HEALTH REPORT FOR 1893 FOR THE CROYDON RURAL SANITARY DISTRICT, BY THE MEDICAL OFFICER OF HEALTH. Wallington: Printed by William Pile, 5, Danbury Terrace. HEALTH REPORT FOR 1893 FOR THE CROYDON RURAL SANITARY DISTRICT, BY THE MEDICAL OFFICER OF HEALTH. Wallington: Printed by William Pile, 5, Danbury Terrace. HEALTH REPORT OF THE CROYDON RURAL SANITARY DISTRICT, 1893. Gentlemen, In presenting to you the following, my first annual report, it is necessary to explain that, although it is called “annual,” yet it refers, as regards work done, and, partly, also statistics, only to the last six months of the year 1893. This is owing to the fact that the appointment of “whole-time” Medical Officer of Health for the entire district was made towards the end of June last. I have, however, endeavoured in several particulars to make it refer to the whole of the year just past, and wherever it is deficient in information concerning the first half of the year, it will be necessary to consult the reports of the three medical gentlemen who held the office, in conjunction, up to the date of my appointment. By an order of the Local Government Board, issued in March, 1891, it is prescribed that every Medical Officer of Health shall:— “Make an annual report to the Sanitary Authority, up to the end of December in each year, comprising a summary of the action taken, or which he has advised the Sanitary Authority to take, during the year tor preventing the spread of disease, and an account of the sanitary state of his District generally at the end of the year. The report shall also contain an account of the inquiries which he has made as to conditions injurious to health existing in the District, and 4 of the proceedings in which he has taken part or advised under any Statute, so far as such proceedings relate to those conditions; and also an account of the supervision exercised by him, or on his advice, for sanitary purposes over places and houses that the Sanitary Authority have power to regulate, with the nature and results of any proceedings which may have been so required, and taken in respect of the same during the year. The report shall also record the action taken by him, or on his advice, during the year, in regard to offensive trades, to dairies, cowsheds, and milk-shops, and to factories and workshops. The report shall also contain tabular statements of the sickness and mortality within the District, classified according to diseases, ages and localities.” I do not propose to adhere to the order given in this memorandum, but for the sake of convenience to arrange my report under various headings, beginning with:— 1. AREA AND POPULATION. The total area of the district is, according to the last census return 22,766 acres, and comprises 9 parishes altogether. These parishes are, as follows, given in the order of greatest to smallest, in point of area:— Name of Area in Name of Area in Parish. Acres. Parish Acres. Coulsdon 4,314 Merton 1,765 Addington 3,605 Woodmansterne 1,591 Sanderstead 3,150 Morden 1,475 Beddington 3,128 Wallington 823 Mitcham 2,915 The Population of the entire district was, in 1891, when the census was taken, 28,717, as compared with '21,712 in 1881. These figures include the population in public institutions, of which only 3 are given separately in the census reports. These were Cane Hill Asylum, in Coulsdon, and the Holborn Workhouse, and Holborn Schools in Mitcham, the inmates of which numbered altogether 2,484. In 1881 the corresponding number of inmates in public institutions, as given in the census returns was 553. Deducting these figures from the above figures, the result is that the corrected population of the 5 entire district was in 1891, 26,233, as compared with 21,159 in 1881, being an increase of 5,074, or nearly 24 per cent The increase for the whole country during the same period was 11.7 per cent. This increase of population was by no means spread over the whole district equally, the increase per cent. in each parish being as follows:—Merton increased by 35 per cent., Woodmansterne 33 per cent., Coulsdon 29 per cent., Mitcham 28 per cent., Wallington 27 per cent., Morden 10 per cent., Beddington 5 per cent., Addington 1½ per cent., whilst Sanderstead decreased by nearly 3 per cent. There are several other matters of importance in connection with the population of the district as taken at the last census, which, as the full returns have just been published, should now be recorded. (a) Sex and Ages of the Population in the District. Excluding the population (inmates only) of the three public institutions I have named, there were 12,483 males and 13,750 females living in the district, or 1,102 females to 1,000 males, as compared with 1,064 females per 1,000 males for the whole of England and Wales. This proportion of males to females differed largely in the various individual parishes, as is shown in the following table:- Table giving the number of females per 1,000 males living in 1891, in the whole district, in each parish, and in some other places. Addington 926 Coulsdon 1,055 Surrey 1.123 Sanderstead 943 Merton 1,084 England & Wales 1,064 Morden . 972 Beddington 1,244 Rural Districts of England and Wales 1,008 Woodmansterne 1000 Wallington 1,409 Mitcham 1030 Entire Distric 1,102 6 As regards the ages of the population, I. have arranged the following table, which shows the numbers living at 12 age groups per thousand living at all ages. Numbers of Males and Females at 12 age Groups per thousand persons of all ages in the Croydon Rural District, and in the Rural Districts of England and Wales respectively. Ages. Croydon Rural District. Rural Districts of England and Wales. Persons. Males. Females. Persons. Males. Females Ml Ages. 1000 480 520 1000 498 502 0 to 115 58 57 123 61 62 5 to 125 63 62 122 61 61 10 to 127 65 62 116 59 57 15 to 88 41 47 97 52 45 20 to 81 34 47 80 40 40 25 to 142 65 77 134 66 69 35 to 120 59 61 107 52 55 45 to 88 42 46 88 43 45 55 to 58 27 31 67 33 34 65 to 40 19 21 46 22 24 75 to 14 6 8 18 8 9 85 and upwards 2 1 1 2 1 1 This table is necessarily based on the population figures including all public institutions, as there are no data whereby they can be excluded. The most obvious feature in the above table is the relatively small number of persons in this district between the ages of 15 and 20, as compared with all other rural districts, and, further, while the males at this age group are considerably less, the females are slightly more numerous than is the case in all other rural districts. (b) Inhabited Houses and Density of Population. The number of inhabited houses increased from 8,730 in 1881 to 4,845 in 1891, or by nearly 30 per cent., as compared with 12.8 for England and Wales. 7 The average number of persons living in each house was 5.7 in 1881 and 5.4 in 1891, as compared with 5.4 and 5.3, respectively, in England and Wales. The density of the population on area in 1891 was 1 person to .79 acre, as compared with 1.29 acres for England and Wales; or, stated in different terms, there were 807 persons per square mile, as compared with 497 in the whole of England and Wales. (c) Tenements. A very important addition was introduced into the census returns for 1891, with a view to discovering the number of houses occupied by more than one family. Every house, or portion of a house occupied by a separate family was called a “tenement,” and where such tenement consisted of less than 5 rooms, the number of rooms had to be stated. In a recent census report the results of such returns are given for every sanitary district in the country, and for this district the following is given:— Table showing Total number of Tenements in the District, and the Tenements with less than 5 rooms, distinguishing those occupied by various numbers of persons. Total Tenements. Rooms in Tenements. Number of Tenements with less than 5 rooms. Number of Occupants of Tenements. 1 2 3 4 5 6 7 8 9 10 11 19 1 143 99 31 6 5 1 1 5,162 2 244 55 76 50 41 13 6 2 1 3 334 20 98 81 45 32 31 11 9 6 1 4 931 15 135 161 163 138 127 89 56 31 13 1 2 1,652 8 That is to say, there were 5,162 tenements, of which 1,652 contained less than 5 rooms; of these 1,652, there were 143 consisting of one room, 99 of which were occupied by one person each, 31 by 2 persons, &c.; and there were 244 tenements consisting of 2 rooms, 55 of which were occupied by one person, 76 by 2 persons, and so on. The Registrar-General points out that, owing to the confusion caused by the word " tenement," and for other reasons, these figures must not be regarded as quite accurate. Nevertheless, they are very important, and I have analysed the above table in the way the RegistrarGeneral has adopted for the figures of the whole country, with the following results. There were 1.06 tenements to each inhabited house, compared with 1.12 for England and Wales. The average number of persons occupying each tenement was 4.9, compared with 4.7 for England and Wales. Seventy-five per cent. of the population of the district lived in tenements of more than 4 rooms, compared with 55 per cent. for England and Wales. Not quite 1 per cent. of the population lived in single-roomed tenements, compared with 2 per cent. for England and Wales; 2½ per cent. lived in 2-roomed tenements, compared with 8 per cent. for England and Wales; 4½ per cent. lived in 3-roomed tenements, compared with 11 per cent. for England and Wales; and 17 per cent. lived in 4-roomed tenements, compared with 23½ per cent. for England and Wales. The average number of occupants per room was 1½ 9 in single-roomed tenements, compared with 2¼ for England and Wales, 1⅓ in 2-roomed tenements, compared with 1¾, 1.2 in 3-roomed tenements, compared with 1.4, and 1.18 in 4-roomed tenements, compared with 1.16. The Registrar General adopts a standard of 2 persons per room as the maximum that can be allowed without overcrowding. Taking this standard I find that 830 persons in this district were living in an overcrowded state. This number is 3*3 per cent, of the total population, and the corresponding figure for England and Wales is 1T23 per cent. Estimated Population at the Middle of 1893. It is necessary to make an estimate of the population of the district at the middle of the past year for the purpose of estimating the mortality, &c. I have estimated that the population gf the whole district was 27,720 exclusive of the public institutions I have already named. This estimate is arrived at by assuming that the last inter-censal increase of the population has been maintained, and this assumption has been corrected by calculations based on the returns which I have received giving the number of inhabited houses in 1893. The population of each parish, and the number of inhabited houses at the middle of 1893 may be estimated as follows:— Parish. Number of Inhabited Houses. Population. Parish. Number of Inhabited Houses. Population Addington 132 671 Morden 140 1 770 Beddington 488 2,758 Sanderstead 106 530 Coulsdon 540 3,470 Wallington 788 4182 Merton 684 3,542 Wood mansterne 83 425 Mitcham 2,146 11,372 - - Total 5,107 27,720 10 2. BIRTHS AND DEATHS, BIRTH-RATES AND DEATH-RATES. During the last six months of the year, 367 Births were registered, of which 188 were males and 171 were females; 8 of the births were illegitimate, 4 of each sex, or 2 per cent, of the total births. The birth-rate for the whole district was at the annual rate of 26.5 per thousand persons living. Table giving the number of births in each parish from July to December, 1893, with the corresponding annual birth-rate. Parish. Registered Births. Annual Birth rate per thousand of Population. Addington 7 20.9 Beddington 28 20.3 Coulsdon 53 30.6 Merton 44 24.9 Mitcham 170 30.0 Morden 8 20.8 Sanderstead 6 22.6 Wallington 45 21.5 Woodmansterne 6 28.2 The average birth-rate for the whole of England and Wales for the ten years, 1881 to 1890, was 32.5, and 4 per cent. of the births were illegitimate. The Deaths registered throughout the district during the same period numbered 321, of which 136 occurred in public institutions, and must be deducted. To the total 185 thus left, must be added, however, 21 deaths of persons belonging to the district who died beyond its boundaries, giving a corrected total of 206 deaths. This number of deaths represents an annual death-rate of 14.9 per thousand of population at the middle of 1893. 11 Table showing the number of deaths belonging to each parish from July to December, 1893, with the corresponding annual death rate. Parish. Registered Deaths. Annual death-rate per thousand of population. Addington 4 11.9 Beddington 12 8.7 Coulsdon 16 9.2 Merton 27 15.3 Mitcham 110 19.3 Morden 6 15.6 Sanderstead 3 11.8 Wallington 25 12.0 Woodmansterne 3 14.1 The average death rate for the whole of England and Wales for the ten years, 1881 to 1890, was 19.'1. The Deaths of Infants under 1 year numbered 68, which is at the rate of 185 per thousand registered births. The average rate for the ten years, 1881 to 1890, in England and Wales was 142. Forty-seven of these infantile deaths occurred in Mitcham, giving the bad rate of 276 deaths of infants tinder 1 year per thousand births for that parish. As to the other parishes, the rate was nil in Morden, Sanderstead, and Woodmansterne, and, in the remaining, varied from 57 in Coulsdon to 182 in Merton. The excessive rate in Mitcham was due to 25 deaths from Whooping Cough and Diarrhœa. The Deaths of Children under 5 years numbered 82, or 39 per cent, of the total deaths. The Deaths from Pulmonary Consumption numbered 13 or .9 per thousand of population at all ages per annum, as compared with 1.6 for England and Wales in 1891, while the Deaths from all Tubercular Diseases numbered 18, or 1.8 per thousand of population. 12 The Deaths from Pulmonary Diseases (except consumption) numbered '28, or '2 per thousand of population. The Deaths from the Seven Principal Zymotic Diseases numbered 39. The diseases in question are Small-pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever (including Typhus, Enteric or Typhoid, and Simple Continued Fevers), and Diarrhoea. The number of deaths recorded represents an annual Zymotic deathrate of 2.8 per thousand of the population at all ages. The deaths from fever numbered 4, equal to a deathrate of .29 per thousand, and from diarrhoea 16, equal to 1:2 per thousand. Further particulars as to the deaths from these and other zymotic diseases will. be found in the section devoted to that subject. 3. INQUESTS, DEATHS NOT CERTIFIED, and DEATHS IN UNION PREMISES AND PUBLIC INSTITUTIONS. Two uncertified deaths occurred, as to which the Coroner decided that it was unnecessary to hold inquests, the cause of death in each case being stated to be " heart disease.” Seventeen deaths occurred where inquests were held, one of which was at Cane Hill Asylum, and another at the Holborn Union Workhouse. Nine of these inquests, including those in the above institutions, resulted in verdicts of “Death from natural causes.” Three resulted in verdicts of “Accidental Death,” one from being “overlaid,” one from “drowning,” and one from “fracture of the skull through being knocked down by a railway engine.” Two resulted in verdicts of “Suicide,” both 13 by drowning, while 8 resulted in verdicts of “found dead.” Of the 136 deaths which occurred in Public Insitutions 96 occurred in Cane Hill Asylum in Coulsdon, 17 of which, or nearly 18 per cent. were due to pulmonary consumption, 38 occurred in the Holborn Union Workhouse in Mitcham, of which 1 was due to pulmonary consumption, while one death from measles occurred in the Holborn Union Schools in Mitcham, and one death from scarlet fever in the Reedham Asylum in Coulsdon. 4. ZYMOTIC DISEASE, ISOLATION, AND DISINFECTION. The diseases which are notifiable in the district are all those scheduled in the Infectious Diseases (Notification) Act, 1889, and Measles, which was added to the list in July, 1890. During the last six months of the year 351 cases of disease have been notified, of which 105 occurred in public institutions, and which, if deducted, leave a total of 246 ; or in other words, nearly 1 out of every 112 persons living suffered from notifiable infectious disease. Small-pox.—No case of small-pox occurred. Scarlet Fever.—This disease has been very prevalent throughout the district, the only parishes which were free from it, being Morden and Woodmansterne. In all, 256 cases occurred, 172 of which were in private houses, the remainder, 84, beiner in various public institutions. The incidence of the disease in the various parishes affected was as follows:— 14 100 cases occurred in Mitcham, or 8.8 cases per 1000 of population 29 „ Merton, or 8.2 „ „ „ 17„ Wallington. or 4.1 „ „ „ 11„ Beddington, or 4.0 „ „ „ 8„ Addington, or 12.0 „ „ „ 5 „ Coulsdon, or 1.4 „ „ „ 2 „ Sanderstead, or 3.8 „ „ „ 172„ the District, or 0.2 „ „ „ The monthly incidence of the disease was as follows: 13 cases occurred in July, 36 cases occurred in October 12 „ „ „ August, 51 „ „ „ November 38 „ „ „ September, 22 „ „ „ December The past year has been marked by the prevalence of Scarlet Fever nearly everywhere, and especially so in the Metropolitan parishes. Situated as this district is, on the confines of these places, it is not surprising that infection has been several times conveyed from them into the district, and I find that the disease was imported 10 times, from London, or from Wimbledon, or Croydon. The main agency which has kept up the prevalence of the disease in the district has been undoubtedly Schools, and altogether 83 cases were due, directly or indirectly, to infection from school. The type of the disease was very mild, and it was found repeatedly that children had attended school until the appearance of the rash, while in some cases, owing to the indistinctness or partial character of the rash, the children had been allowed to return to school or play with their fellows, when, on examination, they were found to be peeling. Such cases were discovered in Mitcham and Wallington, and there were doubtless other cases which were not discovered at all. One school in Mitcham was closed about a week before the usual time, in July, owing to an outbreak affecting one particular class of scholars, namely, females 15 between the ages of 10 and 13; but otherwise it was thought that the closure of any particular school would have led to no good result. Apart from the above outbreak, the disease affected all ages, and both sexes alike, and it was in connection with Mitcham only, that this question had to be considered, and Mitcham is the parish above all the others where, if a school had been closed, the intercourse amongst the children would have been as great as if it had not been closed. I am sorry to say that only 47 cases out of the 172 which occurred, or 27 per cent., were removed to hospital. During the 4 months, July to October, 35 per cent. were removed, while after October only 13 per cent. were removed. The reason for this difference is that after October, the Infirmary at the Croydon Workhouse was closed to all but pauper cases. Consequently, 25 cases were due to defective isolation at home, but to this number should be added several of those which I have included amongst those deriving their infection indirectly from schools. Thirty-seven were sporadic cases, besides which there were six others which could not be traced satisfactorily. There were 8 cases, and possibly 12, which were caused by infection lingering about those discharged from the Croydon Infirmary. Even in the best-managed hospitals, used only for isolation purposes, such unfortunate cases undoubtedly occur from time to time. The most striking example occurred in one house at Addington. A girl employed in Croydon went home ill, and was sent to the Infirmary. On her discharge 3 other children at her house, took the disease within a few days; they were likewise removed, and 2 of them died. On the discharge of the surviving child, 2 more at home became ill, and of these 1 also died. 16 Of the remaining 3 cases of this disease: 2 occurred in the house of a medical man, who was attending several cases at the time, and 1 derived the infection from “rags” There were four deaths from scarlet fever, giving a case-mortality of 2.3 per cent., and a death-rate per annum of .29 per thousand living. Of the 84 cases which occurred in public institutions, 6 occurred in the Holborn Schools in Mitcham, 16 in the Russell Hill School in Beddington, and 62 in the Reedham Asylum in Coulsdon. There was 1 death in the Reedham Asylum. Diphtheria.—25 cases of this disease have occurred, or nearly 1 case per 1,000 of population. The cases were spread pretty equally over the several months, and the numbers in each parish were as follows : 11 in Mitcham, 7 in Wallington, 4 in Sanderstead, 2 in Merton, and 1 in Beddington. Twelve of the cases were sporadic, or could not be traced satisfactorily. Two cases in Mitcham were due, apparently, to an antecedent, unrecognised sore throat; and 1 was infected in Croydon. Three of the cases in Wallington may have been connected with the grave sanitary defects found in their dwellings, while 2 took the disease through nursing a child suffering from it. One case from Merton was infected and treated in London. There were sanitary defects in connection with one case in Sanderstead ; and one, who infected two others at home, was infected by a playmate in a neighbouring parish. There was one death from diphtheria, giving a case- 17 mortality of 4 per cent., and a death rate of '07 per thousand living. Membranous Croup.—No case was reported. Typhus Fever.—No case reported. Enteric or Typhoid Fever (including Continued Fever).—Twenty cases of Enteric and 1 of Continued Fever were reported, 21 in all, being equivalent to .76 case per thousand living in the district; 10 cases occurred in Mitcham, 3 in Merton, 3 in Beddington (1 of which was at the Beddington Orphan Asylum), 2 in Coulsdon, 1 in Merton, and 1 in Wallington. Of these 21 cases, 7 (which includes the solitary case at the Beddington Orphan Asylum), could not be traced to any direct and distinct cause, although every endeavour was made to do so. In some of the cases the patient had been in several districts just prior to being affected with the disease, and it is probable that in some of them, the poison was obtained elsewhere than locally. Of the remaining 14 cases, 8 were without any doubt imported; 2 came from Worthing, and 6 from various parts of London. Of the 6 other cases, 1 was in a little girl in Mitcham, who had been allowed to nurse a sister already suffering from the disease, and no doubt caught it from her. Another case in Mitcham (Beddington Corner), seemed to have some connection with an offensive pit, near which she sat in school. The hole was tilled up, and covered with concrete. A case occurred in Kenley in a house in which there was an extremely foul earthcloset. The three remaining cases were in one insanitary street in Merton. Two of the houses involved were adjoining, and 2 other cases had occured in them previous to my appointment. There was reason to 18 believe that the water cistern used by both these houses in common had become polluted, owing to a direct communication with a closet beneath it. There were 4 deaths from enteric fever, giving a casemortality of 19 per cent., and a death rate per annum of *29 per thousand living. Relapsing Fever.—No case of this disease has been reported. Puerperal Fever.—No case of this disease has been reported. Cholera.—One case of cholera occurred in Mitcham in September. I reported it fully to the Authority at the time, and an account of the case was also published in the “British Medical Journal.”* The case was fatal, and it will be recollected that although the case could not be connected with any previous case, in spite of careful enquiry by Dr. Seaton and myself, yet Dr. Klein, of the Local Government Board, found in the material that was sent to him, the particular kind of “comma bacillus,” which is, at any rate, the invariable accompaniment of true Asiatic Cholera, and, so far as is known at present, of no other disease. Apart from Dr. Klein's statement, everything pointed to the case being one of ordinary “English Cholera,” or “Cholera Nostras.” Very vigorous measures were taken to prevent the spread of the disease, and it is a matter for congratulation that there is only one case to report. Erysipelas.—Twenty cases of erysipelas have been reported. Seven occurred in Mitcham, 5 in Wallington, 4 in Merton, 2 in Beddington, 1 in Coulsdon, and 1 in Woodmansterne. There was no connection between any * November 25th, 1893. 19 of the cases reported. There was one death from this disease in Wallington. Measles.—Only 8 cases of measles were notified from private houses, but 20 have been reported lately from the Holborn Union Schools in Mitcham, and one death from the disease has occurred there. I understand that a new arrival from London introduced the disease into this establishment, and it is still spreading. There is an infirmary attached to the school, in which the cases are isolated. Diarrhoea.—Sixteen deaths from diarrhoea occurred, and they were all in infants below the age of 1 year. This represents a mortality of 1.2 per thousand living, and 43½ per thousand births. Seven of the deaths occurred in July, 5 in August, 3 in September, and 1 in October. Fifteen of the deaths occurred in Mitcham, equal to a mortality of 2.6 per thousand living, or 88 per thousand births, and although these figures are based on 6 months returns only, they are far too high. This incidence is partly accounted for by the extremely hot weather experienced last summer, but the overcrowding which there is reason to believe exists in parts of Mitcham must have contributed to the mortality from this complaint. The average mortality in England and Wales from diarrhoea, during the years 1881 to 1890, was nearly .7 per thousand of population, which is nearly one quarter of the mortality in Mitcham. Whooping Cough.—This disease killed 14 persons, all of whom were children below 5 years of age. Ten of the deaths were of infants below the age of 1 year, which is at the rate of 27 deaths per thousand births. Ten of the deaths occurred in Mitcham, 3 in Wallington, and one in 20 Merton, whilst 4 deaths occurred in July, 3 in August, 5 in September, and 2 in October. In concluding these statistical matters, I should explain that I have abstained from comparing the figures in this report with those of previous reports for two reasons, viz.:— 1st. Because the figures in this report are only based on six months' returns, and 2nd. Because no rates have been given in previous reports, excepting the birth and death-rates for Mitcham, Merton, and Morden, and no correction has been hitherto made for deaths, which have occurred outside the district, but which belonged to the district. For these two reasons, any comparison, where possible, would be fallacious. Isolation.—Every house infected with Scarlet Fever, Diphtheria, Enteric Fever, and in some cases Erysipelas, have been visited by me, and in practically all cases instructions as to the best means of isolation were given. Children belonging to infected houses have been prohibited from attending school, and notice has been sent to the school authorities. Soon after I was appointed, I advised the Authority to have a second notice printed stating when a child could return to school, as a sequel to the first, which prohibits attendance. The object of this is to ensure the absence, from school, of children belonging to infected houses, until such notice has been sent to the authorities, but I am afraid that the School Authorities have, in some cases, permitted children to return to school before the notice has been received. 21 Since the closing of the Croydon Infirmary on October 31st to all except pauper cases, there has been no Isolation Hospital at all for this district. The Authority, I believe, contemplate approaching the Croydon County Council, with a view to making some arrangement with them, to admit cases of infectious disease into their Isolation Hospital, when it is completed. This hospital, however, will not, I am informed, be completed tor two years at least, and it is therefore essential that, at any rate, some temporary building should be erected to tide over that period. I have already reported to this effect to the Authority, and a small committee was appointed to consider any sites for such a building. A site, in an extremely convenient situation, near Mitcham Junction Station, on some land belonging to the Croydon Corporation was first selected, but the Corporation have declined to entertain the proposal, owing to " fear of litigation." I am, therefore, at the present time engaged in making enquiries about a variety of other sites, and I sincerely trust that before the coming year is far advanced, this district will possess some hospital for this purpose. Disinfection.—One hundred and three houses have been disinfected by the servants of the Authority during the last six months of the year, and disinfectants, with instructions as to their use, were issued to every infected house. The question of the disinfection of houses after infectious disease is an important one, and everything depends on the manner in which it is done. I reported to the Authority on the total inadequacy of the arrangement I found in existence, whereby bedding, clothes, &c., were supposed to be disinfected by exposing them to the fumes of burning sulphur. Arrangements were, in 22 sequence, made with the Guardians to permit infected bedding from this district to be stoved in the steam disinfector used at the Infirmary, and a cart for the conveyance of such articles was ordered. It is satisfactory, therefore, that soon after the commencement of the year, bedding, &c., will receive proper and adequate disinfection. As regards “fumigation,” it is a popular supposition that the “fumigation” of a room after infectious disease makes the room perfectly safe, but it is very probable that “fumigation,” by itself, is practically useless, as has been shown by bacteriological investigation. Four processes are necessary before a room and its contents can be regarded as adequately disinfected, viz., fumigation, storing, ventilation, and cleansing. The fumigation is already done, and ventilation too, for the fumigation of a room with sulphur dioxide necessarily involves subsequent ventilation, more or less prolonged and thorough, before the room becomes habitable again. “Storing” will be done very shortly, and the “cleansing” of a room is therefore the one process remaining which the servants of the Authority do not carry out, and I strongly recommend that it should be so done. The practice at present is to serve a notice on owners of houses, calling upon them to strip walls, cleanse floors, and whitewash ceilings. Putting on one side the hardship this might involve in certain cases, on persons free from blame in the matter, it is inevitable that such work is often delayed, and when done, is often badly done. I would, therefore, strongly urge the Authority to sanction a slight increase in their staff, so that the whole of the disinfection process may be carried out by them, and as a sequel the Authority should, I think, consider whether disinfection of rooms should not, in all cases, be done free of cost. 23 The amount that is recovered now is quite a small fraction of the total sum spent, and as it is in the interest of the population at large that every means should be taken to suppress infectious disease, so it is only right that the cost of such means should be borne by the public at large, instead of by a few individuals. What will prove, I feel sure, very useful in the coming year, is the shelter, which, on my suggestion, the Authority have provided and furnished in Mitcham, to receive families temporarily displaced from their houses while disinfection is going on. The shelter will be ready for occupation at the beginning of the year. Several water-tight “excreta pails” were also obtained on my advice, and in every case of Typhoid Fever which has occurred in Mitcham, Merton, and Morden, the discharges and soiled linen have been removed in them, every other day, to the Sewage Works, where they have been destroyed by fire. If a small hand cart were provided, such removal could be extended to Wallington and Beddington in future, and when it is considered that it is by means of the discharges that Typhoid is always spread, it will be seen how important it is to remove this source of danger to other people. 5. WATER SUPPLIES. The mains of several Water Companies extend through the different parishes in the District, and from them water is laid on to the majority of the houses. In Addington, the Croydon Corporation supplies most of the houses; Kenley and Purley, in Coulsdon parish, and Sanderstead, are supplied by the Kenley and Caterham Water Company; Beddington, Wallington, Woodman- 24 sterne, and Morden are supplied by the Sutton Water Company; while Mitcham and Merton are supplied by the Lambeth Company. Where such waters are not used, deep and shallow wells, and in some places Artesian wells, yield the necessary supplies. These latter sources are kept under constant supervision, and where any suspicions exist as to their purity, samples are taken and analysed by Dr. Stevenson, the County Analyst. Six such samples were taken in the last half-year, and of these 3 were pronounced to be unfit for drinking purposes, 1 was said to be doubtful, while the remaining 2 were reported to be of high organic purity. In the first 4 cases the old sources of supply were discontinued, and water obtained from the nearest water main. The water supply of the houses on Coulsdon Common was the subject of a report to the Authority in July last. I found that the only source of supply was rain water, which was stored in underground tanks or in butts, and the water from two surface ponds. Owing to the prolonged absence of rain, these sources of supply were wellnigh exhausted, and I found that the water that was being consumed was foul in the extreme, and was infested with many animalculae, visible to the naked eye. The Authority consequently invited the Caterham Company to extend their main, which was very close to the spot in question. This extension has now been carried out, and it remains for the Authority to have the houses supplied with water from this source. The provisions of the Public Health Water Act have been carried out in those parishes to which bye-laws as to new buildings, &c., do not apply. Four applications for Water Certificates were received under Section 6 of this Act, 2 in Coulsdon and 2 in Sanderstead, and were 25 granted, in each case, on the Authority being satisfied that the supply available was sufficient for domestic purposes. G. SEWERAGE AND SEWAGE DISPOSAL. A large scheme of sewerage was carried out some years ago for the Parishes of Beddington, Wallington, Mitcham, Merton, and Morden, and more recently sewers were also constructed for the Purley district, in the parish of Coulsdon. The last-named join the Croydon system, but the former converge to two levels at the Sewage Works in Collierswood, Mitcham, which together furnish the outfall, to be treated on about 26 acres of land there. The population of these parishes was estimated at the middle of last year to be 24,000, so that there is about one acre of land available for the sewage of 925 persons. The system employed at the Works is "Intermittent Downward Filtration," not preceded by any chemical precipitation, and such an amount of land ought to be sufficient. The reverse has, however, been the case for some time past, mainly on account of the immense volume of sub-soil water which finds its way into the sewers in various parts of the district. As surface water is largely excluded from the sewers, the volume of sewage, which, under normal conditions, should require treatment, is, for the above population, about 700,000 gallons daily, but it appears that the actual volume in dry weather is If millions of gallons, whilst in wet weather, it amounts to no less than 4 million gallons. It is not surprising, therefore, that the Works have been overtaxed, and that the effluent is far from satisfactory; and matters wore such a grave aspect, that after a special report by the Surveyor, Mr. Chatterton, C.E., 26 was asked to investigate the matter, and make what recommendations he thought would meet the case. Such an investigation is bound to take a very considerable time, but Mr. Chatterton informs me that his report will very shortly be presented, and it is to be hoped that his recommendations will be such, that the Authority can adopt them, and that they will effectually overcome the defects, which have so long been a source of anxiety and trouble. In the parishes other than those I have named, drainage is disposed of in cesspools, and there is much reason to fear that the majority are not properly constructed. Bye-laws relating to the construction, position, ventilation, and cleansing of cesspools are in force in the drainage district only, and it is of much importance that they should be extended to all parts of the district without delay. Where complaints are made, steps are taken to secure the proper construction of new cesspools, and in the case of new buildings, similar precautions are also taken. 7. EXCREMENT AND REFUSE COLLECTION AND DISPOSAL. In the parishes comprised in the drainage district water-closets are used, and in the majority of houses the flushing is now done by means of a flushing cistern, and not by hand. As regards the other parishes, privies with small fixed receptacles are used in Addington, and also a few w.c.'s flushed by hand; in Coulsdon village privy-middens with large receptacles are commonly used; in Kenley w.c.'s flushed by hand are in the majority, although there 27 are many with flushing cisterns, and several earth-closets. In Sanderstead there are w.c.'s flushed by hand, and also a few earth-closets, privies, and w.c.'s flushed by cistern; while in Woodmansterne privies with fixed receptacles are mostly used. As regards Kenley, which is a rapidly growing place, a report was made before my appointment as to the water-closets flushed by hand, but the matter was postponed to allow of consideration, whether this part of the district should not have a drainage scheme in connection with that at Purley. Excrement collection is not carried out anywhere, nor is dry earth supplied to any part of the district by the Authority. As to refuse collection, this has been carried out only in the parishes comprised in the drainage district—by the servants of the Authority in Mitcham and Merton, and by contract elsewhere. Removal has been effected once a fortnight hitherto, but I would strongly advise the Authority, when the renewal of the contracts comes up for consideration, to arrange for its removal once a week at least. 8. DWELLING HOUSES AND STREETS. Bye-laws as to New Dwellings and Streets are in force in the parishes comprised in the drainage district, and they, in the main, are the same as the Model Bye-laws issued by the Local Government Board. A Committee was appointed in October to consider and report on the whole of the bye-laws in force in the 28 district, and the Surveyor and myself presented detailed reports on the subject. As regards dwellings, as well as nearly all the other subjects on which bye-laws can be made, I would strongly urge the Authority to make them applicable to the whole of the district. I have been furnished by the Surveyor with the following return, as regards streets and buildings in 1893 : New Buildings. Plans for New Buildings submitted to the Authority 170 Of which were approved 83 Of which were disapproved 87 Amended, re-submitted, and approved 71 Plans for Additions to New Houses submitted and approved 11 Plans for Additions to Houses erected before the adoption of the bye-laws received 11 Of which was disapproved 1 New Streets. Plans for New Streets and Sewers submitted and approved 3 Streets made up, metalled, and kerbed, under Sections 150, 151, and 152 of the Public Health Act 4 Of which have been declared Highways 2 9. NUISANCE ABATEMENT, ORDINARY SANITARY OPERATIONS, AND REPORTS OF INSPECTORS OF NUISANCES. Since the latter part of last June, the two Inspectors of Nuisances have been under my supervision and control. All reports made by them as to sanitary defects and other matters which come under their notice, have been made through me to the Authority, and all remedial measures proposed to be carried out, have been carefully examined by me, before being recommended for adoption as the requirements of the Authority. 29 The various books and records required to be kept by the Inspectors have been regularly examined, and shortly after my appointment took effect, the " Daily Journals" were examined once a week, and the Inspectors were instructed to put on record in their journals, the time at which every inspection was made. Inspections have frequently been made in company with the Inspectors, and reports, in writing, have often been required on specific matters. By these means I have been enabled to become intimately acquainted with the work being done by the Inspectors, and to generally guide and control their work, which plays such a very important part in the administration of the Public Health Acts. Appended to this report, will be found a return embracing the work done by the Inspectors, during the whole of the year 1893, and showing, under various headings, what work has been done in each parish. From this return it will be seen that 2,20(5 " primary" inspections and 1,729 re-inspections were made, or a total of 3,935 in all. On the other hand,. 169 complaints in writing were received. Resulting from these inspections, 296 legal notices were ordered to be served by the Authority for the removal of nuisances ; and, besides these, 436 " preliminary" notices were served by the Inspectors, of which 267 were complied with, without further notice. It will be seen that 345 drains were repaired, cleansed, trapped, etc., and 137 were ventilated. Since June, all drains which have been re-constructed or repaired, have had to undergo the "water-test" before being approved. This test is the only real test of the impermeability of a drain, and should be made 3° compulsory in the future in the case of all new, as well as re-constructed drains. Legal proceedings have been necessary on six occasions. The most important of these was the case against the Gipsies who encamp on a piece of land at Beddington Corner. Repeated complaints have been made concerning these Gipsies, for the encampment is very close to -a large group of houses, and I reported in August, that in my opinion, they constituted a very dangerous nuisance. Proceedings were consequently taken against four Gipsies in the first instance, who were convicted, and a magistrate's order given to the effect that they were to go away and not to return. As the year closed proceedings were ordered to be taken against several more Gipsies. 10. REGULATED TRADES AND OFFENSIVE TRADES. (a) Slaughterhouses. There are 18 slaughterhouses which are licensed, or are under the provisions of the bye-laws of the Authority. These have been regularly visited by the Inspectors at least once a month, and on six occasions, defects have been reported and remedied. The bye-laws of the Authority deal only with slaughterhouses in the parishes of Mitcham, Merton, Morden, Beddington, and Wallington. There are three slaughterhouses in the other parishes, which have been inspected frequently. In my report to the Bye-laws Committee I recommended that steps should be taken to obtain the necessary urban powers, so that the bye-laws might be made to apply to every parish. 31 (b) Bakehouses. There are 20 bakehouses in the district, which have been inspected regularly once a month. No report of uncleanliness or other defects has been made in the last six months of the year. (c) Dairies, Cowsheds, &c. There are 57 registered dairies, cowsheds, &c., in the district, distributed as follows:— Addington 3 Beddington 3 Coulsdon 15 Merton 9 Mitcham 10 Morden 1 Sanderstead 4 Wallington 11 Woodmansterne 1 Total 7 Seven of these have been registered during the past year. All have been visited regularly by the Inspectors, and some of them I have also inspected. In nine cases defects have been reported and remedied. (d) Offensive Trades. Three trades of this character are carried on in the district. The trade of gut-scraping is carried on in Mitcham and in Merton, and that of horse-slaughtering in Mitcham. The premises, where these trades are carried on, have been frequently inspected. In the case of the gut-scraping business, carried on in Mitcham, legal proceedings were taken against the proprietor for causing a nuisance, and a conviction was obtained. Since then the nuisance has been very largely abated, and no complaints have been received. 32 The proprietors of the horse-slaughtering establishment were licensed to slaughter horses before the Authority acquired powers under sec. 169 of the Public Health Act, but quite recently the offensive trade of bone-boiling was established on their premises. This was done without the consent of the Authority, which was necessary, as the Authority possesses urban powers for dealing with offensive trades, in the drainage district. When this was pointed out to the proprietors they gave an undertaking to cease carrying on the trade, until they obtained the necessary permission of the Authority. The matter rested there at the close of the year. There are no bye-laws in force dealing with offensive trades, and I recommended to the Bye-laws Committee that they might be introduced with advantage. 11. UNSOUND. DISEASED, UNWHOLESOME, OR ADULTERATED FOOD. It has been arranged that in the coming year, the Inspectors, while always directing their attention to the detection of unwholesome or adulterated food, shall devote one day in every three months to each parish in the district, to this special purpose, and to taking samples of various articles of food, to be analysed by the County Analyst. In the past year no action has been found necessary in regard to unwholesome food. Two samples of milk have been taken, which, after analysis by the County Analyst, were declared to be genuine. 33 12. OVERCROWDING, HOUSES OF THE WORKING CLASSES, AND COMMON LODGING HOUSES. I have already referred to the amount of overcrowding which the last census returns revealed to be in existence in this district. These returns refer to the district as a whole only, and no data are given whereby any estimate could be made of the amount of overcrowding in each parish. There can be little doubt, however, both from general observation, and from the infantile death-rates which I have recorded, that it is in Mitcham where it exists to the greatest extent. In that portion of Merton adjoining Mitcham, it also probably exists, though to a less extent. For this reason, and in order to become intimately acquainted with the dwellings of the working classes, a house-to-house inspection of Mitcham parish was commenced by me towards the close of the year. Owing to the extensive prevalence of infectious disease, not much time could be found available for this purpose, but 50 houses have been thoroughly examined in detail, and careful records made of the size and condition of rooms, the numbers and ages of the inhabitants, and of the sanitary arrangements and means of ventilation in existence. Soon after the beginning of the year, I hope to be able to continue this important work, and, I hope, extend it more rapidly. Among the above houses, were five in a row, called "Piccadilly," which I reported in December to be, in my opinion, unfit for human habitation, on the grounds of "Dampness of foundations, imperfect roofs, absence of 34 'through' ventilation, insufficient air space in front ami behind, imperfect sanitary appliances, and imperfect water supply." At the close of the year a notice was served on the owner under sec. 32 of the Housing of the Working Classes Act. Besides these houses, three other houses were also condemned under this Act, namely: No. 3, East Cottages, Merton Rush, and two cottages in "Paddy's Bottom," in Sanderstead parish. The former was put into thorough repair, while the latter were demolished. There are no common Lodging Houses in the district. 13. POLLUTION OF THE RIVER WANDLE. A complaint was made towards the close of the year, that the River Wandle at Beddington Corner was being polluted by the effluent from a Leather Factory, near at hand, in Carshalton Parish. An analysis of the effluent was made, with the result that it showed that a large amount of organic matter was finding its way into the river. The facts were reported to the Surrey County Council. Many complaints have been made, mainly to the Local Government Board as to the condition of a stream in the Parish of Mitcham, called the " Graveney Brook." At one time this Brook received the contents of many sewers, but all have, probably, been now disconnected, and only surface-water drains are supposed to discharge into it. In dry weather there is a very small quantity of water in the Brook, but after rain, the volume of water becomes very large, by far the largest quantity of it being due to the contents of a "storm-sewer," belonging to the 35 London Count) Council, and discharging into it at Streatham Lane. The state of the Brook is not satisfactory, and the bed requires frequent cleansing by the Authority. The above sewer is under observation, and I have instructed the Inspector to take samples of its effluent with a view to Analysis. It is by discovering the sources of the pollution of this Brook, and securing their removal that its condition will be improved, and as the Brook is a tributary of the Wandle, the matter is important. It was suggested that the Authority should take proceedings against the adjoining owners of property, under the Nuisance Sections of the Public Health Act, but I advised the Authority, with the concurrence of the County Medical Officer, that the condition of the Brook was not such as would justify these proceedings. Quite lately, a peculiar source of pollution has come to light. In the Lonesome district of Mitcham Parish, is a Chemical Factory, and into an adjoining ditch, at two points, two clear waste-liquors enter. One consists of a weak acid solution, while the other consists of a clear solution of a Hyposulphite. When these two liquors come into contact with each other, precipitation of Sulphur takes place, and some Sulphuretted Hydrogen gas is formed. The result of this chemical reaction is that the contents of the ditch, which eventually find their way into the Graveney Brook, have become offensive, and have given rise to complaints, while a thick whitishyellow deposit is taking place along a gradually increasing length of the bottom and sides of the ditch. Representations have been made to the proprietor of 36 the Factory, and he has promised to construct apparatus whereby the Sulphur will be precipitated before the waste liquors enter the ditch. Should he fail to carry out his promise the matter will be brought to the notice of the Authority. I am, Gentlemen, Your obedient servant, L. W. DARRA MAIR, M.D., D.P.H. Union Offices, Croydon, December 31st, 1898. Postscript.—Through the courtesy of the late Medical OfficesSof Health, I am enabled to state that throughout the whole of the year 1893, 368 deaths occurred within the District, exclusive of those in Public Institutions. To this number must be added 33 deaths of persons belonging to the district, althQugh they occurred outside, the total thus becoming 401. This number represents a death-rate of 14.5 per thousand of population. APPENDIX. Giving various Statistics and a Summary of the Work done by the Inspectors of Nuisances. (A) TABLE OP DEATHS during the last Six Months of the year 1893, in the Rural Sanitary District of Croydon, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities Mortality from all Causes, at Subjoined Ages. Mortality from subjoined causes, Distinguishing deaths of children under 5 years of age. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 60 and upwards. Small Pox. Scarlatina. Diphtheria. MembrMnous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. a b c d e f g h i 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 addington 4 1 2 1 Under 5 1 1 5 upwards 2 1 3 BEDDINGTON 12 3 5 4 Under 5 3 3 5 upwards 2 1 1 5 9 COULSDON 16 3 2 2 5 4 Under 5 5 5 5 upwards 1 1 1 8 11 merton 27 8 1 4 8 6 Under 5 1 1 2 5 9 5 upwards 1 2 1 1 3 10 18 mitcham 110 47 5 8 3 22 25 Under 5 10 15 9 1 1 16 52 5 upwards 1 1 1 7 8 13 2 25 58 MORDEN 6 2 4 Under 5 5 upwards 1 1 4 6 sanderstead 3 1 1 1 Under 5 5 upwards 1 1 1 3 WALLINGTON 25 7 4 10 4 Under 5 3 1 1 1 5 11 5 upwards 1 1 4 1 1 6 14 WOODMAN STERNE 3 1 2 Under 5 1 1 5 upwards 2 2 CANE HILL ASYLUM 96 3 77 16 Under 5 5 upwards 17 6 1 72 96 HOLBORN WORKHOUSE 38 10 28 Under 5 5 upwards 1 1 10 7 19 38 HOLBORN SCHOOLS 1 1 Under 5 5 upwards 1 1 REEDHAM ASYLUM 1 1 Under 5 5 upwards 1 1 Totals 342 68 14 16 9 140 95 Under 5 1 14 16 12 2 2 35 82 ; 5 upwards 4 1 4 1 1 1 1 31 32 28 4 152 260 The subjoined numbers have also been taken into account in judging of the mortality of this Division of the Sanitary District. Deaths occurring outside the Division or District among perpersons belonging thereto, and included in the above figures 21 91 1 5 6 7 Under 5 1 1 1 3 5 upwards 1 1 3 1 2 1 9 18 Deaths occurring within the Division or District among persons not belonging thereto, and have to be deducted from the above figures. 136 2 3 87 41 Under 5 5 upwards 1 1 1 18 16 8 91 136 (B) TABLE OF POPULATION, BIRTHS, and of NEW CASES OF INFECTIOUS SICKNESS coming to the knowledge of the Medical Officer of Health during the last Six Months of the Year 1893, in the Rural Sanitary District of Croydon, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Casts of Sickness in each locality coming to the knowledge of the Medical Officer of Health. Number of such cases Removed from their homes in the several localities for treatment in Isolation Hospital. Census 1891. Estimated to middle of 1893. Small Pox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Typhus. Enteric or Typhoid. 1 Continued. Relapsing Puerperal. Small Pox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Typhus. Enteric or Typhoid Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 adding ton 670 671 7 Under 5 1 2 1 5 upwards 7 4 beddington 2607 2758 28 Under 5 3 1 2 5 upwards 8 1 1 2 4 coulsdon 3335 3470 53 Under 5 1 5 upwards 4 2 1 1 merton 3360 3542 44 Under 5 5 upwards 11 1 1 4 18 1 2 - -s 4 2 6 2 mitcham 10758 11372 170 Under 5 19 6 1 1 3 2 5 upwards 81 5 10 1 1 6 19 1 1 MORDEN 763 770 8 Under 5 1 5 upwards 1 1 sanderstead 509 530 6 Under 5 1 5 upwards - 1 4 1 wallington 3823 4182 45 Under 5 5 upwards 2 15 7 1 5 1 2 2 WOODMANSTERNE 408 425 6 Under 5 5 upwards 1 beddington orphanage Under 5 5 upwards 1 1 holborn schools Under 5 5 upwards 6 20 6 20 russell hill school Under 5 5 upwards 16 16 reedham asylum Under 5 3 3 5 upwards 59 59 Totals 26233 27720 367 Under 5 41 7 2 1 4 13 2 5 upwards 215 18 18 1 1 19 24 118 1 7 4 20 The Workhouse Infirmary at Croydon is used for the Isolation of pauper patients. Every Public Institution possesses Isolation accommodation of its own. (C) INSPECTORS' REPORTS of the SANITARY WORK completed in the Year 1893. PARISHES. No. of Complaints received during the year. No of Houses, Premises, &c., Inspected. No. of Re-inspections of Houses, Premises, &c. Results of Inspection. House Drains. Privies and Waterclosets. Ash Pits. Water Supply. Miscellaneous. Orders issued for Sanitary Amendments of Houses and Premises. Houses, Premises, &c., Cleansed, Repaired, Whitewashed, &c. Houses Disinfected after illness of an Infectious Character. Repaired, Cleansed, Trapped, &c. Ventilated. Repaired. Ac. Supplied with Water. New provided. New provided. Repaired, Covered, &c. Cisterns (new) Erected. Cisterns, Cleansed, Repaired and Covered. Waste Pipes connected with Drains, &c., abolished. No. of Lodging Houses Registered under 35th Section of the "Sanitary Act, 1866," or 90th Section of "Public Health Act, 1875." Dust Removal—No. of Communications received and attended to. Removal of Accumulations of Dung, Stagnant Water, Animal and other Refuse. Animals Removed, being improperly kept. Regularly Inspected. Legal Proceedings, i.e, Summonses. Bakehouses. Licensed Cowsheds. Licensed Slaughter-houses. ADDINGTON 160 66 5 7 7 7 7 1 3 BEDDINGTON 29 161 363 23 21 21 24 20 5 14 20 1 3 3 COULSDON 10 158 300 26 4 2 28 20 15 23 1 2 15 1 MERTON 24 378 287 98 65 29 87 14 48 18 1 22 1 3 1 2 7 2 9 4 MITCHAM 56 719 295 81 84 80 141 36 109 30 2 25 17 1 10 1 14 8 9 10 6 2 MORDEN 5 70 56 10 13 12 10 5 1 1 1 1 SANDERSTEAD 119 27 10 5 5 9 9 3 4 1 WALLINGTON 45 227 299 39 15 15 37 29 9 16 1 24 17 3 11 2 2 WOODMANSTERNE 214 36 4 1 1 2 2 1 1 Totals 169 2206 1729 296 215 172 345 137 175 65 24 108 18 4 11 1 40 22 4 20 57 13 6 LEVI WHITE, SAMUEL BROWN, Inspectors of Nuisances.