EAL3 THE HEALTH OF EALING. THIRTY-FIRST ANNUAL REPORT (1903) by Dr. C. A. PATTEN, Medical Officer to the Borough of Ealing. Ealing. W.: "times" printing and publishing works, broadway. STAFF. Medical Officer of Health: C. A. PATTEN, L.R.C.P., M.R.C.S. Sanitary Inspector: THOMAS HILL, A.R.San.I. Assistant Sanitary Inspector: H. SHARPE, C.S.I. Junior Clerk: G. T. HILL. THE HEALTH OF EALING. To His Worship the Mayor, Aldermen and Councillors of the Borough of Ealing. I have the honour to submit to you my annual report of vital statistics for the year 1905, with observations resulting from the consideration of these and other kindred sanitary subjects. They will be found to be not quite of so highly a satisfactory character as it has been my duty to record from time to time, although the general result may be considered favourable. Our borough still maintains a progressive rate of development, more especially in its west and southern portions, the fact being that building operations are there producing a considerable increase of dwellings adapted for occupation by the artisan and working classes, and out of proportion to the larger houses erected in former years, and still being erected. The causes of the increase of the population of the kind referred to, demanding suitable accommodation, are fairly obvious, and require no detailed elucidation from mo The largely increased facilities of locomotion which has arisen during recent years, will by itself largely account for the development. Population. The difficulty of making a fairly reliable estimate of our population does not diminish, and is not likely to do so during the intercensal period, and it is much to be desired that a general census should be taken more frequently, at least quinquennially. It is interesting to state that the number of inhabited houses in the middle of 1905 was 9,260. compared with 8,756 in 1904, which was an excess of 1,218 houses over the previous year The rate of increase of inhabited houses which took place between 1903 and 1904. has, therefore, not been maintained to the same extent between the same periods of 1904 and 1905; in fact, it only amounted to 444 houses. During the year 1905. 749 houses were passed for occupation by the Surveyor's department, compared with 853 in 1904, being a decrease of fifty-four in number. Due consideration of these data, and other facts, tend to 4 rially alter my estimate of the population at the middle of 1905, which 1 put down at 45,000, when requested to express an opinion several months ago. The conclusion I have come to now is that for the purpose of this report, the population for the middle of last year should be estimated at 46,000, and, therefore, upon that number I have calculated the birth and death rates for the year. Deaths. The deaths actually registered as occurring in the borough during 1905, were 435 (males. 204; females 231), but to this number must be added the deaths of seventy-eight residents which took place outside the district, and are included for purposes of calculation, making up a total of 513. It is only for last year that this information is available so that the increased rate of mortality shown for the past year compared with the previous one is more apparent than real, owing to the deaths of these residents in places outside the borough not having been previously included for calculation. Death Rate. The death rate on this estimated population of 46,000 inhabitants is equal to 11.15 per 1,000, or 1 in 89 of the population. Table No. 1, which is appended shows this rate for the last decade. The annual death rate per 1,000 persons living for 1905 in England and Wales was equal to 15.2. This is 1.0 below the rate in 1901, and lower than the rate in any other year on record. In seventy-four great towns it was 15.7; in 141 smaller towns, 14.4; and in England and Wales, less the 217 towns. 14.9 The usual table (No 4) is appended, showing the distribution of deaths in the different wards of the borough, and classified according to age and causation. Infantile Deaths. The infantile death rate, which includes all infants under one year of age, is calculated in the usual manner on the number of births registered, and is equal to a rats of 101.7. This happily shows a slight decrease in comparison with the previous year, when it was 105.3, and compares very favourably with 1903, which was so high as 136.8. when, during the summer of that year there was a heavy mortality amongst infants from diarrhœa. The infantile death rate per 1,000 births for the whole of England and Wales equalled 128. but in (he seventy-six 5 great towns it was as high as 140. I have on several previous occasions commented on this regrettable waste cf infant life, due, without doubt, in no inconsiderable degree to ignorance on the part of mothers in the matter of feeding, rearing, and general care cf these young children. The feeding is too generally of a ?nost injudicious character, and accounts for a considerable proportion of the mortality. I hope before long to refer again to this subject, and bring it under your notice in greater detail and with certain recommendations. Table No. 5 gives detailed statistics of these infantile deaths, tabulated according to age and causation. Old Age. The number of persons who died above sixtyfive years of age was 146. many of whom attained very advanced age, viz., forty-seven over eighty, and seven over ninety years ot age. Zymotic Disease. Of the seven chief epidemic diseases, often termed zymotic, forty-even deaths occurred during the year, viz.:—Small pox, 0; scarlatina, 2; enteric fever, 3; diphtheria, 6; measles, 13; whooping cough 5; diarrhoea. 18; of which last fourteen were infants under ono year. The so called zymotic death rate, or death from the seven chief epidemic diseases, for the past year equalled 1.02 per 1.000 persons living, as compared with 1.5 in 1904. For England and Wales it was 1.52. Scarlatina. In common with adjoining and other districts, scarlatina was more or less prevalent during the year, but never assumed an epidemic form, although considerable outbreaks of the disease occurred at one period in connection with a private school, but the total number of cases was fewer than in 1904. Diphtheria. Diphtheria attacks show a large increase over the previous year, but here again never assumed an epidemic character, being almost without exception sporadic, and with no definite common or ascertained cause for their production. In this connection 1 would remind my medical brethren that the Council recently sanctioned the free supply of anti-toxin in the case of necessitous patients, and I beg to express the hope that this most valuable adjunct to treatment, when early used, will now be inveriably adopted. 6 Measles. The disease of all others of this type, which was most prevalent, and actually assumed an epidemic nature, was measles, and especially so in the western part of the borough. I gave at length, some months ago, my views to the Council relative to the notification of this disease and came to the conclusion that the disadvantages of such outweighed any probable advantages. Some hundreds of cases, no doubt, occurred, necessitating the undesirable step of temporary closure of one or two elementary schools. It seems to be a fixed idea in the minds of many people that every child must suffer an attack of measles, and that the sooner it is acquired the better. This is a serious fallacy, especially in conjunction with the belief that measles is a trifling complaint. With ordinary care, and medical supervision in each case most patients progress favourably, and serious after-effects, so especially dangerous to young children, will be avoided. To emphasise these statements as to the necessity of care, I may add that measles caused nearly as many deaths in this borough last year as all the other zymotic affections together, infantile summer diarrhoea alone excepted. Phthisis. I do not propose to make any remarks on the subject of general diseases (full particulars of which will be found tabulated in Form No. 4) with the one important exception of phthisis, which was the cause of thirty-seven deaths in the past year. The causes and treatment of this disease have loomed very prominently before the public of late, and it is a satisfaction to me that as I foreshadowed in my last annual report, this Council has joined, in an active and practical way. to help in the movement by the retention of beds in the Mount Vernor. Hospital and Sanatorium. By this means certain pool and eligible persons in the borough suffering from this disease, are treated under more hopeful conditions, and I receive more applications for admission than the accommodation affords. It appears to me that the time for making phthisis compulsorily notifiable has hardly arrived, and would be of comparatively small benefit unless suitable treatment can be arranged for. Voluntary notification, however, I shall be glad to receive, the information relative to each case being considered confidential. I would remark here that I have a strong feeling, more than once expressed in my monthly reports 7 to the Council, that a notice or placard relative to "spitting" should be adopted by the Council and posted in suitable places. 1 think it must have been observed how very materially a notice of this kind deters persons from committing this disgusting offence. Evidence of this is afforded by one's experience when travelling in such conveyances as railway carriages and tramcars where the practice is prohibited. I would add that disinfection of rooms, bedding, etc., after fatal cases of phthisis, is carried our whore medically recommended. Inquests. Fifteen inquests were hell, the verdicts attributing death as due to natural causes in seven oases, to accident in six, and suicide in two. Notifications. In compliance with the Infectious Diseases Notification Act, I have received intimation of 200 cases as against 232 in the previous year, and 324 in 1903. Of the total number of patients 152 received treatment in the Council's I olation Hospital. The cases are classified as follows:— Scarlatina 158 Erysipelas 29 Diphtheria 62 Enteric fever 10 Puerperal fever 1 Of this number, eleven cases proved fatal. It is convenient here to make mention of the inereased facilities for dealing with infectious case, owing to the enlargement of the hospital. This was successfully carried out, and the two fine new blocks, each containing two wards, with smaller rooms for separate treatment, were opened for use in the course of the autumn by the Mayor. It is arranged that these should be utilised by scarlatina patients. In addition to these, the existing old building was partially reconstructed, and adapted for the treatment of diphtheria and enteric fever, the alterations providing for complete separation of the one disease from the other, although under one roof. In addition, increased and greatly improved accommodation was provided for the staff of nurses by moans of enlarging the administrative block and the lodge buildings. It is proposed to retain, for a, time at least, the temporary iron building as an emergency ward. The hospital, in its present enlarged state will enable between sixty and seventy patients to the treated. 8 Births. The births registered during the year numbered 1,072 (males, 529; females, 543), which is slight excess over the number of the previous year, but it affords a slightly lower birth rate, being equivalent to 23.3 of the estimated population, as against 24.07 for 1904. We are, therefore, I regret to say. in sympathy with the falling birth rate in England and Wales, which, although it reached 27.2 per 1,000 of the population, was the lowest on record. The natural increase of our population, that is, the excess of births over deaths, amounts to 559. With regard to general sanitary administration, I have every reason to believe that our system of scavenging maintains its usual efficiency. and certainly the manner in which the read watering was carried out last summer calls for much praise. I look upon this as a most important matter, as above the question of comfort and cleanliness resulting therefrom, enjoyed by ocevpants of houses in all roads (and move especially by those dwelling on our main road, over which such an incessant traffic of all kinds passes), there is the hygienic question of laying the microbe carrying dust which, if not effectually carried out, is, no doubt a considerable factor in the production of certain disorders. With regard to the water supply of the borough I have had no complaints, and I believe its quality to be usually excellent, and its quantity equal to all demands. The general system of drainage is up to its usual standard of efficiency, and there can be no stronger proof of this than the fact that, notwithstanding the very large increase of new roads with their contributory drains completed during the past four or five years, with a resulting large population the existing main drains have proved perfectly competent to deal with the extra quantity of sewage passing through them. The construction of a distinct surfacawater system has, no doubt, materially contributed to that result. Relative to matters in the Borough Surveyor's department, with which I have concern, I can bear testimony to the efficient way in which the sewage has been dealt with at the respective works. The Northern Farm has given off an excellent effluent, with which the authorities of the Middlesex County Council and Thames Conservancy are perfectly satisfied. The new pressing machinery, and the buildings connected therewith are rapidly approaching completion, and within a few weeks will be in full working 9 order. This is an important matter, as permanently solving the question of dealing with the sludge. During the year there was an occasional flooding of the Brent, but in no ease to a serious extent. I beg to congratulate the Council on the acquisition of land laid out in this part of the borough and known as Pitshanger Park. It affords another important open space secured to the public for ever as a recreation ground, and will possibly prove even a greater boon in the future than now, when the land surrounding it becomes built over. At the Southern Works the alterations which are being carried out in connection with the destructors, the construction of additional bacteria beds, the increase of the power of the stone presses, and the proposed erection of an independent chimney shaft, are all subjects of great interest and utility, and afford evidence that these borough works not only maintain their efficiency, but are being brought up to date in every respect. The important subject of sewer ventilation has not escaped my attention, and I am a strong advocate of, and believer in. the sewer ventilation shafts, which have been, and are still being erected in various suitable positions in the borough. Before concluding, I should wish to bear testimony to the active assistance I receive from the sanitary inspectors who, in carrying out the routine work connected with their office, have performed a large amount of valuable service. The accompanying tabulated forms give in classified detail full particulars of the varied duties the sanitary staff is called upon to fulfil, and I am able to certify that inspections, etc. under the provisions of the "Factory and Workshops Act," the "Public Health Acts," and "Daries, Cowsheds, and Milkshops Orders," have received most careful attention, and I consider places affe.;ted by these regulations are in a satisfactory sanitary condition. The systematic meat inspection resulted in the seizure and surrender of considerable quantities of unsound food as set out in the annexed returns. I am, Your obedient servant, C. A. PATTEN. Medical Officer of Health. February 29th, 1904. 10 BOROUGH OF EALIIMQ. SANITARY WORK, 1905. FORM I. INSPECTIONS— Complaints received 136 Cases of Infectious Diseases Notified 260 Number of Premises Periodically Inspected 252 Houses Inspected from House-to-House 183 Total Number of Houses, Premises, &c., Inspected 1,228 Total Number of Re-Inspections after Order or Notice 2,468 Unsound Food Inspections 4,518 Total Number of Inspections and Re-Inspections 8,214 NOTICES— Letters Written and Cautionary Notices Given 348 Statutory Orders Issued 68 DWELLING HOUSES— Houses, Premises, &c., Cleansed, Repaired &c 409 Number of Rooms Stripped and Cleansed 137 Eaves Gutter Repaired or Renewed 15 Roofs Repaired and made Watertight 19 Ventilation Under Floors, or Damp-course Inserted 10 MOVABLE DWELLINGS, CARAVANS, TENTS, &c.— Number Observed during the Year 25 Number Removed from District 25 FORM II. PREMISES PERIODICALLY INSPECTED— Workshops 179 Bakehouses 26 Slaughter Houses 5 Cowshed 8 Dairies and Milkshops 34 UNSOUND FOOD— Inspections 4,518 Seizures ... Meat, 4 Weight 184¼lbs. Surrenders ... Meat. 23 Do. 1.439½lbs. Do. ... Fish, 3 Do. 412 1bs. Do. ... Fruit 1Do. 41bs. WATER SUPPLY AND WATER SERVICE— Wells Closed 1 New Cisterns Provided Cleansed, Repaired, Covered, &c. 16 Draw-Taps Provided to Mains 17 11 FORM III. DRAINAGE AND SEWERAGE— Water Closets—Number of Water Closets substituted for Dry Receptacles 1 Repaired, Supplied with Water, or otherwise Improved 250 Drains—Unstopped, Repaired. Trapped, &c 98 Waste Pipes, Rain Water Pipes, Disconnected, Repaired, &c. 62 Soil Pipes and Drains Ventilated 109 Disconnecting Traps or Chambers Inserted 110 Reconstructed 86 Cesspools—Rendered Impervious, Emptied, Cleansed, &c. 4 DISINFECTION— Rooms Disinfected 232 Rooms Stripped and Cleansed 22 Articles Disinfected or Destroyed 3,828 DUST— New Bins Provided 37 Periodical Frequency of Dust Removal Weekly Number of Complaints of Non-Removal Received 70 SUNDRY NUISANCES ABATED— Overcrowding 5 Smoke 1 Accumulations of Refuse 53 Foul Ditches, Ponds, &c, and Stagnant Water 7 Foul Pigs and Other Animals 32 Other Nuisances 7 Yards Paved and Drained, or Paving Repaired 75 12 BOROUGH OF EALING. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—inspection Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Number of Inspections. Written Notions FACTORIES (Including Factory Laundries). — — WORKSHOPS (Including Workshop Laundries). 377 16 HOMEWORKERS' PREMISES 15 — Total 392 16 2.—defects found. Found. Remedied. Want of Cleanliness 15 15 Overcrowding 2 2 Other Nuisances 3 3 Sanitary Accommodation: — Unsuitable or Defective 10 10 Other offences 7 7 Total 37 37 3.—other matters. Matters Notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 6 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (s. 5):— Notified by 11 M. Inspectors 2 Reports (of action taken) sent to H M. Inspectors 2 Other 1 Underground Bakehouses (s. 101):— In use at the end of 1905 7 Number of Homework:— Lists Outworkers. Lists Received 17 24 Addresses of Outworkers:— Forwarded to other Authorites 8 Received from other Authorities 15 Workshops on the Register (s. 131) at the end of the year:— Workshop Bakehouses 26 Workshop Laundries 6 Dressmaking 70 Miscellaneous 103 Total number of Workshops on Register 205 Table I. Vital Statistics of Whole District during 1905 and Previous Years. BOROUGH OF EALING. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Residents registered in Public Instituions beyond the District. Nett Deaths at all Ages belonging to the District. Number. Rate.* Under 1 Year of Age. At all Ages. Number. Rate per 1000 Births registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 1896 29000 651 20.6 70 107.5 308 9.7 13 — 321 10.6 1897 30000 509 17.8 63 106.9 308 9.3 15 — 323 10.26 1898 31000 539 15.62 61 113.7 309 8.9 15 — 324 9.96 1899 32000 589 16.36 76 128 350 9.72 26 — 374 10.95 1900 33000 608 16.2 67 110 333 8.9 20 — 353 10.09 1901 33274 708 21.2 81 114.4 370 11.1 24 — 370 11.1 1902 33855 789 23.8 89 112.8 400 11.8 15 — 400 11.8 1903 39920 921 23 07 126 136.88 409 10.2 21 — 409 10.2 1904 43780 1054 24.07 111 105.3 466 10.6 — — 466 10.6 Averages for years 1896. 1904 — 716 19.86 82 11505 371 10 — — — — 1905 46000 1072 23.3 109 101.7 435 9.4 35 78 513 11.15 * Rates in Columns 4, 8, and 12 calculated per 1000 of estimated population Area of District in acres (exclusive of area covered by water)—3225. Total population at all ages 33040 Number of inhabited houses 5991 Average number of persons per house 5.5 At Census of 1901. Institutions within the District receiving sick and infirm persons rom outside the District:—Chiswick Isolation Hospital, Brentford Isolation Hospital. Institutions outside the District receiving sick and infirm persons from the District: —Isleworth Workhouse and Infirmary. Other Institutions, the deaths in which have been distributed among the several localities in the District:—West London Hospital, St. Mary's Hospital, Homeopathic Hospital, King's College Hospital, St. George's Hospital, Charing Cross Hospital, Guy's Hospital, Queen Charlotte's Hospital, Fridenheim Hospital, Bedlam Hospital, Marylebone Hospital, Royal Free Hospital, University Hospital, Cancer Hospital, Mount Verncn Hospital, St. Joseph's Hospital, Women's Hcspital, Fulham Infirmary, Hackney Infirmary, Great Ormond Street Hospital, Wandsworth Asylum, Private Nursing Home. Table II. Vital Statistics of Separate Localities in 1905 and Previous Years BOROUGH OF EALING. Names of Localities. Year. Population estimated to middle of each year Births registered. Deaths at all Ages. Deaths under 1 year. * Whole District 1896 29,000 651 321 70 1897 30,000 589 328 63 1898 31,000 539 324 61 1899 32,000 589 374 76 1900 33,000 605 353 67 1901 33,274 708 370 81 1902 33,855 789 400 89 1903 39,920 921 409 126 1904 43,780 1,054 466 111 Averages of Years 1896 to 1904 ) — 716 371 82 1905 46,000 1,072 513 109 *Population of separate Wards not known. Table III. Cases of Infectious Disease Notified during the Year 1905. BOROUGH OF EALING Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in Each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Drayton Ward. Castlebar Ward. Mount Park Ward. Grange Ward. Manor Ward. Lammas Ward. Drayton Ward. Castlebar Ward. Mount Park Ward. Grange Ward. Manor Ward. Lammas Ward. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox — — — — — — — — — — — — — — — — — — — Cholera — — — — — — — — — — — — — — — — — — — Diphtheria 62 1 9 42 5 5 — 11 4 8 20 7 12 9 3 5 6 5 8 Membranous croup — — — — — — — — — — — — — — — — — — — Erysipelas 29 1 — 4 2 17 5 8 2 3 6 2 8 — — — — — — Scarlet fever 158 1 30 97 21 9 — 26 14 18 31 27 42 22 8 11 29 14 36 Typhus fever — — — — — — — — — — — — — — — — — — — Enteric fever 10 — 1 1 3 5 — 3 3 3 — — 1 2 — 1 — — — Relapsing fever — — — — — — — — — — — — — — — — — — — Continued fever — — — — — — — — — — — — — — — — — — — Puerperal fever 1 — — — — 1 — — — — — — 1 — — — — — — Plague — — — — — — — — — — — — — — — — — — — Totals 260 3 40 144 31 37 5 48 23 32 57 36 64 33 11 17 35 19 44 Borough Isolation Hospital at South Ealing (Grange Ward). Table IV. Causes of, and Ages at, Death during Year 1905. BOROUGH OF EALING. Causes of Death. Deaths at the Subjoined Ages of "Residents," whether occurring in or beyond the district. Deaths at all ages of "Residents" belonging to localities whether occurring in or beyond the District. Total Deaths whether of Residents or "Non-Residents" in Public Institutions in the District. All ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Drayton Ward. Castlebar Ward. Mount Park Ward. Lammas Ward. Manor Ward. Grange Ward. Isleworth Infirmary. Measles 13 6 7 — — — — 9 — 1 1 2 — — — Scarlet fever 2 1 1 — — — — — — — — — — — 4 Whooping cough 5 — 5 — — — — — 1 — 2 2 — — — Diphtheria 6 — 3 3 — — — — — — 1 — — — 8 Enteric fever 3 — 1 — 1 1 — — — 1 1 — — — 1 Epidemic influenza 5 — — — 2 — 3 — 1 2 1 1 — — — Diarrhœa 18 14 3 — — 1 — 2 1 — 12 2 1 — — Enteritis 12 9 1 — — — 2 2 — — 8 2 — — — Other septic diseases 5 — — 3 — 1 1 — 1 — 1 1 2 — — Phthisis 37 2 — — 7 28 — 4 6 3 11 5 3 5 — Other tubercular diseases 13 2 3 4 — 4 — 2 4 1 3 1 1 — 1 Cancer, malignant disease 41 — — — — 23 18 7 6 7 5 5 6 4 1 Bronchitis 32 5 6 — 1 6 14 7 2 2 10 6 3 2 — Pneumonia 41 9 11 — — 9 12 6 7 4 12 4 4 1 3 Pleurisy 3 — — — — 2 1 — — — 1 — 2 — — Other Diseases of the Respiratory Organs 5 2 — — — 2 1 — 1 — — — — 4 — Alcoholism 8 — — — — 6 2 1 3 — 1 1 1 — 1 Cirrhosis of liver Venereal Diseases — — — — — — — — — — — — — — — Premature births 19 19 — — — — — 3 1 2 9 2 2 — — Diseases and accidents of parturition 3 — — — 2 1 — — — 2 — — — — 1 Heart diseases 36 — 1 1 2 18 14 3 5 3 9 6 5 3 2 Accidents 8 — 1 — 1 5 1 — — — 2 1 1 — 4 Suicides 4 — — — — 4 — — 2 1 — — 1 — All other causes 194 40 13 3 3 58 77 30 39 26 30 24 16 20 9 All causes 513 109 56 14 19 169 146 76 80 55 120 65 47 40 35 C. A. PATTEN, Medical Officer of Health. Table V. Infantile Mortality during the Year 1905. Deaths from Stated Causes is Weeks and Months under One Year of Age. BOROUGH OF EALING. Causes of Death. 1 Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. | 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes Certified 20 10 5 6 41 4 5 5 11 7 5 7 9 4 4 6 108 Uncertified 1 — — — 1 — — — — - — — — — — — 1 Common Infectious Diseases— - - - - - - - — 2 1 — 1 — 2 — 6 Scarlet Fever —- -- — — - — — — — — —- — 1 — — — 1 Diarhœal Diseases — Diarrhœa, all forms - - - - 1 — 3 1 1 1 2 1 1 — 3 14 Enteritis (not Tuberculous) - — — — — 1 — — 1 — — — — — — — 2 Gastritis, Gastro-intestinal Catarrh - 1 — 1 2 - - — 1 — 2 1 — — — — 7 Wasting Diseases— Premature Birth 13 4 1 — 18 - 1 — - - - - - - - - 19 Congenital Defects — - - - - - - - 1 - - - - - - 1 Atrophy, Debility Marasmus 4 1 3 — 8 - 1 - - - - - 2 - - - 11 Tuberculous Diseases- Tuberculous Meningitis - - - - - - - - - - - 1 - - - - 1 Other Tuberculous Diseases - - - - - - - 1 1 - - - - - - 1 3 Syphilis - 1 1 - - - - - - - - - - - 1 Meningitis (not Tuberculous) — — — — — - 1 — — — — — 1 1 — — 3 Convulsions 1 — 1 2 - — — i — - — — — 1 — 4 Bronchitis — — — 1 1 — — — 1 — — 2 — — — 1 5 Laryngitis — — — — — - — — — — — — 1 - — — 1 Pneumonia — — — 1 1 1 — — 2 1 1 1 - 1 — 1 9 Other Causes 4 3 1 1 9 1 1 1 3 2 — — 2 1 1 — 21 21 10 5 6 42 4 5 5 11 7 5 7 9 4 4 6 109 District (or sub-division) of Ealing. Population (estimated to middle of 1905) 46,000. Births in the year legitimate 1,047. illegitimate 25. Deaths from all Causes at all Ages 513.