CRO 13 HEALTH REPORT for 1910 of the Croydon Rural District by the Medical Officer of Health. Submitted to the Council 2nd February. 1911. WALLINGTON William Pile, Ltd., 6 & 6, Danbury Terrace. Croydon Rural District Council HEALTH REPORT FOR 1910. Gentlemen, I beg to submit to you my thirteenth Annual Report upon the Health and Sanitary condition of the District. Appended are the statistical tables, the report on the working of the Factory and Workshops Act, in accordance with the requirements of the Home Office. The Death Rate, 8.9 per thousand of population, is much lower than in any previous year which I have been your Medical Officer. The Birth Rate is also very low being '23 0 per thousand of population. The year 1910, generally speaking, has been a very healthy one, with no serious outbreaks of epidemic disease. It is with pleasure that I have again to place on record the kind help and assistance which I have received from the Council and all its officers with whom my work has brought me into contact. I have the honour to be, Your obedient servant, C. M. FEGEN. 2nd February, 1911. CONTENTS. PAGES. I.—Area and Population 7 to 10 II.—Vital Statistics 11 to 17 III.—Infectious Disease 17 to 21 IV.—Preventive Measures 21 to 23 V.—General 23 to 83 VI.—Inspector's Work 33 to 35 Appendices— Isolation Hospital 38 to 40 Statistical Tables 41 to 59 Factory and Workshops Act 60 to 65 Index 66 to 68 REPORT. I.—AREA AND POPULATION. The District consists of eight parishes, and the total area is 21,001 acres. The largest Parish is Coulsdon, with 4,314 acres, and the smallest Wallington, with 823 acres. In the year 1901, at the time of the last Census, the population was 38,071, but omitting the three large institutions, viz.:—The Cane Hill Asylum, the Holborn Workhouse, and the Holborn Schools, the total population was 34,180, of which number 16,202 were males and 17,978 were females. At the middle of 1910 the population was estimated to be 07,963, but, omitting all institutions, the corrected number was 63,600, of which number 30,010 were males and 33,590 were females. The number of inhabitants in the three large institutions has increased from 2,468 in 1891 to 3,529 in 1910. There has been, however, a decrease of 35 since the middle of 1909. The number of occupied houses in the District was In 1881 3,730 „ 1891 4,845 „ 1900 6,597 „ 1901 7,027 „ 1902 7.694 „ 1903 8,316 „ 1904 9,421 „ 1905 10,493 „ 1906 11,614 „ 1907 13,086 „ 1908 11,362 „ 1909 11,905 „ 1910 12,630 8 It will be seen that there has been an increase of 8,900 in the number of houses occupied during the last 29 years. The subjoined table shows the number of houses in each parish from 1891 to 1910, and also the increases between the years 1891 and 1901, and also in each year from 1901. 9 Parish. Number of Houses Increase Between 1891 and 1901 Between 1901 land 1902 Between 1902 and 1903 Between 1903 and 1904 Between 1904 and 1905 Between 1905 and 1900 Between 1900 and 1907 Between 1907 and 1908 Between 1908 and 1909 Between 1909 and 1910 Between 1891 and 1910 In 1891 In 1901 In 1902 In 1903 In 1904 In 1905 In 1900 In 1907 In 1908 In 1909 In 1910 Addington 132 131 120 120 138 134 139 139 139 140 140 -1 —11 - 18 -4 5 - - 1 - 8 Beddington 442 751 825 933 1035 1169 1442 1480 1700 1858 2137 309 74 108 102 134 278 38 220 158 279 1695 Coulsdon 537 818 903 1001 1244 1305 1312 1643 1720 1817 1943 281 85 98 243 121 147 131 77 97 126 1100 Mitcham 2055 2743 2934 3070 3337 3806 4177 4874 5131 5359 5463 088 191 142 261 409 371 097 257 228 104 3408 Morden 188 180 115 196 210 200 205 224 236 225 240 48 9 1 14 —4 —1 19 12 -11 15 102 Sanderstead 90 203 211 250 309 342 425 492 545 577 016 107 8 39 59 33 83 67 53 32 39 520 Wallington 710 1063 1108 1272 1388 1404 1540 1504 1068 1714 1858 353 105 104 110 70 82 18 104 46 144 1148 Woodmansterne 81 105 120 120 140 140 183 206 223 215 233 24 15 20 6 37 23 17 —8 18 152 4191 0000 6476 6968 7801 8632 9629 10622 11362 11905 12630 1809 476 492 833 831 997 993 740 543 725 8439 10 It will be observed that considerable activity in the building trade has occurred in Beddington with 279, Wallington with 144, Coulsdon with 126, and Mitcham with 104 new houses. Throughout the District generally the average number of persons occupying each house in 1891 was 5.4, but at the census in 1901 it was found to have fallen to 4.8, but for 1910 it is estimated at 5.0. The average number of persons to each inhabited house remains, as a general rule, fairly constant for each locality, though varying considerably in different parishes, according to the class of house erected. In many parts of the district" tenement" houses or houses let in flats have been built, and these houses have, of course, a considerably larger number of inmates. This is particularly the case in Mitcham. The " Natural increase " during the year was 899, as against 968 in the previous year. In 1897 the increase was 474 „ 1898 892 „ 1899 379 „ 1900 460 „ 1901 543 „ 1902 552 „ 1903 730 „ 1904 763 „ 1905 879 ., 1906 921 „ 1907 986 „ 1908 903 „ 1909 968 „ 1910 899 And this has amounted to 12,491 since the census in 1891. The "Natural increase" was greatest in Mitcham with 562, Coulsdon with 134, and Beddington with 79. 11 Excess of Births over Deaths. Deaths in 1910. Births in 1910. Excess of Births in 1910. Addingtorr 6 11 5 Beddington 77 156 79 Coulsdon 76 210 134 Mitcham 282 844 562 Morden 12 30 18 Sanderstead 16 36 20 Wallington 90 136 46 Woodmansterne 8 43 35 567 1466 899 II.—VITAL STATISTICS. Births. The number of Births registered in the District was 1466, as compared with 1513 last year, and 1487 in 1908. Of this number 29 children were registered as being illegitimate. This gives an illegitimate birth-rate of 1.9 per cent. of total births, as against 2.1 last year. This should be considered very satisfactory. No. of Illegitimate Births. Percentage. Beddington 5 3.2 Coulsdon 3 1.4 Mitcham 17 20 Morden 1 8.3 Sanderstead 1 2.7 Wallington 2 1.4 The birth rate for the entire District was 23.0 per thousand of population, as against 25.0 last year, and 25.8 in 1908. The birth rate in England and Wales in 1910 was 24.8 per thousand of the population, which is 0.8 per thousand below the rate in 1909, and lower than the 12 rate in any other year on record. Compared with the average in the 10 years, 1900-1909, the birth rate in 1910 shows a decrease of 2.7 per thousand. Registered Births and Birth Rates. Parish. Estimated Population middle of 1910. Registered Births. Birth Bates. 1906 1907 1908 1909 1910 1906 1907 1908 1909 1910 Addington 695 11 7 *11 14 11 15.8 10.1 15.9 20.1 15.8 Beddington 9840 157 162 176 194 156 22.2 22.8 22.0 22.1 15.8 Coulsdon 9900 183 163 200 223 210 23.2 19.1 22.7 23.9 21.2 Mitcham 28400 721 716 863 796 844 31.9 27.7 32.3 28.5 29.7 Morden 1220 29 24 26 29 30 23.2 21.8 22.0 25.7 24.5 Sanderstead 2880 35 49 53 54 36 17.1 16.5 20.6 20.0 12.5 Wallington 9480 155 138 139 165 136 18.5 16.4 16.0 18.8 14.3 Woodmansterne 1185 29 44 19 38 43 30.5 41.5 16.5 34.8 36.2 63600 1320 1303 1487 1513 1466 26.7 24.6 25.8 25.0 23.0 Deaths. Exclusive of those Deaths which occurred in Public Institutions situated within the district, the deaths registered during the year numbered 567. In this number there are included those persons from within the district who have died outside, either at the Workhouse, Workhouse Infirmary, or at the General Hospital at Croydon ; the Surrey County Asylum at Brookwood; the County Asylum at Netherne; the Cottage Hospital at Carshalton; or at the Council's Isolation Hospital at Beddington Corner. The number of these Deaths was 100. The mortality corresponds to a death rate of 89 per thousand of population, as against 9.0 last year. 10.1 in 1908, 9.7 in 1907, 11.8 in 1906, 9.6 in 1905, 11.0 in 1904, and 10.4 in 1903, and as against an average of 106 during the ten years 1900-1909. 13 Mortality.* Parish. Population estimated to middle of 1910. Deaths. Death Rates. 1906 1907 1908 1909 1910 1906 1907 1908 1909 1910 Addington 695 4 7 2 5 6 5.7 10.1 2.9 7.1 8.6 Beddington 9840 48 55 56 58 77 6.8 7.7 7.0 6.6 7.8 Coulsdon 9900 79 69 88 49 76 100 8.1 100 5.2 7.6 Mitcham 28400 308 286 330 318 282 13.6 11.0 12.3 11.3 9.9 Morden 1.220 9 12 10 11 12 8.7 10.9 8.4 9.7 9.9 Sanderstead 2880 11 16 13 15 16 5.3 6.8 5.0 5.5 5.5 Wallington 9480 96 76 77 80 90 11.5 9.0 9.0 9.1 9.4 Woodmansterne 1185 6 8 8 9 8 6.3 7.5 6.9 8.2 6.7 63600 561 529 584 545 567 11.3 9.7 10.1 9.0 8.9 *Exclusive of deaths of non.residents occurring in public institutions in the District, but inclusive of deaths of residents occurring in public institution! outside the District. N.B.—The number of deaths occurring to non residents in public institutions in the District in 1910 was 163. Mortality at Different Ages. Infantile Mortality.—The number of infants under the age of one year who died during 1910 was 98, as against 130 in 1909, 120 in 1908, 170 in 1907, 199 in 1906, 138 in 1905, and ]58 in 1904, the infantile mortality rate, therefore, being 67 per thousand births, as against 85 in 1909, 84 in 1908, 103 in 1907, 124 in 1906, and 98 in 1905, and an average of 104.6 in the ten years 1900 to 1909. The deaths of children under the age of one year, numbering 98, gives a percentage rate of 17.2 of the deaths at all ages, as against 23.8 in 1909, 21.5 in 1908, 26.1 in 1907, 29.3 in 1906, and 26.0 in 1905. 14 The rate of Mortality in England and Wales among infants under one year of age to 1000 registered births, was 106, which is 3 per 1000 below the rate in 1909. The rate in 1910 was lower than the rate in any other year on record. Compared with the average in the ten years 1900-1909, the rate of infantile mortality in 1910 showed a decrease of 26 per 1000. The deaths of children between the ages of one and five years, numbering 49, gives a percentage of 8.6 of total deaths, as against 10.4 in 1909, 12.8 in 1908, 10.7 in 1907, 12.9 in 1906, and 7.7 in 1905. The deaths occurring in persons over 65 years of age, numbering 155, give a percentage of 27.3 of total deaths, as against 25.8 in 1909, 26.0 in 1908, 22.9 in 1907, 21.5 in 1906, and 27.4 in 1905. Parish. Children under One Year. Children between One and Five. People over 65 Years. 1907 1908 1909 1910 1907 1908 1909 1910 1907 1908 1909 1910 Addington 1 .. 1 .. 1 .. .. 1 3 1 2 2 Beddington 5 6 17 7 7 0 4 8 14 19 22 21 Coulsdon 22 17 9 12 7 6 4 3 13 26 18 15 Mitcham 92 92 84 62 37 48 41 29 53 69 69 72 Mordeu .. 2 3 3 . . 3 1 1 6 2 2 3 Sanderstead 3 1 4 1 1 3 .. 2 2 2 3 7 Wallington 13 7 9 10 4 7 7 5 25 32 23 34 Woodmansterne 4 1 3 3 1 2 .. .. 1 1 2 1 Totals 140 126 130 98 58 75 57 49 117 152 141 155 15 Causes of Deaths. The deaths registered in 1910 included— 5 from Measles. 12 ,, Scarlet Fever. 6 ,, Whooping Cough. 21 ,, Diphtheria. 26 ,, Diarrhœa. 93 ,, Lung Complaints. 3 „ Puerperal Fever. 46 ,, Phthisis. 23 ,, Injuries (self-inflicted or otherwise). 33 ,, Cancer (malignant disease). 6 ,, Alcoholism (cirrhosis of liver). The Zymotic Death Rate is a term commonly applied to the rates of deaths occurring from the seven principle zymotic complaints:—Small Pox, Measles Scarlet Fever, Diphtheria, Whooping Cough, Diarrhœa and "Fever"; which latter term includes Typhus Typhoid (or Enteric) and Puerperal Fevers. During the year 1910 the deaths from these complaints numbered 71, the Zymotic Death Rate therefore, being 1.1 per 1,000 of population, as against 1.1 in 1909, 1.5 in 1908, 1.6 in 1907, 1.7 in 1906, and 0.9 in 1905. The deaths from Phthisis numbered 46, as against 40 in 1909, 50 in 1908, 51 in 1907, 42 in 1906, and 38 in 1905. The Phthisical Death Rate is, therefore, 0.7 per thousand of population, as against 06 last year, 0.8 in 1908, 0.7 in 1907, 0.7 in 1906, and 0 6 in 1905. The deaths from Pulmonary Diseases numbered 93, as against 97 last year, 94 in 1908, 97 in 1907, 88 in 1906, and 84 in 1905. This gives a Death Rate of 1.4, as against 16 last year, 1.6 in 1908, 1.4 in 1907, 1.4 in 1906, and l.5 in 1905. 16 To various forms of injury, whether self-inflicted or otherwise, 23 deaths were due, in all of which cases inquests were held. This gives a death Rate of 0.4, as against. 0.3 last year, 0.3 in 1908, 03 in 1907, 0.3 in 1906, and 0"2 in 1905. The Death Rate in England and Wales in 1910 was 13.4 per 1000 of estimated population, and this was 1.1 per 1000 below the rate in 1909, and lower than the rate in any year on record. Compared with the average in the ten years 1900-1909, the death rate in 1910 showed a decrease of 2.4 per 1000. Birth Bate, Death Bute, and Analysis of Mortality in the year 1910. Annual hate per 1000 living. Births. Deaths. Principal Epidemic Diseases. (Cols. 4-10) Small-pox. Measles. Scarlet Fever. ; Diphtheria Whooping Cough. ! Enteric Fever. Diarrhoea. Deaths under oneyear to 1000 Births. Cols. 1. 3. 4. 5. 6. 7. 8. 9. 10. 11. England and Wales 24.8 13.4 0.99 0.00 0.23 0.06 0.12 0.24 0.06 0.29 106 77 Great Towns 25.0 14.3 1.23 0.00 0.31 0.08 0.12 0.29 0.05 0.38 115 136 smaller Towns 23.7 12.9 0.88 0.00 0.16 0.06 0.11 0.24 0.05 0.26 104 England and Wales, less the 213 Towns 25.0 12.8 0 .74 0.00 0.15 0.05 0.12 0.17 0.05 0.20 96 Croydon Rural District 230 8.9 1.13 0.00 0.08 0.19 0.33 0.09 0.04 0.41 67 Deaths in Institutions. The Deaths in Institutions situate in the District numbered 163, as against 208 last year, 161 in 1908, 239 in 1907, 204 in 1906, and 178 in 1905. 17 The deaths included :— 19 from Phthisis. 9 ,, Cancer (malignant disease). 23 „ Lung Complaints. 19 „ Heart Diseases. 76 ,, Brain Diseases. III.—INFECTIOUS DISEASE. The Infections Disease (Notification) Act has been in force in this District since the year 1890. In July of that year Measles was also included in the list of notifiable diseases, and continued to be a notifiable disease until June, 1909. In the summer of 1894 it was considered necessary that Diarrhoea should, for a short period, also be considered a notifiable disease. Owing to the epidemic of Small Pox that existed in and around London, as well as in the Croydon Rural District, during the latter part of 1901 and the beginning of 1902, Chicken Pox was also made a notifiable disease, and continued to be so until the end of July, 1903. It was of great assistance in combating the outbreak of Small Pox. In April, 1907, Cerebro-Spinal Meningitis was also made a notifiable disease for twelve months. The Infectious Disease (Prevention) Act, 1890, has also been in force in this District since 1891. During the year 483 cases of Notifiable Disease were either certified to the Sanitary Department or came to its knowledge through the vigilance of its Inspectors, as against 411 last year, 475 in 1908, 591 in 1907, 439 in 1906, and 397 in 1905. 18 Reference to Table III. at the end of the report will show:— Firstly, cases notified in the whole District, with the ages of incidence and the nature of the Infectious Disease. Secondly, the total number of cases (and nature of the disease) in each locality. Thirdly, the number of cases removed from each locality to the Isolation Hospital. Reference to Table XI. will show the number of cases notified since the adoption of the Notification Act. Infantile Summer Diarrhoea. During the summer 17 deaths were registered as occurring from Infantile Summer Diarrhoea. This gives a death rate of 0.26 per thousand of population, as against 016 last year, 0.36 in 1908, and 079 in 1907. Subjoined will be found a copy of a notice, which is very extensively circulated at the commencement of the hot weather, throughout the entire district. CROYDON RURAL DISTRICT COUNCIL. Important to All Parents. SUMMER DIARRHŒA. During the hot months young children are especially liable to very severe attacks of Diarrhoea, which, in a very large number of cases, have a fatal ending. It is probable that most cases arise from the use of tainted milk or other food and want of care. Every article used for the storing or preparation of food must be kept perfectly clean, having been well scalded and then rinsed with clean cold water before use. All milk should be boiled as soon as 19 taken in, and kept in a cool and well-ventilated place. No meat, fish, or cheese should be kept in the same place as the milk. No milk should be kept over night. If condensed milk is employed, none but the best brands should be used, and the tins kept in a cool, ventilated place while in use. Fruit ought not to be given to infants, but if ripe and untainted it may be given to elder children. Great care should be exercised in keeping the house, and especially the backyard, clean, and in not allowing waste vegetable matter or food to lie about rotttng in the sun. The W.C. should be well flushed down, and the seat and pan kept thoroughly clean. C. M. FEGEN, Medical Officer of Health. It is essential that whatever variety of fresh, sterilised, or condensed milk is used, none but the best should be taken, and this should be only used when fresh or freshly prepared. All utensils should be kept perfectly clean, having been rinsed with fresh cold water after scalding with clean water. In every case a careful enquiry was made, and reference to Table XIII. in the Appendix will show the circumstances, feeding, family history of the victims to this, to some large extent, preventable disease in 1910. The parishes and roads (or streets) invaded during the past ten years will be found in Table XIV. Scarlet Fever. During the year 242 cases of Scarlet Fever were notified, which is 30 more cases than was notified during last year. Of these 242 cases the disease had a fatal ending in only 12 cases. Two hundred and seven cases were removed to the Isolation Hospital. 20 Diphtheria. During the year a slight increase in the number of cases of Diphtheria notified took place, viz., 166, as against 150 last year. Of this number Mitcham was responsible for 100 cases, one of which occurred in the Holborn Union Schools. The disease had a fatal ending in 21 cases. One hundred and thirty-two cases were removed to the Isolation Hospital. Typhoid Fever. During the year 16 cases of Typhoid Fever were notified as against 9 last year, 1(5 in 1908, 15 in 1907, and 33 in 1906. Nine of these cases were removed to the Isolation Hospital. No deaths occurred from this disease during the year. Puerperal Fever. An increase took place in the number of Puerperal Fever cases notified during the year, viz., 9, as against 5 last year. Three of these cases were removed to the Isolation Hospital. Of the 9 cases 3 had a fatal termination. Erysipelas. During the year 50 cases of Erysipelas were notified as against 33 last year, 36 in 1908, and 56 in 1907. Four cases were removed to the Isolation Hospital. Of these 50 cases 4 were fatal. Phthisis A slight increase took place in the number of deaths registered as occurring from Phthisis, viz., 46, as against 40 last year. During the year I have examined the sputum of 52 persons with a positive result in 45 cases. 21 Forty-six cases have been notified during the year under the Public Health (Tuberculosis) Regulations, 1908. Disinfection has again been largely carried out in the rooms occupied by Phthisical patients, and the clothing, bedding, etc., has been systematically dealt with at the Council's Disinfecting Station. IV.—PREVENTIVE MEASURES. During the year 4.29 patients were admitted to the Isolation Hospital at Beddington Corner, including 74 patients from neighbouring authorities. The usual routine preventive and precautionary measures have been continued as in previous years to check the extension of infectious disease, with most satisfactory results. Isolation, disinfection and quarantine have been carried out under the careful and intelligent supervision of the Sanitary Staff, and outbreaks of infectious disease have been very materially limited. Unrecognised cases, as in previous years, have been the origin of most outbreaks, and such unrecognised cases are always likely to exist in all diseases, especially if the attack is a very mild type, so mild indeed are some of these cases that the advice of a medical man is, by the parents of the patients, considered superfluous. These, unfortunately, are the cases which prove the nuclei of almost every epidemic. Immediately on notification being received of the existence of cases of Scarlet Fever, Diphtheria, Typhoid Fever, and Small Pox, it is the custom to offer hospital 22 treatment, and, if the offer is accepted, the patient is at once removed to the Hospital; in no case should longer than two hours elapse after receiving the intimation of the existence of infectious disease in any house before the patient, if for removal, is in the Hospital. Any delay is to be deprecated in all cases of Diphtheria. In all cases of Typhoid Fever which are not admitted to the Hospital, sanitary pails, of a special character, furnished with air-tight screw lids, are left at the infected houses for the reception of all excreta and other waste products of the sick room. These pails are collected daily, and their contents are dealt with in the destructor at the Hospital. In every case of Notifiable Disease enquiries are made and recorded as to the number of persons in the house, where they are employed, milk supply, water supply, laundry, conditions of drains, etc., together with the history of the case and the probable cause of infection. Notice is at once sent to any school attended by children from infected houses, and these children are then excluded from school on my certificate, and are not allowed to return until due notice has been given to the school authorities of their freedom from possible infection. Disinfection of infected rooms is carried out by fumigation with sulphur dioxide or formic aldehyde, and of the bedding and the clothes in the steam disinfector at the disinfecting station at the Isolation Hospital. Disinfectants are supplied free of charge during illness. After the rooms have been disinfected the owners of the premises are required to strip and whitewash the ceilings 23 and walls, under the supervision of the Sanitary Inspectors. This applies to all cases of Infectious Disease, and in the event of cases of Phthisis or Cancer occurring, on request, the rooms, as well as the bedding, clothing, etc , are from time to time disinfected. During the year 4.28 houses and 9,690 articles were disinfected. The Council places at the disposal of all medical practitioners, free of charge, means of having the diagnosis of all cases of infectious or contagious disease confirmed or otherwise by bacteriological examination, and also, at the end of the illness, for determining whether the patient is free from the specific bacterium or not. During the year 963 such examinations have been made. While with regard to Diphtheria it is the custom to consider each case infective until the bacteriological examination shows the throat to be free from the true or pseudo-diphtheritic bacillus. V.—GENERAL. Water Courses.—The condition of all the water courses is kept under the constant supervision of your officers. Water Supply. The whole of the eight parishes comprising the district, with the exception of a few cottages, is supplied with a constant service of water. The Metropolitan Water Board supplies the parish of Mitcham; the Sutton Water Company supplies the parishes of Beddington and Woodmansterne and the hamlet of Wallington; the East 24 Surrey Water Company supplies the parishes of Coulsdon and Sanderstead, while the parish of Addington derives its supply from the well sunk in this parish by the Croydon Corporation. With the exception of the water supplied by the Metropolitan Board, all water is derived from deep borings in the chalk. The water is of excellent quality, and in the water supplied by the Sutton Water Company and the East Surrey Water Company, the hardness has been greatly reduced by the use of softening plants. Analyses of all waters in the district are periodically made, and usually disclose a high degree of purity. Sewerage and Drainage. Nearly the whole of the district is sewered, and the sewage is either treated at the Council's Sewage Farm at Mitcham, or at the Croydon Corporation Sewage Farm at Beddington. A large area in the parishes of Beddington, Coulsdon, Sanderstead and Woodmansterne is, at the present time, owing to a dispute with the Croydon Corporation, unfortunately not included within the area specified in the Agreement between the Croydon Corporation and the Rural District Council relative to the reception of sewage by the former body, consequently a number of cesspools are in existence, the periodical emptying of which entails an almost intolerable burden upon the owners. At the present moment, a scheme is being prepared to carry the sewage by means of a tunnel through the hills at Purley and so to reach the Sewage Farm at Mitcham by way of the Beddington and Wallington sewers. It is hoped that by the establishment of this communication the abolition of all cesspools within this area will be effected, 25 Considerable attention is paid to the River Wandle and the Pyl Brook, and it has been found on several occasions that the water has been polluted with the effluent discharging into these watercourses. All necessary steps have been taken in the matter, and permanent improvement is to be expected. House Refuse Removal. The removal of house refuse is effected by the employment of contractors by the various local Committees. Difficulty has been experienced in some districts in securing a suitable tip for the disposal of this refuse, so that it should not be a nuisance. It is probable that in the near future the question of dust destructors in various parts of the district will have to be considered. A great nuisance is experienced, more particularly in the parishes of Mitcham and Wallington, by the importation of offensive London House Refuse. Steps have been taken to minimise this nuisance as much as possible. The difficulty in dealing with this class of nuisance is the fact that Railway Companies as " Common Carriers " are bound to carry this material This nuisance is felt not only by the people who reside within the area of the Croydon Rural District, but also in the neighbouring parishes of Carshalton, Epsom, and Sutton. A conference has been held to discuss the advisability of taking joint action in the matter. Legal Proceedings.—In no case was it deemed necessary to institute legal proceeings. Housing of the Working Classes Acts. During the year 26 houses were dealt with under the Housing of the Working Classes Act. In twenty 26 instances the houses were put into a satisfactory state, four were closed by order of the Council, and the remaining two were voluntarily closed, and remained so at the end of the year. One hundred and seventeen house-to-house inspections were made under the Housing and Town Planning, etc., Act. Notification of Pulmonary Tuberculosis. No system of notification, voluntary or otherwise, with regard to human tuberculosis is in operation in the district, except with regard to pauper patients, when cases are notified under the Public Health (Tuberculosis) Regulations, 1908. During the year. 46 notifications were received. In many cases the sputum of tuberculosis persons has been submitted to bacteriological examination, and disinfection of the rooms and clothing is periodically carried out. Notification of Births Act, 1907. The Notification of Births Act, 1907, lias not been adopted. I regret that the Council are not in a position to apply to the Local Government Board for sanction to adopt this Act, as they do not comtemplate the employment of Health Visitors, nor does any local agency exist in the district which may be employed to ensure the successful operation of the Act. Medical Inspection of School Children. The medical inspection of school children is carried out by the Education Department of the Surrey County Council, but I have in many instances been called in to see children who have been suspected to be suffering from infectious or contagious disease, and my services 27 are always available for this purpose on an application from the Heads of the various schools. Schools. During the year no less than 166 visits have been paid by the sanitary staff to public elementary schools and school premises in the district, and, with the exception of Addington Church School, their condition reflects credit upon the Managers. During the year I have on 13 occasions recommended the closing of schools. REGULATED TRADES. Parish. Dairies. Cowsheds. Milkshops. Butcher's Shops. Slaughterhouses. Piggeries. Bakehouses. Total. Addington .. 3 .. .. .. .. .. 3 Beddington 1 3 5 6 1 3 6 25 Coulsdon 5 10 11 9 5 1 5 46 Mitcham 17 10 18 18 6 45 18 132 Morden 1 4 .. .. .. 6 2 13 Sanderstead 2 4 .. 1 .. .. .. 7 Wallington 2 3 7 7 3 2 4 28 Woodmansterne .. .. .. .. .. .. .. .. Totals 28 37 41 41 15 57 35 254 (1) Dairies, Cowsheds and Milkshops. There were 106 premises registered under the Dairies, Cowsheds and Milkshops Order, 1885, at the end of the year. This is 4 more than in the previous year. Repeated visits have been paid to all the dairies, cowsheds, and milkshops, no less than 455 inspections being made during the year. In 16 instances complaint was made as to uncleanliness and neglect of regulations. 28 MILK SUPPLY. The control of the milk traffic within this area has received a very great deal of attention during the past year. The production of milk within the district is safeguarded in every way. An examination of all cows is made by the Council's Veterinary Surgeon, and in instances where the condition of any cow raises a feeling of doubt as to the desirability of her milk being used for human consumption, bacteriological examination of the milk is at once made, and, pending such examination, the milk has always been voluntarily withdrawn from consumption. An anomalous condition of affairs exist in the parish of Mitcham, Avhere the parish boundary is coterminous with the County of London. In the County of London the various Sanitary Authorities have the right to either refuse to register a milk vendor or to remove such vendor's name from the Register, if a good and sufficient reason exists, but this power is nullified by the want of similar powers outside the London County boundary. It is possible, and it has occurred in many instances, for a man who has been considered unfit to be registered as a milk vendor by the Borough of Wandsworth to move into the parish of Mitcham (in one instance only the small distance of 75 yards), and there he gains access to the Register on his making application to be registered. Now this application for registration must be complied with so long as the man is carrying on a business as a dairyman, or cowkeeper, or purveyor of milk, regardless of the fact that the applicant may have been convicted for offences under the Sale of Food and Drugs Acts with respect to the quality of his milk. 29 It is evident that alteration in the law in this respect is urgently needed. It should be remembered that, as a rule, most milk is consumed either by infants or invalids, to whom, of course, in both cases the quality and purity of the milk is of prime importance. Bacteria develop in milk with extreme facility, and some of these bacteria may originate in unhealthy cows, whilst others come from an extraneous source, such as the air, the fingers of the milkers, or the water used for cleansing the vessels. These organisms multiply rapidly when introduced into the digestive system of, in particular, children, and give rise to serious disturbances, such as diarrhœa, and more particularly to the infantile summer diarrhœa, which is so prevalent during the hot weather, and so fatal to children. This disease is caused by an organism which multiplies prodigiously in milk. Milk should, therefore, remain absolutely unaltered from the time of milking to the time of using, in addition to which no opportunity for the admission of any germ should be afforded. Cooling the milk does not destroy either the pathogenic or non-pathogenic germs, but heat, such as is used in pasteurisation or sterilisation, is of material value. In the process of pasteurisation the liquid should be heated once to 50° C. and then rapidly cooled ; this method enables the milk being sent long distances if properly sealed down. It retards the multiplication, but does not kill the organisms normally found in milk, while sterilisation of milk is achieved by heating the 30 milk to 100° C. for forty-five minutes, and this heat kills nearly all germs, but it is possible that milk so boiled may lose some of its nutritive value. If milk is obtained solely from healthy cows and handled with proper observation with regard to the prevention of admission of dirt or other filth, and if the milk be properly cooled immediately after milking, there is no need for either the pasteurisation, sterilisation, or for the addition of any of the so-called preservatives, which do not in themselves tend to preserve the milk, but to merely mask the putrefactive changes which may have already commenced in the milk. (2) Slaughterhouses. The butchers' shops and slaughterhouses within the district remain much about the same number, and all meat exposed for sale has been under constant supervision. During the year no tuberculous meat was found on any premises. The administration of the Sale of Foods and Drugs Acts is carried out by the County of Surrey, and latterly much attention has been paid by the Inspector in the area of the Croydon Rural District with excellent results. During the year 28'2 visits of inspection were made, and on 9 occasions complaint had to be made of uncleanliness of premises. (3) Bakehouses. There are 35 bakehouses in the District. This is 3 more than the previous year. One hundred and fifty 31 visits were paid to bakehouses, and in 8 instances complaint had to be made as to uncleanliness. One underground bakehouse is in use in this District. (4) Piggeries. There are 57 piggeries in the District, which is 22 more than the previous year. All the piggeries are receiving very special attention from your officers, but several complaints were received during the hot weather respecting the piggeries. In 21 cases piggeries were repaired and improved under the direction of your officers. SANITARY SURVEYOR'S DEPARTMENT. I am indebted to Mr. Chart for subjoined information:— Sewage Disposal Works. The disposal works have been capable of effecting the necessary purification of the sewage, but to meet the needs of the increasing population a further additional contact bed has been commenced. Sewers have been extended in Smithambottom Lane, The Chase, Warwick Road, Howard Road, Woodcote Lane, and through the Model Village, in the Parish of Beddington ; and at Hook Hill and Sanderstead Road, in the Parish of Sanderstead. 32 New Streets and Buildings. The number of new streets and buildings for which plans have been deposited during the year have been as follows:— New Streets. Public Buildings. Houses. Other Buildings. Total. Addington .. .. .. .. .. Beddington 7 .. 201 42 250 Coulsdon .. .. 84 25 109 Mitcham .. 5 191 40 236 Morden .. .. 1 1 2 Sanderstead .. .. 69 5 74 Wallington .. 2 62 11 75 Woodmansterne 1 .. 7 1 9 Total 8 7 615 125 755 The following new streets have been made up and taken over during the year:— In the Parish of Beddington. Bridle Road. Hillside Gardens North. Hillside Gardens South. Milton Road. In the Parish of Coulsdon. Stoats Nest Approach Road. In the Parish of Mitcham. Seaton Road. Langdale Avenue. Whitford Gardens. Elmwood Road. Links Road. Seeley Road. Ascot Road. Boscombe Road. Cromer Road. 33 In the Parish of Sanderstead. Purley Oaks Road. Essenden Road. Brambledown Road. Mayfield Road (footways). In the Hamlet of Wallington. Danbury Mews. VI.—INSPECTORS' WORK. Subjoined appears a summary of the Inspectors work during the past year. It will be seen that 8,939 visits have been paid by them, as against 6,396 last year, 8,798 in 1908, 10,469 in 1907, 9,660 in 1906, 8,905 in 1905, and 7,904 in 1904. I have again to bear testimony to the extreme care and accuracy, and the unceasing vigilance which each Inspector displays in the carrying out of his arduous and trying duties. 34 Summary of Inspectors' Work for the Year 1910. Inspectors. White Payne Rabbetts Fitt Total Total number of visits paid 2535 2383 3280 741 8939 Number of complaints received and investigated 260 47 87 22 416 Number of premises inspected 583 449 873 122 2027 Number of nuisances discovered 188 171 418 117 894 Nuisances abated without report 162 125 319 110 716 ,, ,, after report 25 42 71 3 141 Preliminary notices served 168 153 236 84 641 Legal notices served 20 27 35 6 88 Notices followed by legal proceedings - - - - - Character of Work Done— Houses dealt with under the Housing of the Working Classes Act 9 8 9 - 26 Houses inspected under the Housing and Town Planning Act 22 38 22 35 117 Houses repaired and cleansed generally 153 63 90 56 362 Ventilation of houses improved 9 5 5 2 21 Overcrowding abated — 5 16 5 26 Defective roofs repaired 21 31 20 13 85 Houses under-pinned (damp proof course inserted) or damp walls remedied 44 17 42 3 106 Eaves guttering renewed or repaired 24 32 37 28 121 Water-closets renewed or repaired 72 11 55 10 148 Water-closets provided with water for flushing purposes 5 3 53 17 78 Houses where water supply was reinstated - - - 5 5 Privies or earth-closets re-constructed, improved or abolished - 6 - - 6 Houses supplied with water from the main 2 3 8 - 13 Water cisterns or tanks cleansed or covered 4 4 23 27 58 Yards of houses paved with impervious material 35 17 33 5 90 Paving of yards repaired 38 22 24 20 104 Floors of sculleries paved or repaired 15 12 35 7 69 Ashpits or dustbins provided 49 24 87 27 187 Additional w.c. provided 1 2 — — 3 Cesspools abolished or filled up — 32 1 1 34 Cesspools cleansed 11 308 — 3 322 Houses at which drains were tested 49 46 74 9 178 Houses at which drains were found defective 34 31 39 4 108 35  White Inspectors. Fitt Total Payne Rabbetts Houses at which drains were re-constructed or new provided 11 8 28 4 51 Houses at which drains were cleansed, ventilated, trapped or repaired 44 62 104 23 233 Number of drain tests in course of work done under the two previous headings 42 41 77 7 167 Houses at which inspection chambers in drains were provided 2 8 24 12 46 Stables provided with drainage 2 - - - 2 Premises at which animals improperly kept were removed - 5 9 3 17 Number of inspections of food exposed for sale 157 109 91 28 385 Unsound food destroyed - - 5 boxes fish, 10 rabbits, 36 eggs. 251bs. meat, 5 hearts, leg mutton. - Urinals cleansed and repaired 2 2 12 l 17 Smoke nuisances abated 3 1 - - 4 Offensive accumulations removed 8 11 44 6 69 Number of piggeries 5 1 14 37 57 Piggeries repaired and improved 2 1 12 6 21 Infective houses disinfected and cleansed 133 94 148 53 428 Number of visits to infective houses 285 303 361 55 1004 Number of dairies and milkshops 21 35 34 16 106 Number of visits to ditto 184 163 84 24 455 Number of complaints as to uncleanliness and neglect of regulations 1 5 6 4 16 Number of slaughterhouses 4 5 3 3 15 Number of visits to ditto 122 61 77 22 282 Number of complaints as to uncleanliness - 2 6 1 9 Number of visits to bakehouses 65 28 41 16 150 Number of complaints as to uncleanliness 1 2 4 1 8 Number of visits to butchers' and fishmongers' shops 157 79 91 24 351 Number of drains opened up for examination (Section 41, P.H.A., 1875) - 8 13 - 21 Manure pits provided or repaired 7 2 2 - 11 Number of offensive trades - - - 1 1 Number of visits to ditto - - - 2 2 Quarries or lands fenced - - 6 - 6 * Re-arrangement of Districts, and the appointment of an additional Inspector (Mr. Fitt) took place in September. 36 Articles Disinfected. January 1,034 February 1,131 March 905 April 561 May 746 June 937 July 642 August 629 September 1,100 October 474 November 804 December 727 9,690 APPENDICES. 38 ISOLATION HOSPITAL. The Isolation Hospital, which is situated at Beddington Corner, was opened at the beginning of March, 1899, and since that date 3,217 patients have been admitted. Accommodation.—At the time the Council approved of the plans for the erection of the Isolation Hospital, the population of the district being about 28,000, it was thought that it would be sufficient if accommodation was provided for '28 patients, viz., 10 Scarlet Fever cases, 10 Diphtheria cases, 4 Typhoid Fever cases, and 4 beds for observation purposes. In each succeeding year, however, the shortage of beds became more pronounced, and in 1905 a very considerable enlargement took place by the provision of an additional Scarlet Fever Pavilion of 2'2 beds. The hand laundry was also converted into a steam laundry, and some additional dormitory accommodation provided in the Administrative Block. In 1907 and 1908 very great pressure was placed upon the resources of the Hospital, and on many occasions it was unavoidably overcrowded. After much consideration, the Council, in April, 1909, decided to apply to the Local Government Board for sanction to considerably increase the accommodation of the Hospital itself, and to also provide quarters for a Resident Medical Officer. This new extension was opened in November, 1910. 39 Staff.—The Staff consists of— 1 Resident Medical Officer. 7 Servants 1 Matron 7 Wardmaids. 1 Assistant Matron 1 Seamstress. 11 Nurses 2 Gardeners 2 Laundresses Porter and Portress 2 Engineers Patients. — During the year 429 patients have been admitted, of which number 248 were Scarlet Fever 163 ,, Diphtheria 10 ,, Typhoid Fever 8 ,, Puerperal Fever 5 ,, Erysipelas Forty-one of these patients were admitted by arrangement with other authorities, and 32 were admitted from Merton. Of the 429 patients admitted, 396 were discharged as cured, and 33 died, viz.; 12 from Scarlet Fever, 18 from Diphtheria, 1 from Puerperal Fever, and 2 from Erysipelas. A very careful examination of the throat, nasal passages, and teeth of every patient admitted to the Hospital was made, and it was found that out of the 411 Scarlet Fever and Diphtheria patients admitted, 42 had nasal polypi, 195 had enlarged tonsils, 43 had adenoid growths, 15 had had attacks of tonsilitis, 6 Scarlet Fever and 7 Diphtheria patients had had previous attacks of the same disease for which they were admitted, and 27 were found to be suffering from both Scarlet Fever and Diphtheria. After admission to the Scarlet Fever wards, it was found that several cases of Measles, Chicken Pox, Whooping Cough, and Ringworm were coincident complications of the disease. 40 Parish. Scarlet Fever. Diphtheria. Typhoid Fever. Puerperal Fever. Erysipelas. Total. Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Addington 4 2 1 .. .. .. .. .. .. .. 5 2 Beddington 19 2 17 1 .. .. .. .. 1 .. 37 3 Coulsdon 25 2 5 .. .. .. .. .. .. .. 30 2 Mitcham 87 3 86 9 8 .. 3 1 2 2 186 15 Morden 1 .. 1 .. .. .. .. .. .. .. 2 .. Sanderstead .. .. 3 .. 1 .. .. .. .. .. 4 .. Wallington 68 3 17 4 .. .. .. .. .. 85 7 Woodmansterne 3 .. 2 1 .. .. .. .. 1 .. 6 1 Merton 8 .. 22 2 1 .. .. .. 1 .. 32 2 Carshalton .. .. 1 .. .. .. .. .. .. .. 1 .. Cases admitted by arrangement— Caterham 33 .. 8 1 .. .. .. .. .. .. 41 1 Totals 248 12 163 18 10 .. 3 1 5 2 429 33 41 Deaths under One Year of Age. Deaths at all Ages. Total. Deaths at all Ages. Nett. 11100 25-8 102 118 603 18-1 249 249 48 402 12-0 1901 28-1 105 109 551 16-1 200 200 67 418 12-2 1902 26-0 106 108 585 15-6 219 219 58 424 11-3 litoa 28-2 109 94 585 13-0 203 203 49 431 10-4 1904 27-3 158 123 654 13-9 210 210 77 521 11-0 1905 •25-7 138 98 615 11-2 178 178 92 529 9-r, 1906 26-7 199 124 781 130 204 204 102 679 11-3 1907 24-6 170 103 775 11-6 239 239 113 649 9-7 1908 25-8 126 84 639 11-0 161 161 106 584 10-1 1909 •25-0 130 8-5 649 10-7 208 208 104 545 9.0 Averages for Years, 1900—1909 26-3 134-3 104-6 643-7 13-4 207-1 207-1 81-6 518-2 10-6 1910 23-0 98 67 630 9-9 163 163 100 567 8-9 * Kates calculated per 1,000 of estimated population. 42 Note.—The deaths included in Column 7 of this table are the whole of those registerd during the year as having actually occurred within the district. The deaths included in Column 12 are the number in Column 7, corrected by the substraction of the number in Column 10, and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in Public Institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in Public Institutions elsewhere. The " Public Institutions " to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, suc has hospitals, workhouses, and lunatic asylums. Alist of the institutions in respect of the deaths in which corrections have been made should be given on the back of this Table. Total population at all ages 38071 Number of inhabited houses 7027 Average number of persons per house 4.8 At Census of 1901. Area of District in acres (exclusive of area covered by water) 22766 Institutions within the District receiving sick and infirm persons from outside the District— Cane Hill Lunatic Asylum, in the Parish of Coulsdon. Holborn Workhouse, in the Parish of Mitcham. Holborn Union Schools, in the Parish of Mitcham. Institutions outside the District receiving sick and infirm persons from the District— Surrey County Asylum, at Brookwood. Surrey County Asylum, at Netherne. Carshalton Cottage Hospital, at Carshalton. Croydon Rural District Isolation Hospital, at Carshalton. Joint Small Pox Hospital, in the Parish of Cheam. Croydon General Hospital, at Croydon. Croydon Infirmary and Workhouse, at Croydon. Other Institutions, the deaths in which have been distributed among the several localities in the District— Russell Hill School, in the Parish of Beddington. Royal Female Orphanage, in the Parish of Beddington. Reedham Orphanage, in the Parish of Coulsdon. 43 TABLE II.—Vital Statistics of separate Localities in 1910 and previous years Names of Localities WHOLE DISTRICT. 1 Addington. 2 Beddington. 3 Coulsdon. 4 Merton. 5 Mitcham. 6 Morden 7 Sanderstead. 8 Wallington. 9 Woodmansterne. 10 Year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1900 33304 862 402 102 663 11 9 1 3732 69 31 4 3960 92 50 12 4398 116 48 14 13155 409 185 54 943 26 14 3 936 19 8 0 5002 113 49 10 515 20 8 4 1901 34180 961 418 105 642 14 9 1 3846 85 29 9 4042 90 40 6 4510 164 62 18 13493 409 200 56 960 27 13 3 1001 22 4 1 5152 126 54 10 534 25 7 1 1902 37500 976 424 106 620 10 12 3 4050 84 30 9 4600 108 31 7 5350 168 71 23 14500 428 202 56 1000 25 9 1 1050 15 7 0 5720 120 47 4 610 16 5 3 1903 41120 1166 431 109 620 7 5 1 4750 101 34 6 5150 122 40 9 6060 221 70 20 15500 497 195 57 1018 24 13 5 1260 26 8 2 6330 152 58 8 612 10 8 1 1904 47030 1284 521 158 700 13 11 2 5170 144 45 15 6450 149 41 9 7450 219 75 21 17000 542 247 86 1100 20 7 3 1550 28 16 6 6875 142 74 15 735 23 5 1 1905 54763 1403 529 138 670 11 11 1 5789 123 39 9 7137 150 39 8 9150 258 80 22 20617 642 270 78 1035 29 15 3 1660 28 8 2 7935 155 62 13 770 21 5 2 1906 59800 1600 679 199 695 11 4 0 7050 157 48 11 7860 183 78 14 9290 280 117 32 22550 721 310 118 1025 27 9 1 2040 35 11 0 8340 155 96 19 950 29 6 4 1907 66300 1635 649 170 690 7 7 1 7100 162 55 5 8500 163 69 22 25800 716 286 92 1100 24 12 0 2350 49 16 3 8400 138 76 13 1060 44 8 4 1908 57600 1487 584 126 690 11 2 0 8000 176 56 6 8800 200 88 17 26700 863 330 92 1180 26 10 9 2580 53 13 1 8500 139 77 7 1150 19 8 1 1909 60300 1513 545 130 695 14 5 1 8740 194 58 17 9300 223 49 9 27900 796 318 84 1125 29 11 3 2700 54 15 4 8750 165 80 9 1090 38 9 3 Averages of years, 1900— 1909 49189.7 1289.2 518.2 134.3 668.5 10.9 7.5 1.1 5822.7 129.5 42.5 9.1 6579.9 148.0 52.5 11.3 19721.5 602.3 254.3 77.3 1048.6 25.7 11.3 2.4 1712.7 32 9 10.6 1.9 7100.4 140.5 68.3 10.8 802.6 24.5 6.9 2.4 1910 63600 1466 567 98 695 11 6 0 9840 156 77 7 9900 210 76 12 28400 844 282 62 1220 30 12 3 2880 36 16 1 9480 136 90 10 1185 43 8 3 Notes.—(a) The separate localities adopted for this table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes, or registration sub-districts. Block 1 may, if desired, be used for the whole district- and blocks 2, 3, etc., for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (b) Deaths of residents occurring in public institutions beyond the district are to be included in sub-columns c of this table, and those of non-residents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms "resident" and "non-resident.") (c) Deaths of residents occurring in public institutions, whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. (d) Care should be taken that the gross totals of the several columns in this Table respectively equal the corresponding totals for the whole districts in Tables X. and IV. ; thus the totals of sub-columns a, b, and c should agree with the figures for the year in the columns 2, 3, and 12 respectively, Table I the gross total of the sub-columns c should agree with the total of column 2 in Table IV., and the gross total of sub columns d with the total of column 3 in Table IV. 44 TABLE III—Cases of Infectious Disease notified during the year 1910. Notifiable Diseases. Cases Notified in whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At Ages—Years. 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8 Addington. Beddington. Coulsdon. Mitcham. Morden. Sanderstead. Wallington. Woodmans'rrne Addington. Beddington. Coulsdon. Mitcham. Morden. Sanderstead. Wallington. Woodmanst'rn Totals. At all Ages. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including 166 2 43 108 9 4 .. 1 28 7 100 1 4 22 3 1 17 5 86 1 3 17 2 132 Membranous Croup) Erysipelas 50 .. 2 3 4 35 6 .. 6 4 34 .. .. 5 1 .. 1 .. 2 .. .. .. 1 4 Scarlet Fever 242 2 66 149 20 5 .. 4 26 32 97 3 3 74 3 4 19 25 87 1 .. 68 3 207 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 16 .. 1 4 4 7 .. .. .. 3 11 .. 1 1 .. .. .. .. 8 .. 1 .. .. 9 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 9 .. .. .. 2 7 .. 1 .. 2 6 .. .. .. .. .. .. .. 3 .. .. .. .. 3 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 483 4 112 264 39 58 6 6 60 48 248 4 8 102 7 5 37 30 186 2 4 85 6 355 The Isolation Hospital is situated at Beddington Corner, Mitcham Junction, but is within the Carshalton Urban District. The Small Pox Hospital is situated at Cheam, and is the Joint Hospital for Croydon Borough, \\ imbledon, Penge, and tho Cioydo Rural Councils. 45 TABLE IV.—Causes of, and ages at, Death during 1910. Causes of Death. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the District. Deaths at all ages of all "Residents" belonging: to Localities, whether occurring in or beyond the District. Total Deaths whether of Residents or non "Residents" in Public Institutions in the District. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All ages. - Under 1. 1 and under 5. 5 and under 15. 15 & under 25. 25 & under 65. 65 & upwards. Addington. Beddington. Coulsdon. Mitcham. Morden. Sanderstead. Wallington. Woodmanst'rne 17 18 Cane Hill Asylum Holborn Union Workoouse Measles 5 .. 5 .. .. .. .. .. 1 1 3 .. .. .. .. .. .. Scarlet Fever 12 .. 6 5 .. 1 .. 2 2 3 .. .. 3 .. .. .. Whooping Cough 6 3 1 2 .. .. .. .. 2 1 1 1 .. 1 .. .. .. Diphtheria (including Membranous Croup) 21 1 8 12 .. .. .. .. 2 .. 13 .. 1 4 1 .. 1 Croup 1 .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. .. Epidemic Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Diarrhoea 8 5 2 1 .. .. .. .. .. 1 7 .. .. .. .. .. .. Enteritis 14 11 1 1 .. 1 .. .. 1 1 12 .. .. .. .. .. .. Gastritis 4 1 1 .. .. 1 1 .. 1 1 1 .. .. 1 .. .. .. Puerperal Fever 3 .. .. .. .. 3 .. .. .. 1 2 .. .. .. .. .. .. Erysipelas 4 1 .. .. .. 2 1 .. .. .. 4 .. .. .. .. .. .. Phthisis (Pulmonary Tuberculosis) 46 .. 1 .. 10 32 3 1 12 5 18 1 2 6 1 11 8 Other Tubercular Diseases 14 3 3 5 2 1 .. .. 2 2 8 .. 1 1 .. .. .. Cancer, malignant disease 33 .. .. 1 1 18 13 .. 7 7 9 1 2 6 1 6 3 Bronchitis 32 5 2 .. .. 9 16 .. 4 5 17 1 1 4 .. .. 11 Pneumonia 54 13 10 3 5 19 4 .. 3 7 36 2 .. 4 2 8 1 Pleurisy 1 .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. Other Diseases of Respiratory Organs 6 .. .. .. .. 4 2 .. .. .. 4 1 .. 1 .. 3 .. Alcoholism—Cirrhosis of Liver 6 .. .. .. .. 2 4 .. .. .. 4 1 .. 1 .. .. .. Premature Birth 17 17 .. .. .. .. .. .. 2 5 10 .. .. .. .. .. .. Diseases and accidents of Parturition 23 21 .. .. .. 2 .. .. .. .. 14 1 1 7 .. .. .. Heart Diseases 71 1 2 1 6 32 29 1 12 9 28 1 4 16 .. 15 4 Accidents 18 4 3 2 2 5 2 .. 2 5 9 .. .. .. 2 .. 1 Suicides 4 .. .. .. .. 4 .. .. 2 .. 1 .. .. 1 .. 1 .. Homicide 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. Brain Diseases 63 4 .. .. 1 28 30 2 8 6 27 1 1 18 .. 73 3 Other Septic Diseases 4 .. .. 2 .. 1 1 .. 1 .. 2 .. .. 1 .. .. 1 Kidney Diseases 19 .. 1 .. .. 11 7 .. 4 4 9 .. 1 1 .. 6 .. All other causes 77 8 3 2 5 17 42 .. 9 11 39 1 2 14 1 4 2 All causes 567 98 49 38 32 195 155 6 77 76 282 12 16 90 8 127 36 46 Notes.—(a) In this Table all deaths of " Residents " occuring in Public Institutions, whether within or without the district, are to be included with the other deaths in the columns for the several age groups (columns 2-8). They are also, in columns 9-16 to be included among the deaths in their respective " Localities " according to the previous addresses of the deceased as given by the Registrars. Deaths of "Non-Residents" occurring in Public Institutions in the District are in like manner to be excluded from columns 2-8 and 9-16 of this table. (b) See notes on Table I. as to the meaning of "Residents" and "Non-Residents," and as to the "Public Institutions to be taken into account for the purposes of these Tables. The "Localities" should be the same as those in Tables II. and III. (c) All deaths occurring in Public Institutions situated within the District, whether of " Residents" or of " Non-Residents," are, in addition to being dealt with as in note (a), to be entered in the last column of this Table. The total number in this column should equal the figures for the year in column 9, Table I. (cZ) The total deaths in the several "Localities" in columns 9-16 of this Table, should equal those for the year in the same localities in Table II., sub-columns c. The total deaths at all ages in column 2 of this Table should equal the gross total of columns 9-16, and the figures for the vear in column 12 of Table I. (e) Under the heading "Diarrhoea" are to be included deaths certified as from diarrhoea, alone or in combination with some other cause of ill-defined nature; and also deaths certified as from Epidemic enteritis; Zymotic enteritis; Epidemic diarrhoea. Summer diarrhœa; Dysentery and dysenteric diarrhœa; Choleraic diarrhoea, cholera, cholera nostras (in the absence of Asiatic cholera). Under the heading of "Enteritis" are to be included those certified as from Gastroenteritis, Muco-enteritis, Gastric catarrh, unless from information obtained by enquiry from the certifying practitioner or otherwise, the Medical Officer of Health should have reason for including such deaths, especially those of infants, under the specifiec term "Diarrhoea." Deaths from diarrhoea secondary to some other well-defined disease should be included under the latter. 47 TABLE V.—Infantile Mortality during the Year 1910. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 1 Month. 1—2 Months. 2—3 Months. 3 —4 Months. 4—5 Months. 5 — 6 Months. 6—7 months. 7—8 Months. 8—9 Months. 9-10 Months. 10—11 Months. 11—12 Months. Totals Deaths under One Year. All Causes— Certified or Inquest 20 12 5 3 40 16 6 8 2 3 5 4 6 3 2 4 98 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Common Infectious Diseases- Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken Pox .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous Croup) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Whooping Cough .. .. .. .. .. 1 2 .. .. .. .. .. .. .. .. .. 3 Diarrhœal Diseases — Diarrhœa, all forms .. .. .. .. .. 2 .. .. .. 1 1 .. I .. .. .. 5 Enteritis, Muco-enteritis, Gastro-enteritis .. .. .. .. .. .. 1 3 1 1 .. 4 .. 1 .. .. 11 Gastritis, Gastro-intestinal Catarrh .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Wasting Diseases— Premature Birth 12 .. .. .. 16 1 .. .. .. .. .. .. .. .. .. .. 17 Congenital Defects 1 2 .. 1 4 1 .. .. .. .. .. .. .. .. .. .. 5 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast-milk, Starvation .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Atrophy, Debility, Marasmus 5 5 3 .. 13 3 1 1 .. .. .. .. .. .. .. 1 19 Tuberculous Diseases— Tuberculous Meningitis .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. 2 Tuberculous Peritonitis: Tabes Mesenterica .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Causes— Erysipelas .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. 2 Convulsions 1 1 .. .. 2 .. .. .. .. .. 1 .. .. .. .. .. 3 Bronchitis .. .. .. .. .. 2 .. 1 .. .. .. .. 1 .. .. 1 5 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia .. .. 1 .. 1 2 .. 1 .. 1 3 .. .. 1 2 1 12 Suffocation, overlying .. .. .. 1 1 .. 2 .. .. .. .. .. .. .. .. .. 3 Other Causes 1 .. 1 1 3 .. .. 2 1 .. .. .. .. .. .. .. 6 20 12 5 3 40 16 6 8 2 3 5 4 5 3 2 4 98 Births in the year— Legitimate 1437. Illegitimate 29. Deaths from all Causes at all Ages, 567. Deaths in the year of— Legitimate infants 92. Illegitimate infants 6. Population—Estimated to middle of 1910, 63,600. 48 Table VI.—The Area in Acres, Inhabited Houses, Population, and Density of each Parish in the District in 1891 and 1910. Parish. Area in Acres. Inhabited Houses. Population. Density. Persons per acre. Persons per house. 1891. 1910. 1891. 1910. Persons. Males. Females. Persons. Males. Females. 1891. 1910. 1891. 1910. Addington 3605 132 140 670 346 324 695 355 340 .18 .18 5.0 4.9 Beddington 3128 442 2137 2607 1162 1445 9840 4710 5130 .8 3.1 5.9 4.6 Coulsdon 4314 537 1943 3335 1623 1712 9900 4700 5200 .7 2.2 6.2 5.1 Mitcham 2915 2055 5463 10758 5300 5458 28400 13240 15160 3.6 9.7 5.2 5.1 Morden 1475 138 240 763 387 376 1220 570 650 .5 .8 5.5 5.0 Sanderstead 3150 9(5 616 509 262 247 2880 1340 1540 .1 .8 5.3 4.6 Wallington 823 710 1858 3823 1587 2236 9480 4530 4950 4.6 11.5 5.4 5.1 Woodmansterne 1591 81 233 408 204 204 1185 565 620 .25 .7 5.0 5.0 21001 4191 12630 22873 10871 12002 63600 30010 33590 1.1 30 54 5.0 In no instance are Institutions considered in this calculation. 49 TABLE VII.—Showing Parishes with Institutions. Parish. Area in Acres. Inhabited Houses. Population. Density of persons per acre. Average number of persons per house. 1891. 1910. 1891. 1910. 1891. 1910. 1891. 1910. Persons. Males. Females. Persons. Males. Females. Beddington 3128 442 2137 2607 1162 1445 9840 4710 5130 .8 3.1 5.9 4.6 Royal Female Orphanage .. .. .. .. .. .. 152 — 152 Russell Hill School .. .. .. .. .. .. 366 218 148 10358 4928 5430 Coulsdon 4314 537 1943 3335 1623 1712 9900 4700 5200 .7 2.2 6.2 5.1 Cane Hill Asylum .. .. .. .. .. .. 2198 962 1236 Reedham Orphanage .. .. .. .. .. .. 316 173 143 12414 5835 6579 Mitcham 2915 2055 5463 10785 5300 5458 28400 13240 15160 3.6 9.7 5.2 5.1 Holborn Workhouse .. .. .. .. .. .. 937 598 339 „ Schools .. .. .. .. .. .. 394 212 182 29731 14050 15681 50 TABLE VIII.—Showing the Annual Birth and Death Rates, and Death Rates of Infants for the Year 1910 and 10 preceding years. In the Year. Birth Rate per 1,000 of Population. Corrected Death Bate per 1,000 of Population. Children under 1 year per 1,000 of Registered Births. 1910 23.0 8.9 67 1909 25.0 9.0 85 1908 25.8 10.1 84 1907 24.6 9.7 103 1906 26.7 11.3 124 1905 25.7 9.6 98 1904 27.3 11.0 123 1903 28.2 10.4 94 1902 26.0 11.3 108 1901 28.1 12.2 109 1900 25.8 12.0 11 Average of 10 Years, 1900—1909. 26.3 10.6 104.6 51 TABLE IX.—Showing the Population, Births and Deaths for the Year 1910, and 10 years preceding. GROSS NUMBERS. Year. Estimated Population. Registered Births. Corrected No. of Deaths. Deaths in Institutions. Total. Under 1 year. Under 5 years. 1910 63600 1466 567 98 49 163 1909 60300 1513 545 130 57 208 1908 57600 1487 584 126 75 161 1907 66300 1635 649 170 70 239 1906 59800 1600 679 199 88 204 1905 54763 1408 529 138 41 178 1904 47030 1284 521 158 42 210 1903 41120 1166 431 109 29 203 1902 37500 976 424 106 145 219 1901 34180 961 418 105 154 200 1900 33304 862 402 102 139 249 Average of 10 years, 19001909 49189.7 1289.2 518.2 134.3 84.0 207.1 52 TABLE XI.—Ascertained Cases of Infectious Disease since the adoption of the Notification Act. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 Small-pox .. 7 1 2 .. .. 3 .. .. .. .. 29 9 5 1 1 .. .. .. .. Scarlatina 85 117 316 99 51 65 262 144 84 115 81 161 131 125 181 189 317 209 212 242 Diphtheria 17 16 44 63 26 45 35 107 38 62 87 77 48 169 134 161 190 204 150 166 Membranous Croup .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhoid Fever 9 12 24 12 18 14 13 15 19 15 13 14 11 9 18 33 15 16 9 16 Continued Fever .. .. 1 .. 1 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 1 4 6 1 .. 2 2 .. 4 1 5 5 8 2 3 5 10 5 9 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. *'Cerebro-spinal Meningitus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 .. 2 .. Cholera .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 13 22 31 18 18 33 26 23 29 34 20 35 23 27 44 52 56 36 33 .. ***Measles 237 579 138 458 29 1083 172 1023 251 420 862 636 280 1085 679 954 326 999 472 50 Acute Diarrhœa .. .. .. 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. *Chicken Pox .. .. .. .. .. .. .. .. .. .. .. 162 188 .. .. .. .. .. .. .. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. Totals 362 754 560 664 144 1243 513 1314 421 650 1064 1119 695 1428 1076 1393 917 1474 883 483 * Chicken Pox was a notifiable disease until July 31st, 1903. ** Cerebro-spinal Meningitis was a notifiable disease from the 22nd April, 1907, to April, 1908. *** Measles ceased to be a notifiable disease on the 19th June, 1909. 58 TABLE XII.—Cases of Typhoid Fever (including Continued Fever) in each Parish since Notification was adopted. Addington * Beddington † Coulsdon ‡Mitcham * Morden † Sanderstead * Wallington * Woodmansterne Institutions The District 1890 .. 6 .. 3 .. .. 4 .. 1 14 1891 .. 2 2 2 .. 1 1 .. .. 8 1892 .. 2 .. 4 .. .. 3 .. 1 10 1893 .... 2 4 12 1 .. 1 .. 1 21 1894 .. .. 4 2 .. .. 4 .. .. 10 1895 .. 1 1 6 1 .. 3 .. 3 15 1896 .... 1 2 9 .. l 2 .. .. 15 1897 .. 1 2 6 .. .. 3 .. .. 12 1898 1 .. 1 11 .. .. .. .. .. 13 1899 .. 1 2 4 1 2 1 4 .. 15 1900 .. 1 2 3 .. .. 3 3 .. 12 1901 .. .. 3 3 .. 2 1 .. .. 9 1902 1 2 1 3 1 2 2 .. .. 12 1903 .. .. 5 4 .. .. .. .. .. 9 1904 .. 1 .. 5 .. 1 2 .. .. 9 1905 1 .. 1 8 .. .. .. .. .. 10 1906 .. 2 l 20 .. 1 3 1 .. 28 1907 .. 1 2 10 .. .. .. .. .. 13 1908 .. 3 .. 11 1 .. 1 .. .. 16 1909 .. 1 .. 7 .. .. 1 .. .. 9 1910 .. .. 3 11 .. 1 1 .. .. 16 3 27 36 144 5 11 36 8 6 276 * Water supplied by Sutton Water Company, † „ „ ,, East Surrey Water Company. ‡ „ ,, „ Lambeth Water Company. Addington is principally supplied by the Croydon Corporation. 54 INFECTIOUS DISEASE during 1910. Showing Disease; also place and month of incidence TYPHOID FEVER. Parishes. January. February. March. April. May. June. July. August. September. October. November. December. Grand Totals. Addington .. .. .. .. .. .. .. .. .. .. .. .. .. Beddington .. .. .. .. .. .. .. .. .. .. .. .. .. Coulsdon .. .. .. .. .. .. 1 1 .. .. 1 .. 3 CaneHill Asyl'm .. .. .. .. .. .. .. .. .. .. .. .. .. Mitcham 1 .. .. .. 2 2 1 2 .. 2 .. 1 11 Holborn Schools and Workhouse .. .. .. .. .. .. .. .. .. .. .. .. .. Morden .. .. .. .. .. .. .. .. .. .. .. .. .. Sanderstead .. .. .. .. .. .. 1 .. .. .. .. .. 1 Wellington 1 .. .. .. .. .. .. .. .. .. .. .. 1 Woodmansterne .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 2 .. .. .. 2 2 3 3 .. 2 1 1 16 PULMONARY TUBERCULOSIS. Public Health (Tuberculosis) Regulations, 1908. Parishes. January. February. March. April. May. June. July. August. September. October. November. December. Grand Totals. Addington .. .. .. .. .. .. .. .. .. .. .. .. .. Beddington 1 .. .. .. .. .. .. .. .. 1 1 .. 3 Coulsdon 1 .. .. .. .. 1 .. .. 1 .. .. .. 3 Cane Hill Asyl'm .. .. .. .. .. .. .. 1 .. .. .. .. 1 Mitcham 3 2 1 .. 1 .. 2 6 2 3 2 1 23 Holborn Schools .. .. .. 3 .. .. 3 1 .. .. .. .. 7 and Workhouse .. .. .. .. .. .. .. .. .. .. .. .. .. Morden .. .. .. .. .. .. .. .. .. 2 .. .. 2 Sanderstead .. .. .. .. .. .. .. .. .. .. .. .. .. Wallington .. .. 3 .. 1 .. .. 1 1 .. .. .. 6 Woodmansterne .. .. .. .. .. .. .. .. .. .. 1 .. 1 Totals 5 2 4 3 2 1 5 9 4 6 4 1 46 55 PUERPERAL FEVER. Parishes. January. February. March. April. May. June. July. August September. October. November. December. Grand Totals. Addington .. .. 1 .. .. .. .. .. .. .. .. .. 1 Beddington .. .. .. .. .. .. .. .. .. .. .. .. .. Coulsdon .. .. .. .. .. .. 1 .. .. .. .. 1 2 CaneHill Asyl'm .. .. .. .. .. .. .. .. .. .. .. .. .. Mitcham .. 2 1 .. .. .. .. .. 1 .. 1 1 6 Holborn Schools and Workhouse .. .. .. .. .. .. .. .. .. .. .. .. .. Morden .. .. .. .. .. .. .. .. .. .. .. .. .. Sanderstead .. .. .. .. .. .. .. .. .. .. .. .. .. Wallington .. .. .. .. .. .. .. .. .. .. .. .. .. Woodmansterne .. .. .. .. .. .. .. .. .. .. .. .. .. Totals .. 2 2 .. .. .. 1 .. 1 .. 1 2 9 ERYSIPELAS. Parishes. January. February. March. April. May. June. July. August. September. October November. December. Grand Totals. Addington .. .. .. .. .. .. .. .. .. .. .. .. .. Beddington .. 1 .. .. .. 2 .. .. .. .. 2 1 6 Coulsdon .. .. 1 .. 1 1 1 .. .. .. .. .. 4 CaneHill Asyl'm .. .. .. .. .. .. .. .. .. .. .. .. .. Mitcham 3 3 .. 1 6 .. 3 1 3 5 2 3 30 Holborn Schools 1 .. .. .. .. .. .. .. .. .. .. 1 2 and Workhouse .. .. .. .. 1 .. .. .. 1 .. .. .. 2 Morden .. .. .. .. .. .. .. .. .. .. .. .. .. Sanderstead .. .. .. .. .. .. .. .. .. .. .. .. .. Wallington .. .. .. 1 2 .. .. 1 .. 1 .. .. 5 Woodmansterne .. 1 .. .. .. .. .. .. .. .. .. .. l Totals 4 5 1 2 10 3 4 2 4 6 4 5 50 56 SCARLET FEVER. Parishes. January. February. March. April. May. June. July. August. September. October. November. December Grand Totals Addington .. .. .. 3 .. .. .. 1 .. .. .. .. 4 Beddington 2 6 4 5 2 1 2 .. 1 1 1 1 26 Coulsdon 3 1 3 3 2 1 1 4 8 2 1 3 32 CaneHill Asyl'm .. .. .. .. .. .. .. .. .. .. .. .. .. Mitcham 15 15 10 4 5 2 10 9 13 6 4 4 97 Holborn Schools .. .. .. .. .. .. .. .. .. .. .. .. .. and Workhouse .. .. .. .. .. .. .. .. .. .. .. .. .. Morden .. .. .. .. 1 1 1 .. .. .. .. .. 3 Sanderstead .. 1 .. .. .. .. .. .. .. .. 1 1 3 Wallington 5 14 12 3 7 5 4 3 3 4 3 11 74 Woodmansterne .. .. .. 1 .. .. .. .. 1 1 .. .. 3 Totals 25 37 29 19 17 10 18 17 26 14 10 20 242 DIPHTHERIA. Parishes. January. February. March. April. May. June. July. August. September. October. November. December Grand Totals. Addington .. .. .. .. .. .. .. .. 1 .. .. .. 1 Beddington 1 2 2 2 4 3 3 3 1 1 1 5 28 Coulsdon .. 1 1 .. .. .. .. 1 1 2 1 .. 7 Cane HillAsyl'm .. .. .. .. .. .. .. .. .. .. .. .. .. Mitcham 4 10 11 5 7 5 4 3 11 17 13 9 99 Holborn Schools and Workhouse .. .. 1 .. .. .. .. .. .. .. .. .. 1 Morden .. .. .. .. .. .. .. .. .. .. .. 1 1 Sanderstead .. .. .. 1 2 .. .. .. .. 1 .. .. 4 Wallington 1 4 1 2 1 5 3 3 2 .. .. .. 22 Woodmansterne 1 .. .. .. 1 .. 1 .. .. .. .. .. 3 Totals 7 17 16 10 15 13 11 10 16 21 15 15 166 57 TABLE XIII.—Deaths from Infantile Summer Diarrhoea, showing place of incidence and condition of domestic surroundings. Address. Age. Sex. L. or Ill. Number in family and how many have died of similar complaints. How fed : Cow, Breast or Tin Milk Note conditions and cleanliness of Cooking Utensils. Condition of Notes. Interior of house. Back and front yards. W.C's. Ellen Avenue, Coulsdon 6½ months F. Leg. Five children in family Breast entirely for first three months, afterwards with prepared barley and cows' milk. Iron saucepan used. Clean Booms are dirty. Notice served to cleanse Both paved and good W.C. in back yard, and in good order Bath Road, Miteham 8 months F. Leg. Six children in family Cow's milk and barley food in bottle. Utensils clean Clean Back yard paving good. Forecourt unpaved In order and kept clean Byegrove Road, Miteham 3 months M. Leg. Seven in family Cow's milk and barley water in tubeless bottle. Utensils clean Clean Small part of back yard paved, but is in a dirty state, due to fowls being allowed to run over it W.C. in yard, is in order, but pan is very foul College Road, Mitcham 5 months F. Leg. Four in family; one died eleven years ago Cow's milk and barley water given in bottle with tube ; milk kept in cupboard without external ventilation. Utensils dirty Very unwholesome smell about the house, due to unclean habits of occupants Back yard is paved, but is in a defective condition W.C. in yard, and is in proper order The mother is in a bad state of health, and is unable to attend to household duties Fortescue Road, Mitcham 3 weeks F. Leg. One child in family Cow's milk in tubeless bottle. House left in cleanly state Back yard paved W.C. in order Greyhound Terrace. Mitcham 7 months M. Leg. Three children in family Nestle's Condensed Milk and barley water given in tube bottle. Utensils clean Fairly clean Forecourt and back yard paved W.C. on 6rst floor, soil pan foul Greyhound Terrace, Mitcham 6 months M Leg. Five children in family Nestle's Condensed Milk given in tubeless bottle. Utensils clean The living room is in a somewhat dirty state Back yard is partly paved W.C. is in yard, and in good order Maple Terrace, Mitcham 9 months F. Leg. Two children in family Fed on Bobinton's Batent Barley, later on barley water, lime water, brandy, and white of egg. Utensils enamelled and clean Clean and in good order Paved Clean This house is well situated, and quite open at rear Marian Road, Mitcham 7 months F. Illeg. One other illegitimate child living Cow's milk boiled, and given In tubeless bottle. Utensils clean Kept in a reasonably clean state Back yard partly paved W.C. in yard in proper order The mother, who is 18 years of age, is a lodger at this house, and when at work the child is attended to by the occupiers of the house Miles Lane, Mitcham 5 weeks F. Illeg. •• Breast. Utensils are very clean Very clean Back is pavad, front ununpaved W.C. is outside; soil pan is foul Park Avenue, Mitcham 4 months F. Leg. One child living When child was in South Africa she was given Bobinson's Groats and milk ; when on boat travelling to England, was given malted milk, and since arrival has been given barley water only in a boat-shaped bottle. Utensils clean House very clean Back yard partly paved W.C. on first floor, and in good order Child born in South Africa Portland Road, Mitcham 35 days M. Illeg. Three in family Bottle. Utensils clean Clean Back yard paved, front is unpaved W.C. in good condition Seeley Road, Mitcham 10 weeks M. Leg. Two other children in family Nestle's Condensed Milk given by common bottle with rubber tube. Utensils clean, but food kept in larder with no external ventilation Very clean Forecourt and back yard paved W.C. is on first floor, and in good order Sibthorpe Road, Mitcham 8 months F. Illeg. None Nestle' Milk given in tubeless bottle. Utensils clean Kept in a cleanly state. Premises are damp Back yard is partly paved W.C. is in proper order Sibthorpe road, Mitcham 7 months M Leg. One died of similar complaint seven years ago Nestle's Milk and Dr. Bidge's Patent Food given in tubeless bottle. Utensils unclean Scullery walls damp and defective. Floor defective Back yard is paved, but defective W.C. is in proper order Sibthorpe Road, Mitcham 3 months M. Leg. Seven in family; one died of similar complaint eight years ago Nestle's Condensed Milk given in an old-fashioned tube bottle. Utensils clean House is kept clean Back yard is paved W.C. is', in yard, and in good order Tynemouth Road, Mitcham 7 months M. Leg. One child in family Cow's milk and prepared barley given in tubeless bottle. Utensils clean. House kept in a cleanly state Forecourt and back yard paved W.C. is inside house on ground floor, in good order 58 TABLE XIV.—Table showing Total Deaths from Infantile Summer Diarrhœa, during the ten years, 1901—1910, in each Parish, and in every Street invaded:— ADDINGTON. 1. Badger's Hole; 1. Keeper's Lodge. BEDDINGTON. 4. Bandon Hill. 1. Francis Road. 1. Beddington Lane. 1. Guy Road. 1. Foxley Lane. COULSDON. 1. Brighton Road. 1. Godstone Road. 1. Coulsdon. 3. Lower Road, Kenley. 1. Ellen Avenue. 1. Roke Avenue, Kenley. MITCHAM. 1. Acre Road. 3. Lewis Road. 1. Allen's Cottages, Lonesome. 3. Leonard Road. 2. Allen's Terrace. 3. London Road. 1. Aberdeen Road. 1. Lonesome. 1. Ashbourne Road. 2. Love Lane. 10. Bath Road. 4. Lilian Road. 2. Bailey Road. 1. Lock's Lane. 2. Belgrave Road. 3. Manor Road. 1. Benedict Walk. 1. Maple Terrace. 1. Bond Road. 10. Marian Road, Lonesome. 1. Boundary Road. 1. Miller Road. 1. Broadway. 2. Miles' Lane. 2. Bruce Road. 1. Nicholls' Cottages, Eastfields. 2. Byegrove Road. 1. Norfolk Road. 2. Caithness Road. 1. Marlboro' Road. 5. Chapel Road. 3. Palestine Grove. 1. Chestnut Road. 4. Park Avenue. 2. Church Buildings. 3. Phipp's Terrace. 9. Church Road. 1. Piccadilly. 4. College Road. 1. Pitcairn Road. 2. Commonside. 2. Portland Road. 1. Concrete Cottages. 5. Princes Road. 1. Courtney Road. 8. Queen's Road. 3. Denison Road. 1. Robinson Lane. 2. Devonshire Road. 3. Robinson Road. 1. Durham Place. 1. St. Mark's Road. 1. Eastfields. 1. Sarah Place. 2. Firework Road. 5. Seaton Road. 5. Fortescue Road. 2. Seeley Road. 1, Fernlea Road. 8. Sibthorpe Road. 59 2. Fountain Place. 3. Smith's Buildings. 8. Fountain Road 1. Spencer Road. 2. Gladstone Road. 1. Ravensbury Cottages. 1. Grange Villas, Eastfields 2. Tramway Terrace. 4. Greyhound Terrace. 5. Tynemouth Road. 4. Grove Road. 1. Upper Green. 1. Grove Terrace. 1. Waterfall Road. 1. Hare wood Road. 1. Warren Road. 7. Heaton Road. 4. Western Road. 1. Homewood Road. 2. Westfields. 1. Lewis Cottages. 1. Whitford Gardens. 2. Willow View. MORDEN. 1. Bishop's Cottages. 1. Crown Road. SANDERSTEAD. 1. Mayfield Road. 1. Riddlesdown Road. WALLINGTON. 2. Hackbridge. 2. Ross Parade. 2. Maldon Road. 1. Seymour Road. 2. Manor Road. 1. Wood Street. 2. Percy Road. WOODMANSTERNE. 1. Chipstead Valley Road. 1 St. Dunstan's Cottages. 1. Rutland Cottages. 1. Woodman Road. 60 FACTORY AND WORKSHOP ACT, 1901. The title of this Act is "An Act to consolidate with amendments the Factory and Workshop Acts." It will be seen from the subjoined list that there are now 250 Factories and Workshops on the Register, which is 24 more than last year. All these are periodically visited, and due attention has been paid to maintaining them in such a condition as to comply with the requirements of the Act. During the year 382 visits of inspection were paid, and in 23 instances nuisances or irregularities were found, and 9 written notices were served. FACTORIES AND WORKSHOPS. Trades. Factories. Workshops. Total. No. of Employees. Laundries 9 22 31 386 Cycle Works 1 14 15 25 Carriage Makers and Wheelwrights 1 7 8 26 Distilleries and Essential Oils 1 4 5 28 Printing 5 4 9 63 Brickmaking 2 2 24 Carpenters and Builders 5 12 17 61 Shoeing Forges – 15 15 32 Dressmaking – 15 15 54 Bakeries 1 34 35 66 Harness Making – 4 4 4 Boot making & Repairing 1 18 19 22 Bottle Washing & Marine Stores 4 4 11 Snuff Mills 1 – 1 1 Buff, Parchment, and Chamois leather, Patent leather and Degreasing 2 4 6 115 Dye Extractors 1 – 1 14 Chaff Cutting and Corn Grinding 2 – 2 14 Flour Mills 1 – 1 8 Bedding Manufacturers – 1 1 1 Cardboard ditto 1 – 1 42 Motor ditto 2 – 2 8 61 Trades. Factories. Work shops. Total. No Of Employees Brewers 2 – 2 34 Varnish Making 12 3 15 150 Confectionery Making 1 – 1 300 Saw Mills & Timber yards 3 – 3 11 Silk and Chintz Printing – – – – Artificial Horse Hair Manufacturers 1 – 1 12 Gas Works 1 – 1 419 Watch Making – 3 3 1 Firework Making 1 – 1 119 Mineral Water 1 – 1 20 Chemical Works 2 1 3 86 Margarine Works – – – – Well Boring 1 – 1 2 Iron Works l – 1 50 Cork Cutting l – 1 26 Organ Building l – 1 1 Brush Making l 3 4 10 Belt Making l – 1 20 Sack Making – – – – Trunk Cloth Leather Substitute Making – – – – Golf Club Making – 2 2 4 Smelting Works 2 – 2 44 Engineering 2 – 2 6 Glove Cleaning – 3 3 25 Furniture Making – – – – Tailoring – 1 1 1 Art Printers on Iron, etc. 1 2 3 108 Tobacco Mills 1 – 1 70 Floor Cloth Makers – – – – Monumental Mason – 1 1 3 Cinemetograph Film Manufacturers – 1 1 12 Totals 72 178 250 2539 62 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories (including Factory Laundries) 146 4 Workshops (including Workshop Laundries) 221 5 Workplaces (other than Outworkers' premises included in Part 8 of this Report 15 Total 382 9 63 2.—DEFECTS FOUND. Particulars. Number of Defects Found. Remedied. Referred to H.M. Inspector. Number of Prosecutions. (1) (2) (3) (4) (5) Nuisances under the Public Health Act—* Want of cleanliness 5 5 Want of ventilation – – Overcrowding – – Want of drainage of floors 1 1 Other nuisances 6 6 † Sanitary accommodation insufficient – – unsuitable or defective 7 7 not separate for sexes – – (Sec. 22 of the Public Health Acts Amendment Act, 1890, has been adopted.) The standard of sufficiency and suitability enforced being that in the Order of the Secretary of State, of 4th February, 1903. 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) 4 4 Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) – – Total 23 23 * Including those specified in sections 2, 8, 7, and 8 of the factory and Workshop Act as remediable under the Public Health Acts. † For districts not in London state here whether section 22 of the Public Health Acts Amendment Act, 1890, has been adopted by the District Council; and if so what standard of sufficiency and suitability of sanitary accommodation for persons employed in factories and workshops has been enforced. 64 3 —HOME WORK. NATURE OF WORK* OUTWORKERS' LISTS, SECTION 107. Inspections of Outworkers' Premises. OUTWORK IN UNWHOLESOME PREMISES, Sec. 108 OUTWORK IN INFECTED PREMISES, Sec. 109. 110 Lists received from Employers. Addresses of Outworkers Notice served on Occupiers as to keeping or sending lists Prosecutions Instances. Notices served. Prosecutions. Instances. Orders made (S. 110), Prosecutions (Sections 109, 110). Twice in the year Once in the year Received from Other Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send list. Lists.* Outworkers. † Lists. Outworkers. + Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6. (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— (1) making, etc. 10 10 20 4 16 3 43 (2) cleaning and washing Lace, lace curtains and nets Artificial Flowers Nets, other than wire nets Tents Sacks Furniture, Upholstry Fur pulling Feather sorting Umbrellas, etc. Carding, &c. of buttons, &c. Paper bags & boxes Basket making Brush making 1 1 2 Racquet and tennis balls Stuffed Toys File making Electro plate Cables and Chains Anchors & Grapnels Cart Gear Lock, Latches & Keys Pea picking Total 10 10 21 5 16 3 45 * If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 4 as the case may be) against the principal class only, but the outworkers should be assigned in column 3 (or 5) into their respective classes. A footnote should be added to show that this has been done. † The figures required in column 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 on 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 list of the same employer the same outworkers name will often be repeated. § In view of the wide discrepancies found to exist between the totals when the returns are added together, it is desired that care may be taken to give exact figures. Only those addresses should be counted which have actually been received from or forwarded to other Councils during the year covered by the report. 65 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year (1) Number. (2) Laundries 22 Bakehouses 34 Dressmakers 14 Various 108 Total number of Workshops on Register 178 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories Failure to affix Abstract of the Factory and Workshop Act (s 133) 5 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act, (s. 5) Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspector 1 Other Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year 1 66 INDEX. Accommodation, Isolation Hospital 38 Ages at Death 13, 14, 45, 47 Appendices— Factory and Workshop Act 60—65 Infectious Diseases (number of cases, month, and parish) 54—56 Isolation Hospital 38—40 Tables I. to XIV. (see "T") 41—59 Area 7,48 Articles Disinfected 36 Bakehouses 30, 31 Births in 1910 11—12 Births (1900 to 1910) 41, 43, 51 Birth Rates 12 Birth Rates (1900- 1910) 41, 51 Birth Rates (England and Wales)11, 12, 16 Buildings 31, 32 Bye-Laws, Contravention of 25 Cancer, Disinfecting after 23 Cane Hill Asylum (inmates, deaths, &c.) 45—49 Cases of Infectious Diseases (ages, parishes, &c.) 44, 52—56 Cases of Removal to Hospital 39, 40, 44 Cases of Typhoid Fever (1890—1910) 53 Causes of Death 15—17, 45, 47 Collection of House Refuse 25 Contravention of Bye-Laws 25 Cowsheds, &c. 27 Dairies, Cowsheds &c 27 Deaths 12—17,45,47 Deaths (1900—1910) 41,43,50 Deaths from Zymotic Disease 15 Deaths in Isolation Hospital 39, 40 Deaths, Causes of 15—17, 45, 47 Deaths, Ages at 13, 14, 45, 47 Deaths in Public Institutions 12, 13, 16, 17, 41, 45, 51 Deaths and Death Rates from various causes (Zymotic Diseases, Phthisis, &c.) 15—16 Death Rates 12—16, 50 Death Rates (1900—1910) 41, 50 Death Rates (England and Wales) 16 Death Rates of Infants 13,14 Density of Population 48 Diarrhoea Deaths (Table XIII. XIV.) 57, 58 Diphtheria 20 Diphtheria Cases (month and parish) 56 Disinfecting Articles 36 Disinfecting Houses 23 67 Erysipelas 20 Erysipelas Cases (month and parish) 55 Excess of Births over Deaths 11 Factory and Workshop Act 60—65 Holborn School and Workhouse (Inmates, Deaths, &c.) 45, 49 Hospital, Isolation 38, 40 Hospital, cases removed to 39, 40, 44 House Refuse Removal 25 Houses (Number and Increase) 7—10 Housing of the Working Classes Act 25 Illegitimate Births 11 Increase in Number of Houses 8, 9 Increase of Buildings 31,32 Infantile Mortality 13, 14, 41, 48, 47 Infantile Mortality (England and Wales) 14 Infantile Summer Diarrhœa 18, 19, 57—59 Infectious Diseases 17—21,44,52—56 Inspectors' Work 33—85 Institutions (Inmates, Deaths, &c.) 16, 17, 45, 49 Isolation Hospital— Accommodation 38 Patients admitted 39,40 Staff 39 Deaths from various Infectious Diseases 39, 40 Legal Proceedings 25 Medical Inspection of School Children 26 Milk shops, &c 27 Milk Supply 28—80 Mortality at different ages 13 14, 45, 46 Mortality Rate (Infantile) 50 Mortality Rate (England and Wales) 16 Notification of Births Act 26 Notified Cases of Infectious Disease 44, 52 Patients admitted to Hospital 39, 40 Phthisis 20,21 Phthisis, Disinfecting after 28 Phthisical Death Rate 15 Piggeries 31 Pulmonary Tuberculosis 26 Pulmonary Tuberculosis (month and parish) 54 Population 7, 41, 43, 48 Population, Density 48 Preventive Measures 21—23 Public Institutions (Deaths, &c.) 16, 17, 45, 49 Puerperal Fever 20 Puerperal Fever Cases (month and parish) 55 Pulmonary Death Rate 15 Rates, Birth 12 Rates, Death 12, 13, 14, 15, 16,50 68 Regulated Trades 27 Removal of House Refuse 25 Removals to Hospital 39—40 Scarlet Fever 19 Scarlet Fever Cases (month and parish) 56 Schools 27 Sewage Works 31 Sewerage and Drainage 24,25 Slaughterhouses 30 Staff, Isolation Hospital 39 Table I.—Vital Statistics (1900—1910) 41, 42 Table II.—Vital Statistics (1900—1910), separate parishes 43 Table III.—Infectious Disease Cases (ages, parishes, removals to Hospital) 44 Table IV.—Causes of, and Ages at, Death 45, 46 Table V.—Deaths of Infants at ages 47 Table VI.—Area, Houses, Population, Density (each parish) 48 Table VII.—Area, Houses, Population, Density (parishes with Institutions) 49 Table VIII.—Birth, Death, and Infantile Death Rates (1900-1910) 50 Table IX.—Population, Births, and Deaths (1900—1910) 51 Table XI.—Cases of Infectious Disease (1891—1910) 52 Table XII.—Typhoid Fever Cases in each parish (1891 —1910) 53 Table XIII.—Deaths from Infantile Summer Diarrhoea 57 Table XIV.—Deaths from Infantile Summer Diarrhoea (parish and street) 58 Trades, Regulated 27 Typhoid Fever Cases (1891—1910) 53 Typhoid Fever Cases (month and parish) 54 Vital Statistics (Tables I. to XIV.) 41—58 Water Courses 23 Water Supply 23,24 Zymotic Death Rate 15—16 Zymotic Death Rate (England and Wales 16