THE HEALTH OF EALING. THIRTY-THIRD ANNUAL REPORT (1907), BY Dr. C. A. PATTEN, Medical Officer of 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. Sanitary inspector: H. SHARPE, C.S.I. Clerk : G. T. HILL. THE HEALTH OF EALING, To His Worship the Mayor, Aldermen and Councillors of the Borough of Ealing. It is my honour and privilege to present to you the annual report on the health of Ealing and its sanitary conditions, being the thirty-third occasion of my doing so, and I wish to acknowledge with sincere thanks the help and support invariably accorded to me by the Chairman and members of the Public Health Committee, and also to express to the members of my staff my thanks for the satisfactory and helpful manner in which they have carried out their responsible duties. It is gratifying to be able to inform you that the vital statistics, under all heads, present a favourable aspect, and in several respects exhibit improved Features over the previous year (1906) and the general results may therefore be considered satisfactory. Population. The population of the borough continues to be considerably added to although the rate of increase is not quite so largely marked as in some recent years. Houses of various kinds passed for occupation between June 30th, 1906. and June 30th, 1907, numbered 699, being a small decline compared with some previous years. A considerable portion of these new buildings were erected in the south-western and western parts of the borough, and adapted for the dwellings of clerks, artizans, and members of the working classes. It is needless to trouble the Council with further details on this subject or to explain the difficulties, which increase rather than diminish, the further we get from the last census, in forming the reliable estimate of population, and which a quinquennial census would do mucfh to facilitate. The existing convenient modes of communication with and our accessibility 4 from, all parts of London make it obvious that so long as building areas are available in suitable portions of our district the ratio of increase of our population is not likely to receive a marked check. The conclusion 1 have come to, after careful consideration, is that for the purposes of this report our population calculated at the middle of last year, should be estimated at 49,588 and, therefore, on that number, the death and birth rates are based. Deaths. The deaths registered in the borough during 1907 were 507, but in addition the number of eighty-nine residents, whose deaths occurred outside the confines of our district have to be included, making up an actual total of 596, (males 276, females 320). The death rate on this estimated population of 49,588 is equal to 12.01 per thousand, or one in eighty-three of the population, being .79 less than the previous year. The average death rate for the past ten years is 11.06 per thousand. The general death rate for England and Wales equalled 15.0 per thousand living, and table four shows the distribution of deaths in the wards of the boroughl classified' according to age and causation. Infantile Mortality. Probably greater satisfaction can be expressed in connection with this subject than with any other in this report. It will be in your recollection that last year we had to deplore a very large and regrettable death rate among infants under one year of age, which arose, to a great extent, from fatal attacks of "epidemic summer diarrhoea." These deaths numbered 152, whereas last year they happily dropped to 112, of which nineteen only were due to diarrhoea and allied disorders, and the total of children dying under five years of age was 170. This gives an infantile death rate of 91.2 per thousand, compared with 129.8 in the previous year, an important reduction in this rate of 38.6 per thousand. The infantile mortality for England and Wales was 118 per thousand. I attribute this result to several causes not the least of which were the favourable climatic conditions prevalent 5 during last summer (so far at least as this diarrhceal disorder is concerned) when we were not visited by any long spells of extreme heat or dry weather, and consequently enjoyed a great -immunity from germ laden dust, plagues of flies, etc. I feel I should not leave this topic without alluding to the useful work, voluntarily performed by certain lady visitors, members of the Ealing Women's Association, in the Lammas Ward. They have visited as far as practicable, the homes of mothers who have recently borne children and afforded advice as to the proper feeding and bringing up of the young infants, not only with no inconsiderable success but also with appreciation on the part of the mothers. I should view with much satisfaction the extension of such useful work in certain other portions of the borough. By far the greatest proportion of infants who succumb to this serious disorder are bottle fed, and otherwise improperly fed, whereas among those attacked who are breast fed a very largely diminished mortality occurs. Old Age. 199 persons died aged sixty-five vears and upwards, of whom sixty-three had attained eighty years and upwards and seven over ninety years. Inquests. Twenty inquests were held, the verdicts returned attributing the causes of death as " accidental " in nine instances, " natural" in six, and "suicide" in five cases. Notifiable Diseases. A considerable amount of disease of this class has to be recorded, and was very general throughout the country at some periods of the year and especially during the autumnal months. Within our borough at no time has there been anything of an epidemic character, but rather a more or less continuous chain of cases distributed over all parts, although as would be expected the poorer and most populous portions contributed the largest number of patients. The cases, as a rule, were of a markedly sporadic nature. A serious and 6 sudden outbreak of diphtheria arose in July among children attending St. Mary's Schools, no doubt caused by the inclusion of a child Buffering from sore throat, the character of which had not been suspected early enough to ward off serious consequences. About twenty-four cases rapidly ensued, but temporary school closure and other precautionary measures quickly arrested the mischief. Isolation Hospital. This valuable institution received during the year 230 patients (exclusive of thirteen cases of diphtheria from Isleworth, two from Brentford, six cases of scarlatina from Hanwell, and one from Greenford) of the infectious notifiable class, and has, as usual, been satisfactorily administered, and the patients successfully treated with comparatively few exceptions of a fatal character. The number of scarlatina patients admitted was 138, and of diphtheria ninety-four. Of the former only two cases ended fatally, and of the latter eight. Table 3 gives full details of the total number (333) of notifiable patients with regard to age, locality, etc. They included 174 scarlatina eases, 118 cases of diphtheria, nine of enteric fever, three of puerperal fever, and twenty-nine of erysipelas. The total zymotic death rate is thus equal to .82 per thousand living, a gain of .08 over last year. For England and Wales it equalled 1.26. General Diseases. With regard to the Large class of diseases included under this heading, I confine myself to making a few remarks relative to phtlvsis, which it; answerable for thirtytwo deaths. I have more than once stated how satisfactory it would prove to receive voluntary notification of its presence amongst the poorer classes, and also I desire to remind medical men that we are only too anxious to have the beds at Mount Vernon Hospital, retained by the Council, as continuously occupied as possible. Judging from the mortality, there must be a considerable number of cases ill our midst which would be at least benefited, if not cured, by sanatorium treatment, and it is 7 somewhat difficult to realise why there is a lack of suitable applicants for this advantage. The expenditure by the Council for the retention of beds is costly, and it is regrettable that sometimes tor weeks together it is practically wasted. Of the fourteen applicants for admission, twelve were passed and all derived considerable benefit from their treatment. Births. The births registered in t.he borough during the year were 1,228 (males 632 and females 596), and of these twentyfive were illegitimate. The total number is fifty-seven more than last year, and the largest yet recorded. A birth-rate of 24.7 is thus afforded, being .5 higher than the year before. The natural increase of our population was 632. The birth-rate for England and Wales was 26.3 per thousand living. General Sanitary Administration. On the question of general sanitary administration, 1 have every reason to feel satisfied with the methods adopted to carry it out efficiently. As may be surmised, the duties of inspection have increased largely with the growth of the borough, and especially in connection with the "Factory and Workshops Act," "House to House*' inspections, and visits to "Dailies. Cowsheds and Milkshops." During the year I came, without hesitation, to the conclusion that without the services of an additional sanitary inspector this kind of work would inevitably get into serious arrear with prejudicial results, and, therefore, it was I felt compelled to ask for an increase in my staff, which you have been good enough to grant. Without at meat inspection, for instance, must, owing to the presence of other duties, have received less attention. The returns made by the sanitary inspectors will, as usual, afford detailed information of tihe work accomplished. The number of inspections and re-inspections during the year amounted to a total of 6,402. It is unnecessary to dwell in any detail in connection with this, but great attention has been bestowed on the state of the dairies and 8 daily farms and milk sellers' shops. I have every reason to feel satisfied with their general condition, and if all the milk consumed in this borough was derived from home sources little anxiety on that score need be entertained by the public. But, as we know, a very considerable proportion of it is imported from various outside farms, the surroundings and arrangements in connection with which are, 1 fear, not invariably so surely satisfactory that ordinary precautions should be neglected. Hence it is I have from time to time suggested such measures as pasteurising, sterilising or what can easily be done in every household, simply bringing the milk to the boiling point lor a single moment. By such processes the bacilli of tubercle and those of diseases, which are often milk borne, as diphtheria, enteric lever, etc., are destroyed, and the consumer of the milk so far protected from their invasion. In the process of pasteurisation, these various germs are renidered quite sterile, and the actual taste, colour, and nutritive properties of the milk remain unchanged. It may be well to explain that by the term " pasteurisation " is meant exposing milk, in a proper form of vessel, for twenty to thirty minutes to a temperature of 155 to 165 degrees F. Milk very readily becomes contaminated by gases and effluvia to which it is exposed. To guard against its contamination it should never be kept in dwelling rooms or illventilated places, and never in proximity to decomposing organic matter (dustbins, etc.), and should be lightly covered with muslin or similar substance. The vessels it is kept in should be frequently scalded, and be scrupulously clean. It has been my custom before concluding these reports to make a reference to subjects which strictly belong to the Borough Surveyor's department, but at the same time are of public and: eanitarv interest and importance in their bearing on public health and in connection with which we, from time to time, meet in conference. At the risk of repeating what our Surveyor no doubt reports in due course I am happy to confirm his opinion that the new roads and new properties constructed during the year have drainage arrangements ample and complete, and also that the large number of 9 new roads taken over by the Council have been brought into a fit and proper condition. There are still a few more of the latter remaining to be dealt with, and from a sanitary point of view the sooner they are taken in hand the better. The system of scavenging and general cleansing of the roads has been improved by making them into two divisions each under the supervision of a well qualified foreman. I must also allude to the care which is bestowed upon the collection and removal of house refuse. This is so important a factor in the sanitary well-being of a district that too great attention cannot be given to it, and when it is realised that ten thousand calls for this purpose have to be made every week, and that a complaint is rarely received, I think it sneaks very highly of the method devised to effect so excellent a result. I have occasionally accompanied my colleague on his visits to the sewage works, and have to repeat what I have said on previous occasions, that the drainage works maintain their efficiency, and are quite up to modern requirements. The analyses which have been periodically made of the samples of the effluent taken by the Thames Conservancy and the Middlesex County Council prove the excellence of the processes at work, and the complete purification of the sewage rendered by the bacteria beds. Perhaps the most difficult problem your Borough Surveyor has to encounter is that of the road dust question, and one of supreme importance in relation not only to the health of the population but likewise to their comfort. I am assured that in this matter we are in as good if not better position than any other district in Greater London, and certainly the experiment of laying down slag tar macadam adjacent to the shops and cab rank on Haven Green has been very satisfactory, as the dust has been much lessened. I am glad to learn it is intended to lay a long stretch of this material in the High-street, and possibly elsewhere, the effect of which I shall watch with interest. This subject of dust nuisance abatement is so large a one and so largely associated with health and well-being, as well as comfort, of the country at large, that it is greatly to be 10 wished some suitable system will ere long be devised or discovered to settle by some means legislative or otherwise, a difficult and vexed question. With reference to road watering, your Surveyor is so entirely in accord with me as to its necessity and beneficial effects, that I have no apprehension so important a procedure will be neglected, and the same remark applies to the frequent flushing of the sewers, either with or without disinfectants, according to the character of the season. I believe I have recorded and commented upon sufficiently all subjects of material importance. I am, Your obedient servant, C. A. PATTEN, Medical Offioer of Health. March 2nd. 1908. 12 BOROUGH OF EALING. SANITARY WORK 1907. FORM I. INSPECTIONS— Number of Premises Inspected on Complaint 132 Number of Premises Inspected in connection with Infectious Diseases 333 Number of Premises under Periodical Inspection 313 Houses Inspected from House-to-House 274 Total Number of Inspections and Re-inspections made 6,402 NOTICES— Cautionary or Intimation Notices Given 528 Statutory Orders Issued 332 Summonses Served 1 DWELLING HOUSES— Houses, Premises, &c., Cleansed, Repaired, &c. 595 FORM II. MOVABLE DWELLINGS. CARAVANS, TENTS, &c.— Number Observed during the Year 16 Number Removed from District 16 BAKEHOUSES— Number in District 27 SLAUGHTER-HOUSES— Number on Register 4 Number of Inspections made and Freqnency of Inspection Quarterly COW-SHEDS— Number on Register 8 32 Number of Inspections made and Frequency of Inspection Qaarterly Number of Milch Cows in District About 250 DAIRIES AND MILK-SHOPS— Number on Register 42 Number of Inspections made and Frequency of Inspection Quarterly UNSOUND FOOD— Articles or Parcels Surrendered 3 WATER SUPPLY AND WATER SERVICE— Wells Closed as Polluted 1 Percentage of Houses supplied from Public Water Service 100% Cisterns—New Provided 2 Cleansed, Repaired, Covered, &c 19 Draw-Taps placed on Mains ... ... ... 54 Percentage of Houses supplied on Constant System 100% 13 FORM III. DRAINAGE AND SEWERAGE— Water Closets—Repaired, Supplied with Water, or otherwise Improved 343 Percentage of Houses provided with Water Closets 99.9 Drains—Examined, Tested, Exposed, &c. 270 Unstopped, Repaired, Trapped, &c. 139 Waste Pipes, Rain Water Pipes, Disconnected, Repaired. &c 135 New Soil Pipes or Ventilating Shafts fixed 144 Existing Soil Pipes or Ventilating Shafts Repaired 37 Disconnecting Traps or Chambers Inserted 190 Reconstructed 113 Cesspools—Rendered Impervious, Emptied, Cleansed, &c. 1 Abolished, and Drain connected to Sewer 1 Percentage of Houses Draining into Sewers 99.9 DISINFECTION— Rooms Disinfected 352 Rooms Stripped and Cleansed 18 Articles Disinfected or Destroyed 4,727 DUST— New Bins Provided 107 Periodical Frequency of Dust Removal Weekly. Number of Complaints of Non-Removal received 50 Method or Disposal Destructor. SUNDRY NUISANCES ABATED— Overcrowding 5 Smoke 3 Accummulations of Refuse 61 Foul Ditches, Ponds, &c., and Stagnant Water 5 Foul Pigs and other Animals 46 Dampness 14 Yards Repaved or Repaired 214 Other Nuisances 171 Ventilation under Floors or Damp Course Inserted 55 Rooms Stripped, Cleaned and Repaired, &c. 332 Roofs Repaired 87 14 BOROUGH OF EALING. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Inspections Written Notices. FACTORIES (including Factory Laundries) 21 — WORKSHOPS (including Workshop Laundries) 361 7 Total 382 7 2.—DEFECTS FOUND. Found. Remedied. Nuisances under the Public Health Acts— Want of Cleanliness 18 18 Overcrowding 1 1 Other Nuisances 3 3 Insufficient 2 2 Sanitary Accommodation Unsuitable or Defective 10 10 Not Separate for Sexes 1 1 (Sec. 22, P.H.A.Amen. A., 1890, adopted.) Total 35 35 3.—HOME WORK. OUTWORKERS' LISTS, Section 107. Twice in the year. Lists received from Employers— Lists. Outworkers. Wearing Apparel (making, &c.) 6 20 Once in the year. Lists. Outworkers. Wearing Apparel (making, &c.) 2 5 Addresses of Outworkers received from other Councils 14 Cleaning and Washing 1 Artifical Flowers 1 Addresses of Outworkers forwarded to other Councils 8 INSPECTIONS OF OUTWORKERS' PREMISES— Weartng Apparel (making, &c.) 21 Cleaning and Washing 1 Artificial Flowers 1 15 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year— Bakehouses 27 Laundries 10 Dressmakers 82 Miscellaneous 140 Total number of Workshops on Register 259 5—OTHER MATTERS. Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not unier the Factory and Workshop Act (s. 5)— Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspector 1 Other 1 Underground Bakehouses (s. 101)— In use at the end of the year 7 C. A. PATTEN, Medical Officer of Health. 2nd March, 1908. Table I. Vital Statistics of Whole District during 1907 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 Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number. 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 13 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 1905 46000 1072 23.3 109 101.7 435 9.4 35 — 78 513 11.15 1906 48316 1171 24.2 152 129.8 558 11.5 38 9 73 622 12.8 Averages for years 18971906 37114 796 20.5 93 115.9 393 10.1 20 — — 415 10.8 1907 49588 1228 24.7 112 91.2 516 10.4 43 9 89 596 12.01 * Rates in Columns 4, 8, and 13 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 from outside the District:—Chiswick Isolation Hospital. Institutions outside the District receiving sick and infirm persons from the District : —Isleworth Workhouse and Infirmary, Middlesex County Asylum, Wandsworth. Other Institutions, the deaths in which have been distributed among the several localities in the District :—Nil. Table II. Vital Statistics of Separate Localities in 1907 and Previous Years BOROUGH OF EALING. Names of Localities. Year. Population estimated to middle of each year Births registered. Deaths at all Ages. Deaths tinder 1 year. 1897 30,000 509 328 63 * Whole District 1898 31,000 539 324 61 1899 32,000 589 374 76 1900 33,000 608 353 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 1905 46,000 1,072 513 109 1906 48,316 1,171 622 152 Averages of Years 1897 to 1906 37,114 796 415 93 1907 49.588 1,228 596 112 * Population of separate Wards not known. Table III. Cases of Infectious Disease Notified during the Year 1907. BOROUGH OF EALING Notifiable Disease. Cases Notified in Whoi.e District. Total Cases Notified in Each Locality. No. of Cases Removed to Hospital from each Locality. Total cases removed to Hospital. At all Ages. At Ages—Years. Lammas Ward. Manor Ward. Grange Ward. Drayton Ward. Castlebar Ward. Mount Park Ward. Lammas Ward. Manor Ward. Grange Ward. Drayton Ward. Castlebar Ward. Mount Park Ward. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox — — — — — — — — — — — — — — — — — — — — Cholera — — — — — — — — — — — — — — — — — — — Diphtheria (including Membranous croup) 118 — 40 60 7 10 1 54 15 24 12 8 5 46 14 20 7 2 5 94 Erysipelas 29 2 1 1 2 19 4 13 1 — 6 5 4 1 — — — — — 1 Scarlet fever 174 1 47 90 19 17 — 81 26 16 23 15 13 71 23 12 19 10 3 138 Typhus fever — — — — — — — — — — — — — — — — — — — — Enteric fever 9 — — 1 3 5 — 4 1 — — 1 3 2 — — — — 1 3 Relapsing fever — — — — — — — — — — — — — — — — — — — — Continued fever — — — — — — — — — — — — — — — — — — — — Puerperal fever 3 — — — 1 2 — 3 — — — — — — — — — — — — Plague — — — — — — — — — — — — — — — — — — — — Totals 333 3 88 152 32 53 5 155 43 40 41 29 25 120 37 32 26 12 9 236 Borough Isolation Hospital at South Ealing (Grange Ward) Table IV. Causes of. and Ages at, Death during Year 1907. 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 "on-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. Measles 5 1 2 1 1 — — 1 2 1 — — 1 — — Scarlet fever 2 — 2 — — — — — — — — — — — 7 Whooping cough 4 2 2 — — — — 1 — 1 1 1 — — — Diphtheria 11 — 3 8 — — — — — — 1 — 1 — 11 Enteric fever 2 — — — — 2 — — — 2 — — — — 4 Epidemic influenza 12 — — — 1 4 7 2 5 2 1 1 1 — — Diarrhoea (inc. Mem. Croup) 21 19 2 — — — — 1 1 3 13 — 3 — — Enteritis 2 — 1 — — — 1 — — — 1 1 — — — Puerperal fever 3 — — — 1 2 — — — — 3 — — — Erysipelas 1 — — — — 1 — — — 1 — — — — — Other septic diseases — — — — — — — — — — — — — — — Phthisis 32 2 1 2 5 22 — 6 6 1 9 4 6 — — Other tubercular diseases 16 2 9 3 2 — — 3 — 1 10 1 1 — — Cancer, malignant disease 52 — — — — 26 26 5 13 8 11 8 7 — — Bronchitis 49 10 5 1 2 7 24 10 5 5 19 4 5 — 1 Pneumonia 48 11 3 3 1 14 16 5 6 6 12 11 6 — 2 Pleurisy 3 — — — 1 — 2 — 1 — 1 — 1 — — Other Diseases of the Respiratory Organs — — — — — — — — — — — — — — — Alcoholism 8 — — — — 4 4 2 1 1 2 1 1 — — Cirrhosis of liver Premature births 16 16 — — — — — 3 1 2 3 3 4 — — Diseases and accidents of parturition — — — — — — — — — — — — — — — Heart diseases 45 2 — 2 1 22 18 7 9 7 15 6 1 — — Accidents 10 1 3 — 2 2 2 2 — — 2 — 3 — 3 Suicides 5 — — — 1 4 — 2 1 — 1 1 — — — All other causes 249 46 25 6 5 68 99 32 35 27 68 29 33 — 15 All causes 596 112 58 26 23 178 199 82 86 68 173 81 74 — 43 C. A. FATTEN, Medical Officer of Health. Table V. Infantile Mortality during the Year 1907. Deaths from Stated Causes in Weeks and Months under One Year of Age. BOROUGH OF EALING. Causes of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months Total Deaths under One Year. All Cases Certified 31 4 5 5 45 9 10 5 6 7 9 4 6 7 2 2 112 Uncertified — — — — — — — — — — — — — — — Common Infectious Diseases— Measles — — — — — — — — — — — — 1 — — — i Whooping Cough — — — — — — — — — 1 — — 1 — — — 2 Diarrhceal Diseases— Diarrhoea, all forms 1 1 1 — 3 1 1 — 1 2 1 — — 2 — — 11 Enteritis, Muco-enteritis, Gastroenteritis 1 — — 1 2 — — 1 1 — 1 — — — — — 5 Gastritis, Gastro-intestinal Catarrh — — — 1 1 — 1 1 — — — — — — — — 3 Wasting Diseases— 1 Premature Birth 12 — 2 — 14 — — 1 — — — — — — — 16 Congenital Defects 1 — 1 — 2 — — — — — — 1 — — — — 3 Injury at Birth 2 — — — 2 — — — — — — — — — — — 2 Atrophy, Debility, Marasmus 8 — — — 8 5 i 1 — 1 1 — — 1 — — 18 Tuberculous Diseases — Tuberculous Meningitis — — — — — — — — — — — — — — — 1 1 Other Tuberculous Diseases — — — — — — — — 1 — 1 — — — — 3 Rickets — — — — — — — — — — — — 1 — — — 1 Meningitis (not Tuberculous) — 1 — 1 2 — 1 — — — — 1 — 1 — — 5 Convulsions — 1 — 2 3 1 i — 1 1 1 — — — — — 8 Bronchitis 1 — — — 1 1 3 — — 1 1 1 1 1 — — 10 Laryngitis — — — — — — — — 1 — — — — — — — 1 Pneumonia 1 1 — — 2 — — 1 — 1 2 — 1 2 1 1 11 Suffocation, Overlying — — — — — — — — — — — — — — — — 1 Other Causes 4 — 1 — 5 1 1 — 1 — 1 — 1 — — — 10 31 4 5 5 45 9 10 5 6 7 9 4 6 7 2 2 112 District (or sub-division) of Ealing. Population (estimated to middle of 1907) 49,588. Births in the year legitimate 1,203. illegitimate 25. Deaths in the year of legitimate infants illegitimate infants 112.