CHIS 012 Urban District of Chiswick ANNUAL REPORT of the Medical Officer of Health. 1910. CHISWICK: PRINTED BY J. H. BROAD AND CO., 331-333 HIGH ROAD, 1911, Urban District Council of Chiswick. PUBLIC HEALTH COMMITTEE. Councillor Diplock, J.P. Chairman. Councillor Bovill. Councillor O'Brien. „ Gosset. „ Roper. „ Harvey. „ Sich. „ Norris. „ White. 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. &tc. Assistant Inspector: P. B. F. Burr. Health Visitor: Miss J. Cruickshank. Clerks: W. Tillcock and L. Webb. CHISWICK URBAN DISTRICT COUNCIL. Public Health Department, Town Hall. March, 1911. To the Chairman and Members of the Chiswick Urban District Council. Gentlemen, I have the honour to submit for your consideration my annual report on the health of the district during the past year, which you will, I believe, deem satisfactory; the chief points being a considerable reduction, both in the general and infantile death rates, which compare very favourably with those of previous years, bearing in mind the materially increased population. It is always a matter of some difficulty to estimate more or less accurately the number of inhabitants at a given date in a rapidly-growing neighbourhood such as ours and more especially when ten years have elapsed since the last census; next year my calculations will be based on the figures of the new census to be taken in April next. On duly considering all the facts at my disposal and using the ordinary methods for arriving at a conclusion, I consider it a fair estimate to take the population of our Urban District at the middle of last year at 37,643, and on this total I have made my calculations. 5 Births. Nine hundred and forty-three births were registered during the year, of which 482 were males and 461 females. The birth rate was 25.05 per thousand, or one in 39.9 of the population. For England and Wales it was 24.8, and for London 23.6. Deaths. The number of deaths registered last year was 400 (males 138, females 262), as compared with 535 for 1909, and 443 for 1908. The number registered outside or beyond the district was 100, and within the district 300. The death rate in the district alone was 8.18 per thousand, or about 1 in 162.3 of persons living, and the death rate calculated on the net deaths at all ages belonging to the district was io'62. That for London was 12.7, and for England and Wales 14.3. The deaths from the seven principal zymotic diseases numbered 23 against 49 for the preceding year, indicating a decrease of 24. The zymotic death rate was 0.66 per thousand, the rate for London was 0.1 and for the 77 large towns 1.1. Zymotic deaths were classified as follows:— Measles 1 Scarlet Fever 1 Whooping Cough 9 Diphtheria (including Membranous Croup) 5 Croup 1 Diarrhœa 5 Enteritis 3 Total 25 6 You will observe that Whooping Cough and its complications were responsible for the largest number of the above. Infantile Deaths. On referring to Table V. you will notice that the number of children who died under the age of one year was 66, which number includes 29 under one month, and was equal to 69.9 per thousand births against 106.9 for the previous year. For London it was 103, and for the 77 large towns 115. I have reason to believe that the very decided decrease in the number of deaths of infants and voung children is due to the adoption of the Notification of Births Act, together with the supervision given by your Health Visitor to young mothers and their infants. Old Aye. One hundred and twenty persons died at 60 and upwards, including twenty-one between 80 and go, three at 90, and one at 91. Notifications. 7 I have received 286 notifications during the year, and append a table showing their headings for last and the preceding years:— 1910 Scarlet Fever 125 Diphtheria 58 Enteric Fever 4 Erysipelas 41 Phthisis (voluntary) 39 Phthisis (under regulations by Local Government Board) 19 Total 286 1909 Scarlet Fever 117 Enteric Fever 7 Diphtheria (including membranous Croup) 52 Puerperal Fever 1 Erysipelas 46 Phthisis 55 Total 278 1908. Scarlet Fever 89 Enteric Fever 5 Diphtheria 32 Phthisis 1 Erysipelas 38 Total 165 For 1907 they amounted to 298, for 1906 there were 206, and for 1905 they numbered 238. 8 Scarlet Fever. As in the last three years, it will be observed that by far the largest number of notifications came under the heading of Scarlet Fever and Scarlatina—125 from a total of 286. This disease has been very prevalent throughout the County for several years; it was, however, of a very attenuated type (with some few exceptions) as the solitary death testifies. Next in number comes Diphtheria, of which there were 58 notifications. This disease has been more or less prevalent during several months of the year. There is, I consider, no reasonable ground to doubt that the general use of the antitoxin treatment is successful in proportion to the early period resorted to. I would remind my professional colleagues that, under the Order of the 23rd March last, issued by the Local Government Board, a supply of antitoxin is kept at my house, that of the Chief Sanitary Inspector, and at the Town Hall, which is supplied to any local medical man who may apply for it; also the diphtheritic swabs. Measles. An outbreak of this complaint occurred in the latter part of the year, resulting in one death only, compared with twenty in the previous year. The patients were all children, and the complaint was mostly associated with diseases of the pulmonary organs. 9 Whooping- Cough occurred during the autumn and winter months, resulting in nine deaths of children under six years of age. In the previous year, the deaths numbered two, and in 1908 they were eleven. Diarrhoea was responsible for five deaths in children under the age of one year. This complaint is much influenced by the temperature, being far more general during the summer months, and is also due, to a certain extent, to injudicious feeding, rather than insanitary surroundings. Enteritis was the cause of three deaths of children under five years of age. Enteric or Typhoid Fever. There were four notifications but no deaths from this disease. Three were of young persons under twenty-five, and one over that age. Cancer or Malignant Diseases. Twenty-six deaths were attributed to these fatal diseases, (9 males, 17 females), compared with thirty-six for the previous year and 39 for the year 1908. The following table indicates the locality, age, and sex:— 10 Deaths from Cancer during 1910 (distributed according to locality, age and sex). Wards. Under 15 IS to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 All ages. 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 CH1SWICK PARK ... ... ... 1 ... ... ... ... ... ... ... 1 1 2 1 ... 2 4 6 GROVE PARK ... ... ... ... 1 ... ... ... ... ... ... 2 ... 2 ... ... 1 4 5 GUNNERSBURY ... ... ... ... ... ... ... 1 ... ... ... 2 1 ... ... ... 1 3 4 OLD CHISWICK ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... 1 2 3 TURNHAM GREEN ... ... ... ... ... ... ... ... 2 ... ... 3 1 ... ... ... 3 3 6 Totals ... ... ... 1 1 ... ... 1 3 2 ... 8 4 5 1 ... 9 17 26 Phthisis or Pulmonary Tuberculosis was responsible for 34 deaths (21 males, 13 females), against 38 for the year 1909, and compared with 29 for the year 1908. There were six deaths from other tuberculous diseases in the district, Five were children under five years, and one was an adult. Voluntary notification was adopted in Chiswick in 1902, the usual fee being paid on the notification of the diagnosis after a bacteriological examination. A system of compulsory notification has been carried out with success both in Sheffied and Edinburgh and several other large towns. I note with gratification that in the Council's Bill now before Parliament it is proposed to make notification compulsory in the District. The Council, as one of the Constituent Authorities of the Middlesex Districts Joint Smallpox Hospital Board, will have the great advantage of sending patients suffering from Phthisis to the Clare Hall Hospital when the Provisional Orders of the Hospital Board have been altered by the proposed amending Order so as to permit of that action being taken, A Sanatorium in the County for cases of Phthisis is much needed and there is no reason why a Smallpox Hospital (when not in use for Smallpox cases) should not take cases of Phthisis. It is an established fact that in the County of Middlesex over one-ninth of the total death rate is due to the different forms of tuberculosis, the exact number of deaths from this disease in 1908 being 1,267, of which number 899 were cases of Phthisis or Pulmonary Consumption. For every 67 persons who die from acute infectious diseases, 60 die from Tuberculosis. More than half the former are children under 10, whereas 81 per cent. of the deaths from Phthisis occur in persons between 20 and 60, and 56 per cent. between the ages of 20 and 45, this period being the most valuable in life. The following table indicates the locality, sex and age 12 Deaths from Phthisis during 1910 (distributed according to locality, age and sex.) Wards. Under 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 All ages. Totals. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. m. f. BEDFORD PARK ... ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... 1 2 3 CHISWICK PARK ... 1 1 1 1 ... 2 1 ... 1 ... 1 ... ... ... ... 4 5 9 GROVE PARK ... ... ... ... 1 2 1 1 ... ... 2 ... ... ... ... ... 4 3 7 GUNNERSBURY ... ... ... ... 2 ... 1 ... 1 ... 1 ... ... ... ... ... 5 ... 5 OLD CHISWICK ... ... 2 1 ... ... ... ... 1 ... 1 1 ... ... ... ... 4 2 6 TURNHAM GREEN ... ... ... ... 1 ... 1 ... 1 ... ... 1 ... ... ... ... 3 i 4 Totals ... 1 3 2 5 2 6 4 3 1 4 3 ... ... ... ... 21 13 34 Influenza was in evidence during several months of the year, resalting in five deaths, mostly associated with diseases of the pulmonary organs. Inquests. It may be recorded here that there were 23 inquests. The deaths are returned as 16 due to natural causes, 4 to suicide, and three to accidents. Milk Supply. There being but one cow shed in the district, the milk is chiefly conveyed by rail in churns from the country daily. It is a matter of importance that all milk for consumption, especially in the case of young children, should be either brought for a moment to the boiling point, or sterilized; by this means the risk of acquiring tuberculosis, diphtheria, or scarlet fever, is lessened to a degree that I fear is not sufficiently appreciated by the public. It is satisfactory to be able to record that a new type of churn has been recently invented which is practically air tight, without any complicated parts, and easily cleaned. It is sealed at the dairy with the owner's label, after having been filled, and is so constructed that it delivers both accurately and automatically any quantity of milk that is desired, which runs out perfectly clean to the last drop. I understand that this churn has been approved by several hygienic authorities. Water Supply. The water supply for the year has been satisfactory both in quantity and quality. We have almost 14 variably a constant supply, and water drawn direct from the main for general consumption is enjoyed by a very large percentage of our inhabitants. When water is constantly supplied it can be drawn as required ; and there is no reason why it should be stored in a house, at least, as far as domestic consumption is concerned. Where there is a constant supply, storage cisterns are not only unnecessary and useless, but are, in fact, harmful, inasmuch as they lead to contamination, the stored water being too frequently placed under the rafters of the roof, without covering, and exposed to dirt and other impurities. A supply of water direct from the main should be provided for every house or tenement. Public Abattoirs. I hope that the time is not far distant when local slaughter houses will be superceded by the former as in Liverpool, Croydon, and many of the large towns where the slaughtering is carried out and greater facilities afforded for the meat inspection. I do not consider that many of the existing private slaughter houses are in suitable situations in this district. Cremation. I find that there is an annual increase in the total number of cremations in the United Kingdom, yet it is comparatively small considering there are thirteen crematoria in operation. The number of cremations has gradually risen from three in 1885 to 855 last year. There is no doubt that a prejudice exists against this form of disposal of the dead, except amongst the more intellectual class of the community, and the progress of this practice must depend on the education of the people. 15 Sanitary Inspection. The appended returns of the Chief Sanitary Inspector (to whose skill and diligence I beg to bear witness) will show in detail that a large amount of useful work has been carried out, and I have had occasion, in my monthly reports, to bring before your notice a certain number of insanitary and dilapidated houses which required both cleansing and repairing. I refer more especially to those known as Essex Place, Turnham Green, which are not only old and dilapidated, but damp, with serious structural defects in some, such as bulging and cracked brickwork, rendering them in their present condition uninhabitable, and I hope that in the near future they will be pulled down and replaced by a block of workmen's dwellings, similar to those at Strand-on-the-Green. • Whilst on the subject of general sanitary administration, I have every reason to believe that our system of scavenging maintains its usual efficiency. The general system of drainage is up to the usual standard of excellence and there can be no stronger proof of this than the fact that in spite of the considerable increase of new roads with their contributory new drains completed during recent years with a resulting large population, the existing main drains have proved themselves competent to deal with the extra quantity of sewage passing through them. The construction of a distinct surface water system has doubtless contributed materially to that result. Sewage Disposal Works. I am indebted to your Engineer of these works for the following details of the alterations and extensions 16 carried out and brought into operation during the course of the past year. The capacity of the precipitation tanks has increased to 1,660,000 gallons by the addition of two new tanks and the alteration and extension of the existing tanks, which have more than double the former capacity of those previously in use, thus providing for an improved settlement of the suspended matters in the chemically treated sewage and to producing an improved tank effluent. In addition to this, thirteen bacterial filter beds have been constructed covering a total area of 3½ acres, and fully capable of dealing with three times the amount of the average daily dry matter flow of sewage. The filling and emptying of the whole of the filtering beds is controlled by automatic apparatus, and the beds are arranged for single contact. The tank effluent, after passing through the contact beds, is discharged into the River Thames through a new outfall. Motor Ambulance. Your Engineer and Surveyor has kindly furnished me with the following particulars. The ambulance was used one hundred and sixty-seven times during the year. Of these eighty-seven were for private patients ; the longest distance travelled was 36½ miles, when a resident who had met with a cycle accident was brought home to Chiswick. The largest fee received for the use of the motor was 3 guineas. It is the practice, I believe, to remit the charges on occasions when the patients are in needy circumstances. I am informed that on 80 occasions it was used for 17 street accidents or ordinary illnesses, the call being made by Doctors or Police. In my capacity of Divisional Surgeon, I am able to testify to the great advantages of the Ambulance, which have been duly appreciated by all concerned. Another long journey was to and from Leyton, in connection with a street accident. Buildings. The following new buildings were erected during the year:— 80 dwelling-houses. 29 additions and small temporary buildings. Workshops, offices, and recreation building, Chiswick Soap Co., Hogarth Lane. St. Michael's Church, Sutton Lane. Electric Theatre, Chiswick High Road. Drill Hall, Stamford Brook. Special Subjects Centre. This building, formerly known as the Turnham Green Girls' and Infants' School has recently been converted and equipped as what is recognised as a "Special Subjects Centre," where boys are taught carpentry, woodcarving, &c., on the ground floor, and above are rooms for girls to be instructed in cooking, laundry work, &c. The position of the building is very central and convenient, and will prove an important addition to the Elementary Schools. Open-Air Swimming Bath. The above, which has recently been provided by the Council, is in every respect a good, up-to-date bath, and 18 is fully appreciated by the residents of Chiswick, more especially during the summer when young and old have facilities for the enjoyment of a healthy and useful pastime. I am informed that it has received a considerable amount of patronage during the bathing season, and it should appeal to all local residents, so that its extensive use will ensure the least possible expense to the ratepayers. The Isolation Hospital. This Institution continues to fulfil its useful purpose, and I may state that all is done that is possible in order to effect a speedy removal to the hospital of every case of notifiable infectious disease that cannot be treated with safety at home. The wards are disinfected frequently and all bedding, clothing, etc., which has been in contact with the patient is thoroughly disinfected. The condition of the premises from which a patient is removed is strictly enquired into with regard to drainage, water, and milk supply. In the case of school children, the headmasters and head mistresses are at once communicated with. I must again remind you, in connection with the hospital, of the great need which exists for what is known as an "observation ward" for those cases which are occasionally sent in and wrongly diagnosed. With regard to the number of patients admitted during the year there were 126 compared with 122 for the year 1909:— Scarlet Fever 90 Diphtheria 35 Enteric or Typhoid Fever 1 19 There were five deaths; several of these were in extremis" on admission. Although there was but a slight increase in the number of admissions, the diseases were of a more severe type which naturally added to the responsibility and work of the matron and nurses. The porter has also carried out his duties diligently and effectively. The reports of your Chief Sanitary Inspector, and that of your Health Visitor, are appended together with the usual tables prescribed by the Local Government Board. In conclusion I wish to express my appreciation of the kindness which I have received from the Chairman and Members of the Public Health Committee during the past year, and I must again testify to the zeal and loyalty characteristic of my staff in the execution of their several duties. I am, Gentlemen, Obediently yours, FREDC C. DODSWORTH, Medical Officer of Health. Medical Superintendent of the Isolation Hospital. Fellow of the Society of M. O. H. Member of the Royal Society of London. 20 "Sir, I beg to report that during the year ended the 31st December, 1910, I have registered the notification of 939 births, and in 662 cases 1 have visited the homes. The total number of visits and re-visits during the year was 1,287. There were 29 deaths amongst the infants visited and of these 13 were artificially fed; 19 infants died from premature birth, etc., before I visited the homes, and two deaths occurred amongst infants under one year of age who were born outside the district. Of the total number of deaths of children under one year of age, seven occurred in various institutions outside the district. During the year ten notifications of stillborn infants were received. As you are aware, 58 cases of phthisis and tuberculosis have been notified, and 35 of these have been enquired into and reported upon. The majority of the patients have been re-visited from time to time. Yours faithfully, J. CRUICKSHANK, Health Visitor." 21 I. CHISWICK URBAN DISTRICT. Vital Statistics of Whole District during-1910 and previous Years. Year. Population estimated to middle of each year. blrths. Deaths under One Year of Age. Deaths at all Ages. Deaths in Public Institutions. Deaths of Nonresidents registered in District. Deaths of Residents registered beyond 1 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 1900 29,77-2 826 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 80 501 15.37 1906 33,873 852 25.15 98 115.2 361 10.65 17 12 92 441 13.01 1907 35.970 915 25.43 109 119.1 339 9 42 12 13 88 414 11.5 1908 36,377 898 24.68 96 106.9 351 9.64 11 16 108 443 12 17 1909 37,059 877 23.66 95 108.3 418 11.27 14 15 132 535 14.43 Averages for years 1900-1909 33,037 882 26.86 106 120.9 379 11.44 1910 37,643 943 25.05 66 69 9 308 8.18 10 8 100 400 10.62 * Rates in Columns 4, 8 and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of Total population at all ages 29,809 area covered by water) 1,245. Number of inhabited houses 5,235 Average number of persons per house 5.7 Institutions within the District receiving sick and infirm persons from outside the District—S. Joseph's Hospital and Chiswick House Asylum. Institutions outside the District receiving sick and infirm persons from the District—Metropolitan Hospitals and Asylums and Isleworth Workhouse Inpirmary. Census of 1901. Table II. chiswick urban district. • Vital Statistics of Separate Localities in 1910 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 Regist'd. Deaths at all ages. Deaths under year. Population estimated to middle of each year. Births Regist'd Deaths at all ages. Deaths under i year. Population estimated to middle of each year. Births Regist'd. Deaths at all ages. Deaths under i year Population estimated to middle of each year. Births Regist'd. Deaths at all ages. Deaths under year. Population estimated to middle of each year. Births Regist'd. Deaths at all ages. Deaths under i year. Population estimated to middle of each year. Births Regist'd. Deaths at all a?es. Deaths under i year. Population estimated to middle of each year Births Regist'd. Deaths at all ages. • Deaths under 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 1900 29,772 826 ... 144 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1901 30,005 844 ... 103 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... ... ... 1902 30,609 870 ... 112 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1903 31,377 907 ... 94 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1904 32,177 889 469 111 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 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 1 19 73 14 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 1908 ... 36,377 898 443 96 4,413 48 49 3 8,586 249 111 35 5,081 131 74 10 4,317 91 33 4 7,308 218 102 28 6,672 161 74 16 1909 ... 37,059 877 535 95 4,458 70 51 4 8,592 268 167 37 5,238 120 91 14 4,477 72 54 6 7,361 194 101 21 6,931 153 1 71 13 Averages) of Years 1900 to," 1909. 33,037 882 ... 106 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1910 37,643 943 400 66 4,564 78 41 4 8,689 254 106 20 5,328 157 67 13 4,567 76 33 4 7,468 % 214 78 17 7,028 164 75 8 TABLE III. CHISWICK URBAN DISTRICT. Cases of Infectious Disease notified during the Year 1910. Notifiable Disease. Classes 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. Sto 15 15 to 25. 1 25 to 65. 65 and upwards. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Small-pox ... ... ... ... ... ... ... ... ... ... ...»... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria including Membranous Croup 58 1 15 35 3 3 1 ... 14 14 5 16 9 ... ... 11 6 4 11 6 38 Erysipelas 41 ... ... 4 5 26 6 1 9 5 5 11 10 ... ... ... ... ... ... ... ... Scarlet Fever 125 1 30 85 5 4 ... 6 57 17 4 29 12 ... 1 42 12 3 25 9 92 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 4 ... ... ... 3 1 ... 1 ... 3 ... ... ... ... ... ... 2 ... 2 Relapsing fever ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... Continued fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ......... ... ... ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis & Tuberculosis 58 ... 1 2 8 44 3 2 21 9 5 8 13 ... ... ... ... ... ... ... ... Totals 286 2 46 126 24 78 10 10 101 48 9 64 44 1 53 20 7 36 15 132 Chiswick Council's Isolation Hospital, Clayponds Lane, Brentford, W. Total available beds, 20. Number of Diseases that can be concurrently treated : Scarlet Fever, Enteric Fever and Diphtheria. CHISWICK URBAN DISTRICT. TABLE IV. Causes of, and Ages at Death during* the Year, 1910. Causes of Death. Deaths in whole Distkict at subjoined ages. Deaths in ok bbi.ongino to Localities (at all ages). Dbaths in Public Institutions. All ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 26. 25 and under 65. 65 an J upwards. Bedford Park. Cliiswick Park. Giove P;irk. Gunnersbury. Old Chiswick. Turnham Green. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... Scarlet Fever 1 ... ... 1 ... ... ... ... ... ... ... 1 ... ... Whooping-cough 9 3 5 1 ... ... ... 1 3 ... ... 4 ... ... Diphtheria (including membranous croup) 5 1 3 1 ... ... ... ... 1 ... ... 2 2 ... Croup 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea 5 5 ... ... ... ... ... ... 3 1 ... 1 ... ... Enteritis 3 2 1 ... ... ... ... ... ... 1 ... 1 1 ... Gastritis 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... Puerperal fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis (Pulmonary tuberculosis) ... 34 ... ... 1 5 28 ... 3 9 7 5 6 4 ... Other tuberculous diseases 6 2 3 ... ... 1 ... ... 4 2 ... ... ... ... Cancer, malignant disease 26 ... ... ... 1 16 9 2 6 5 4 3 6 1 Bronchitis 33 4 ... ... 2 5 22 5 9 4 1 6 8 3 Pneumonia 42 10 8 2 2 13 7 2 16 2 2 14 6 1 Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other diseases of Respiratory organs 8 ... ... ... 1 4 3 ... 1 2 1 ... 4 1 Alcoholism Cirrhosis of liver 10 ... ... ... ... 8 2 2 2 1 3 1 1 ... Venereal diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... Premature birth 11 11 ... ... ... ... ... 1 2 4 1 1 2 ... Diseases and accidents of parturition ..t 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... Heart diseases 49 1 1 3 1 26 17 7 13 8 2 7 12 2 Accidents 7 ... 1 2 1 2 1 ... 3 1 ... 3 ... ... Suicides 5 ... ... ... ... 5 ... 1 ... 1 ... 1 2 ... Influenza 5 ... ... ... ... 4 1 2 ... 1 1 1 ... ... Diseases of Digestive Organs ... 16 3 1 2 1 5 4 6 2 1 2 2 3 ... Diseases of Brain and nervous system 49 6 5 3 ... 17 18 2 15 9 2 12 9 1 Atrophy and Inanition 8 8 ... ... ... ... ... ... 2 ... ... 5 1 ... Senile decay 25 ... ... ... ... ... 25 1 5 6 5 5 3 ...... All other causes ... 39 9 1 4 1 10 14 6 10 9 3 2 9 1 All causes 400 66 31 20 16 144 123 41 106 67 33 78 75 10 TABLE V. CHISWICK URBAN DISTRICT. Infantile Mortality during the Year 1910. Deaths from stated causes in weeks and months under the age of one year. 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 20 4 4 1 29 1 8 4 6 2 3 3 2 2 4 ... 64 Uncertified ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 2 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Common Infectious D iseases. Chicken-pox ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria: Croup ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... 3 Diarrhoeal Diseases. Diarrhœa, all forms ... ... ... ... ... ... ... ... 1 1 1 ... 1 ... 1 ... 5 Enteritis, Muco-enteritis, Gastro-enteritis ... ... 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... Gastritis, Gastro-intestinal Catarrh ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 2 Wasting Diseases. Premature Birth 9 1 1 11 ... ... ... ... ... ... ... ... ... ... ... 11 Congenital Defects 7 1 1 ... 9 ... ... ... ... ... 1 ... ... ... ... ... 10 Injury at Birth 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Want of Breast-milk ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... Atrophy, Debility, Marasmus ... ... ... ... ... 1 ... 3 2 ... ... 1 ... ... ... ... 7 Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Diseases. Tuberculous Peritonitis : Tabes Mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other T uberculbus Diseases ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 2 Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Rickets... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions 1 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Bronchitis ... ... 1 ... 1 ... 1 1 1 ... ... ... ... ... ... ... 4 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... 1 1. ... 2 l 2 ... ... ... ... 1 ... 2 2 ... 10 Suffocation, overlaying ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Causes ... ... ... ... ... ... 2 1 1 ... ... ... ... ... ... ... 4 20 4 4 1 29 2 8 • 5 6 2 3 3 2 2 4 66 District or Sub-division of Brentford (Chiswick). Population estimated to middle of 1909 37,643 Births in the year 22 Deaths from all causes at all ages 400 ANNUAL REPORT oh MEDICAL OFFICER OF HEALTH for 1910 for the URBAN DISTRICT OF CHISWICK on the-: Administration of the Factory and Workshop Acts, in connection with FACTORIES, WORKSHOPS, WORKPLACES & HOMEWORK 1—INSPECTION. Including Inspections made by Sanitary Inpectors ok Inspector of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries) 38 - — Workshops (Including Workshop Laundries) !60 9 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) 51 6 - Total 249 15 — 3.—HOMEWORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Number of Inspections of Outworkers' premises. Lists received from Employers. Numbers of Addresses of Outworkers received from other Councils. Numbers of Addresses of Outworkers forwarded to other Councils. Twice in the year. (1) Lists, 1 (2) Outworkers, 1 (3) (4) (5) (6) Wearing Apparel— (1) making, &c. 14 28 38 21 47 (2) cleaning and washing — — 1 — — Total 14 28 39 21 47 4.—REGISTERED WORKSHOPS Workshops on the Register (s. 131) at the end of the year. Number. Imported classes of workshops, such as workshop bakehouses, may be enumerated here. Workshops 140 Workplaces 51 Total number of workshops on Register 191 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) — Action taken in matters referred by H.M. Inspector as j Notified by H.M. Inspector 3 remediable under the Public Health Acts, but not •{ Reports (of action taken) sent under the Factory and Workshop Act (s. 5) I, to H.M. Inspector 3 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 Acts 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. 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecut'ns Found Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Actb : * Want of Cleanliness 6 6 — — Want of Ventilation — — ' — — Overcrowding — -- — — Want of drainage of floors — — — — Other Nuisances 15 15 — — f insufficient — — — tSanitary accommodation \ unsuitable or defective 4 4 — — ^not separate for sexes — — — — Offences under the Factory and Workshop Act :— Illegal occupation of underground bakehouse (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 25 25 — — Table showing Births and Birth Rates; Deaths and Death Rates; Deaths from Zymotic Diseases, also Death Rates during the past ten years. 1901 1902 903 . 1904 1905 1906 1907 1908 1909 1910 Average of last 10 years Births during the year 844 870 907 889 947 852 915 898 877 943 894.2 Birth rate per thousand 28.12 28.42 28.90 27.62 28.55 25.15 25.43 24.68 23.66 25.05 26.55 Deaths from all causes 352 394 328 462 510 441 414 443 535 400 427.9 Death rate per thousand 73 12.51 10.46 1435 15.37 13.01 11.50 12.17 14.43 10.62 12.61 Deaths from Small Pox 1 0 0 0 0 0 0 0 0 0 0.1 „ Measles 1 22 2 39 0 3 12 1 20 1 101 „ Scarlet Fever i 1 0 5 3 0 7 0 2 1 2 „ Diphtheria 5 2 1 6 5 5 3 2 5 5 39 Whooping Cough 4 6 9 9 5 7 9 11 2 9 7.1 „ Enteric & other Fevers 0 5 2 0 1 1 5 2 0 0 1.6 „ Diarrhoea 22 13 9 '5 36 32 20 10 9 5 17.1 „ Enteritis 22 13 19 18 6 5 2 8 8 3 10.4 „ Croup 0 1 0 1 1 0 0 0 0 1 0.4 „ Erysipelas 2 3 4 4 1 2 0 2 3 0 2.1 „ Puerperal Fever 1 1 0 2 0 0 i 1 0 0 0.6 „ principal Zymotic diseases 69 67 46 99 58 55 59 . 37 49 25 55.4 Death rate from ditto 1.6 2.1 1.4 307 1.7 1.62 1.64 1.01 1.32 .66 1.61 Urban District of Chiswick ANNUAL REPORT of the Sanitary Inspector. 1910. chiswick: printed by j. h. broad and co., 331-333 high road. 1911. Public Health Department, Town Hall, Chiswick, W. January, 1911. To the Chairman and Members of the Urban District Council of Chiswick Mr. Chairman and Gentlemen, I have the honour to submit to you, pursuant to the recent Order and Circular of the Local Government Board with respect to the duties of Sanitary Officers, my Nineteenth Annual Report dealing with the work performed by the sanitary staff during the year 1910 in accordance with the requirements of the several Acts which affect the Public Health Department. Statistical information is also presented herewith, more particularly with regard to the general and house-to-house inspection of the district. The Circular of the Local Government Board, issued with the Sanitary Officers (outside London) Order, 1910, states that, "By Sub-Clause 16 the Inspector of Nuisances is to make an Annual Report to the Council on the work performed by him during the year," and I therefore propose, as in previous reports, to give a general account of my duties, performed under the general supervision of the Medical Officer of Health, in connection with:— (a) General and Systematic Inspection of the District. (b) The Housing of the Working Classes Acts. 27 (c) House Drainage. (d) Water Supply. (e) Infectious Diseases and Disinfection. (f) The Factory and Workshop Acts. (g) Dairies, Cowsheds, Milkshops, Slaughterhouses, Fish Shops, etc. (h) Food Inspection. (t I The Sale of Food and Drugs Acts. (/) The Petroleum Acts. (k) General Matters It is worthy of note that certain provisions of the Public Health Act, 1875, and the Housing of the Working Classes Act, 1890, which I have repeatedly referred to as the authority for the systematic inspection of this district as carried out for some time past in compliance with the instructions of the Council, are reiterated by Section 17, Sub-Section 1, of the Housing, Town Planning, &c., Act, 1909, which is as follows:— 17.—(1) It shall be the duty of every local authority " within the meaning of Part 2 of the principal Act to " cause to be made from time to time inspection of their " district, with a view to ascertain whether any dwelling" house therein is in a state so dangerous or injurious to " health as to be unfit for human habitation, and for that " purpose it shall be the duty of the local authority, and of " every officer of the local authority, to comply with such " regulations and to keep such records as may be " prescribed by the Board. On the issue of the regulations referred to in the sub-section, it was only necessary to re-arrange the special registers of inspection to precisely comply with the requirements of the Local Government Board. 28 Article 1 of the Housing (Inspection of District Regulations, 1910, requires that the local authority shall make provision for a thorough inspection to be carrried out from time to time according to the varying needs of the dwelling-houses or localities in the district, and that the Medical Officer of Health or an Officer designated by the local authority shall prepare from time to time a list or lists of dwellinghouses for inspection. The Council having appointed me as the Executive Officer (to act under the direction and supervision of the Medical Officer of Health) under the Regulations, I prepared the requisite list, and having regard to the efficiency of the work which has been carried out in connection with house-tohouse inspection, your Public Health Committee agreed that it was unnecessary to make any appreciable alteration in the areas to be scheduled for inspection during the year 1911. Table 5 gives particulars of the systematic and periodical inspections which are to be made in the ensuing twelve months. Whilst dealing with the matter of general and systematic inspections, I venture to submit that the sanitary condition of a district is best judged by the death-rate, and as the Medical Officer of Health has reported that the death-rate for the year under review is the lowest on record, it is certain that the sanitary state of this district has been greatly improved, which condition can only be maintained by continuous inspection of the district, and by the stringent, yet reasonable application of the various health statutes. 29 House-to-House Inspection. This important branch of the public health service has received close attention during the past year, and I am pleased to report that the importance of the work has been more clearly recognized, and that it is now a statutory duty of every local authority under the Housing of the Working Classes Acts. In this connection I might mention that Chiswick for a number of years led the way in the matter of house-tohouse inspection in the County of Middlesex, and there is no doubt that as a result of these inspections the sanitary condition of the houses has been enhanced. This is clearly proved by the fact that, although an annual inspection is made of the scheduled areas, many and varied nuisances are discovered and abated; and as there is no appreciable diminution in the number of sanitary defects dealt with, the need of frequent inspection of tenement houses is very apparent. On referring to Table 4, it will be observed that 2,689 houses, comprising 3,830 tenements were inspected during 1910, as compared with 3,024 and 4,320 for the previous year. The variation in the number of houses and population is chiefly due to the fact, that a portion of Bedford Park was scheduled for inspection in 1909, as a special area, by direction of the Public Health Committee. Otherwise the number of inspections remains approximately the same, owing to our strict adherence to the table of scheduled areas for each month. 30 Table 4 also gives other details of house-to-house inspections, and shews that practically fifty per cent. of the houses so inspected are let in two or more tenements. Particulars are given of the number of nuisances and sanitary defects reported, and amongst the most important matters dealt with were—44 defective drains, 23 choked drains, 164 insufficient water supplies to water-closets, 33 defective soil-pipes and ventilators, 155 defective and unpaved yards, 527 premises requiring repairing and cleansing, and 215 drinking-water cisterns improperly situated, etc. Very little trouble was experienced in persuading owners and occupiers to remedy the sanitary defects reported, but in the case of a number of houses in Devonshire Road, the Council gave instructions for the paving of the yards and execution of certain cleansing work at the owners' expense. The yards of all the houses were previously in a very insanitary state, but a portion of each has now been properly paved and drained; and as regards the cleansing work, the passages, staircases and certain rooms were disinfected and cleansed in accordance with the certificates of the Medical Officer of Health. Whilst the work was in progress, it was found that the walls in many instances were covered with several papers and infested with vermin. I referred in my last Annual Report, to two roads at Strand-on-the-Green, which were requiring special attention. During the past year, in consequence of complaints, I was compelled to make a house-to-house 31 inspection of these particular roads earlier than usual; and although there was a slight improvement in the condition of the tenements, I had to severely caution the owners and several occupiers, regarding the overcrowded and insanitary state of many rooms. Subsequently drastic action was taken to enforce the disinfection and cleansing of a large number of rooms, and attention to other sanitary matters, such as paving of yards and the provision of direct supplies of water from the main. The application toexisting buildings of the Council's bye-law with respect to ashpits, has proved to be of great service in securing in every case where a new dustbin is required, the provision of a moveable, galvanized-iron receptacle, fitted with a proper cover and handles, and of adequate capacity. Nearly 200 such dustbins have been provided as a result of the house-to-house inspection. Housing' of the Working- Classes Acts, 1890 to 1909. Every attention has been given to the provisions of these Acts, and representations were made to the Council as to the uninhabitaable condition of seven houses, each of which was closed by Order of the Council. The dilapidations in one case were sufficient to warrant the subsequent demolition of the building; but with regard to the remaining six, such structural repairs and alterations were made as enabled me to recommend the determination of the Closing Orders. At four of the houses it was found necessary to require the re-building of the whole of the front main walls, which were considerably out of plumb, 32 There are a great many old cottages in Essex Place which must of neccessity be dealt with at an early date, as, notwithstanding the frequent inspections made, they are, by reason of their situation and construction, in such a condition as to cause them to be scheduled for action under these Acts. House Drainage. It will be observed on reference to Table 3, that the total number of drains re-constructed during the past year was 98, as compared with 143 for the previous year. The large number of house drains which have been tested by one or more of the several methods, shews that great care has been exercised to ensure that the sanitary appliances of every house are properly maintained; and, as a matter of fact, practically the whole of the houses in this district are now provided with modern drainage. The presence of rats has in several instances resulted in the discovery of defective drainage, otherwise house drains are usually tested after the superficial examination in the course of houseto-house inspection and enquiries into complaints and infectious diseases. Some trouble was again experienced in connection with combined drainage, but I am pleased to report that in the four or five cases dealt with, satisfactory negotiations were entered into with the owners, and the expenses of legal proceedings avoided. The Council's bye-laws with respect to the drainage of existing buildings, made on the 21st September, 1910, and confirmed by the Local Government Board 33 on the 5th December, 1910, will remove many of the difficulties hitherto encountered. Amongst the most important provisions are—the giving of notice prior to the commencement of drainage work, and the compulsory construction of inspection chambers. Water Supply. As the whole of this district is now supplied with water by the Metropolitan Water Board, it is only necessary for me to refer to the method of service and storage at the houses; and in this respect it is gratifying to note that an endeavour is being made by a private Act to require that all houses should be supplied with water direct from the mains. The powers already existing are unfortunately inadequate for compelling a direct supply in every case, as the requirement that "cisterns used for the supply of water for domestic purposes must be properly placed, constructed and kept," is not sufficiently stringent to meet the needs of populous districts. Infectious Diseases and Disinfection. In every case of infectious disease the usual enquiries for the guidance of the Medical Officer of Health have been made, the drains and sanitary appliances have been carefully examined and tested, and all infectious rooms immediately fumigated with formaldehyde after the removal or convalescence of the patients. Whenever necessary, notice has been given by the Clerk of the Council, on the certificate of the 34 Medical Officer of Heath, requiring the stripping, stopping, and cleansing of infected rooms after the preliminary disinfection. There is now a greater demand for the disinfection of rooms, bedding, etc., which have been used by patients suffering from diseases other than thosenotifiable under the Infectious Disease (Notification) Act, particularly after cases of phthisis. One of the additional duties of Sanitary Officers recently ordered by the Local Government Board is that of superintending the removal of infectious patients, and the disinfection of infected premises, but I may mention that this work has also been carried out here by the sanitary staff for many years past. Factory and Workshop Acts. Although the official inspection of factories under the Factory and Workshop Acts is practically in the hands of H.M. Inspectors of Factories, I have made it a rule to inspect under the above Acts and the Public Health Acts, all factories and workshops, as this obviates unnecessary delay in the abatement of any nuisance which may exist, and gives additional facilities for dealing with other matters in connection with this department. In the month of December I reported as follows on my annual inspection in accordance with the provisions of these Acts:— "Having completed my annual inspection of the 219 factories workshops and workplaces in this district, I have to report 35 the usual details in connection therewith. It will be observed that there is a slight increase in the number of registered premises, as also in the number of employees." "It is with pleasure that I am again able to record a minimum number of contraventions of the Act, a fact which proves that the majority of the persons concerned do their utmost to comply with the Act and the various Orders made thereunder; and having given special attention to the existence of want of cleanliness, overcrowding, absence of proper ventilation, defective drainage and sanitary accommodation, and other nuisances, I am able to report that the whole of the workshops throughout the district are kept in a sanitary state." "Complaint was made as to overcrowding of workrooms, but upon enquiry it was found that the occupiers complained of were not contravening the Act. The absence of cases of overcrowding is chiefly due to the cards, supplied by the Council and exhibited in each workroom, showing exactly how many persons may be employed in the rooms during ordinary hours and overtime." "Only three notices were received from H.M. Inspector of Factories. One was with respect to the sanitary accommodation at a laundry, and this being a new building, the matter was referred to the Surveyor. The other two notices dealt with minor defects which were attended to." "Every attention has been given to the Home-work provisions of the Factory and Workshop Act, and in cases where out-workers are employed, notice has been sent to the respective districts concerned, and in accordance with the Statute, other local authorities have reported the residences of out-workers within this district. All the outworkers are registered for reference in case of an outbreak of infectious disease." 36 The following are particulars of the number of factories, workshops, work-places, employees, and trades represented, together with a list of the nuisances or sanitary defects discovered."— FACTORIES. Trades represented Number of Premises. Employees. Breweries 2 188 General Engineers 1 3 Laundries 5 425 Motor Car and Launch Works 5 323 Printers and Bookbinders 6 155 Saw Mills and Joiners 6 94 Soap Works 1 260 Tramway Depot 1 250 Wall Paper Manufacturers 1 547 WORKSHOPS AND WORKPLACES. Trades Represented. Number of Premises. Employees. Art Metal Workers 5 118 Bakers 16 51 Barge and Boat Builders 5 25 Blacksmiths 4 9 Blind Makers 1 2 Boot Repairers 28 60 Blouse Makers 2 37 Carriage Builder and Wheelwright 1 10 Coffin Makers 4 6 Cycle and Motor Works 10 27 Dressmakers 27 128 Hairdressers 18 36 Harness Makers 2 5 Laundries 15 139 Locksmiths and Gasfitters 2 6 37 Milliners 8 33 Musical Instrument Maker 1 3 Organ Builder 1 3 Patent Time Clock Maker 1 14 Pattern Maker 1 3 Photograph Works 1 4 Picture Frame Makers 4 8 Restaurants and Coffee Houses 14 37 Toy Manufacturer 1 27 Tailors 11 19 Umbrella Maker 1 1 Upholsterer 1 2 Watch Makers and Repairers 6 12 Totals 219 3,070 Sanitary Defects and other Matters. Want of Cleanliness 6 Defective Sanitary Accommodation 4 Other Nuisances 15 Trade Premises. Under this heading are included dairies, cowsheds, milk-shops, slaughterhouses, fish-shops, etc., all of which are inspected quarterly and at other times as occasion arises. The numbers of such premises on the registers are given in Table 2, and I am pleased to be able to state that there were very few violations of the Regulations and Byelaws, and cautions were quite sufficient to compel attention to the various requirements of the Council. In the early part of the year I reported that it would be of great advantage to the district if the Council would declare by Order the business of fish-frying to 38 be an offensive trade, as complaints were frequently made respecting the offensive effluvia therefrom, and as to the unsatisfactory condition of some of the premises, and the use of unsuitable apparatus. The Council declared the business of fish-frying to be an offensive trade under the Public Health Acts, 1875 to 1907, and the Order was confirmed by the Local Government Board. The establishment of such trades will therefore be restricted where they are likely to cause a nuisance, and if the requisite bye-laws are made a uniform sanitary condition of these premises can be enforced. Food Inspection. Special attention is at all times given to the food supply, and during the past year it has only been necessary in one instance to apply for a Justices Order for the destruction of unwholesome food, with respect to which, owing to the circumstances, the Public Health Committee did not recommend the institution of legal proceedings, With regard to the powers which are being sought for the erection of a public abattoir, I may state that under existing conditions it is impossible to adequately carry out meat inspection, although the occupiers of the various slaughter-houses give every facility. Sale of Food and Drugs Acts. I have again found it unnecessary to increase the expense incurred in obtaining samples for analysis under these Acts, in consequence of the satisfactory 39 result of the enquiries and of the quantity of samples taken from time to time by the County Inspectors. The total number of samples purchased was 61, viz.: milk 33, separated milk 2, butter 25, and blackberry wine 1. One sample of milk contained added water to the extent of 16 per cent. and the vendor was fined £2 and costs. A sample of separated milk was adulterated with added water to the extent of 5 per cent. and in this case the vendor was fined 20s. and costs. Two samples of milk were certified to be inferior in quality. Twelve of the twenty-five samples of butter were purchased informally, and one was reported as adulterated. I was not able to obtain a formal sample from the same vendor until the present month, so that the record of the official analysis and proceedings will have to be included in the report for 1911. Petroleum Acts. Owing to a continuous growth in the use of petroleum and carbide of calcium, my duties as Inspector under these Acts are correspondingly increasing from year to year. Twenty applications for licenses were received, and after it was ascertained that the Council's requirements with respect to the places of storage had been complied with, the necessary licenses were issued. The quantities kept vary from 20 to 2,000 gallons, and in cases where more than forty gallons are stored, special precautions are taken. All premises which may be dealt with under the Petroleum Acts, the Orders in Council with respect to 40 other substances of a like nature, or the regulations as to petroleum used for light locomotives, are registered and inspected from time to time. General Matters. The provisions of the County Council of Middlesex (General Powers) Act, 1906, with respect to premises where ice-cream is manufactured and stored have been enforced, aad 29 such places were registered for periodical inspection. As in previous years, the 14 private schools in the district have been visited quarterly, and all the proprietors appear to exercise the greatest care regarding the sanitation of their schools. I have, on various occasions, inspected the registered marine stores, with a view to discovering whether the provisions of the Public Health Acts Amendment Act, 1907, as to dealers in old metal and marine stores, were being contravened, but the persons carrying on this business are so far strictly complying with the Act. In concluding this report, I beg to record my appreciation of the support of the Council and the Medical Officer of Health in the discharge of my duties. I am, Gentlemen, Your obedient Servant, JOHN H. CLARKE, Chief Sanitary Inspector. 41 CHISWICK URBAN DISTRICT. County of Middlesex.—Sanitary Work, 1910. Inspections— Number of premises inspected on complaint 117 Number of premises inspected in connection with Infectious Diseases 314 Number of premises under periodical inspection 352 Houses inspected from house-to-house 2689 Total number of inspections and re-inspections made 8667 Notices— Cautionary or intimation Notices given 905 Statutory Orders issued 789 Summonses served *15 Convictions obtained 11 Four withdrawn. Dwelling Houses— Houses, premises, &c., cleansed, repaired, &c. 464 Closed as unfit for habitation (a) as result of action under H.W.C. Acts 7 Re-opened after repairs, alterations, &c. 5 Demolished 1 Houses Let in Lodgings (Tenement Houses) — Number registered under Bye-laws 341 Number of Contraventions Dealt with under Public Health Acts 42 CHISWICK URBAN DISTRICT. County of Middlesex—Sanitary Work, 1910. Movable Dwellings, Caravans, Tents, &c.— Number observed during the year 8 Number removed from district 8 Bakehouses— Number in district 15 Slaughter Houses— Number on register 7 Frequency of inspections When slaughtering is carried on Cowsheds— Number on register 1 Number of inspections made 4 Frequency of inspection quarterly Number of Milch cows in district 4 Dairies and Milkshops — Number on register 54 Number of inspections made 216 Frequency of inspection quarterly Unsound Food— Parcels seized 3 Condemned by Magistrate 3 Articles or parcels surrendered 15 Adulterated Food— Samples taken by the District Local Authority 61 Found adulterated 3 Offensive Trades Number of premises in district 1 Number of inspections made 4 Water Supply and Water Service— Percentage of houses supplied from Public Water Service 100 Cisterns—Cleansed, repaired, covered, &c. 31 Draw-taps placed on mains 228 Percentage of houses supplied on constant system 100 43 CHISWICK URBAN DISTRICT. County of Middlesex.—Sanitary Work, 1910. Drainage and Sewerage of Existing Buildings— Water Closets—Repaired, suppled with water or otherwise improved 210 Percentage of houses provided with water-closets 100 Drains—Examined, tested, exposed, &c. 219 „ Unstopped, repaired, trapped, &c. 114 „ Waste pipes, rain-water pipes disconnected, repaired, &c. 101 „ New soil pipes or ventilating shafts fixed 104 „ Existing soil pipes or ventilating shafts repaired 50 „ Disconnecting traps or chambers inserted 59 „ Reconstructed 98 Percentage of houses draining into sewers 100 Disinfection— Rooms Disinfected (a) Ordinary infectious disease 145 „ (6) Phthisis 8 Rooms stripped and cleansed 19 Articles disinfected or destroyed:— (a) Ordinary infectious disease 24 (b) Phthisis 8 Dust— New Bins provided 252 Periodical frequency of dust removal weekly Number of complaints of non-removal received 29 Method of disposal Destructor Sundry Nuisances Abated— Overcrowding 8 Smoke 1 Accumulation of refuse 5 Foul Pigs and other Animals 3 Dampness 131 Yards repaved or repaired 211 Other nuisances 556 44 TABLE IV. HOUSE.TO.HOUSE INSPECTION DURING THE YEAR 1910. STREET OR ROAD. No. of inspections. Times inspected during 1910. Houses let in 2 tenements. Houses let in 3 tenements. Houses let in 4 or more tenements. No. of Inhabitants Average No. of Nuisances and Sanitary Defects Discovered and Remedied. Adults. Children under 12 years. Total. Living and sleeping rooms per house. Persons per house, including Children. Defective drains. Defective drain connections. Choked drains. Defective inspection chambers, covers, etc. Defective fresh air inlets. Defective water closets. Defective water supplies to water closets. Defective and leaky sinks. Defective eaves guttering. Defective waste, rain water pipes, etc. Defective soil pipes and drain ventilators. Leaky roofs. Damp walls. Insufficient ashpits. Defective yard paving. Premises requiring repairing and cleansing. Water from cisterns. Overcrowding, Nuisance from keeping animals. Glebe Estate: Duke Road 140 1 59 1 .. 658 309 967 6 6.90 3 3 1 .. .. 3 12 1 4 3 3 7 2 10 21 26 .. 1 .. Glebe Street 69 1 34 4 .. 291 111 402 6 5.82 .. .. .. 1 .. 1 2 .. .. 7 .. 3 2 7 1 15 1 .. .. Dale Street 89 1 44 3 .. 398 175 573 6 6.43 1 .. 2 .. .. 2 9 1 2 18 .. 2 3 3 2 12 1 .. .. Binns Road 44 1 29 .. .. 199 136 335 6 7.61 .. .. 2 .. .. 3 5 .. 1 11 13 3 1 4 .. 16 1 .. .. Reckitt Road 47 25 3 .. 223 112 335 6 7.32 .. 5 .. 1 .. .. 3 1 5 .. 2 5 .. 5 13 17 2 1 .. Quick Road 46 1 32 .. .. 201 113 314 6 6.60 .. 2 .. .. .. .. 1 .. 2 1 .. 1 2 3 10 14 2 .. .. Fraser Street 27 1 17 .. .. 127 79 206 6 7.62 .. 5 .. .. .. 2 2 .. .. .. .. 3 2 1 3 9 .. .. .. Devonshire Road (part of) 56 1 21 1 .. 242 73 315 6 5.62 .. 1 .. .. .. .. .. .. .. 8 .. 3 .. 3 .. 18 3 .. .. Totals 518 .. 261 12 .. 2339 1108 3447 6 6.65 4 16 5 2 .. 11 34 3 14 48 18 27 12 36 50 27 10 2 .. Sulhamstead Estate: Devonshire Road (part of) 74 1 37 1 .. 298 118 416 6 5.62 .. 1 2 .. .. .. 10 .. .. 1 2 1 .. 6 5 17 7 .. .. Annandale Road 42 1 24 8 3 224 85 309 8 7.36 1 .. 1 .. .. .. 3 .. .. 2 1 .. .. 1 .. 4 12 .. .. Swanscombe Road 62 1 41 6 4 338 209 547 7 8.82 .. .. 1 .. .. .. 1 .. .. 5 1 .. .. 1 1 18 10 .. .. Alkerden Road 22 1 16 1 .. 104 63 167 6 7.58 .. .. .. .. .. .. 2 .. 3 2 4 3 1 1 .. 7 4 .. .. Totals 200 118 16 7 964 475 1439 7 7.19 1 1 4 .. .. .. 16 .. 3 10 8 4 1 9 6 46 33 .. .. Devonshire Rd. (part of S .E side) 40 1 22 1 .. 181 144 325 6 7.11 1 .. 2 .. .. 1 1 .. 2 1 .. .. .. 4 1 15 8 .. .. Mawson Lane 22 1 18 .. .. 93 84 177 6 8.04 .. .. 1 .. .. .. 1 .. 1 2 .. .. .. 5 1 9 18 1 .. Eastbury Grove 75 1 66 .. .. 339 216 555 6 8.46 2 1 6 .. .. .. 3 .. .. 10 .. 1 .. 6 1 20 7 .. 1 Dorechester Grove 42 1 39 .. .. 195 127 322 6 7.66 .. .. .. .. .. 4 3 2 6 .. .. 3 .. 3 .. 8 3 .. .. Cornwall Grove 47 1 46 .. .. 195 114 309 6 6.58 1 .. .. .. .. 1 2 .. .. 1 .. 5 .. 4 2 4 6 .. .. Balfern Grove 45 1 21 .. .. 201 59 260 6 5.77 .. .. .. .. .. 2 .. .. 2 .. .. .. .. 2 2 1 17 .. .. Ashborne Grove 22 1 20 .. .. 103 51 154 6 7.0 .. .. .. .. .. .. 4 .. .. .. .. 3 .. 1 .. 2 17 .. .. Wilton Avenue 57 1 52 .. .. 254 83 337 6 5.91 1 .. .. .. .. .. 1 .. 1 l .. .. .. 4 1 1 6 .. .. Chiswick Lane (part of) 35 1 11 .. 1 178 51 229 6 8 4 .. .. .. .. .. .. 2 1 .. .. .. 3 .. 3 .. 2 19 .. .. Totals 385 .. 295 1 1 1739 929 2668 6 6 93 5 l 9 .. .. 8 17 3 12 15 .. 15 .. 32 8 62 101 1 1 Chiswick New Town: Devonshire Road (part of) 50 1 2 1 .. 181 95 276 4 5.52 .. 5 1 .. .. 2 7 10 7 6 .. 8 1 7 10 21 6 .. .. Hogarth Lane 33 1 12 .. .. 141 98 239 6 7.24 .. .. 1 .. 1 .. 4 4 .. 1 .. 4 1 2 7 10 4 .. .. Hogarth Lane 17 1 .. .. .. 74 19 93 6 5.47 .. .. .. .. .. .. .. .. .. .. .. .. 1 1 4 2 2 .. .. Hogarth Avenue 22 1 18 .. .. 102 87 189 5 8.59 .. .. .. .. .. 4 1 1 1 1 .. .. 1 1 3 5 .. .. .. Devonshire Place 28 1 .. .. .. 92 28 120 4 4.28 .. .. 1 .. .. 4 5 2 .. .. .. 1 .. 4 1 6 2 .. .. Devonshire Street 33 1 5 .. .. 118 72 190 4 5.75 .. .. .. .. .. .. 1 .. .. 1 .. .. .. 2 .. 14 2 .. .. Hunt Street 17 1 7 .. .. 83 71 154 6 9.05 .. .. .. .. .. .. .. .. .. 2 .. 1 .. 4 2 10 .. .. .. Bennett Street 43 1 5 .. .. 132 91 223 4 5.18 .. .. 1 .. .. .. 7 .. 1 1 .. 1 .. 5 7 13 1 .. .. William Street 41 1 3 .. .. 131 94 225 3 5.48 .. .. 2 .. .. 4 10 .. 1 .. .. 7 1 5 2 17 1 .. .. Wood Street 30 1 8 .. .. 115 79 194 4 6.46 .. .. .. .. .. .. 5 .. 1 1 .. .. .. 4 .. 11 .. .. .. Furze Street 19 1 .. .. .. 54 29 83 3 4.36 .. .. .. .. .. .. 1 .. .. l .. .. .. 2 .. 11 .. .. .. James Street 24 1 .. .. .. 63 43 112 3 4.66 .. .. .. .. .. 1 2 .. 7 l .. .. .. .. 7 4 .. 1 .. Totals 357 .. 60 1 .. 1292 806 2098 5 5.87 .. 5 6 .. 1 15 43 17 18 15 .. 22 5 37 43 126 18 1 .. Chiswick Proper: (Part of) Sutheland Road 32 1 5 1 .. 128 42 170 6 5.31 .. .. .. .. .. .. .. .. 3 6 .. .. 1 .. .. 2 .. .. .. Short Road 17 1 5 .. .. 73 18 91 4 5.35 1 .. .. .. .. 1 3 .. 1 2 .. .. .. 2 2 1 1 .. .. Paxton Road 72 1 21 1 .. 329 115 444 6 6.16 .. .. .. 1 .. .. 4 2 4 8 .. 4 1 10 6 7 .. .. .. Totals 121 .. 31 2 .. 530 175 705 5 5.82 1 .. .. 1 .. 1 7 2 8 16 .. 4 2 12 8 10 1 .. .. Strand.on.the.Green: Strand on the Green (front) 98 1 3 .. .. 275 91 366 4 3.73 1 .. .. .. .. 1 3 2 4 2 .. 4 .. 4 2 8 5 .. .. Thames Road(including Westeria Gardens) 58 1 14 .. .. 196 57 253 4 4.36 .. .. 1 .. .. .. .. .. 1 1 .. .. .. 6 .. 2 .. .. .. Magnolia Road 50 1 .. .. .. 133 89 222 5 4.44 .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. Geraldine Road and Gardens 46 1 .. .. .. 138 73 211 4 4.58 .. .. .. .. .. .. 2 .. .. 5 .. .. .. 1 .. 1 .. .. .. Pyrmont Road 34 1 23 5 .. 169 121 290 6 8.52 .. .. .. .. .. .. 3 .. .. .. .. .. 1 2 2 19 9 1 .. Waldeck Road 51 1 27 6 1 240 208 448 6 8.78 .. .. 1 .. .. 1 1 .. 1 7 1 1 1 7 5 24 11 .. .. Hearne Road 27 1 7 .. .. 113 47 160 6 5.92 .. .. .. .. .. .. 4 .. .. 13 1 1 .. 2 .. 2 .. .. .. Loraine Road 38 1 .. .. .. 75 35 110 4 2.89 .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. 2 .. .. .. Spring Grove and Nelson Place 36 1 .. .. .. 100 43 143 4 3.97 .. .. .. .. .. .. .. 3 .. 2 .. .. .. .. 8 3 .. .. .. Totals 438 .. 74 11 1 1439 764 2203 5 5.02 1 .. 3 .. .. 3 14 5 6 30 2 6 2 23 18 61 25 1 .. Back Common: Belmont Road 20 1 4 .. .. 81 39 120 6 6.0 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. Belmont Grove 52 1 14 1 .. 255 108 363 6 6.98 .. .. .. .. .. 2 5 .. .. .. .. .. 1 1 1 10 .. .. .. Clifton Gardens 51 1 21 3 1 256 116 372 6 7.29 1 .. .. .. .. .. 3 .. 3 4 3 1 .. 1 3 12 .. .. .. Holly Road 46 1 23 3 .. 235 89 324 6 7.04 .. 1 .. .. .. .. 3 .. .. 7 .. 1 .. 4 .. 3 19 .. .. Fisher's Lane 35 1 1 .. .. 126 51 177 6 5.05 .. .. .. .. .. .. 4 .. .. .. .. 1 1 4 5 1 .. .. .. Back Common Road 53 1 10 .. .. 185 91 276 6 5.20 .. .. .. .. .. 2 4 1 .. 1 .. 1 .. .. .. 6 .. .. .. Bond Street 10 1 .. .. .. 42 21 63 4 6.3 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 3 .. .. .. Windmill Road 51 1 5 .. .. 187 75 262 6 5 13 3 .. .. .. .. 1 3 .. .. .. .. 4 .. 4 2 10 .. .. .. Totals 318 .. 78 7 1 1357 590 1957 6 6.15 4 1 .. .. .. 5 22 1 3 12 3 8 3 14 11 47 19 .. .. Gunnersbury (Part of): Surrey Crescent 37 1 11 .. .. 159 59 218 6 5.89 .. .. 1 .. 2 .. 2 1 1 1 .. 1 2 6 2 2 2 .. .. Chertsey Road 19 1 4 .. .. 80 21 101 6 5.31 .. .. .. .. .. .. 1 2 1 .. .. 3 1 .. .. 3 2 .. .. Stonehill Road 27 1 6 1 .. 121 28 149 6 5.51 .. 2 1 .. .. .. .. 2 2 1 2 .. 1 .. .. 2 .. .. .. Clarence Road 18 1 3 .. .. 79 15 94 6 5.22 .. .. .. .. 4 .. .. .. .. 1 .. 2 1 2 .. 1 .. .. .. Oxford Gardens 48 1 46 .. .. 196 105 301 6 6.27 .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. Brooks Road (Part of) 6 1 6 .. .. 24 19 43 6 7 16 .. .. .. .. .. .. 1 .. .. 1 .. .. .. 4 .. .. .. .. .. Dewsbury Crescent 36 1 .. .. .. 79 30 109 4 3.02 .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. 2 .. .. .. Totals 191 .. 76 1 .. 738 277 1015 6 5.31 .. l 2 .. 6 .. 7 5 4 4 2 7 5 13 2 10 4 .. .. Miscellaneous: British Grove 37 1 9 .. .. 154 59 213 5 5.75 1 .. .. .. .. .. .. .. .. 1 .. 2 .. 4 .. 4 .. .. .. Church Street 36 1 1 .. .. 127 34 161 5 4.47 .. .. .. .. .. .. 2 .. 1 .. .. .. 1 .. 2 2 .. .. Essex Place 88 1 3 .. 1 261 143 404 3 4.58 1 .. 1 .. .. 1 2 .. .. 2 .. 5 .. 10 9 32 2 .. .. Totals 161 .. 13 .. 1 542 236 778 5 4.83 2 .. 1 .. .. 1 4 .. 1 3 .. 7 .. 15 9 38 4 .. .. Grand Totals 2689 .. 1006 51 11 10940 5360 16310 6 6.06 18 26 30 3 7 44 164 36 69 153 33 100 30 191 155 527 215 5 1 TABLE V. TABLE OF SYSTEMATIC INSPECTIONS. Public Health Act, 1875, Section 92. It shall be the duty of every local authority to cause to be made from time to time inspection of their District, with a view to ascertain what nuisances exist calling for abatement under the powers of this Act, &c. Housing, Town Planning, &c., Act, 1909. It shall be the duty of every local authority within the meaning of Part 2 of the principal Act to cause to be made from time to time inspection of their district, with a view to ascertain whether any dwelling house therein is in a state so dangerous or injurious to health as to be unfit for human habitation, &c. Month. District. Number of Premises. Inspections per annum. Jan. Sulhamstead Estate 200 l Feb. Chiswick Proper (part of) 157 1 Mar. Chiswick New Town 357 1 „ Public Schools 4 2 „ Trade Premises Bakehouses 15 4 „ Slaughterhouses 7 4 „ Milkshops and Dairies 55 4 „ Fishshops 15 4 „ Inspections for the renewal of Game License 7 1 April Glebe Estate 518 1 May „ „ June Essex Place 88 1 „ Back Common (part of) 318 1 „ Trade premises 92 4 July Strand-on-the-Green 438 1 Aug „ „ Sept. Manor House Estate (part of) 221 1 „ Public and Private Schools 18 2 „ Trade Premises 92 4 Oct. Manor House Estate (part of) 164 1 „ Factories and Workshops 219 1 Nov. Gunnersbury (part of) 191 1 „ Inspection of Special Premises — — Dec. Powell Road 29 1 „ Trade Premises 92 4 3187