EAL5 THE HEALTH OF EALING. THIRTY-FOURTH ANNUAL REPORT (1908.) 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. Chief Sanitarp Inspector: THOMAS HILL, A.R.San.I. Sanitarp Inspectors: H. SHARPE, C.S.I. J. STUBBS, A.R.S.I. Clerk: G. T. HILL. THE HEALTH OF EALING. TO HIS WORSHIP THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF EA LING. I have the honour of submitting to you the following report in connection with the health and sanitary conditions of your Borough for the year 1908, it being the thirty-fourth occasion on which it has been my privilege to present an annual return. I have made this report as brief as possible, avoiding reference to theoretical subjects, and have thus confined myself practically to the same plan adopted in previous returns. I am able to state what I believe will be fully verified by a consideration of the facts shown in the accompanying tables, that the general health and sanitary well-being of the Borough are fully, indeed, better maintained, and, therefore, show no tendency to a falling off of the invariably excellent position we have for so many years been able to occupy in the sanitary world ; and I may safely challenge comparison with any other district of similar size and population. The staff of this health department has worked diligently and successfully throughout the year, as the compiled statements made by it conclusively show. I am much indebted to the inspectors for the way in which their duties have been performed ; a great deal of their labour can hardly be expressed in statistical tables, as in addition to recorded facts much useful work is done by verbal advice and informal suggestions. I believe that under the lead of Mr. Hill tact and discretion are shown by all the inspectors, and a comparatively small amount of their recommendations is opposed or attempted to be disregarded. In 4 quence of the pressure of work devolving upon two inspectors being far more than they could successfully cope with, the Council, early in the year, consented to the appointment of a third with very satisfactory results. We have been fortunate in possessing for considerable periods the services of the two senior inspectors, one for eleven years, and the other for seven, so that there has been no break of continuity or drawback incidental to the installing of new members, but simply an addition to the existing experienced ones—and certain work, especially in connection with house to house inspection, which had of necessity been somewhat neglected, is now satisfactorily carried on. Population. As the time approaches for the taking of another census, and nearer to the end of an inter-censal period, the difficulties increase in arriving at a correct estimate of the population. I have explained this in former reports, and do not now propose to recapitulate it. Deaths. It is satisfactory to be able to state that the death rate for the year shows a decrease of .81 compared with that of 1907. The deaths registered in the borough during the year were 593 (male 289, females 284), including those of residents who died outside its confines, and who have to be included in the total number. The death rate on this calculated population of 51,000 is equal to 11.2 per thousand or 1 in 89 of the population. Table IV. shows the distribution of deaths in the wards, classified according to age and causation. The following summary of vital statistics for 1908 will be found convenient:— Population (estimated to middle of year), 51,000; total number of births, 1,251; birth rate, 24.5; deaths 5 (residents only), 573; death rate, 11.2; infantile mortality rate, 80.7; zymotic death rate, .19; excess of births over deaths (residents only), 678. Comparing the above figures with those for 1907, the following differences will be noted:—An increase of 1,412 in the total population; an increase of 23 in the number of births registered; a decrease of .81 in the number of deaths of residents; a decrease of .2 in the birth rate; a decrease of 10.5 in the infantile mortality rate; a decrease of .63 in the zymotic death rate; the density of the Borough is equal to 15.8 persons per acre. Vital statistics for England and Wales, 1908 :— Births 26.5 per 1,000 Deaths 14.7 ,, ,, Deaths from seven principal zymotic diseases, 1.29; infant mortality, annual death rate of infants under one year per 1,000 births, 121. With regard to the causes of the mortality, a comparison with the previous year is, on the whole, satisfactory, although there is a small increase under the heads of cancer and phthisis. It is sad to reflect that from this latter and other tuberculous complaints 53 deaths have to be recorded. Now that Phthisis is proved to be not an hereditary disease, but an infectious one, it is hoped that the crusade against it will in the near future bear good results. A first official step in this direction has been taken by making the disease compulsorily notifiable amongst certain classes of the community, and thus bringing to the notice of the sanitary authority cases which would otherwise escape its notice and attention. I am happy to be able to state that there appears to be increasing interest shown in the provision made by the Council for the reception of cases of this disease at Mount Vernon Hospital, and the beds retained there have been nearly continuously occupied throughout the year. The disease being a preventible one, there can be no reason to doubt that as time goes on it will be as effectually 6 stamped out as small-pox, for example, has been. With regard to cancer, the only remark I have to make is the consolatory one, that the latest researches conclusively show that the disease cannot be considered an hereditary one. Infantile Mortality. It is especially satisfactory to be able to record a still further decrease in the number of deaths under this head. The total number of deaths of infants under one year are 101, against 112 in 1907, and 152 in 1906. This is the lowest number registered since 1900 (sixtyseven), notwithstanding the increase of population in the interval. The reasons for this happy result are several; one being the temperate summers of the past two years, which greatly spared these infants the fatal incidence of diarrhceal diseases; and another, which in my opinion has great influence in one of the poorer districts of the borough, and should not be overlooked, viz., the exceedingly useful work voluntarily performed by members of the " Ealing Women's Health Association " in South Ealing. I referred to this beneficent work in my last annual report, and from further experience I am still more strongly impressed with the excellent results achieved. It should be realised that this society is actually, and most efficiently carrying out solely at its own cost, within a limited area, work of a preventive character relative to infantile mortality, a duty, too, which in many districts not dissimilar to ours, is performed by paid health visitors, and one which no ordinary sanitary male inspector can possibly fulfil. In my official position I am only too ready to afford any assistance possible to this society, so greatly do I appreciate its valuable work. An infantile death rate of 80.7 is a gratifying result to record as against 121 under one year per thousand for England and Wales. 7 Old Age. One hundred and twenty-nine persons died aged seventy years and upwards ; of these sixty-three had attained eighty, and six over ninety years of age; one also was a centenarian. Inquests. Twenty-three inquests were held, the verdicts returned attributing the causes of death as " acci. dental " in nine cases, " natural causes " in ten, and as suicide, in four cases. Notifiable Diseases. Under this heading: I am able to make a most satisfactory statement, a great reduction in the number of cases notified having occurred in comparison with the previous year. The case rate is 3.8 per 1,000 of population. A considerable amount of this class of disorder is sure to prevail in a district like ours; but at no period of the year did it assume any serious proportions, although more prevalent in the poorer and more thickly populated portions of the borough. Scarlatina, as a rule of a benign type, afforded the largest number of infectious cases, and of these only one died. This disease accounts for 108 of the total of 194 notifications. Diphtheria came next with forty-three, five cases of which proved fatal; and erysipelas with thirty-six and two deaths. Only five cases of enteric fever were notified, and of this number four contracted the disease outside the borough. Two cases of puerperal fever were also reported. Each of these two latter diseases resulted in one death. Thus 139 fewer cases were notified than in 1907. 8 The Isolation Hospital. The zymotic death rate equalled .19 per 1,000. This institution, as in former years, has been largely requisitoned for the reception and treatment of the infectious sick, but, fortunately, owing to the smaller number of such cases seeking admission, there has been considerably less pressure than usual on its resources throughout the greater part of the year; 108 cases in all were treated, or under treatment, against 236 in the previous year—a decline of 128 patients. The admissions included twenty-nine diphtheria, seventy-seven scarlatina, and two enteric fever patients, and there were only three fatal results; this represents a hospital death rate of 2.77 per cent, on admissions; a fact reflecting credit on the medical and nursing staff. Table III. gives full derails respecting age, locality, etc., in connection with these notifiable and hospital patients. Births. The 1,251 births (male 647, females 604) registered were the largest number yet recorded in the borough, being twenty-three in excess of the previous year, and affording a birth rate of 24.5 per 1,000, being an inappreciable reduction on that for 1907. The natural increase of population, i.e., the excess of births over deaths, was 678. General Sanitary Administration. Under this important heading I am able to inform you that the various duties connected with it have been fully performed with much good result. Especial attention has been bestowed on the inspection of dairy farms, dairies, and milk-shops. "House to house" inspections have been continuously carried out by myself and the inspectors, and many insanitary 9 conditions have been abolished or materially modified. The requirements of the " Factory and Workshops Act " have been complied with, and the inspection of meat and food generally has demanded much time, care, and skill on the part of Mr. T. Hill, the senior inspector. The decision come to by the Council to take action in certain cases in connection with diseased or unsound meat, etc., cannot but have good and far-reaching consequences. The total number of inspections and re-inspections amounted to 9,174 during the year, and will be found in full detail in the inspectors' forms appended to this report. This number is 2.772 in excess of inspections made in 1907. In my last, and in some former reports, I have made special allusion to the important question of milk and its supply, and I hardly think it necessary here to refer at length to that matter, but I wish to reiterate the opinion that it is very essential and necessary whenever practicable that milk should either be pasteurized, sterilized, or even brought for a single moment to the boiling point before its use as food. By such processes the bacilli of tubercle, diphtheria, enteric fever, etc., are destroyed or rendered inert, and the consumer of the milk in a very large degree protected from disease. As a general rule the sanitary state of premises connected with the supply of milk has been found satisfactory, and no serious disorder attacking the comparatively few cows which give milk in the district has been reported. With probably as much as 98 per cent. of our milk supply being drawn from distant areas, it is wise to adopt precautions. The "Milk Bill" promised by the President of the Local Government Board to be introduced shortly, may possibly give sanitary authorities extended powers in connection with their milk supply. It will, I trust, be considered that a considerable amount of useful, practical work has been done during the year, and I feel assured no really important or urgent matter has failed to receive attention. I 10 believe, however, we have now arrived at a point in our local history when it is safe to predict that our present sanitary staff will for a long time to come prove sufficient for its work. You are aware that during the year the important duty of " medical inspection of school children " became compulsory, and has been actively carried on by Dr. Arthur and Miss Gough, respectively the medical inspector and health visitor appointed by the Council for the purpose. This subject has been specially reported on to the Education Committee, and I need make no further allusion to it here. As "school medical officer" it is my duty to pay quarterly visits to all the elementary schools in the borough, and exercise a supervision over their general and hygienic condition. This, I am able to state, is satisfactory—and as a result of no serious outbreak of infectious disease having occurred in any department, no school closure has been necessary. Before concluding this report 1 wish to state that when I am brought into contact with the Borough Surveyor and his department, I continue to receive, as in former years, and which I greatly appreciate, the utmost assistance in carrying out my duties. From information afforded me it appears that the class of houses erected during the year differs but little from that of previous ones ; two-thirds of the dwellings being of the smaller class, necessitating, what I believe is fully done, the most careful supervision on the part of the building inspectors. It is, perhaps, not to be expected that our population will increase during the next few years with the same ratio of rapidity that it has done in the immediate past. A possible indication of this is the fact that only 421 houses were passed for occupation last year, against the number of 699 given in my report for 1907. I am aware that this may be exceptional and due to a variety of causes such as depression in the building trade, etc. The important " public works " under the control of the 11 Borough Surveyor continue to be carried out with the usual care and completeness. Some alteration has been made in the system of collecting " house refuse," and with success, for so satisfactorily is this performed that, notwithstanding the 11,000 calls which are made weekly, a complaint is rarely received. At an early period it is intended to improve the handling of this refuse at the Destructor Works, which will fully justify the Borough Surveyor's proposal. With regard to the treatment of the sewage it is gratifying to know that the system carried out for so many years by your Borough Surveyor is a continued success; and the " Finding of the Royal Commission on Sewage Disposal " justifies work done at the Ealing Works, and proves that it is practicable to deal effectively with sewage, and obtain a good effluent suitable for discharge into flowing water, without having subjected it to land filtration, etc. In these days of change, your Borough Surveyor may feel proud of the fact that the process he has used for forty years at your works at South Ealing continues an absolute success. I may add that the " bacteria treatment " is carried out at a minimum cost, owing to the material used in the filter beds being clinker from the destructors. The highly necessary work of flushing the sewers continues to be systematically performed, and doubtless the absence of objectionable and harmful effluvia arising from them is greatly the result of this cleansing. Again, the "dust question" calls for a few remarks, it being of great importance from the sanitary point of view. Apart from its discomfort, much danger to health exists in connection with it, owing to the "micro-organisms" and other hurtful suspended matter it contains. It has been calculated that the number of dust particles in a cubic inch of fresh air varies from about 2,000 in the open country to upwards of 3,000,000 in towns, while in inhabited rooms the number may be ten times as great as that 12 last mentioned. Doubtless many otherwise inexplicable attacks of disease are caused by dust, and, therefore, in addition to the palliative process of laying it as far as possible by frequent watering, it is highly essential to discover some preventive to lessen the evil, so far at least as roads are concerned. Of many materials in the market, several have been tested in Ealing with varying success. There is a concensus of opinion, in which your Borough Surveyor concurs, that before deciding on any one in particular, it is expedient to give a still longer trial to those " dustlayers " he has already experimented with. I am pleased to see that the planting of trees along the side of the roads is still being continued. Ealing has always taken the lead of other suburbs in making this a distinctive feature, and I hope will always do so. Since 1874, when a commencement of this work was made, 12,000 trees and shrubs of various kinds have been planted. Finally, I wish to express to the Chairman and other members of the Public Health Committee, my sincere thanks for their support and assistance in my work during the year, which has greatly added to its interest and value. To myself, personally, it is a matter of great satisfaction that his Worship the Ma\or, as Chairman of the Committee, has found it possible, notwithstanding his manifold engagements, to continue to preside at its meetings, as he has done for many years past. I am, Your obedient servant, C. A. PATTEN. Medical Officer of Health. March ist, 1909. 13 BOROUGH OF EALING. SANITARY WORK 1909. FORM I. INSPECTIONS— Number of Premises Inspected on Complain 138 Number of Premises Inspected in connection with Infectious Diseases 194 Number of Premises under Periodical Inspection 366 Houses Inspected from House-to-House 382 Unsound Food Inspections 537 Total Number of Inspections and Re-inspections made 9,174 NOTICES— Cautionary or Intimation Notices Given, and Letters Given 472 Statutory Orders Issued 450 DWELLING HOUSES— Houses, Premises, &c., Cleansed, Repaired, &c 778 FORM II. BAKEHOUSES— Number in District 27 SLAUGHTER-HOUSES- Number on Register 5 Number of Inspections made and Freqnency of Inspection Quarterly COW-SHEDS— Number on Register .. 7 Number of Inspections made and Frequency of Inspection Quarterly Number of Milch Cows in District About 200 DAIRIES AND MILK-SHOPS— Number on Register 44 Number of Inspections made and Frequency of Inspection Quarterly UNSOUND FOOD— Articles or Parcels Surrendered 12 WATER SUPPLY AND WATER SERVICE— Percentage of Houses supplied from Public Water Service ... 100% Cisterns Cleansed. Repaired, Covered, &c. 21 Draw-Tups placed on Mains 45 Percentage of Houses supplied on Constant System 100% 14 FORM III. DRAINAGE AND SEWERAGE— Water Closets—Repaired, Supplied with Water, or otherwise Improved 398 Percentage of Houses provided with Water Closets 999 Drains —Examined, Tested, Exposed, &c. 302 Unstopped, Repaired, Trapped, &c. 252 Waste Pipes, Ram Water Pipes, Disconnected, Repaired. &c 169 New Soil Pipes or Ventilating Shafts fixed 129 Existing Soil Pipes or Ventilating Shafts Repaired 43 Disconnecting Traps or Chambers Inserted 201 Reconstructed 114 Cesspools—Abolished, and Drain connected to Sewer 1 Percentage of Houses Draining into Sewers 99.9 DISINFECTION— Rooms Disinfected 135 Rooms Stripped and Cleansed 18 Articles Disinfected or Destroyed 2,605 DUST— New Bins Provided 136 How Frequently is Dust Removed from each House ? Weekly. Number of Complaints of Non-Removal received 43 Method or Disposal Destructor. SUNDRY NUISANCES ABATED— Overcrowding 15 Smoke 6 Accummulations of Refuse 65 Foul Ditches, Ponds, &c., and Stagnant Water 6 Foul Pigs and other Animals 27 Dampness 38 Yards Repaved or Repaired 232 Other Nuisances 205 Roofs Repaired 119 Ventilation under Floors Provided 81 Rooms Stripped and Cleaned 651 15 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) 17 — WORKSHOPS (including Workshop Laundries) 293 6 Total 310 6 2.—DEFECTS FOUND. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts— Want of Cleanliness 11 11 — Overcrowding 3 3 1 Want of Drainage of Floors 1 1 — Other Nuisances 4 4 — Sanitary Accommodation — Insufficient, Unsuitable or Defective, Not Separate for Sexes 15 15 — Total 34 34 1 3.—HOME WORK. OUTWORKERS LISTS, Section 107. Twice in the year. Lists received from Employers— Lists. Outworkers. Wearing Apparel (making, &c.) 6 26 Cleaning and Washing 1 16 Once in the year. Lists. Outworkers. Wearing Apparel (making, &c) 2 5 Addresses of Outworkers— Received from other Councils 12 Forwarded to other Councils 10 Artificial Flowers 1 INSPECTIONS OF OUTWORKERS' PREMISES— Weartng Apparel (making, Ac.) 33 Cleaning and Washing 16 Artificial Flowers 1 OUTWORK IN UNWHOLESOME PREMISES, SEC. 108— Instances 4 Notices Served 4 16 4.—REGISTERED WORKSHOPS. Workshops on the Register (s 131) at the end of the year— Bakehouses 27 Laundries 10 Dressmakers 85 Miscellaneous 148 Total number of Workshops on Register 270 5.-OTHER MATTERS. 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 2 Reports (of action taken) sent to H.M. Inspector 2 Other 1 Underground Bakehouses (s. 101)— In use at the end of the year 6 C. A. PATTEN, Medical Officer of Health. Table I. Vital Statistics of Whole District during 1908 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 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 24.07 111 105.7 466 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 – 73 622 12.8 1907 49588 1228 24.7 112 91.2 516 10.4 43 9 89 596 12.01 Averages for years 18981907 39073 867 21.2 98 114.3 414 10.2 23 – – 442 11.1 1908 51000 1251 24.5 101 80.7 497 9.7 22 0 76 573 11.2 * 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 33031 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 1908 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 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 1907 49.588 1,228 596 112 Averages of Years 1898 to 1907 39,073 867 442 98 1908 51,000 1,251 573 101 *Population of separate Wards not known. Table III. Cases of Infectious Disease Notified during the Year 1908. BOROUGH OF EALING Notifiable Disrase. Casks Notified in Whole District. Total Casks 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. Drayton Ward. Manor Ward. Castlebar Ward. Grange Ward. Mount Park Ward. Lammas Ward. Drayton Ward. Manor Ward. Castlebar Ward. Grange 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) 43 1 12 15 8 7 – 22 3 6 5 2 5 16 2 3 2 2 4 29 Erysipelas 36 — 1 3 6 25 1 23 3 2 2 2 4 — — — — — – – Scarlet fever 108 — 28 57 15 8 — 49 21 16 10 2 10 38 18 12 3 1 5 77 Typhus fever — — — — — – — — – — — — — — – — — — — Enteric fever 5 — — 2 — 3 — – — 1 — 3 1 – — 1 — — 1 2 Relapsing fever — – — — — – — – — – – — — — — — — — — — Continued fever – — — — — — — — — — — — — — — — — – — — Puerperal fever 2 — — — — 2 — 2 — — — — — — — — — — — — Plague – — — — — — – — — — — — – — — — — — — Totals 194 1 41 77 29 45 1 96 27 25 17 9 20 54 20 16 5 3 10 108 Borough Isolation Hospital at South Ealing (Grange Ward). Total available beds, 73. Number of diseases that can be concurrently treated, 3. Table IV. Causes of, and Ages at, Death during Year 1908. 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. Measles 1 — 1 — — — — — — — — 1 — — Scarlet fever 1 — 1 – – – – – – – – – – 1 Whooping cough 12 6 6 — — — — 1 — — 8 2 — 1 Diphtheria (inc. Mem. Croup) 5 — 3 2 — — — 1 — – 2 — — 4 Enteric fever 1 — — — — 1 — — — — — 1 Epidemic influenza 12 — — — 1 5 6 3 3 — 3 — 3 — Diarrhoea 6 5 1 — — — 1 — — 4 1 — — Enteritis 11 8 1 1 — — 1 — — 4 4 – 3 – Puerperal fever 1 — — — — 1 — — — 1 — — — Erysipelas 2 — — — — 1 1 — 1 1 — — — Other septic diseases — — — — — — — — — — — — — — Phthisis (Pul. Tuberculosis) 40 — 2 5 5 24 4 6 4 5 18 4 3 — Other tubercular diseases 13 2 3 – 3 5 — 4 — 1 5 2 1 — Cancer, malignant disease 42 — — — — 29 13 9 7 7 7 7 5 — Bronchitis 36 6 2 1 — 11 16 7 4 2 14 7 2 – Pneumonia 36 6 4 — 1 16 9 5 2 2 17 5 3 2 Pleurisy 2 — – 1 — 1 — 1 — — — 1 — Other Diseases of the Respiratory Organs – – – – – – – – – – — — — — Alcoholism 6 — — — – 6 – 1 1 1 1 2 — Cirrhosis of liver Premature births 19 19 — — — — – 1 2 2 9 3 2 — Diseases and accidents of parturition 1 – – – – 1 – — 1 — — — — — Heart diseases 58 1 2 1 5 25 24 11 12 6 10 10 8 1 Accidents 15 2 1 3 2 4 3 3 — 1 4 2 2 3 Suicides 7 — — — — 6 1 1 — 1 4 — — 1 All other causes 246 46 12 3 5 67 113 35 36 34 61 44 27 9 All causes 573 101 39 16 23 202 192 89 74 67 172 90 61 22 C. A. PATTEN, Medical Officer of Health. District (or sub-division) of Ealing. Population (estimated to middle of 1908) 51 000. Births in the year legitimate 1,223. illegitimate 28. Deaths in the year of legitimate infants illegitimate infants 101. Table V. Infantile Mortality during the Year 1908. 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-]0 Months. 10-11 Months. 11-12 Months Total Deaths under One Year. All Causes Certified 25 8 4 6 43 10 9 7 6 10 4 4 4 0 2 1 100 Uncertified — — – – — — – — — — — — 1 — — 1 Common Infectious Diseases— Measles – – – – – – – – – – – – – – – – – Whooping Cough — – — — — — 1 1 1 2 — 1 — — — — 6 Diarrhœal Diseases — Diarrhœa, all forms – – – – – 1 1 – 1 1 1 – – – – – 5 Enteritis, Muco-enteritis, Gastroenteritis – – – – – – – 2 1 1 – – – – – 1 5 Gastritis, Gastro-intestinal Catarrh – – – – – – 1 1 1 – – – – – – 3 Wasting Diseases— Premature Birth 16 2 – 1 19 – – – – – – – – – – – 19 Congenital Defects 2 1 — — 3 2 – – – – 1 — — — – – 6 Want of Breast-milk, Starvation — 1 — 1 2 – – – – – — — — – – 2 Atrophy, Debility, Marasmus 5 2 1 2 10 3 1 – – 1 1 – 1 – 2 – 19 Tuberculous Diseases— Tuberculous Meningitis – – – – – – – – – – – – – – – – Other Tuberculous Diseases — — — 1 1 – — – — – — – — 1 — — 2 Rickets — – – – – – – – – – – – – – – – – Meningitis (not Tuberculous) — — — — – — – — — – — — — — — — — Convulsions — 1 — – 1 2 1 2 — — — — — — — — 6 Bronchitis — 1 1 – 2 1 1 – – 1 — – 1 — — — 6 Laryngitis — — – – – – – – – — 1 — — — — 1 Pneumonia — – — – – – 1 1 2 1 – — 1 — – — 6 Suffocation, Overlying — – – – – 1 – 1 – – – – – – – – 2 Other Causes 2 — 2 1 5 — 2 – — 2 1 2 1 – — — 13 25 8 4 6 43 10 9 7 6 10 4 4 4 1 2 1 101