EAL 7 the HEALTH OF EALING. THIRTY-SIXTH Annual Report (1910) by % DR. C. A. PATTEN, Medical Officer of the Borough of Ealing. Mealing, by.: "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 (London). Sanitary Inspectors: H. SHARPE, C.R.San.I. Cert. Insp. of Meat and other Foods (London). J. STUBBS, A.R.San.I. Cert. Insp. of Meat and other Foods (Liverpool University). Clerk : G. T. HILL, C.R.San.I. THE HEALTH OF EALING. TO HIS WORSHIP THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF EALING. Gentlemen, I have the honour of furnishing you with my Annual Report relative to the vital statistics for the year 1910, with a statement of the general sanitarywork carried out during that period. I have much gratification in doing so on this occasion, as the account I have to render is one of the most favourable in nearly all important respects it has been my djity to present to you for many years. I have made it as brief as possible, confining it generally to recorded facts. I believe a consideration of the accompanying Tables affords ground for much satisfaction and indicates rather than otherwise a material improvement of the excellent sanitary position we have almost invariably occupied, and one which can safely challenge comparison with any other place of equal importance and population. As usual, I have been well supported and served by Mr. Hill and his assistant inspectors, who have performed their duties with diligence and success, as the inspectors' tabular returns prove. It will be seen by these that a large amount of work has been carried out to the extent of 11,284 ordinary inspections, including 1,946 visits to butchers' premises, etc., and very rarely have their recommendations been opposed or disregarded, or requiring compulsory measures to be adopted. Population. The question of estimating our population, at all times a somewhat intricate one for reasons I have fully explained in previous reports, and which ground 4 I need not go over again, is not rendered easier at the end of a censal period and on the verge of another census taking. I have, therefore, only to state that for the purposes of this return, and after careful consideration, I have estimated the population of this Borough, at the middle of last year, to be 54,259, and upon this figure the vital statistics and rates applying to this report have been calculated. A distinct revival of the bulding of dwelling houses has been apparent, several hundreds of these having been passed for occupation during the last year. Deaths. The number of deaths registered of people resident in the Borough was 533 (males 186, females 247), but of this total 96 deaths of these residents occurred in public institutions outside the district, but have to be included in our mortality returns. Twelve fatal cases occurred in the Cottage Hospital, two in our Isolation Hospital, and the deaths of three non-residents were registered. A considerat:on of these figures, contrasted with those of the previous year (1909) gives the gratifying result of a death rate of only 9.80 per thousand of the estimated population, being equal to a decline of 2.22 per thousand, or 99 fewer deaths than in the previous year. This is the lowest rate recorded for live years, notwithstanding since then a very considerable increase of population, amounting indeed to several thousands. In other words and figures, one person died last year in every 100.79 of our estimated population. As contributory and evident causes to this very satisfactory result may be named favourable climatic conditions throughout all seasons, and an absence of epidemic diseases. The deaths were distributed in the different Wards as follows, viz. :—133 in the Lammas Ward, 134 in the Manor Ward, 82 in the Drayton Ward, 59 in the Grange Ward, 66 in the Castlebar Ward, and 59 in the Mount Park Ward. The first two Wards have probably the densest and poorest class of residents. All details are fully set forth in Table IV. 5 Births. One thousand two hundred and forty-two births (males 597, females 645) were registered, equal to a birth rate of 23.4 per thousand of population, which is an increase of .87 over the previous year, or 58 more births. I may add that the density of population is equal to 16.8 persons per acre. The birth rate for last year, per thousand living, was 24.8 in England and Wales, and the death rate equalled 13.4. The deaths from the principal epidemic diseases in the Borough equalled 0.18 per thousand against 1.04 in 1909. In the Country generally it was 0.99 per thousand. With regard to the causes of deaths during the past year, a comparison of the Tables for that and the previous year shows a material decrease under almost all heads in favour of the present returns. Owing to the temperate conditions of that season, " epidemic summer diarrhcea," so frequently fatal to infant life, did not pervail, and disorders most prevalent during the winter months (which were comparatively mild), such as Pneumonia, Bronchitis, Influenza, etc., etc., were far less fatal than usual. Fifty-seven deaths arose from Cancer, being an increase of two. The deaths from Pulmonary Tuberculosis were 40 in number, being equal to 0.73 per thousand of population, and an increase of two over 1909. It is unnecessary to do more than briefly allude to the increasing efforts being made to combat the ravages of this prevalent but preventible, although fatal, disease, efforts which, if actively and generally pursued, give hope that in the course of another generation or two the scourge will be greatly abated, if not actually wiped out. At the time of writing a Conference of delegates from all the County Sanitary Authorities is proposed to be held by the County Council, and the need for some uniform system being adopted for the proper and modern plan of treatment of Phthisis is of pressing necessity. 6 You are aware that, at present, we arrange for the retention of three beds at Mount Vernon Hospital and the Northwood Sanatorium for our most necessitous cases. These are usually occupied but not quite so continuously as I should desire, the supply of patients depending for the most part on the recommendations of our local medical men. In effect, we do not obtain, in a considerable proportion of these cases, patients who are in an incipient stage of the disease, and who would be likely to receive permanent benefit, or even cure, from the treatment. Not a few of the candidates are in a somewhat advanced stage, and consequently, their residence and treatment when admitted are somewhat disappointing, and even discouraging in results. I therefore hold strongly the opinion that until compulsory notification of Phthisis is in force we shall not readily acquire knowledge of the earlv existence of the disease among the class of patients for whom Sanatorium treatment is essential and necessary. I am quite aware objections exist regarding this proposal, but I am convinced the practical good results will outweigh them. There must be a considerable number of persons in every locality with a large population who are afflicted with consumption in an early stage, and who would come under the notice, or to the knowledge, of their Sanitary Authority, if notification was compulsory. An estimate of recognisable cases of Phthisis in proportion to the mortality has been made by various Authorities. Dr. Newsholme, the Medical Officer of the Local Government Board, states, " In adults the proportion is usually given as three to one, though this is probably too low." Dr. Young, the County Medical Officer, in a recent report states, " On the assumption that the proportion of three cases to each death is too low, the proportion has, by some Authorities, been taken as five to one, with the object of arriving at a working basis, and if for the purpose of this report this proportion be taken, the number of definite or recognisable cases of consumption in Middlesex is about 4,000." In a healthy residential district such as this, 7 one may perhaps assume the minimum proportion of three to one, which would give the recognisable number of cases of Consumption in the Borough to be about 120. Of course, of this number there would be, or are, many who would not have to resort to the provision at present made by the local authority. I have referred at some length to this' important subject to strengthen my views regarding compulsory notification, and also to give me the opportunity of stating that 1 am of opinion the establishment of a County Sanatorium is advisable. At the present time 1 am officially not aware of a single case of Phthisis in the Borough, with the exception of those at Mount Vernon, to which institution we sent eight patients last year, whose average stay was about fourteen weeks. I may add that Table IV., previously alluded to, affords detailed information of the " Causes and Ages at Death " from all causes. There is only one other subject to which I especially wish to draw your attention, and that is the highly important one of "Infantile Mortality" or the deaths of children under one year of age, and it is satisfactory to be able to refer to it favourably as regards the past year. You are aware that for several years there has been a very marked decline in the mortality under this heading, until it has reached now the lowest rate I have yet had to record. A great reduction commenced in the year 1907, when it was 91.2 per thousand births registered against 129.8 in the previous vear. It has, happily, continued to fall, being 80.7 in 1908, 76 in 1909, and, for the past year, onlv 65.2, a difference of 10.8 in its favour. The rate for England and Wales was 106. This is a very satisfactory rate indeed for our Borough, and the question naturally arises as to the several causes which have conduced to it. Generally stated, the climatic conditions were favourable, and no serious amount of epidemic disease prevailed, and when it did it was for short periods, and comprised very limited outbreaks, such as Measles, which usually presented a sporadic 8 character. We were practically free from the latter disease in epidemic form. In my opinion, an important factor in producing this graduated reduction of infantile mortality is the result of work and teaching done through the agency of the " Ealing Ladies' Health Society," which for several years now has performed invaluable work not only by help in kind in cases of poverty affecting infants' nutrition, but by instructing large numbers of mothers as to the proper care and treatment of their offspring, especially in the matter of feeding and rearing. I have been fully cognisant, from the formation of the Society, of the valuable work it has so unostentatiously carried on, and I have watched with interest the valuable results accruing from it. With a falling birth rate, it is our duty to check and counteract by all means in our power a waste of infant life, and I feel convinced that by some such plan and method as this voluntary Society adopts, the principal remedy exist. I have reason to believe that, owing to unavoidable circumstances, the work of this Society in the near future is likely to be seriously curtailed, or even abandoned, for want of sufficient financial support, and this with serious consequences, I fear, in the matter of prevention of infantile mortality. I feel, therefore, it is my responsible and proper course to bring forward for your serious consideration the question of the appointment of a " female health visitor," who would largely devote herself to the duties connected with the care and upbringing of infants and very young children. I mentioned in my last Annual Report that I foresaw the time was approaching when I should feel it my duty to bring this subject before you, and I likewise stated, " that such appointments have been made, or are about to be made, in adjoining districts "—which has proved to be the fact. I am, therefore, more convinced that it is advisable this Council should give a favourable consideration to my proposal. It is to be desired that the voluntary Society may still be able to supplement the work of an official visitor by help in kind, at least, as at present, in necessitous cases, but I believe that 9 you will agree with me that, in an important and populous Borough such as this, we should not, with regard to a subject of the highest importance, like the prevention of infant mortality, be wholly dependent upon voluntary agency, or merely follow in its wake. The voluntary visitor should supplement but not replace the official worker. It has been my endeavour to keep in touch with the Society, and I see no difficulty in this being continued in the event, as I trust, of the duties being brought more under official control, thereby providing a co-ordinated scheme with a larger scope and extended benefits. Old Age. Eighty-three persons died over 60 years of age and upwards, mJ over seventy years, 44 over eighty years, and 8 over ninety years, the oldest of these latter attaining ninety-nine years. Inquests. Twenty-three inquests were held, ten of the deaths being due to natural causes, two to suicide, three to accident, and one to murder. Notifiable Infectious Diseases. As might be expected, a considerable amount of this class of disease prevailed more or less throughout the year, making a total of 276 Notifications. The principal causes accounting for this were cases of Scarlatina, 148; Diphtheria, 55 ; and Erysipelas, 47. In addition, there were likewise two cases of modified Small Pox, seven of Enteric Fever (four of these imported patients), and seventeen of Pulmonary Tuberculosis, these last being all Poor Law medical cases, and principally notified from the Infirmary at Isleworth. The Small Pox patients did well, and were treated in our local Small Pox Hospital. The Scarlatina cases were usually of a benign type, with only one fatal result, and two children died from Diphtheria. 10 Relating to the latter disease I should mention that during the year arrangements were made for the free supply of Anti-Toxin for necessitous cases, and this can be obtained at all hours from Mr. Cleave, Chemist, St. Mary's Road, and from Dr. Brown, at his residence in the Uxbridge Road. This affords a case rate, excluding Tuberculosis, of 4.9 per thousand. Isolation Hospital. The Isolation Hospital received lor treatment 164 of the total number of 276 cases notified, and the hospital death rate on admissions equalled only 1.2 per cent. This satisfactory result reflects great credit on the medical and general administration of the institution, which stands in much favour with all classes of our residents. Table III. gives full details of age, etc., of these above cases. General Sanitary Administration. 1 am able to assure the Committee that the important and multifarious duties under this heading have been performed efficiently and systematically throughout the year. A reference to the inspectors' tabular forms will, 1 believe, afford convincing proof of this. The requirements of inspection with regard to the " Factor}' and Workshops Act," the " Houseto-House " visits, and the condition of the Dairies, Milkshops, Bakehouses, etc., have all been met and, generally speaking, these premises were all found satisfactory. At all events, orders issued with regard to any sanitary defects were complied with. The condition of meat, and other food stuffs, receives constant inspection by Mr. Hill, and, with few exceptions, there was little to complain of. I have regularly paid my quarterly visits to the elementary schools of the Borough, and can state that their hvgiene and general sanitary condition is satisfactory. The work of the Medical Inspector (Dr. 11 Arthur) and that of the School Health Visitor (Miss Gough) have been productive of good results, as it will be my duty to report to the Education Committee. It may be well to observe here that the School Health Visitor's duties deal wholly with children of school age, and are in no way concerned with the health and well-being of the infant class. Public Works, etc. It is my usual custom in connection with these reports to make a few references to the important subject of " Public Works," so far as they come under my notice. It is a pleasure to state that, as is invariably the case, the connection between the Borough Surveyor and his staff and my department is very helpful and harmonious, and 1 receive every assistance I require. My personal experience of both the Northern and Southern Works enables me to express an opinion that the high standard of efficiency they have so long been noted for is still maintained, and every effort is made to keep them at the highest possible standard. The bacteria beds are in first rate working order, as proved bv the resulting satisfactory effluent reported on periodically after analysis by Professor Kenwood. To meet the requirements of our still increasing population, new Tanks and Bacteria Beds have been constructed at both sets of works, and thus the coming wants of the Borough in these respects will be satisfied for a long period in advance. The fact that about 500 dwellings (excluding public buildings, additions, etc.) were passed for occupation last year is sufficient evidence of the necessity for these additional works. As in previous reports, I would express satisfaction with the rapidity everything of an insanitary character is dealt with at the works, where not only is there no waste, but where no opportunity is allowed for accumulations which might possibly prove detrimental to health. It is gratifying, too, that the important work of scavenging, which increases vear bv year in magnitude owing to the construction 12 of new roads, with fresh houses and a greater mileage, is performed in a complete manner. The introduction and use of more capacious dust waggons greatly conduces to this satisfactory result. Very few complaints have been received relative to unpleasant smells from the sewers and drains, this being attributable to the system of doing away with dead ends, and thus obtaining a free current of air throughout the whole system of main drainage. The important matters of road watering and dust-laying continue to receive careful consideration and attention. I believe I have now sufficiently referred to all matters of importance, and, in conclusion, I wisn to express my thanks to the members of this Committee for the consideration and assistance I invariably receive from them and for their confidence, which I greatly appreciate. I am, Gentlemen, Your obedient servant, C. A. PATTEN, Medical Officer of Health March 25th, 1911. 13 BOROUGH OF EALING. SANITARY WORK 1910. FORM 1. INSPECTIONS— Number of Premises Inspected on Complaint 155 Number of Premises Inspected in connection with Infectious Diseases 276 Number of Premises under Periodical Inspection 347 Houses Inspected from House-to-House 541 Unsound Food Inspections 1,940 Total Number of Inspections and Re-inspections made 11,284 NOTICES— Cautionary or Intimation Notices Given, and Letters Written 797 Statutory Orders Issued 388 DWELLING HOUSES— Houses, Premises, &c.t Cleansed, Repaired, &c 841 FORM II. MOVABLE DWELLINGS, CARAVANS, TENTS. &c.— Number Removed from District 15 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 6 Number of Inspections made and Frequency of Inspection 24 Quarterly Number of Milch Cows in District About 150 DAIRIES AND MILK-SHOPS— Number on Register 54 Number of Inspections made and Frequency of Inspection 216 Quarterly UNSOUND FOOD— Articles or Parcels Surrendered 30 Meat 309lbs. Fish 2661bs. Fruit 2801bs. Total 8551bs. WATER SUPPLY AND WATER SERVICE— Percentage of Houses supplied from Public Water Service 100% Cisterns Cleansed, Repaired, Covered, &c. 68 Draw-Taps placed on Mains 90 Percentage of Houses supplied on Constant System 100% 14 FORM III. DRAINAGE AND SEWERAGE— Water Closets—Repaired, Supplied with Water, or otherwise Improved 410 Percentage of Houses provided with Water Closets 99.9 Drains - Examined, Tested, Exposed, &c. 350 Unstopped, Repaired, Trapped, &c. 217 Waste Pipes, Rain Water Pipes, Disconnected, Repaired. &c. 126 New Soil Pipes or Ventilating Shafts fixed 203 Existing Soii Pipes or Ventilating Shafts Repaired 24 Disconnecting Traps or Chambers Inserted 205 Reconstructed 126 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— Ordinary Infectious Diseases 304 Phthisis 55 Rooms Stripped and Cleansed 19 Articles Disinfected or Destroyed— Ordinary Infectious Disease 3,536 Phthisis 135 DUST— New Bins Provided 94 How Frequently is Dust Removed from each House ? Weekly. Number of Complaints of Non-Removal received 72 Method or Disposal Destructor. SUNDRY NUISANCES ABATED— Overcrowding 26 Smoke 1 Accumulations of Refuse 38 Foul Ditches, Ponds, &c., and Stagnant Water 2 Foul Pigs and other Animals 30 Dampness 33 Yards Repaved or Repaired 333 Other Nuisances 326 Rooms Stripped and Cleansed (ordinary) 492 Ventilation under Floors Provided 105 Roofs Repaired 61 15 BOROUGH OF EALING. FACTORIES, WORKSHOPS, WORKPLACES, AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Inspections. Written Notices. FACTORIES (including Factory Laundries) 10 1 WORKSHOPS (including Workshop Laundries) 297 5 Total 307 6 2—DEFECTS FOUND. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts— Want of Cleanliness 20 20 — Want of Ventilation 3 3 — Other Nuisances 14 14 — Sanitary Accommodation— Insufficient 2 2 — Unsuitable or Defective 9 9 — Total 48 48 - 3.—HOME WORK. OUTWORKERS' LISTS. Section 107. Twice in the year. Once in the year. Lists received from Employers— Lists. Outworkers. Lists. Outworkers. Wearine Anpa'el—Making, &c. 4 15 3 10 Addresses of Outworkers— Received from other Councils. Forwarded to other Councils. Wearing Apparel—Making, &c. 22 13 Artificial Flowers 1 - 16 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year— Bakehouses 29 Laundries 9 Dressmakers 80 Miscellaneous 135 Total number of Workshops on Register 253 5.-OTHER MATTERS. Matters Notified to H.M. Inspector of Factories— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 4 Underground Bakehouses (s. 101)— In use at the end of the year 7 Table I. Vital Statistics of Whole District during 1910 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 Dkaths 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 1900 33000 608 16.2 67 110.0 333 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 1901 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 91.2 561 10.4 43 9 89 596 12.01 1908 51000 1251 24.5 101 80.7 497 9.7 22 - 76 573 11.2 1909 52550 1184 22.53 90 76.0 557 10.59 25 7 82 632 12.02 Averages for years 19001909 43128 998 22.75 103 105.9 458 10.4 24 - - 493 11.29 1910 54259 1272 23.4 83 65.2 440 8.1 17 3 96 533 9.8 * Rates 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 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, 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 1910 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. * Wholk District 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 1909 52,550 1,164 632 90 Averages' of Years 1900 to 1909 43,128 998 493 103 1910 54.259 1.272 533 83 *Population of separate Wards not known. Table III. Cases of Infectious Disease Notified during the Year 1910. 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. 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 2 - - 1 - 1 - - - - 2 - - - - - 2 - - 2 Cholera — — — — — — — — - — — — - — — — — — — — Diphtheria (including Membranous croup) 55 - 16 28 8 2 1 16 1 19 8 7 4 11 i 15 4 7 2 40 Erysipelas 47 — — 1 4 38 4 15 9 7 3 9 4 — — — — — — — Scarlet fever 148 3 37 91 10 7 — 35 15 38 23 27 10 32 15 33 9 24 4 117 Typhus fever — — — — — — — — — — - — — — — — — — — — Enteric fever 7 — — 1 1 5 — 1 2 1 2 1 — 1 1 1 1 1 — 5 Relapsing fever - - - - - - - - - - - - - - - - - - - - Continued fever - - - - - - - - - - - - - - - - - - Puerperal fever - - - - - - - - - - - - - - - - - - - - Pulmonary Tuberculosis (Poor Law) 17 — 1 2 5 9 — 6 3 6 — 2 - - - - - - - - Totals 276 3 54 124 28 62 5 73 30 71 38 46 18 44 17 49 16 32 6 164 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 1910. BOROUGH OF EALING. Causes of Death. Deaths at the Subjoined Aoes of ,4 Residents," whether occurring in or beyond the district. Deaths at am. 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. Lammas Ward. Manor Ward. Drayton Ward. Grange Ward. Castlebar Ward Mount Park Ward. Measles 1 - 1 — — - — - - 1 — — — — Scarlet fever 1 — 1 - 1 — — 1 Whooping cough 3 — 3 — — — — 2 1 — — — — — Diphtheria (inc. Mem. Croup) 2 — 1 1 — — — 1 — — i — — 3 Enteric fever - - - - - - - - - - - - - - Epidemic influenza 4 — — — — 4 — 1 — — 2 1 — — Diarrhoea 3 3 — — — — — 2 — — 1 — — — Enteritis 3 3 — — — — — — 2 — — — 1 — Puerperal fever — — — — — — — — — — — — — — Erysipelas — — - — — - — — — — - — — — Phthisis (Pul. Tuberculosis) 40 - 1 3 10 25 1 17 9 4 4 5 1 — Other tuberculous diseases 15 3 3 2 3 3 1 4 5 3 3 — — 2 Cancer, malignant disease 57 — — — — 25 32 8 13 7 9 12 8 — Bronchitis 37 5 — 1 — 8 23 6 12 7 3 5 4 — Pneumonia 41 5 5 1 2 17 11 15 9 8 3 5 1 2 Other Diseases of the Respiratory Organs 4 - - - - 3 1 - 1 1 1 - 1 - Alcoholism 6 — — — — 3 3 2 1 1 — 1 1 — Cirrhosis of liver Venereal diseases 1 1 - - - - - 1 - - - - - - Premature births 21 21 — — — — - 5 6 6 — — 4 — Diseases and accidents of parturition 1 - - - - 1 - - - - 1 - - - Heart diseases 39 — — 1 4 17 17 9 9 7 3 6 5 i Accidents 16 4 1 3 1 5 2 11 2 1 — 1 1 4 Suicides 2 — — — 1 1 — 1 — — 1 - — — Murder 1 — — — — 1 — — — — 1 - — — All other causes 235 38 6 8 4 79 100 57 61 33 24 29 31 4 All causes 533 83 22 20 25 192 191 142 131 79 58 65 58 17 C. A. PATTEN, Medical Officer of Health. Table V. Infantile Mortality during the Year 1910. 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 Certified 27 6 1 2 36 9 8 4 7 2 2 5 2 5 2 1 83 Causes Uncertified — — — — - — — — - — — — — - — — — Common Infectious Diseases— Measles — — — — — — — — — — — — — — — - - Whooping Cough — — — — - — — — — — — — — — — — — Diarrhceal Diseases — Diarrhoea, all forms — 1 — — 1 1 — — — - — — — - - - 3 Enteritis, Muco-enteritis, enteritis — — — — — — — - 1 — 1 — — 1 — - 3 Gastritis, Gastro-intestinal Catarrh — — 1 — 1 — 1 — — — — — — - - - 2 Wasting Diseases— Premature Birth 18 2 — 1 21 — — — — — — — — — — - 21 Congenital Defects — 1 — 1 2 — 1 - - - - - - - - - 3 Injury at Birth 1 — — — 1 — | — — — — — — — - - - 1 Want of Breast-milk, Starvation 1 — — — 1 — — — — — — — 1 — — — 2 Atrophy, Debility, Marasmus 2 — — — 2 5 2 — 1 1 — 2 — — — — 13 Tuberculous Diseases— Tuberculous Meningitis — — — — — — 1 — — — — — — — — - 1 Tuberculous Peritonitis Tabes Mesenterica - - - - - - - 1 1 - - - - - - - 2 Other Tuberculous Diseases — — — — — — — — — — — — — — — Syphilis — — — — — — — 1 — — — — — — — 1 Meningitis (not Tuberculous) — — — — — — — — — — — — — 1 — — 1 Convulsions — 1 — — 1 2 — — 1 — — — — 1 1 — 6 Bronchitis — — — — — — — 1 2 — — 1 1 — — — 5 Pneumonia - - — — — — 1 — — — 1 1 — 1 1 - 5 Suffocation, Overlying 1 — — — 1 — 1 1 — — — — — — — - 3 Other Causes 4 1 — — 5 1 1 — 1 1 — 1 — 1 — — 11 27 6 1 2 36 9 8 4 7 2 2 5 2 5 2 1 83 District (or sub-division) of Ealing. Population (estimated to middle of 1910) 54 259. Births in the year legitimate 1,235. illegitimate 37. Deaths in the year of legitimate infants illegitimate infants 93. Deaths from all Causes at all Ages 533.