 1 ... 1 ... ... ... ... 1 1 ... ... ... 1 ... 4 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... ... ... ... ... 2 3 2 ... 2 2 4 ... ... 1 ... 16 Suffocation, overlying ... 1 ... ... 1 ... ... ... ... ... 1 ... ... 1 ... ... 3 Other causes ... ... ... ... ... ... ... ... 1 1 ... ... 1 ... ... ... 3 16 10 3 3 32 10 9 9 6 6 7 10 5 5 7 3 109 Births in the year—915. Deaths from all causes at all ages—109. Population, estimated to middle of 1907—35,970. TABLE VI. ANNUAL REPORT of MEDICAL OFFICER OF HEALTH for 1907, for the URBAN DISTRICT OF CHISWICK on the Administration of the Factory and Workshop (1901), in connection with FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES & HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries.) 43 4 — Workshops (Including Workshop Laundries.) 165 8 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) 39 — — Total 247 12 — 2.—DEFECTS FOUND. Particulars. Number of Defects Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:— Want of Cleanliness 7 7 — — Want of Ventilation — — — — Overcrowding — — — — Want of drainage of floors — — — — Other Nuisances 2 2 — — †Sanitary accommodation insufficient — — — — unsuitable or defective 6 6 — — not separate for sexes — — — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses (s. 101) — — — — Breach of special sanitary requirements for bakehouses (ss. 97 to 100) — — — — Other offences — — — — (Excluding offences relating to outwork which are included in Part 3 of this Report). Total 15 15 — — 3.—HOMEWORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Lists received from Employers. Numbers of Addresses of Outworkers received from other Councils. Numbers of Addresses of Outworkers forwarded to other Councils. Number of Inspections of Outworkers' premises. Twice in the year. Lists.‡ Outworkers.‡ (1) (2) (3) (4) (5) (6) Wearing Apparel— (1) making, &c. 12 25 33 16 33 (2) cleaning and washing — — — — — Total 12 25 33 16 33 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. Important classes of workshops, such as workshop bakehouses, may be enumerated here. Workshops 147 Workplaces 31 Total number of workshops on Register 178 5.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 2 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factor}' and Workshop Act (s. 5) Notified by H.M. Inspector — Reports (of action taken) sent to H M. Inspector — Other — Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 4 *Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. †For 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 accommodation for persons employed in factories and workshops has been enforced. ‡The figures required in columns 2 and 3 are the total number of lists received from employers who sent them both in February and August as required by the Act and of the entries of names of outworkers in those lists. They will, therefore, usually be double of the number of such employers and (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. (I) CHISWICK URBAN DISTRICT. County of Middlesex.—Sanitary Work, 1907. Inspections— Number of premises inspected on complaint (a) 172 Number of premises inspected in connection with Infectious Diseases (b) 280 Number of premises under periodical inspection (e) 349 Houses inspected from house-to-house (d) 2895 Total number inspections and re-inspections made (e) 8584 Notices— Cautionary or Intimation Notices given 411 Statutory Orders issued 1422 Summonses served 4 Convictions obtained 2 Dwelling Houses— Houses, premises, &c., cleansed, repaired, &c. 403 Closed as Unfit for Habitation 2 Demolished 2 Houses Let in Lodgings (Tenement Houses)— Number registered under Byelaws 341 Chief Sanitary Inspector:—Mr. John H. Clarke. (Also Inspector under Petroleum Acts, and Sale of Food and Drugs Acts). Assistant Inspectors:—Two. Junior Clerk:—One. Men are obtained from Works Department when necessary. (II.) CHISWICK URBAN DISTRICT. County of Middlesex.—Sanitary Work, 1907. Movable Dwellings, Caravans, Tents, &c.— Number Observed during the Year 30 Number Removed from District 30 Bakehouses— Number in District 16 Slaughterhouses— Number on Register 7 Number of Inspections made and frequency of inspection 4 times a year Cowsheds— Number on Register 2 Number of Inspections made and frequency of inspection 4 times a year Dairies and Milkshops— Number on Register 30 Number of Inspections made and frequency of inspection 4 times a year Unsound Food— Articles or Parcels surrendered 13 Adulterated Food— Samples taken (if any) by the District Local Authority 68 Found adulterated 11 Offensive Trades— Number of Premises in District 1 Number of Inspections made 1 Water Supply and Water Service— Percentage of Houses supplied from Public Water Service 100 per cent. Cisterns—Cleansed, Repaired, Covered, &c. 232 Draw-Taps placed on Mains 125 Percentage of Houses supplied on Constant System 100 per cent. (III.) CHISWICK URBAN DISTRICT. County of Middlesex.—Sanitary Work, 1907. Drainage and Sewerage of Existing Buildings— Water Closets—Repaired, supplied with water, or otherwise improved 254 Percentage of Houses provided with Water Closets 100 per cent. Drains—Examined, tested, exposed, &c. 363 Unstopped, repaired, trapped, &c. 70 Waste Pipes, Rain Water Pipes disconnected, repaired, &c. 27 New Soil Pipes or Ventilating Shafts fixed 89 Existing Soil Pipes or Ventilating Shafts repaired 39 Disconnecting Traps or Chambers inserted 43 Reconstructed 123 Percentage of Houses draining into Sewers 100 per cent. Disinfection— Rooms disinfected 208 Rooms stripped and cleansed 305 Articles disinfected or destroyed 13 Dust— New Bins provided 230 How frequently is dust removed from each house weekly Number of complaints of non-removal received 77 Method of Disposal Destructor Sundry Nuisances Abated— Overcrowding 10 Accumulations of Refuse 9 Foul Pigs and other Animals 24 Dampness 68 Yards repaved or repaired 119 Other Nuisances 668 Chorley Rural District Council. Medical Officer of Health's REPORT. 1907. S. FLOWER & SONS. GUARDIAN OFFICE , CHORLEY. CHORLEY, FEBRUARY, 1908. TO THE RURAL DISTRICT COUNCIL OF CHORLEY. Gentlemen, In reviewing the vital statistics for the thirty-two years that I have been Medical Officer of Health to the Chorley Rural District Council, and the Chorley Rural Sanitary Authority, the most striking features are the great decline in the Birth-rate that has been steadily going on during the last twenty years, and the decrease in the Death-rate which has been satisfactory, though not so marked as that in the Birth-rate. The same condition has prevailed throughout England, and whilst the decline in the Birth-rate is to be deplored, the lower Death-rate, and especially the decreasing rate from such diseases as Typhoid Fever, gives evidence that the labours of your predecessors and yourselves have not been in vain, more especially when you consider that the average duration of life has increased within this period. The number of Births registered in the Rural District of Chorley in 1907 was five hundred and thirteen (513), two hundred and sixty-nine (269) of which were Males, and two hundred and forty-four (244) Females. Eleven (11) Births were illegitimate, that is about two per cent., as compared with three per cent. of illegitimate Births in 1906. The Birthrate, calculated upon an estimated population of 21,000 on July 1st, 1907, was 24.43 per thousand, the lowest Birth-rate that I have ever had to record. The Birth-rate in your District in 1906 was 25.96, and the average Birth-rate for the ten years preceding 1907 was 27.8, more than three (3) per thousand higher than the Birth-rate of 1907. Throughout England and Wales the Birth-rate in 1907 was 26.3 per thousand of the estimated population, which, though the lowest Birth-rate recorded for the country was nearly two (2) per thousand higher than the Birth-rate obtaining in your District. Excluding the large and small towns the Birth-rate for the more rural portions of England was, in 1907, 25.6 per thousand, that is 1.2 per thousand higher than the rate calculated for your District. I give in Table I. (Local Government Board Tables), appended to this Report, the number of Births and Birth-rates for 1907 and the ten preceding years, and the average number and rate for the decade, and in Table A the number of Births and Birth-rates in each Sub-District during 1907 and the preceding three years. TABLE A. Sub-District. 1907. 1906. 1905. 1904. Number of Births. Birth Rate. Number of Births. Birth Rate. Number of Births. Birth Rate. Number of Births. Birth Rate. Chorley 170 30.4 172 32.1 156 30.6 152 30.7 Brindle 69 20.3 79 23.1 81 23.8 70 20.6 Croston 109 25.1 100 23.0 107 25.1 105 24.7 Leyland 113 21.7 133 25 6 123 23.9 131 25.7 Rivington 52 21.2 56 22.4 61 24.4 56 22.4 Totals. 513 24.43 540 25.96 528 25.8 514 25.4 4 You will notice that in Chorley Sub-District alone has there been a high Birth-rate; in Croston Sub-District the Birth-rate is slightly above the rate for the whole of your District; whereas in Brindle, Leyland, and Rivington the Birth-rate is considerably below the low rate obtaining throughout the Rural District of Chorley. Last year I was able to congratulate you upon the lowest Death-rate on record in the Rural District of Chorley. I regret that I am not able to give so favourable a report for 1907, the Death-rate being considerably higher than in 1906, though still well below the average of the previous decade. The number of Deaths registered in your District in 1907 was two hundred and ninty-five (295), of which one hundred and fifty-nine (159) were Males, and one hundred and thirty-six (136) Females. The Death-rate upon the same estimated population of 21,000 was 14.05 per thousand. In 1906 the Death-rate was only 12.74, only two hundred and sixty-five (265) Deaths having been registered during that year. The Death-rate throughout England and Wales in 1907 has been estimated at 15.0 per thousand, and of the more rural districts, excluding two hundred and eighteen towns, the rate was 14.7 per thousand. You will notice that the Death-rate in your District, though higher than last year, is not only decidedly less than that of the country at large, but is also below the average of the rural districts with which your District can be most appropriately compared. From Table I. appended to this Report you will see that, though the Death-rate of 1907 was higher than that of 1906, in only one other year (1901) was there a lower Death-rate than that of 1907, and that the rate of 1907 was nearly one per thousand lower than the average rate for the previous ten years. The increase in the number of Deaths in 1907, as compared with 1906, occurred in each of the Quarters of the year, except the second, in which the number of Deaths was slightly below that of the corresponding Quarter of 1906. This you will see in Table B, in which the Deaths of 1907 and the five preceding years are given in the Quarters in which they occurred. TABLE B. Year. Deaths in First Quarter. Deaths in Second Quarter. Deaths in Third Quarter. Deaths in Fourth Quarter. Total. 1907 83 66 62 84 295 1906 79 68 51 67 265 1905 105 63 56 63 287 1904 84 63 57 87 291 1903 81 70 62 85 298 1902 100 73 57 88 318 5 As you will see in the next Table, there has been a decided increase in the numbers of Deaths registered in 1907, as compared with those in 1906, in Brindle, Coppull, Bretherton, and Heapey; a slighter increase in Eccleston, Whittle, Duxbury, Wheelton, etc. On the other hand, Heath Charnock and Cuerden show a distinct decrease in the number of Deaths, the decrease in the former township being due to the much smaller number of Deaths in the Isolation Hospital; whilst Hoghton, Euxton, Anderton, Rivington, etc., show a slighter diminution in Mortality in 1907, as compared with 1906. TABLE C. Townships. 1907. 1906. 1907. Number of Deaths. Number of Deaths. Increase. Decrease. Charnock Richard 9 7 2 ... Coppull 53 43 10 ... Duxbury 5 2 3 ... Heapey 9 3 6 ... Welch Whittle ... 2 ... 2 - - - - Total in Chorley Sub-district 76 57 21 2 Brindle 19 7 12 ... Hoghton 14 17 ... 3 Wheelton 23 20 3 ... — - — - Total in Brindle Sub-district 56 44 15 3 Bretherton 14 7 7 ... Eccleston 20 15 5 ... Heskin 9 10 ... 1 Mawdesley 9 9 ... ... Ulnes Walton 7 5 2 ... - - - - Total in Croston Sub-district 59 46 14 1 Clayton-le-Woods 12 12 ... ... Cuerden 3 8 ... 5 Euxton 18 21 ... 3 Whittle-le-Woods 41 36 5 ... - - - - Total in Leyland Sub-district 74 77 5 8 Anderton 9 12 ... 3 Anglezarke 1 ... 1 ... Heath Charnock 17* 23† ... 6 Rivington 3 6 ... 3 - - — - Total in Rivington Sub-district. 30 41 1 12 Totals 295 265 56 26 *Including two deaths in Isolation Hospital. †Including nine deaths in Isolation Hospital. 6 In the preceding Tables (B and C) I have given the Deaths registered in the Rural District of Chorley. Several Residents in the District have died in public institutions (Chorley Workhouse, Rawcliffe Hospital, Wigan and Blackburn Infirmaries, etc.), and one patient who died in the Isolation Hospital did not belong to your District. As you will see from Table I. at the end of this Report, I have included the Deaths of fifteen (15) Residents dying beyond the District, and excluded the Death of one (1) non-resident dying in your District. The number of Deaths of Residents was, accordingly, three hundred and nine (309), and the Death-rate of Residents 14.71, as compared with a rate of 13.03 in 1906 obtained from the Deaths of two hundred and seventy-one (271) Residents occurring in that year. The Death-rate in 1907 was highest in the Brindle Sub-District, and lo.vest in the Rivington Sub-District, as you will see from Table D, in which the Deaths of Residents occurring in 1907 and the three preceding years are arranged under the Sub-District to which they belonged. TABLE D. Sub-District. 1907. 1906. 1905. 1904. Number of Deaths Death Rate. Number of Deaths Death Rate. Number of Deaths Death Rate. Number of Deaths Death Rate. Chorley 83 14.9 61 11.4 74 14.5 72 14.5 Brindle 61 17.9 46 13.5 49 14.4 45 13.2 Croston 59 13.6 47 10.8 60 14.1 65 15.3 Leyland 78 15.0 81 15.6 81 15 7 71 13.9 Rivington 28 11.4 36 14.4 38 15.2 36 14.4 Totals 309 14.71 271 13.03 302 14.8 289 14.3 In Table E I give the numbers of Deaths of Residents in 1907 and the five preceding years in age groups, and you may notice that there has been an increase in the number in each group, as compared with the numbers in 1906, with the exception of that containing the Deaths of Infants under one year. TABLE E. Year. Deaths from all Causes at Subjoined Ages. Total. Under 1 Year. l and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1907 57 27 22 19 101 83 309 1906 63 23 12 10 95 68 271 1905 64 30 11 15 106 76 302 1904 69 37 10 10 88 75 289 1903 69 35 14 15 82 71 286 1902 88 31 18 8 88 75 308 7 The diminution in the number of Deaths under one year of age is satisfactory, only 18 per cent. of the total Mortality in your District in 1907 occurring in infants, whilst in 1906 23 per cent., and upon the average of the last five years, 24 per cent. of the Deaths occurred in infants. The most marked increases occurred in the two age groups, five and under fifteen, and fifteen and under twenty-five, and also in the old age group (sixty-five years and upwards), in which nearly twenty-seven per cent. of the total Mortality was placed. The Infantile Mortality was, in 1907, I am glad to say, the lowest on record. Only one hundred and eleven (111) per one thousand Births was the rate obtaining in 1907, as compared with one hundred and seventeen (117) in 1906, one hundred and nineteen (119) in 1905, and an average of one hundred and thirty (130) in the decade 1897— 1906. It is satisfactory to note the steady decrease in the Deaths of infants and the longer duration of life on the average, and this affords some compensation for the deplorable condition of the Birth-rate. The Infantile Mortality throughout England and Wales in 1907 was one hundred and eighteen (118) per thousand Births, and for the Rural Districts one hundred and six (106) per thousand; that of your District being below the general rate of the whole country, but somewhat higher than the average rate for the more rural portions of England. Croston Sub-District, as in 1906, has again yielded the lowest Infantile Mortality, viz, seventy-three (73) per thousand Births, Rivington seventy-seven (77), Chorley one hundred and seveneeen (117), Leyland one hundred and twenty-four (124), and Brindle one hundred and fifty-nine (159) per thousand Births. I give in Table V., appended to this Report, the Deaths of Infants under one year of age, arranged under the diseases to which they were due, and the number of weeks or months that they lived. Eighteen (18) Infants died under one month from Birth, and thirty-nine between one and twelve months. Four (4) died from Infectious Diseases, viz, Measles two (2), and Whooping Cough two (2); three (3) from Diarrhœal Diseases, twenty-six (26) from Wasting Diseases, two (2) from Tuberculous Diseases, and twentytwo (22) from other causes. 8 TABLE F. Cause of Death. 1907. Number of Deaths. 1906. Number of Deaths. 1907. Increase. 1907. Decrease Measles 9 — 9 — Scarlet Fever — 3 — 3 Whooping Cough 5 1 4 — Diphtheria & Membranous Croup 8 6 2 — Croup 1 — 1 — Typhoid Fever — 2 — 2 Influenza 7 3 4 — Diarrhœa 5 8 — 3 Enteritis 2 1 1 — Puerperal Fever — 2 — 2 Erysipelas 1 1 — — Other Septic Diseases 2 1 1 — Phthisis 23 13 10 — Other Tubercular Diseases 4 6 — 2 Cancer, Malignant Disease 16 16 — — Bronchitis 22 14 8 — Pneumonia 27 25 2 — Pleurisy 2 — 2 — Alcoholism & Cirrhosis of Liver 5 — 5 — Premature Birth 7 14 — 7 Heart Disease 33 25 8 — Accidents 12 18 —- 6 Suicides — 2 — 2 All Other Causes 118 110 8 — Totals 309 271 65 27 From the above Table (Table F), in which I have given the numbers of Deaths due to the several causes in 1907 and 1906, and the increase or decrease of Deaths due to the same cause in 1907, as compared with the number obtaining in the preceding year, you will see that an increased Mortality has occurred more specially in Deaths due to Measles, Whooping Cough, Influenza, Phthisis, Bronchitis, Alcoholism, and Heart Diseases, and other causes, and that only in Deaths due to Premature Birth and Accidents has there been any marked decrease. In Table IV. (Local Government Board Tables) the Deaths due to the various causes are arranged under the groups of ages at which they occurred, and in the Sub-Districts to which they belonged. Seventeen (17) of the whole number of Deaths were registered as uncertified, and these Deaths I have included in the last class (all other . causes). The Zymotic Death-rate of Residents during 1907 was 1.29 per thousand, whilst those of the three preceding years, 1906—1904, were respectively 1.06, 0.78, and 1.68. The epidemic of Measles and the prevalence of Diphtheria account for the increased Zymotic Death-rate. 9 Nine (9) Deaths occurred from Measles, five (5) from Whooping Cough, eight (8) from Diphtheria and Membranous Croup, and five (5) from Diarrhœal Diseases. The Zymotic Death-rate throughout England and Wales in 1907 was 1.28 per thousand—almost the same as your Zymotic rate—but in the Rural Districts of the country the average rate was only 0.91 per thousand— decidedly less than your Zymotic Death-rate. Eighty-seven (87) cases of Infectious Diseases were notified to me, viz, Diphtheria and Membranous Croup fifty-two (52), Scarlet Fever nineteen (19), Erysipelas eleven (11), and Typhoid Fever five (5). Table III. (Local Government Board Tables) gives the number of each Infectious Disease in the various Sub-Districts, and the number of cases of such disease removed from each Sub-District to the Isolation Hospital. I give in Table G the number of eases of each Infectious Disease notified to me in 1907, and in each of the ten preceding years, and also the average number of each Infectious Disease notified to me in that decade (1897—1906). TABLE G. Year. Smallpox Diphtheria and Membranous Croup. Scarlet Fever. Erysipelas. Typhoid Fever. Other continued Fevers. Puerperal Fever. Totals. 1897 ... 7 32 22 43 l 3 108 1898 ... 13 36 22 27 5 ... 103 1899 ... 36 55 34 44 2 1 172 1900 ... 16 29 19 28 4 1 97 1901 ... 48 76 34 15 ... 4 177 1902 ... 24 175 31 27 1 3 261 1903 4 15 86 21 20 ... 1 147 1904 ... 19 115 38 11 ... 2 185 1905 ... 22 61 24 12 1 1 120 1906 ... 44 65 26 11 1 ... 147 Average of Decade 1897-1906. .4 24 73 27 24 1.5 1.5 152 1907 ... 52 19 11 5 ... ... 87 The chief features to notice in Table G are the marked diminution in the number of Infectious Cases reported to me (the lowest on record since the adoption of the Infectious Diseases Notification Act, except during the second year, 1892), and the decided decrease in every one of the Infectious Diseases, with the exception of Diphtheria which, on the other hand, has as markedly increased in the number of cases reported. In the next Table, Table H, I give the number of each Infectious Disease reported from each township, and compare the total number of Infectious Diseases notified from each township in 1907 with similar totals for 1906. 10 TABLE H. Townships. Scarlet Fever. Diphtheria and Membranous Croup. Typhoid Fever. Other Continued Fevers. Erysipelas Totals, 1907 Totals, 1906 Charnock Richard ... ... ... ... ... ... 5 Coppull 4 12 1 ... 2 19 39 Duxbury ... 2 ... ... ... 2 1 Heapey ... ... ... ... ... ... 2 Welch Whittle ... ... ... ... ... ... 1 Brindle ... 10 ... ... ... 10 2 Hoghton 3 ... ... ... ... 3 19 Wheelton 2 4 ... ... 2 8 7 Bretherton 6 3 ... ... ... 9 17 Eccleston 1 1 ... ... ... 2 10 Heskin ... ... ... ... 1 1 4 Mawdesley ... 1 ... ... ... 1 1 Clayton-le-Woods. ... 2 ... ... 1 3 3 Cuerden .. 1 .. ... 1 ... Euxton ... 1 ... ... 2 3 9 Whittle-le-Woods. 1 7 2 ... 1 11 12 Anderton ... 4 ... ... 2 6 4 Heath Charnock .. 4 ... ... ... 4 9 Rivington 2 1 1 ... ... 4 2 Totals 19 52 5 ... 11 87 147 You will notice that no cases of Infectious Diseases were notified in 1907 in Charnock Richard, Heapey, Welch Whittle, Ulnes Walton, and Anglezarke; and from the two latter townships none were reported in the previous year. Most of the townships show a marked decrease in the number of infectious cases, more especially Coppull, Hoghton, Bretherton, Eccleston, Euxton, and Whittle-le-Woods. In Brindle owing to an epidemic of Diphtheria there was a marked increase in the number of cases of that disease. Smallpox has not been notified in your District since 1903, and if any cases should occur, the Joint Hospital Board have provided in the Finnington Hospital, Hoghton, belonging to the Blackburn Corporation, sufficient accommodation for the reception of such cases. It would be more satisfactory to all the Health Officers if the people at large were rendered insusceptible of Smallpox by Infant Vaccination and He-vaccination, which, I fear, are being neglected now that the incidence of cases is so rare, and that the means of obtaining exemption have been made so easy. Scarlet Fever.—Only nineteen (19) cases of Scarlet Fever have been reported during the year, six (6) of which occurred at Bretherton, four (4) at Coppull, three (3) at Hoghton, two (2) each at Wheelton and Rivington, and one (1) each at Eccleston and Whittle-le-Woods. Nine (9) of these capes were removed to the Isolation Hospital, as they were not able to be effectually isolated at home. 11 The disease was of a mild type, and no Death resulted from it during the year. Diphtheria and Membranous Croup were unusually prevalent, fiftytwo (52) cases having been notified to me during the year. Twelve (12) cases were reported from Coppull, ten (10) from Brindle, seven (7) from Whittle, four (4) each from Wheelton, Anderton, and Heath Charnock, three (3) from Bretherton, and one (1) or two (2) from six other townships. Eight (8) Deaths resulted from these Diseases, viz, five (5) from Diphtheria, and three (3) from Membranous Croup, or 15 per cent. of the whole number of cases. Nine (9) cases were removed to Hospital, and one (1) died in that institution. One or more cases were notified in each month of the year, but the second and third Quarters yielded the fewest cases, viz, five (5) and four (4) respectively. Eighteen (18) cases were reported in October, seven (7) in February, six (6) in March, and five (5) in November. The Brindle cases, I believe, originated from an undiscovered and unreported case, the child being allowed to go to school, and thereby communicate the infection to other children attending there. Nine (9) of the ten (10) notified cases occurred in October, and most of them were in children attending the National School. I recommended the closure of the school, which your Council directed to be carried out. Six (6) of the Coppull cases were reported in October, two (2) in November, and one (1) each in four other months. Typhoid Fever.—Only five (5) notifications of Typhoid Fever were received in 1907, as compared with eleven (11) in 1906, and an average of twenty-four (24) for the decade (1897—1906). This is one of the most satisfactory features of my Report, and I think your District is beginning to realise the benefit conferred upon the inhabitants by the various Draining and Sewage Works constructed by you, and by the supply of pure water to many portions of the District. No death occurred from Typhoid Fever during the year. The houses infected by Scarlet Fever, Diphtheria, or Typhoid Fever were visited by myself or my deputy, Dr. Webb, instructions given to the persons in charge, disinfectants supplied, and on the termination of the case, the houses were fumigated and disinfected by one of your Caretakers. Any sanitary defect that has been found has been reported to you, and has been remedied. Measles has been very prevalent in various portions of your District during the year, but has now subsided. In January there was an outbreak at Higher Wheelton, spreading in February and March to Lower-lane, Heapey, and Town-lane, Whittle; in June many cases occurred in Anderton, etc.; and in September and October a distinct epidemic occurred in Coppull, Ulnes Walton, and Eccleston; and in November this epidemic spread to Heskin, Mawdesley, and Charnock Richard. I have no means of ascertaining the exact number of children who suffered from this disease, but on my visits to the various schools I obtained lists of cases that amounted to several hundreds in the aggregate. 12 I recommended your Council to close the schools at the following places, and for the times mentioned:— Higher Wheelton National School, January 29th to February 17th. Whittle South Hill, February 13th to March 11th. Wheelton Council School, March 20th to April 10th. Anderton St. Joseph's School (Infant Department), June 25th to July 16th. Coppull National, September 16th to October 7th. Ulnes Walton, October 1st to October 21st. „ „ further closure to November 5th. Coppull Moor, October 7th to October 28th. Coppull St Oswald's, October 7th to October 28th. Eccleston, October 28th to November 25th. „ further closure to December 9th. Heskin, November 27th to after Christmas. Charnock Richard, November 15th to after Christmas. Mawdesley R.C., November 22nd to after Christmas. In one or two instances I think it would have been better to have closed the schools for a somewhat longer period, as the epidemic had not sufficiently subsided when the schools were re-opened. In most of the cases the information on which I acted arrived too late for me to successfully adopt the advice of the Board of Education— to exclude only the children suffering and the inmates from the same house —or to exclude all from the same class. I have to thank the Teachers in the various schools for the great help they have rendered me in giving me much information, and supplying me with lists of cases of disease. Whooping Cough caused five (5) Deaths during the year. All these Deaths occurred in the last four months, and two (2) were registered from Brindle and Coppull respectively, and one (1) from Rivington. The Inspection of School Children will probably be inaugurated during the coming year, and ought to prove of great service in the early detection and removal or amelioration of many physical incapacities undiscovered or neglected by the parents. In addition to relieving the present physical defects, and thus rendering the life of the child happier and more complete, the improvement in health, and the consequent sharpening of the mental faculties are likely to make the young people, on leaving school, better fitted for the battle of life, and more capable for any work that may be their lot to do. The Board of Education, acting under Section 13 of the Education (Administrative Provisions) Act, 1907, have issued a Memorandum in which the duty of providing for such inspection in County areas is laid upon the County Council, and the County Medical Officer of Health is to be the responsible head and supervisor of this inspection, with such assistants as may be thought necessary for the adequate carrying out of the work. The Board have decided that not less than three inspections of each child will be necessary during school life—the first at the time of entering school, the second at or about the third year, and the third at about the sixth year of school life. 13 I consider that when this school inspection is in good working order, an inestimable benefit will be conferred upon the population in your District. Sewerage.—The Sewage Disposal Works at Whittle and Clayton, Heapey and Wheelton, Eccleston and Euxton, are generally working satisfactorily, and the extension of the works at Coppull made in 1906 has relieved the over-pressure upon the precipitating tanks and filters caused by the great increase in the number of houses since they were first constructed. There will soon be required at the Whittle and Clayton Sewage Works a similar increase in size, as they are now barely adequate for the treatment of the large amount of sewage from these townships. During the year you have ordered drains to be laid from Bay Horse, Euxton, to Randsnap Brook; from houses near Paletot Inn and Oak Tree Inn, Whittle, to the main drain there; and in other places. Water Supply.—The Waterworks of Anderton and Heath Charnock, and of Whittle, Clayton, Heapey, and Wheelton from Thirlmere, continue to give a good and constant supply of water to these townships. During the year you have resolved to grant the wishes of the householders near Heapey Station by furnishing them with a supply from your storage reservoir, at the estimated cost of £372. At Clayton-le-Woods an extension of the main towards Sheephill Brow has been made to supply three farms and a dwelling-house. The Coppull water supply from Liverpool Corporation Works, through the Urban Council of Standish, has generally been good, though for a short time there were complaints about the impurity of the water. I would like to suggest that in any case of deficiency or impurity of supply from any of the public waterworks, notice be sent at once to the caretaker, and if not immediately attended to, to the Surveyor and myself, so that we may be able to ascertain the cause of such default, and remedy it as soon as possible. You have given directions that, under certain conditions, the water mains in Coppull be extended to Whittle Bridge, in order to supply a farm situate in that locality. The Western Water Scheme to supply the townships of Euxton, Charnock Richard, Welch Whittle, Heskin, Eccleston, Ulnes Walton, and Bretherton, in your jurisdiction, and the Urban District of Croston, is now being rapidly proceeded with. Long negotiations between the Croston and Manchester Authorities and yourselves delayed the sending of the plans and estimates to the Local Government Board, but an enquiry was held, and sanction to the loan was granted by that Board in May. Four contracts for laying the pipes were entered into by you, clerks of the works appointed, and contracts for the supply of iron pipes, etc., etc., were made. The work is now going on very satisfactorily, and it may reasonably be expected that the pipe-laying will be finished in three or four months. 14 You have, further, advertised and received tenders for the laying of house service branches, and appointed a contractor to lay such branches; and you have decided that only tin-lined lead pipes be used for service branches. Certificates of sufficient water supply have been applied for and granted to the owners of six (6) houses in Coppull, live (5) in Wheelton, two (2) in Heskin, and one (1) each in Mawdesley and Clayton-le-Woods. I wish again to draw the attention of all owners of newly-erected dwelling-houses to the duty imposed upon them by Section 6 of the Public Health (Water) Act, 1878, of applying to your Council for a Certificate of sufficient water supply before permitting the houses to be inhabited. There have been several cases in which houses have been occupied weeks before Certificates have been applied for. I would like to suggest to your Council that, in townships where there is a public water supply provided by you, and where the connection of the newly-erected house to the water main has been made, you should empower your Surveyor automatically to give the necessary permission to occupy on account of sufficient water supply at the same time as he gives a Certificate of compliance with the building requirements. You have decided that in the case of cattle-keepers, all farmers using the water from your various Waterworks, should be required either to pay scale charges for the cattle, or to receive water through meter with a minimum cost, and further that all clubs, etc., be charged for the amount of water consumed by meter. House Accommodation.—Plans have been laid before you, and have received your approval, for the erection of ninety-eight (98) houses, viz, sixty-two. (62) houses in Coppull, eight (8) in Heapey, and four (4) in Wheelton; and as regards drainage, for nine (9) in Eccleston, five (5) in Heskin, three (3) in Heath Charnock, two (2) each in Anderton, Mawdesley, and Charnock Richard, and one (1) in Bretherton. You have also passed plans for a spinning mill, a weaving shed, and extension to another ; a slaughter-house, and several shippons, etc. The building of so many houses in Coppull is relieving the previously somewhat overcrowded condition of that township. As a rule in your District the house accommodation is good, and there are only a few houses that are in an unsatisfactory condition. No action has been taken by your Council under the Housing of the Working Class Act, and at present I do not see the need of any action being taken in your District. Scavenging.—At the beginning of 1907 only two townships, viz, Coppull and Euxton, were scavenged at the public expense. I am triad to say that during the year you have added five townships to that list, viz., Anderton, Heath Charnock, Whittle, Clayton, and Wheelton. Contracts have been entered into by you with men in each of these townships, to regularly and effectually empty all privies, bogholes, and ashpits, and to remove all household refuse from the premises. 15 I am sure that this will be of great benefit, not only to the health, but to the comfort of the inhabitants of these townships, and any default in the regular carrying out of the contract should be at once communicated to the Nuisance Inspector, Mr. J. Froes, 111, Moor-road, Chorley. You advertised also and received tenders for the scavenging of Rivington, but the cost seemed so prohibitory that you did not accept either of the tenders. Another from the Liverpool Corporation will be laid before you very shortly. Dairies and Cowsheds.—I have practically completed my visitation of the Farms, Dairies, and Cowsheds in your district, and have complied a mass of information as the result of such inspection. I have examined into the lighting, ventilation, drainage, and cleansing of the shippons, the amount of air space contained in each building, the number of cows, both milkers and otherwise, kept at the time of my visit by the farmer, the condition of the Dairy, the water supplied to the cattle, and also I have ascertained whether milk was sold in the district or sent away to towns, whether butter or cheese was made by the farmers, etc. In some cases I found that everything was satisfactory, the cowsheds with sufficient cubic air space for each cow, well ventilated and lighted, and with the drainage outside the shippon, a plentiful supply of good water, and a clean, well-attended-to dairy. In the majority of cases there were one or more defects, some slight, and only temporary, such as the blocking up of ventilating holes, covering over the outside grids, and thus driving sewer air into the cowsheds, etc. In some cases, however, the cowsheds were wholly unfit for the purpose, no light, no ventilation, less than half the lowest computation of air space necessary for the health of a milking cow, defective drainage, and dairies full of all kinds of articles of food, clothing, and rubbish These cases I purpose to bring before your notice at an early meeting of your General Purposes Committee. You have adopted the Model Regulations of the Local Government Board for Dairies and Cowsheds with slight alterations, and these Regulations came into force at the beginning of the present year. I intend also to bring bring before your notice the names and addresses of several purveyors of milk, who have not as yet applied to be put on the Register, in response to the advertisement in the newspapers, eighteen months ago. Factories and Workshops.—Very little work has been done by your Officer during 1907, in respect of Factories and Workshops. I hope to devote more time to the subject in 1908. Food and Drugs Act.—The County Police have taken forty seven (47) samples of food, and submitted them to the County Analysts No adulteration warranting a prosecution has resulted. The examples taken were Milk, thirteen (13); Butter, eight (8); Lard, five (5); Vinegar, five (5); Jam, three (3); Ginger, three, (3); Coffee, three (3); Cheese, two (2); Gin, two (2); Rum, Pepper, and Golden Syrup (1) each. 16 At the end of the year, Mr. Jackman resigned the position of Nuisance Inspector, which he had held for nearly thirty-five years. Whilst naturally regretting the loss of a fellow worker during over thirty years. I hope that the services of Mr. Froes, the Inspector appointed in Mr. Jackman's place, will prove of great value to the health and welfare of the district. I give in the last table, Table I, a short resume of some of the Nuisances abated, and Sanitary improvements made during the year, and I append to my Report a copy of the five Tables drawn up by me for the Local Government Board. TABLE 1. Townships. Drains Laid, Repaired, or Cleaned Out. Privies, etc., Erected or Repaired. Houses Infected with Fever Fumigated and Disinfected. Other Nuisances Abated. Totals. Charnock Richard ... ... ... 6 6 Coppull 1 ... 17 4 22 Duxbury ... l 1 ... 2 Heapev l ... ... ... 1 Welch Whittle l ... ... ... 1 Brindle 2 ... 6 2 10 Hoghton ... l 4 ... 5 Wheelton 1 6 7 ... 14 Bretherton 2 ... 5 ... 7 Eccleston ... 2 2 2 6 Heskin 4 ... ... 4 8 Mawdesley 1 ... 1 1 3 Ulnes Walton ... ... ... 2 2 Euxton 3 ... ... 1 4 Whittle 11 1 8 1 21 Anderton ... ... 2 3 5 Heath Charnock 7 2 1 3 13 Rivington ... ... 3 1 4 Totals 34 13 57 30 134 TABLE I. Vital Statistics of whole District during 1907 and previous years. Year. Population estimated to Middle of each Year. Births Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered in Public Institutions in the District Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number. Bate.* Under 1 Yearof Age At all Ages. Number. Kate per 1000 Births Regist'rd Number Rate.* Number. Rate * 1 2 3 4 5 6 7 8 9 10 11 12 13 1897 18200 548 30.1 77 140 302 16.6 — — — — — 1898 18460 532 28.8 74 139 284 15.4 — — — — — 1899 18730 547 29.2 80 146 313 16.7 — — — — — 1900 19000 514 28.6 67 123 300 15.8 — — — — — 1901 19310 542 28.1 57 105 258 13.3 — — — — — 1902 19700 603 30.6 89 147 318 16.1 12 12 2 308 15.6 1903 20000 526 26.3 69 131 298 14.9 13 12 — 286 14.3 1904 20200 514 25.4 69 134 291 14.4 6 4 2 289 14.3 1905 20400 528 25.8 63 119 287 14.07 4 2 17 302 14.8 1306 20800 540 25.9 63 117 265 12.74 9 5 11 271 13.03 Averages for years 1897-1906. 19490 543.4 27.8 70.8 130.1 291.6 15.0 - - - - - 1907 21000 513 2443 57 111 295 1405 2 1 15 309 14.71 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water), 39,983; total Population at all ages, 19,310; number of Inhabited Houses, 3,910; average Number of Persons per House, 4 91, at Census of 1901. Institutions within the District receiving Sick and Infirm Persons from outside the District: Isolation Hospital, Heath Charnock. Institutions outside the District receiving Sick and Infirm Persons from the District: Rawcliffe Hospital, Chorley; Union Workhouse, Chorley. Other Institutions, the deaths in which have been distributed among the several localities in the District: Wigan Infirmary, Blackburn Infirmary, Lancaster County Asylum, and Knutsford Gaol. The Union Workhouse is not within the District. TABLE II. Vital Statistics of separate Localities in 1907 and previous years. Names of Localities. Chorley Sub-district. Brindle Sub-district. Croston Sub-district. Leyland Sub-district. Rivington Sub-district. Year. Births Registered., Deaths at all ages. Deaths under 1 year Deaths under 1 year Births Registered. DeathsBirths Registered. Deaths at all ages. at all ages. Deaths under 1 year Births Registered. Deaths at all ages. Deaths under 1 year Births Registered. Deaths at all ages. Deaths under 1 year 1897 143 77 22 92 45 12 119 69 9 131 82 18 63 29 4 1898 142 63 25 90 56 11 109 55 7 142 82 25 49 28 6 1899 161 84 23 74 66 15 114 51 8 141 85 26 57 27 8 1900 142 65 20 92 65 13 115 64 13 128 76 17 67 30 4 1901 161 70 22 80 40 3 113 44 10 134 75 16 54 29 6 1902 164 77 25 70 47 14 115 65 11 149 77 26 105 42 12 1903 159 79 26 74 58 12 113 57 11 124 64 12 56 28 8 1904 152 72 20 70 45 5 105 65 10 131 71 22 56 36 12 1905 156 74 19 81 49 6 107 60 14 123 81 16 61 38 9 1906 172 61 18 79 46 8 100 47 6 133 81 25 56 36 6 Avgs. of years 1897 to 1906 155.2 72.2 22.0 80.2 51.7 9.9 111.0 57.7 9.9 133.6 77.4 20.3 62.4 32.3 7.5 1907 170 83 20 69 61 11 109 59 8 113 78 14 52 28 4 TABLE III. Cases of Infectious Disease notified during the year 1907. Notifiable Disease. At all ages Total cases notified in each locality. No. of cases removed to Hospital from each locality. Cases Removed to Hospital. Chorley Sub-district Brindle Sub-district Croston Sub-district Ley land Sub-district Rivington Sub-district Chorley Sub-district Brindle Sub-district Croston Sub-district Leyland Sub-district Rivington Sub-district Diphtheria (including Membranous Croup) 52 14 14 5 10 9 2 3 ... 3 8 Erysipelas 11 2 2 1 4 2 ... ... ... ... ... ... Scarlet Fever 19 4 5 7 1 2 I 4 3 ... ... 2 9 Enteric Fever 5 1 ... ... 3 1 1 ... ... l 1 3 Totals 87 21 21 13 18 14 7 6 ... l 6 20 TABLE IV. Causes of, and Ages at, Death during Year 1907. CAUSES OF DEATH. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the district. Deaths at all ages of "Residents" belonging to Localities, whether occurring in or beyond the District. Total Deaths whether of "Residents" or 'Non-Residents' in Public Institutions in the District All Ages. Under One Year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Chorley SubDistrict. Brindle SubDistrict. Croston SubDistrict. Ley land SubDistrict. Rivington SubDistrict. Measles 9 2 4 2 1 ... ... 3 l 4 l ... ... Whooping-cough 5 2 3 ... ... ... 2 2 ... ... 1 ... Diphtheria (including Membranous croup) 8 ... 2 6 ... ... ... 2 1 ... 3 2 1 Croup 1 ... 1 ... ... ... ... ... 1 ... ... ... ... Enteric Fever ... ... ... ... ... ... ... ... ... ... ... ... l Epidemic influenza 7 ... ... ... ... 6 1 2 2 1 2 ... ... Diarrhoea 5 3 ... ... ... ... 2 1 ... 3 ... 1 ... Enteritis 2 1 ... ... ... 1 1 ... ... 1 ... ... Erysipelas 1 1 ... ... ... ... ... ... 1 ... ... ... ... Other septic diseases 2 ... ... 2 ... ... ... ... 1 1 ... ... ... Phthisis (Pulmonary Tuberculosis) 23 ... ... 1 6 14 2 8 2 5 6 2 ... Other tubercular diseases 4 2 2 ... ... ... ... 2 ... ... 2 ... ... Cancer, malignant disease 16 ... ... ... ... 13 3 3 2 3 5 3 ... Bronchitis 22 4 1 ... ... 5 12 4 4 5 6 3 ... Pneumonia 27 9 4 2 1 8 3 9 4 4 6 4 ... Pleurisy 2 ... ... ... ... 2 ... 1 ... 1 ... ... ... Alcoholism—Cirrhosis of liver 5 ... ... ... ... 4 1 ... 2 2 1 ... ... Premature birth 7 7 ... ... ... ... ... ... 1 1 4 1 ... Heart diseases 33 1 2 5 13 12 6 11 8 5 3 ... Accidents 12 1 2 8 1 6 3 2 1 ... Uncertified 17 3 2 6 6 7 1 2 5 2 ... All other causes 101 24 5 5 6 22 39 26 22 19 29 5 ... All causes 309 57 27 22 19 101 83 83 61 59 78 28 2 TABLE V. INFANTILE MORTALITY DURING THE YEAR 1907. Deaths from stated causes in Wee s and Months under One Year of Age. Cause of death. Under 1 week 1-2 weeks 2—3 weeks 3—4 weeks Total under 1 month 1-2 months 2—3 months 3—4 months 4- 5 months 5—6 months 6—7 months| 7—8 months 8—9 months 9-10 months 10-11 months 11-12 months Total deaths under one year All Causes— Certified 7 5 3 2 17 5 5 3 4 l 4 5 2 2 3 3 54 Uncertified ... ... 1 ... 1 ... 1 ... ... ... 1 ... ... ... ... ... 3 i. Common Infectious Diseases— Measles ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 Whooping Cough ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 2 ii. Diarrhœal Diseases— Enteritis, MuEo-Enteritis, Gastro-Enteritis ... 1 ... ... 1 1 ... ... ... ... ... ... ... ... ... 2 Gastritis, Gastrointestinal Catarrh ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 iii. Wasting Diseases— Premature Birth 4 1 1 1 7 ... ... ... ... ... ... ... ... ... ... ... 7 Congenital Defects 1 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Atrophy, Debility, Marasmus 2 2 ... 1 5 1 5 2 ... 1 1 1 ... ... ... 1 17 iv. Tuberculous Diseases- Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 Tuberculous Peritonitis, Tabes Mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 v. Other Causes— Erysipelas ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 3 Bronchitis ... ... 1 ... 1 1 ... ... 2 ... ... ... ... ... ... ... 4 Pneumonia ... ... ... ... ... 1 ... ... 2 ... 1 3 ... 1 1 ... 9 Other Causes ... ... 2 ... 2 ... 1 ... ... ... 1 ... ... ... ... ... 4 7 5 4 2 18 5 6 3 4 1 5 5 2 2 3 3 57 Population, estimated to middle of 1907, 21,000. Births in the year: Legitimate 502, illegitimate 11. Deaths from all causes at all ages: Registered 295, residents 309.