THE HEALTH OF EALING. THIRTY-FIFTH Annual Report (1909) 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 Sanitary inspector : THOMAS HILL, A.R.San.I. Cert. Insp. of Meat and other Foods. Sanitary Inspectors : H. SHARPE, C.S.I. Cert. Insp. of Meat and other Foods. 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 EALING. I have the honour of presenting to you the following report on the health and sanitary conditions of the Borough of Ealing for the year 1909. I regret that, in one or two particulars, it is not quite so satisfactory as on some previous and similar occasions; but what may be termed the less favourable points are few and, with one or two exceptions, not of a marked character. I must refer more especially to a slightly increased death-rate, and to a material falling-off of the birthrate. These, however, are agreeably contrasted with a considerable decline in infantile mortality. Population. The question of estimating the population of a still increasing and progressing borough such as ours, is not lessened towards the end of an inter-censalperiod, and the error one is most likely to be led into is of rather over-estimating than under-estimating the population increase year by year. A census is to be taken next spring, which will enable the estimate of the population for the year, at least, to be correctly arrived at. I have explained in more than one previous report the difficulties to be encountered in connection with this subject, and I do not consider it necessary to repeat them. I may state that for the purpose of calculating the vital statistics and rates as affecting this return, I have estimated the population of the borough at the middle of last year to be 52,550 persons. There is evidence that the falling-off in the number of new houses erected in the borough which 4 has been apparent in one or two recent years is coming to an end; as a distinct revival is shown by the fact that ninety-one houses in excess of the previous year, were passed for occupation in 1909, and a considerable development of building is going on in various parts of the district. Deaths. During the past year the deaths, at all ages, of people belonging to the district, number 632 (males 302, females 330), as compared with 573 in 1908—an increase of fifty-nine. This total number includes the deaths of eighty-two residents in public institutions beyond the district; of twenty-five in public institutions within the district, and of seven non-residents, whose deaths are registered in the borough and have to be included in the total. The calculated death-rate per 1,000 of the estimated population is 12.02, being an increase of .82 over that of the previous year. Table 4 shows the distribution of deaths in the wards, classified according to age and causation. It is convenient here to summarise the vital statistics for 1909 :— Population (estimated to the middle of the year), 52,550; total number of deaths of residents only, 550, but including the eighty-two referred to above, an actual total of 632; equal to a death-rate of 12.02 per 1,000, or one in every eighty-three of the population; infantile mortality rate, 76.0; zymotic death-rate, 1.04, including the deaths from what are styled"the seven principal zymotic diseases," viz., measles, small-pox, scarlet fever, diphtheria, whooping cough, diarrhoea, and " fevers." The total number of births is 1,184 (boys 627, girls 557), equal to a birth-rate of 22.53 per 1,000, or nearly 2 per 1,000 less than in 1908. Excess of births over deaths, 552. A comparison of these data with those for the year 1908, shows an increase of population of 1,550, a decrease of sixty-seven in the number of births registered, an increase of fifty-nine in the number of deaths of residents—an increase in the 5 zymotic death-rate of .85—and the reduction of 4.7 in the infantile rate of mortality. The density of the borough population is equal to 16.2 persons per acre. The vital statistics in England and Wales (1909) are given as follows, viz., births 25.6 per 1,000 living; deaths, 14.5; principal epidemic diseases, 1.12; deaths under one year to 1,000 births, 109. A consideration of the causes which have contri buted to a slightly increased death-rate need not give rise to anxiety, as the circumstances to which it is largely due were not entirely unexpected or unlooked for. For instance, the periodical return of measles occurred in the earlier months of the year, and accounted for twenty-two deaths, and whooping cough appeared subsequently, the majority of the cases of both diseases occurring in the southern and western portions of the borough. The twenty-two deaths from measles compare with only one in 1908, and there were nineteen deaths from whooping cough, being an increase of seven over the previous year. These diseases, when attacking the very young, are serious, and the majority of deaths from measles occurred in children under five years of age—nineteen out of the total of twenty-two. Among a certain, section of the inhabitants of the poorer districts a lamentable amount of ignorance still prevails regarding the precautions to be taken, and the necessity for the seeking of medical advice, in the earliest stages of these disorders. In no small degree the excessive death-rate of measles is due to a want of care and ignorance of the very serious nature of these diseases, especially when associated with complications. Diseases of the respiratory organs were responsible for many more deaths than in 1908; the weather conditions of the year, no doubt, predisposing to these disorders ; no fewer than 117 deaths were due to pneumonia and bronchitis, against seventy-two in 1908. There were fifty-four deaths from cancer, being an increase of twelve, and thirty-eight deaths from phthisis, being two less than the year previous. 6 I referred in my last report to the fact that notification of this latter disease among certain classes had been adopted, but the number is a small proportion only of the total. However, it enables the sani tary authority in many instances to afford advice as to the precautions which should be adopted; and "spit bottles" or cups are loaned when needful, and the necessary disinfectants supplied. Disinfection of rooms, bedding, etc., is done in all cases where practicable. In the course of the year I suggested to the Public Health Committee that as pulmonary tuberculosis is largely spread by material discharged by the lungs when coughing, it would be desirable to have notices exhibited prohibiting spitting in public places, and I am glad to record that this has been determined on. Our arrangements with Mount Vernon Hospital is taken advantage of by those phthisical patients recommended for such treatment, although necessarily in numbers limited to the amount of accommodation. Thirteen patients were recommended for admission during the year, many deriving much benefit; but it is regrettable that in many instances patients do not come under observation sufficiently early, and, of course, when the disease is considerably advanced, the treatment is necessarily palliative instead of curative, as in the earlier stages. The average stay of these thirteen patients in the hospital was sixty days. From these observations on the chief mortality causes of the year, there is evidence to show that had it not been for the exceptional epidemic influences at work in connection with measles and whooping cough, our death-rate would have shown no falling off, slight as it is, compared with that of the previous year. Infantile Mortality. With regard to the infantile mortality of ninety deaths, it is exceedingly satisfactory to be able to show such a material reduction in the death-rate, this being the lowest I have yet had to record. During the past year this death-rate fell to 76.0 per 1,000 births 7 tered, against 80.7 in 1908, and during the last ten years the maximum rates reached were 136.88 in 1903, and 129.8 in 1906. During the last few years there has been a steadily progressive decline of this rate, and the question naturally arises as to the causes of this satisfactory result. No doubt, climatic conditions very materially contribute to a greater or less mortality among these infants, and during the past year there prevailed cold weather during the late summer and the autumnal months, being the season when epidemic diarrhoea is most prevalent. This is doubtless an important influencing cause in connection with the subject, but it is not to be lost sight of that in two of the poorest, if not the poorest and most largely populated parts of our borough, very beneficent and valuable work is being carried on through the voluntary agency of the "Ealing Ladies' Health Society," which not only affords help in kind to children of necessitous families where illness exists, but instructs mothers as to the proper feeding and bringing up of infants. In the face of the serious fact that in the country generally the birth-rate is steadily decreasing, and to which Ealing provides no exception, the importance of checking the sad waste of infant life is beyond question. Sanitary authorities are now becoming alive to the necessity of adopting means to this end, and the most effective measure appears to be the work performed by properly qualified female health visitors. It must be borne in mind that the valuable influences alluded to above only affect one portion of our borough; indeed, it may be said that they are practically restricted to two wards—the Lammas and Drayton. As I write, I learn that a creche is being established in South Ealing, to be supported by voluntary agency. These institutions are of valuable use to mothers at work, who are necessarily compelled to leave their infants at home for long intervals, and for the most part imperfectly looked after and attended to. The result of skilled care for such children is obviously valuable. I may add that the appointment of a health visitor has 8 already been made, or is about to be made in adjoiningdistricts, and I am of opinion that ere long it will be advisable that this matter should receive careful consideration by the Council of this borough. Old Age. One hundred and seventy persons died over seventy years of age; sixty-nine over eighty years; and eight ninety years and upwards. Inquests. Inquests were held on twenty-nine occasions. The verdicts returned the causes of death as "accidental" in ten cases, "natural causes" in sixteen, and "suicide" in three instances. Notifiable Disease. A considerable number of these disorders have to be noted; their distribution gives no evidence of an epidemic type, and for some considerable periods during the summer and early autumn there was a marked absence of these notifiable diseases. They prevailed above the average in number throughout the country, and in our borough were more numerous during the first and last quarters of the year. The largest proportion of the scarlatina cases appeared to be of a sporadic character, as careful investigation failed to show in a large majority of the cases the origin of the infection. The number of notifications received was 271, being an increase of seventy-seven over the previous year, and they are thus classified, viz., scarlatina, 160 (being 52 in excess of 1908); diphtheria, 48 (an excess of five compared with 1908); erysipelas, 35 ; enteric fever, 6; puerperal fever, 4; pulmonary tuberculosis, 18. These latter cases, as I have stated, are notified by Poor Law medical officers, and appear for the first time in the category. At present, pulmonary tuberculosis, with the above exceptions, is only voluntarily notifiable, and I should be glad to receive intimation 9 of any case where the sanitary authority's help or attention is likely to be useful. Excluding tubercular cases, this affords a notifiable rate of 4.78 cases per 1,000 of the population, and compares very favourably with other large towns, such places, for instance, as Torquay and Leamington being only slightly lower. Notwithstanding the considerable number of scarlatina attacks, no case terminated fatally; but four children died of diphtheria. The enteric fever patients, without doubt, contracted the disease outside the borough; at all events, in each case there was the strongest presumptive evidence to that effect. Two cases ended fatally. The Isolation Hospital received for treatment 172 of the total number of 271 cases notified, viz., 140 scarlatina patients, twenty-seven suffering from diphtheria, and two from enteric fever. There is every reason to feel satisfied with the administration of this institution, and the treatment of the patients, under the respective care of the matron and its medical officer. The hospital death-rate on admissions was 1.19 percent. With regard to the general sanitary administration of the borough, I believe the accompanying forms will give full information of the amount of work performed by the sanitary staff. Their duties have been carried out systematically and continuously, and my thanks are due to Mr. Hill and his colleagues. "House to house" inspections have received special attention, and form a not inconsiderable part of the duties. It is hardly necessary to refer in detail to the inspections under the " Factory and Workshops Act," etc., as the requirements in connection with them have been efficiently and regularly complied with, and close attention has been directed to the condition of dairies, milk shops, etc., which, without exception, are in a proper sanitary condition. It will be noticed that the total number of inspections and re-inspections amounted to 12,501 during the year. This is an increase of 3,327 over those made 10 in the previous year, and is largely due to frequent inspections of meat and other food-stuffs. I may here repeat in connection with the latter, what I have year by year stated, that it is very essential and needful whenever practicable to pasteurise, sterilize, or even bring for a single moment to the boiling point all milk before its use as food. By such processes the bacilli of tubercle, diphtheria, enteric fever, etc., are rendered inert, and the consumer of the milk is proportionately guarded against disease. I have regularly carried out my quarterly visits to the numerous elementary schools of the Council, and have reason to consider them generally in a satisfactory hygienic state. It has been unnecessary to resort to any school closure during the year. The "medical inspection of school children" has been most carefully and efficiently performed under the able supervision of Dr. Arthur and Miss Gough, and the results will be embodied in a separate report to the Education Committee. Public Works. On the subject of public works under the Borough Surveyor's administration, it is my custom to make a few remarks, which is always a pleasing duty, because the results shown year by year are so successful and generally satisfactory in connection with this important matter. As usual, when my duties bring me into relation with the Borough Surveyor and his department, I continue to derive every assistance and information. I have paid occasional visits to the Northern and Southern Works, which are conducted in a highly efficient method, and one of the chief features of the year has been the clarification of the bacteria beds. Probably in no sanitary district in the country has the system of bacterial purification been so severely and completely tested as in this borough, one set of beds having been worked for nearly eight continuous years. The time, however, arrived when, in the opinion of the Borough Surveyor and myself, these beds required renewal, and the process has been duly carried out at 11 both sets of sewage works. The removal of clinker forming these beds, the cleansing of the same, and their re-making has occupied a considerable period, but the result is they are restored to original usefulness, and rendered serviceable for several more years of continuous filtration. Their success is borne testimony to by the monthly analysis reports of Professor Kenwood. The last report issued by the Royal Commission on Sewage Disposal contains the important conclusion that a high degree of purification can be obtained without passing sewage over and through land (a process which has never been resorted to at the Southern Works), and it must be peculiarly gratifying to the Borough Surveyor to know that his system of sewage treatment is endorsed by so high and independent authority. Owing, too, to the manufacture of artificial stone, etc., it can be fairly said that no waste occurs directly or indirectly at either the Northern or Southern Works. Again, it is satisfactory to comtnent on the freedom from offensive smells emanating from the public sewers throughout the borough. In years gone by complaints of such were frequently received, and I believe their absence is due to the system of linking up the sewers, abolishing deadends, and the erection of numerous ventilating shafts. So successful have these means been that more than a year has elapsed since I heard of annoyance caused by offensive sewer odours. A free current of air can now circulate through these main sewers, and with their frequent and thorough flushing the drainage of the borough may be said to be practically perfect. And another important result of the system is that floodings, with their subsequent inconvenience and damage, no longer occur. I may add that the scavenging, as usual, is most efficiently performed. It is not out of place, I think, to refer to the work of laying slag-tar on some of the roads, notably in the neighbourhood of Haven Green and the Grove. This marks a great advance upon the ordinary road-making, and although it involves a slightly higher initial cost, in my opinion, as your Medical Officer, I am convinced that 12 this is amply compensated for by more economical upkeep, a great diminution in the dust nuisance, more effective cleansing, and a lessening of noise. Roadwatering last summer, owing to climatic conditions, was reduced to a minimum, but on occasions this necessary and salutary matter received due attention. I can confirm the very great improvement brought about by the relaying of the wood pavement of the main road, which is evident to all who travel over it, but it is a matter of regret that the portion of it belonging to the London United Tramways Company is, as I suppose is necessary, being so continuously opened up. Upon the subject of new buildings passed by the Surveyor's Department, it appears, as I have previously mentioned, that the check to their extension, which has been apparent for one or two previous years, is passing away, as the numbers approved by the department number 512. This is evidence that the extension of the borough shows no indication of limit under this head, and is perhaps more apparent where it might least have been expected, and that is in the extreme northern portions of the borough. I believe I have now referred to most subjects of interest relating to the borough during the year, and, in conclusion, I beg to express my thanks to this committee for the kindness and assistance I have, as usual, invariably received from all its members, and I share, in common with them, the gratification felt that Mr. Alderman Kasner, notwithstanding his arduous duties as Mayor, was able to regularly preside as chairman at our meetings. I am, Your obedient servant, C. A. PATTEN. Medical Officer of Health. 13 BOROUGH OF EAING. SANITARY WORK 1909. FORM I. INSPECTIONS— Number of Premises Inspected on Complaint 134 Number of Premises Inspected in connection with Infectious Diseases 271 Number of Premises under Periodical Inspection 338 Houses Inspected from House-to-House 480 Unsound Food Inspections 3,769 Total Number of Inspections and Re-inspections made 12,501 NOTICES— Cautionary or Intimation Notices Given, and Letters Written 620 Statutory Orders Issued 377 DWELLING HOUSES— Houses, Premises, &c., Cleansed, Repaired, &c 808 FORM II. MOVABLE DWELLINGS, CARAVANS, TENTS, &c.— Number Observed during the Year 4 Number Removed from District 4 BAKEHOUSES— Number in District 29 SLAUGHTER-HOUSES— Number on Register 5 Number of Inspections made and Frequency of Inspection 20 Quarterly and at times of Slaughter. COW-SHEDS— Number on Register 7 Number of Inspections made and Frequency of Inspection Number of Milch Cows in District 28 Quarterly About 150 DAIRIES AND MILK-SHOPS— Number on Register 49 Number of Inspections made and Frequency of Inspection 196Quarterly UNSOUND FOOD— Articles or Parcels Seized 2 Condemned by Magistrate 2 Articles or Parcels Surrendered 14 WATER SUPPLY AND WATER SERVICE— Percentage of Houses supplied from Public Water Service 100% Cisterns Cleansed, Repaired, Covered, &c 19 Draw-Taps placed on Mains 91 Percentage of Houses supplied on Constant System 100% 14 FORM III. DRAINAGE AND SEWERAGE— Water Closets—Repaired, Supplied with Water, or otherwise Improved 388 Percentage of Houses provided with Water Closets 90 9 Drains - Examined, Tested, Exposed, &c. 319 Unstopped, Repaired, Trapped, &c. 315 Waste Pipes, Rain Water Pipes, Disconnected, Repaired. &c 120 New Soil Pipes or Ventilating Shafts fixed 115 Existing Soii Pipes or Ventilating Shafts Repaired 16 Disconnecting Traps or Chambers Inserted 174 Reconstructed 96 Cesspools—Rendered Impervious, Emptied, Cleansed, &c. 1 Percentage of Houses Draining into Sewers 99.9 disinfection— Rooms Disinfected— Ordinary Infectious Diseases 356 Phthisis 24 Rooms Stripped and Cleansed 14 Articles Disinfected or Destroyed— Ordinary Infectious Disease 3.702 Phthisis 129 DUST— New Bins Provided 130 How Frequently is Dust Removed from each House ? Weekly. Number of Complaints of Non-Removal received 47 Method or Disposal Destructor. SUNDRY NUISANCES ABATED— Overcrowding 21 Smoke 2 Accumulations of Refuse 48 Foul Ditches, Ponds, &c., and Stagnant Water 1 Foul Pigs and other Animal 32 Dampness 47 Yards Repaved or Repaired 298 Other Nuisances 227 Rooms Stripped and Cleaned 575 Ventilation under Floors Provided 99 Roofs Repaired 75 15 BOROUGH OF EALING. FACTORIES, WORKSHOPS, WORKPLACES, AND HOMEWORK. 1.—inspection. Including Inspections made bi/ Sanitary Inspectors or Inspectors of Nuisances. Written Inspections. Notices. FACTORIES (including Factory Laundries) 19 1 WORKSHOPS (including Workshop Laundries) 414 7 Total 533 8 2.—defects found. Referred to H.M. Found. Remedied. Inspector. Nuisances under the Public Health Acts— Want of Cleanline 21 21 — Overcrowding 3 3 — Other Nuisances 5 5 — Sanitary Accommodation— Insufficient 4 4 — Unsuitable or Defective 44 44 — Total 77 77 - 3.—home work. OUTWORKERS LISTS, Section 107. Twice in the year. Lists received from Employers— Lists. Outworkers. Wearing Appa'el—Making, &c 10 36 Cleaning and Washing 1 16 Addresses of Outworkers— Received from other Councils 15 Forwarded to other Councils 7 INSPECTIONS OF OUTWORKERS' PREMISES— Weartng Apparel—Making, &c 34 Cleaning and Washing 16 Artificial Flowers 1 Stuffed Toys 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 28 Laundries 10 Dressmakers 87 Miscellaneous 123 Total number of Workshops on Register 248 5.—other matters. Failure to affix Abstract of the Factory and Workshop Act (s. 133) 10 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not unler 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 7 C. A. PATTEN, Medical Officer of Health. 3rd March, 1910. Table I. Vital Statistics of Whole District during 1909 and Previous Years. BOROUGH OF EALING. Year. Population estimated to Middle of each Year. Births. Total. Deaths Rgisterrd 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. Nrtt Draths at all Ages bri.ong1ng to the District. Number. Rate. Under 1 Year of Age. At all Ages. Number. Kate per 1000 Births registered. Number. Kate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1899 32000 589 16.36 76 128 0 350 9.72 26 - - 374 1095 1900 33000 608 16.2 67 110.0 333 8.9 20 — — 353 1009 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 49.588 1228 24.7 112 91.2 561 10.4 43 9 89 596 12 01 1908 51000 1251 24.5 101 80.7 497 9.7 22 — 76 573 11.2 Averages for years 1899. 1908 41073 939 22.14 102 111.1 437 10.3 24 - - 467 11.19 1909 52550 1184 22.53 90 76 0 567 10.59 25 7 82 632 12.02 * Kates in Columns 4, 8, and 13 calculated per 1000 of estimated gross population. Area of District in acres (exclusive of area covered by water)—3225. Total population at all ages 33031 Number of inhabited houses 5991 All Census of 1901. Average number of persons per house 5.5 Institutions within the District receiving sick and infirm persons from outside the District:—Chiswick Isolation Hospital, Ealing Cottage Hospital. Institutions outside the District receiving sick and infirm persons from the District : — Isleworth Workhouse and Infirmary, Middlesex County Asylum, Wandsworth. Table II. Vital Statistics of Separate Localities in 1909 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. * WHOLR DISTRICT 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 1908 51,000 1,251 573 101 Averages of Years 1899 to 1908 , 41,073 939 467 102 1909 52,550 1,184 632 90 *Population of separate Wards not known. Table III. Cases of Infectious Disease Notified during the Year 1909. 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- Total cases removed to Hospital. At all Ages. Under 1. 1 to 5. At Ages—Years. 25 to 65. 65 and upwards. 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. 5 to 15. 15 to 25. Small-pox - — - — - - - - - - - - - - - - - - - - Cholera — — — — — — — — — - — — — — — — - — — - Diphtheria (including Membranous croup) 48 - 11 24 10 3 - 18 10 2 9 2 7 11 6 1 3 2 4 27 Erysipelas 35 — 1 1 3 22 8 17 7 6 1 2 2 3 - - - - - 3 Scarlet fever 160 - 29 113 10 8 - 97 18 9 12 10 14 90 14 8 10 6 12 140 Typhus fever — — — — — — — - - - - — — - — - - — — — Enteric fever 6 — — — — 6 — 1 1 — 2 — 2 — — — 2 — — 2 Relapsing fever — — — — — — — — — — — — — — — — — — — - Continued fever — — — — - - - - - - - - - - - - - - - - Puerperal fever 4 - - - - 4 - 3 - 1 - - - - - - - - - - Plague — — — — — - - - - - - — - - - - - - - - Pulmonary Tuberculosis 18 — — 1 4 12 1 11 3 3 1 - - - - - - - - - Totals 271 — 41 139 27 55 9 147 39 21 25 14 25 104 20 9 15 8 16 172 Borough Isolation Hospital at South Ealing (Grange Ward). Total a ailable beds, 73. Number of diseases that can be concurrently treated, 3. Table IV. Causes of, and Ages at, Death during Year 1909. BOROUGH OF EALING. Causes of Death. Dkaths at the Subjoined Agks of Residents," whkthkk occurring in or bkyond the district. Deaths at am. ages of "Residents" BELONGING TO LOCALITIES WHETHE 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 22 5 14 3 - - - 6 1 - 11 2 2 - Scarlet fever - - - - - - - - - - - - - 1 Whooping cough 19 2 16 1 - - - 4 - - 7 6 2 - Diphtheria (inc. Mem. Croup) 4 - 4 - - - - — - - 2 - 1 6 Enteric fever 2 - - - 2 - - - - 1 - - 1 1 Epidemic influenza 10 — - — - 5 5 1 1 2 1 2 3 2 Diarrhoea 8 7 1 — — - - 1 - - 6 1 — - Gastritis 5 4 1 — — — — — — — 5 — — — Puerperal fever 1 — — — — 1 — — — — — 1 — — Erysipelas 2 - - - - - 2 1 - - - - 1 - Phthisis (Pul. Tuberculosis) 38 — 3 1 5 29 — 6 3 2 18 4 5 — Other tuberculous diseases 6 2 3 1 — - — — 1 — 3 — 2 — Cancer, malignant disease 54 — — — — 32 22 6 7 6 16 11 8 1 Bronchitis 62 6 4 — - 9 43 11 4 16 17 12 2 - Pneumonia 53 7 8 1 1 19 17 6 6 3 23 13 2 3 Pleurisy 2 — — - 1 — 1 — 2 — — — — — Other Diseases of the Respiratory Organs - - - - - - - - - - - - - - Alcoholism . 12 — — — - 11 1 - 3 2 3 2 2 — Cirrhosis of liver Venereal diseases 1 1 - - - - - - - - 1 - - - Premature births 15 15 - - - - - 3 1 - 7 2 2 - Diseases and accidents of parturition 4 - - - - 4 - - - 1 3 - - - Heart diseases 48 1 - 2 2 24 19 7 7 6 10 13 5 2 Accidents 11 1 1 2 — 6 1 2 2 2 2 3 — 4 Suicides 3 — - 1 1 1 — — — — 1 2 - — All other causes 250 39 11 2 6 62 130 28 28 39 79 58 18 5 All causes 632 90 66 14 18 203 241 82 67 80 215 132 56 25 C. A. PATTEN, Mcdical Officcr of Health. Table V. Infantile Mortality during the Year 1909. Deaths from Stated Causes in Weeks, and Months under One Year of Age. BOROUGH OF EALING. Causks 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. 1 J 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 16 7 6 2 31 16 5 4 6 2 3 4 9 5 2 2 89 Uncertified 1 - - — 1 - - — - - - - - - - 1 Common Infectious Diseases:- Measles — — — — — 2 — — — — 1 — 1 — — I » Whooping Cough — — — — — — — — — — — 1 — 1 Diarrhoeal Diseases — Diarrhoea, all forms — — 1 — 1 — 1 2 — - 1 2 — — — — 7 Enteritis, Muco-enteritis, Gastroenteritis - - - - - - - - - - - - - - - - - Gastritis, Gastro-intestinal Catarrh — - — — — 2 — — — — — — 2 — — — 4 Wasting Diseases— Premature Birth 8 2 — — 10 4 — 1 — - — — — — — 15 Congenital Defects - - - - - - - - - - - - - - - - - Injury at Birth . - - - - - - - - - - - - - - - - 1 Want of Breast-Milk, Starvation - - - - - - - - -1- - - - - - - - 1 Atrophy, Debility, Marasmus 7 1 1 1 10 3 3 1 — 1 — 1 — — — — 19 Tuberculous Diseases— Tuberculous Meningitis - - - - - - - - 1 - - - - - - - 2 Other Tuberculous Diseases - - - - - - - - - - - - - - - — - Syphilis - — — — — 1 — — — — — — — — 1 Rickets — — — — — — — — - — - — — 1 — — 1 Meningitis (not Tuberculous) - - - - - - - - - - - - 1 — — — 1 Convulsions — 1 — — 1 1 — — 1 — - — — — — — 3 Bronchitis — 1 — — 1 1 — — - — — — 2 1 1 — 6 Laryngitis - - - - - - - - - - - - - - - - - Pneumonia - - — — — 2 1 — — — 1 1 - - - - 7 Suffocation, Overlying - - - - - - - - - - - - - - - - 1 Other Causes 2 2 4 1 9 — — 1 1 1 — 1 1 — — 14 17 7 6 2 32 16 5 4 6 2 3 4 9 5 2 2 90